Inkosi Albert Luthuli Central Hospital

“I overheard the doctor saying something about four. I heard him saying something over the phone. Something about four.”

And then moments before a nurse aid pushed the 41-year old mother of five to the bus that would take her back to the provincial hospital, she turned to us and said: “Pray for me. Please find a place for me in your prayers. I just want to have my radiotherapy and get better. Please pray for me.”

This journalist and a human rights activist who had met her at the entrance to Durban’s Inkosi Albert Luthuli Hospital, promised that they would pray for this frail cervical cancer patient.

Neither said anything more about the “four” the woman had heard the doctor talking about over the phone.

Her visit to get cancer radiotherapy treatment had been thwarted. The consulting doctor said she needed a scan of her liver before he could commence with radiotherapy. And then it was when he was calling the provincial hospital to arrange a scan for the emaciated mother of five that she heard him “saying something about four”.

But the journey to get to that fear that the doctor may have pronounced her as having Stage IV cancer started almost a year ago for this mother, whose identity and name is known, but is being withheld to protect her.

In late April 2016 she noticed “blood globules” and straight away took herself to the local provincial hospital.

Two weeks later tissue samples were taken from her cervix and she was told to come back to the hospital six weeks later. This she did, but there were no results available. She was advised to return a further two weeks later. Still, no results were available.

On August 28, 2016 – almost four months after she had first visited the hospital – did she get the results. And they were devastating. She had been diagnosed with cervical cancer Stage 3B.

According to one oncologist, who spoke on condition of anonymity, at that stage the woman would have had a 40 to 60 percent chance of survival.

Professor Ammo Jordaan, the former head of Addington Hospital’s oncology unit, said that with the modern cancer radiotherapy machines, the survival rate could be as high as 60 to 80 percent.

“That is with the new modern machinery, but they must treat her within a month. Then there is a very good chance,” he said.

However, for this woman, that never happened. After she obtained her results on August 28, she was sent to King Edward VIII Hospital in Durban for more blood tests. She was then sent back home.

Her condition progressively deteriorated, as she became sicker and sicker. She started suffering from a variety of symptoms and was forced to take more and more days off work.

With her condition having deteriorated in October she returned to the provincial where she had first presented herself in April, Doctors there, then sent her to the oncology section of KwaZulu-Natal Department of Health’s flagship hospital – the Inkosi Albert Luthuli Hospital.

There, the oncologist was furious that the patient had been sent without her medical records. Despite this, she still booked the woman in for a planning session at Addington Hospital in mid November 2016. This never happened.

She went back home to work. Shortly afterwards it appears that the cancer began spreading. From November last year to March this year she lost weight and developed a severe infection in her private areas. By Christmas, she was in a wheelchair.

With the machines down in Addington Hospital, she was again scheduled last week to undergo a cancer radiotherapy planning session. However, before she could bring herself for the planning session, but she had become so ill that she was admitted to her local provincial hospital on March 1.

When this journalist and the human rights activist met her outside Inkosi Albert Luthuli Hospital a week later she had developed a pain on the side of her body. The doctors had told her that she needed a CT scan because there were fears the cancer had spread to her liver.

“Now when I come here, the plan never worked out, because now my livers are swellened (sic) up. I have to go for a CT scan. All of this could have been avoided if I only got my radiotherapy done last year like they said it was going to be done.”

In a subsequent interview a few days later from her hospital bed at the provincial hospital, she said she had never even made it to the oncology section of Addington Hospital. It was while she was at her local hospital that she found out that the machines at Addington Hospital were not working.

“The place I was supposed to be at for the radiotherapy was Addington.… I never got there. I’ve never even seen the hospital yet. I had no idea about the machines being broken there. The doctors here at hospital told me. And as soon as the machines are fixed they will phone me and let me know.”

The machines are still not fixed and as of March 10 were still not working.

“How can something so important that can help to save somebody’s life be broken? And if you look at the months … so long, just for a radiotherapy. Now it’s late. Now I am at stage 4B and my livers are swellened up.”

Stage 4 cancer means that the cancer has spread beyond its original source and is invading other parts of the body. There are people who do survive Stage 4 cancer, but according to Professor Jordaan, at Stage 4, the chances of survival are between 10 and 15 percent.

The two state-of-the-art R120 million Varian Rapid Arc Linear Accelerator machines at Addington Hospital have not been fully functional since the end of 2012. The health department has been in a dispute with the authorised South African agents – Techmed Africa – and refused to pay them for the maintenance, with health MEC Sibongiseni Dhlomo accusing them of corruption. A seven-year corruption investigation by the Directorate for Priority Crime Investigation (Hawks) has to date not seen the light of day or seen anyone being prosecuted.

In 2015, the department broke literally every rule governing the way departments are meant to procure services and appointed another company, KZN Oncology, to repair and maintain the machines. Ever since the contract to appoint KZN Oncology Inc was signed by health department head Dr Sifiso Mtshali on December 17, 2015, only one of the machines has ever worked – and intermittently at that.

When the machines were working after they were installed in 2010, waiting periods for cancer radiotherapy at Addington were reduced from eight months to two weeks.

Apart from the machines not working, the department has been bedevilled by a loss of specialist oncologists, with four having left the department since October last year – including department head Dr Pooven Govender. Even if the all the department’s machines were working, it no longer has the staff to operate at capacity. It is understood that at Inkosi Albert Luthuli and Addington there are only two oncologists.

** One of Giordano Stolley’s two interviews with the woman can be viewed here:

– African News Agency (ANA)