The state of cancer services: Are oncologists a dying breed in SA

The number of oncologists is decreasing in South Africa. Picture: iStock/Gallo Images
The number of oncologists is decreasing in South Africa. Picture: iStock/Gallo Images

Cancer patients in South Africa are bearing the brunt of, not only the disease, but also the health system.

Not only is there a shortage of radiographers, ageing equipment and an overload of cancer patients, but South Africa faces a massive oncologist crisis, with a progressive decrease in clinical and radiation oncologists in the academic and state sector.

This is according to the 2018 annual census of clinical and radiation oncologists conducted by the South African Society of Clinical and Radiation Oncology, which indicated that although the number of oncologists in the country had decreased, the rate had decelerated – from a 25% decrease in 2016 to 20.5% in 2018.

Yet the rate of prevalence is high – 100 000 South Africans are diagnosed with cancer every year.

In 2017 the South African Human Rights Commission released a damning 68-page report into how the KwaZulu-Natal department of health had failed its cancer patients.

Among some of the findings was that cancer patients were being denied treatment at hospitals.

Not only had the number of specialist doctors declined but hospitals had a shortage of chemotherapy drugs, including Addington Hospital and Inkosi Albert Luthuli Central Hospital.

Last year KwaZulu-Natal health MEC Dr Sibongiseni Dhlomo dismissed claims that the province was facing an oncology crisis.

“We were quite disappointed to read big newspaper headlines yet again about a so-called oncology ‘crisis’ for KwaZulu-Natal cancer patients. Now, this is most unfortunate on many levels. Firstly, this shortage of chemotherapy drugs is not our fault as a department; and it is not unique to KwaZulu-Natal,” Dhlomo said at a press briefing in Durban in November.

The rest of the country was not absolved from the oncology crisis, however.

In a separate report compiled by the South African Human Rights Commission last year, Steve Biko Academic Hospital in Tshwane was found to be facing “shortages of radiographers, ageing equipment and an overload of cancer patients”.

Last year, Dhlomo pledged before the provincial legislature to implement certain changes.

These included measures to deal with the backlog of the waiting times for patients and repairing health technology machinery, including a linear accelerator that was upgraded at Grey’s Hospital in Pietermaritzburg.

Dhlomo said that, as of November, there were eight full-time oncologists who were employed at various hospitals – two at Grey’s, four at Inkosi Albert Luthuli Central Hospital and two at Addington.

In Gauteng, only two state hospitals provide oncology treatments – Steve Biko Academic Hospital and Charlotte Maxeke Hospital.

Dr Medupi Modisane, head of hospital services at the Gauteng health department told City Press that at Steve Biko, all radiation posts except for the head of the clinical department post had been filled.

“Interviews [are being] held and are at appointment level. Medical oncologists are still recruiting the head of clinical unit, otherwise oncology services are covered,” Modisane said.

There are currently four full-time and one part-time radiology specialists as well as one part-time and four part-time medical oncologists at the hospital.

Modisane said that depending on the type of service required by the patient, the average waiting times for radiation oncology is on average three months, but that there was no waiting period for medical oncology services.

Modisane added that the department had increased its staff contingency by increasing the funding.

This was among the interventions that the department had put into place to ensure patients received the necessary treatment

“We have improved staffing through increasing funding of active recruitment of the scarce staff which includes oncologists, radiotherapists, medical physicists, oncology nurses with all posts being filled except for the head of the clinical department as mentioned,” Modisane said.

At Charlotte Maxeke, Modisane said that the oncology department is fully equipped, but that some of the machines had reached their life span.

“There is a need for replacement of the present machines with state of the art machinery. The department is replacing two machines this year. [There is a] new patient planning system along with patient information software, recording and verification as well as CT for planning (CT Simulator) and Brachytherapy equipment,” he said.

One of the major challenges the department faced when it came to treating patients was the extended waiting periods.

“Causing delays in starting and continuing treatments thus increases the stage of cancers and reduces the local control and survival of patients as well as affects the quality of life of patients,” Modisane said.

However, there are non-governmental organisations that are trying to make a difference, and offer patients a glimmer of hope.

Read: I am and I will: The drive to reduce the impact of cancer

#IAmAndIWill – You have the power to reduce the impact of cancer for yourself, the people you love and for the world. February 4 is World Cancer Day, and 2019 marks the launch of the three-year I Am and I Will campaign. I Am and I Will is an empowering call-to-action urging for personal commitment and represents the power of individual action taken now to impact the future.

Avantika Seeth
Multimedia journalist
City Press
p:+27 11 713 9001  e:
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