Ailing KwaZulu-Natal health system faces crippling claims
Several departments could lose accreditation to train specialists
The KwaZulu-Natal health system is on the brink of collapse as the province suffers from a shortage of medical specialists and equipment, and a mountain of medical negligence cases that continue to pile up.
The situation has worsened to the point where the Health Professions Council of SA has warned several departments they will lose their accreditation to train specialists.
The South African Medical Association’s (Sama’s) coastal branch chairman, Dr Mvuyisi Mzukwa, says specialist training has been affected since 2015 when the department decided to cut the number of registrars trained — doctors studying to become specialists in various areas of health. Sama says the health department cited funding shortages for scaling down the programme.
Mzukwa says the cutbacks of registrars are significant, declining from about 700 a year to about 200, and has reduced hospitals’ functionality.
"They help with operations being done under the supervision of specialists," he says.
Cancer units have been hit the hardest by the KwaZulu-Natal health department’s weaknesses. Treatment at public hospitals includes chemotherapy, radiotherapy and surgery. Most of these procedures have to be administered by a specialist, an area in which the province is fatally lacking.
Experienced specialists such as the former head of oncology in Durban Dr Pooven Govender and Dr S’thembile Ngidi — KwaZulu-Natal’s first black female oncologist and SA’s second — have left, owing to the deepening health crisis and lack of support.
Despite several requests, the KwaZulu-Natal health department did not respond to questions e-mailed to them.
Lobby group Section27 reports that the Inkosi Albert Luthuli and Addington Hospitals are not providing adequate treatment for cancer patients due to constant breakdowns of equipment as well as a shortage of specialists.
An estimated 100,000 South Africans are diagnosed with cancer annually. A Lancet report projected the disease’s prevalence would increase by 78% by 2030.
About 50% of cancer patients in KwaZulu-Natal require radiotherapy but the department has been unable to provide the treatment due to broken equipment.
Sama says there is one oncologist for Durban and the South Coast and one urologist in the region. There is a nine-month wait for MRI scans for state patients.
The Cancer Alliance, a national advocacy body, says patients are waiting for up to two years to receive treatment, and some are dying while they are waiting.
"Patients are dying on a daily basis waiting for the repair of those machines," Mzukwa says.
Section27 says airconditioners are also not being repaired, resulting in surgery operations being cancelled or outbreaks of hospital infections.
The Cancer Alliance says the core of the callous attitude towards patients lies in the fact that cancer is not recognised as a priority disease.
The cancer registry in KwaZulu-Natal is not functioning properly as many cancer cases go unrecorded, along with cancer-related deaths, the alliance’s Salome Meyer says.
A woman who did not want to be named for fear of being stigmatised says although her mother made an appointment at Grey’s Hospital to see an oncologist in September 2015, she only received an appointment in February 2016.
Her mother lived in the Eastern Cape, but hoped she would receive services in KwaZulu-Natal that were superior to what was available at home.
"At times, it would take five to seven weeks from one appointment to the next, the reason being a lack of resources in public hospitals," she says.
When they eventually saw a specialist, she was attended to with another woman also in the room. The doctor confirmed her cancer was in Stage 2b and radiation therapy with chemotherapy was advised. However, they were told that only one machine was available to treat patients, and she would only be treated a year later.
The National Cancer Registry has been failing to release a report into the prevalence of cancer in the country since 2012 due to underreporting of cancer cases and deaths at hospitals.
The KwaZulu-Natal health department was facing medical negligence claims against it amounting to R10.6bn in 2016.
Health MEC Sibongiseni Dhlomo pleaded in April with victims of medical negligence to accept special public medical attention rather than sue the department.
However, the Health and Other Service Personnel Trade Union of SA (Hospersa) has demanded a conclusive report on the cancer crisis in KwaZulu-Natal and that the department provides the full facts surrounding the nonmaintenance of radiotherapy machines at Addington Hospital that has compromised the lives of cancer patients as far back as 2009.
Hospersa general secretary Noel Desfontaines says the department has done nothing to tackle the maintenance issues of the radiotherapy machines at the hospital since then.
"While the machines remain idling, patients bear the brunt with unnecessary suffering and sometimes untimely deaths," says Desfontaines.
In 2015, the province awarded a R2.5bn tender to Resultant Finance, a technology asset financing company, to buy and maintain all provincial hospital equipment.
Hospersa says the company has failed to do so.
In response to questions on the nonmaintenance of machines, Resultant CE Mdu Gama said the matter between Resultant and KwaZulu-Natal health was pending before the courts as the company has instituted legal proceedings against the department.
"As a result, I have been advised that it would not be in the best interest of Resultant for us to engage with the media on this matter while it is sub judice," Gama said.