Crisis in cancer wards

● Two new cancer-treatment machines worth more than R100m have been in storage for more than a year, while state hospitals turn away increasing numbers of patients at overwhelmed existing facilities.

The Linear Accelerator (Linac) machines, which deliver high-energy X-rays or electrons to destroy the cancer cells while sparing the surrounding normal tissue, need to be housed in protective bunkers that haven’t been built yet.

Gauteng health spokesperson Kwara Kekana said the equipment was earmarked for new radiotherapy centres at Chris Hani Baragwanath and Dr George Mukhari hospitals but the projects had been “delayed by Covid-19 disruptions”.

Kekana did not answer when asked when the projects would be completed. “The Linac machines arrived from overseas around November 2020. Each machine has been procured at a cost of R52m. The process of preparing ground for the turnkey radiology buildings is under way,” she said.

Radiotherapy for cancer patients attending state hospitals in Gauteng is currently offered only at Charlotte Maxeke and Steve Biko hospitals.

At Charlotte Maxeke there are bunkers in place and the cobalt machines they were built for are no longer functioning. But these bunkers are too small to accommodate the new Linacs, and expanding or altering them would be unaffordable, according to an inside source.

An official who works at the Charlotte Maxeke oncology department said that of nine machines originally bought for the department when it was established 17 years ago, only four are fully functional.

The lack of working equipment means the unit at Charlotte Maxeke now manages a reduced patient load of about 3,000, and has a huge backlog.

“We do what we can in terms of patient management. You up the dosage and lower the number of visits for the patient, but it’s not ideal and now there’s a bottleneck,” the official said.

“We don’t have the equipment and staff needed for the volume we are dealing with. The worst is prostate cancer. We see between 30 and 40 new patients a month and we can only treat about five.”

A colleague who heads the oncology department at another large government hospital where the prostate cancer challenge is equally desperate said screening for that type of cancer should be done away with at public health services.

“It’s inhumane to tell someone they have cancer, and then you don’t treat them. It’s cruel and unnecessary if there is nothing you are going to do for them anyway.”

The Gauteng health department did not respond to detailed questions from the Sunday Times.

Salomé Meyer of the Cancer Alliance — an organisation representing 33 nonprofit organisations and cancer advocates — said the list of public health cancer patients waiting for radiation treatment in Gauteng is almost to 2,000.

“Why do you procure machines for Chris Hani and George Mukhari when you know they don’t have bunkers or even the correct staff? So you then put those machines in storage until you can procure bunkers in the next year’s budget, and in the meantime Charlotte Maxeke sits with a specific requirement for radiation immediately, but you can’t help them because there’s no money,” Meyer said.

“How do you justify leaving brand-new machines in storage when there is such desperate need for them? They could just have bought smaller Linacs that would fit in the cobalt bunkers,” she said.