Lydia’s heart is one for giving, though she waits patiently for the cancer treatment that could save her life. She is one of the patients waiting for radiology treatment from Charlotte Maxeke Academic Hospital in Johannesburg.
The hospital has a huge radiology backlog of more than 3,000 patients, including people suffering from prostate, breast, cervical and colon cancer.
NPOs Section27, Cancer Alliance and Treatment Action Campaign (TAC) embarked on a march at the end of April to demand that the provincial health department spend the R784m set aside by the Gauteng treasury in March 2023 to outsource radiation oncology services for the thousands on the backlog list.
In a statement issued by the three organisations in April, they detailed the reasons behind the crisis.
“The cancer crisis in Gauteng is driven by severe shortages of both operational radiation oncology equipment and staff within the public sector. This is particularly evident at Steve Biko Academic Hospital and Charlotte Maxeke Johannesburg Academic Hospital, with [Charlotte Maxeke hospital] experiencing the most critical shortages. In 2020, [it] had seven operational radiation oncology machines, but today it operates with only two while serving approximately 2,000 new patients annually.”
The NPOs urged the department to use the allocated funds to outsource the necessary radiology oncology to save thousands of lives. “The longer these funds remain unused, the more cancer patients lose their lives. [The department] must fulfil its constitutional duty of providing access to cancer treatment for these patients.”
Lydia was diagnosed with cancer in 2021 after finding a lump in her breast. “In February, I was diagnosed with stage 3 breast cancer ... It wasn’t just in my breast, it had already spread to my lymph nodes under my armpit. So then, I had to start chemotherapy at Charlotte Maxeke hospital in March 2022.”
Lydia finished her chemotherapy in September 2022 and had to undergo a double mastectomy in November 2022. Though declared in remission after her operation, to ensure that her cancer didn’t return, Lydia had to undergo radiation at Charlotte Maxeke Hospital but had couldn’t receive it immediately due to the backlog.
In May 2023, Lydia had her six-month post-op mammogram. She had last visited the radiology department in March of that year and was told that she was still on the waiting list during the consultation. “They did an ultrasound and found suspicious-looking lymph nodes and they did a biopsy. On June 8 2023, I got my results and the cancer was back.”
The cancer crisis in Gauteng is driven by severe shortages of both operational radiation oncology equipment and staff within the public sector
Lydia’s story isn’t unique. In an open letter to Gauteng MEC for health and wellness Nomantu Nkomo-Ralehoko from Section27, Cancer Alliance and TAC, another patient’s plight is highlighted.
“Unfortunately, very few of those who rely on the public healthcare system have access to or are able to afford loan facilities. These people rely on your office as the custodian of their right to access healthcare. For example, Ms Thato Moncho, a single mother, has been waiting for radiation oncology treatment for over three years. In this time, Ms Moncho has suffered three recurrences of her cancer, with the latest pathology results showing that her cancer has now spread to her lungs. Any further delays in treatment place Ms Moncho and patients like her at risk of suffering further recurrences and possibly even death.”
When Moncho challenged the delay with medical professionals at Charlotte Maxeke hospital, she received a frustrating response. “I remember saying to them that I don’t have much time because my cancer is aggressive. I need to see the doctor [immediately] because if I don’t have radiation within six weeks of surgery, there’s a possibility that I can have another recurrence. I remember them saying I don’t have faith, I need to have more faith and pray harder.”
Moncho has tried to put pressure on Nkomo-Ralehoko and Charlotte Maxeke hospital CEO Gladys Bogoshi. She says she was told that she has to fall in line with everybody else, just as family members of both Nkomo-Ralehoko and Bogoshi have had to.
On hearing the news of her third recurrence in October 2022, the chemotherapy department at the hospital reached out to the head of radiation. This time, radiation was offered to Moncho but not the full treatment that she needed. She then found out in August 2023 that the cancer had now spread to her lungs, but the only option available for her was to take chemotherapy tablets as the intravenous chemo had devastating effects on her body.
“My doctor said that if I had gotten radiation immediately after my first surgery, we would be speaking a different language now because I most likely wouldn’t have had multiple recurrences,” says Moncho.
She says she has remained strong because her family depends on her. “I didn’t break down from day one when I was diagnosed. I needed to fight for my daughter and my mother, so a breakdown was not an option for me at that time. But what was most stressful for me was not getting the treatment that I was supposed to get. It was so difficult for me to go home and tell them that my cancer was back and go back again months later and say my cancer was back again.”
Lydia has also focused on staying strong to be a voice of strength for other cancer patients.
She says it feels like the government has no regard for those suffering with cancer and those who do not get treatment in time and pass away. “It feels like they don’t care about us. They have no excuse. Why didn’t they do anything in the last 15 months? Apparently they have put in tenders for private sector [assistance], but why did it take them so long to start doing that? In 15 months, how many cancer patients could have had radiation already if they didn’t sit on their bums and got the tenders immediately when they were given those funds.”
The department says it has appointed a service provider to assist with radiation treatment. “Currently, radiation oncology services are offered at Charlotte Maxeke Johannesburg Academic Hospital and Steve Biko Academic Hospital. The finalisation of the radiation oncology services tender will assist to expand the provision of radiation oncology healthcare service in the province.”
The department has denied that any funds have been misspent since receiving them. “Contrary to allegations that the department has not utilised the R784m allocated to address the backlog in surgical and radiation oncology services, a total of R534m had already been invested in oncology, medical and allied equipment.
“The department remains committed to provide quality healthcare service to all members of the community, hence we are patient-centred, clinician-led and stakeholder-driven.”
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