At 32, Linda Greeff was employed as a social worker with a special focus on cancer care. Despite her extensive experience, nothing could prepare Linda for what it would be like to be diagnosed with cancer herself.
She remembers experiencing an overwhelming sense of fear of what may happen, and how her two small children would cope if she passed away. Linda has since recovered and has dedicated her life to helping South Africans access the cancer care they so desperately need – a near impossible challenge against the background of the country’s socio-economic issues.
She is now the manager of Oncology Social Work Services at GVI Oncology and co-founder of People Living with Cancer. She shares her insight on some of the big questions surrounding cancer in SA with Health24.
Here are Linda’s answers to some of the big questions surrounding cancer care in South Africa:
How big is the cancer problem in South Africa?
I think it’s reached epidemic proportions. Unfortunately we don’t have a proper cancer registry in our country. This means we have no way of knowing how big the problem really is.
Another fact is that, although cancer is a notifiable disease, doctors aren’t adhering to the legislation. Nor is their adherence being enforced. Also, everything is paper-based rather than digital.
Then there’s the problem of our death certificates not showing how many people are dying of cancer. Instead, they state that someone died from lung failure, heart failure, multi-organ failure or something else.
So, while we know cancer kills more people than HIV, malaria and tuberculosis in South Africa, we can only guess at the true figures.
Read: It's a first: SA woman has cancerous tumour removed by a robot
Many South Africans don’t have medical aid. What kinds of problems prevent them from getting proper treatment?
Eight million people have medical aid in South Africa. The other 47 million depend on the State sector.
A friend of mine and I have just completed a qualitative study about the challenges patients face with regards to cancer. We interviewed 318 people and asked them about their biggest challenges during their cancer journey. The biggest challenge was poverty. Others were a lack of transport, the stigma attached to cancer, and poor service delivery (which includes waiting lists, broken medical machines and unavailable chemotherapy).
Then there are staff attitudes and the lack of emotional support at hospitals. In fact, a big hospital in South Africa can have one social worker being assigned 2,000 new patients a year. None of these patients will see a social worker, except for the allocation of a grant.
Other problems revolve around the physical challenges of cancer. There are, for example, the side effects like nausea and fatigue. Then there’s the loss of a job due to cancer. For children suffering with cancer, the illness may lead to them being out of school for up to a year and a half. That can have a big impact on their lives.
What are the problems with primary healthcare clinics in South Africa?
Basically, primary health-care services in South Africa are not cancer-orientated. By that I mean a patient might go in with a lump on her breast, and the nurse will say, “The lump is too small. Come back later.”
We’ve got to train those nurses and doctors to do proper testing. We have to have pathology services. We have to have feedback services. We need a proper medical system. Also, the referral pathway from primary clinic to tertiary hospital takes up to one-and-a half years. By the time patients get there, they’re terminal. They die. If they’d got in early, they might have been cured. Prompt treatment is why I’m alive today.
What do we need to do to improve cancer treatment in South Africa?
We’re advocating for bigger budgets. We also want the state department to have a national fund for cancer, and not put money into the provinces. That way, cancer treatment can be equal across the whole country. We also need to train doctors and nurses to be more cancer-minded.
If we can achieve these things, the situation will improve. Currently we have a big crisis on our hands. Actually, we’ve been fighting cancer without a cancer plan for 15 years. There’s just a lack of political will to improve things. Consequently, we’ve learned to be more aggressive in our advocacy.
Read: Black women more likely to carry breast cancer gene
You’ve spoken about the stigma attached to cancer. Can you elaborate on that?
It's a huge problem. If you ask a lot of people about their first thought when they learned they had cancer, they answer, “It felt like a death sentence.” That’s the belief among the general public. So, it’s very important to showcase survival, and to show people that if you get treatment early, you can survive the illness. And you can survive for a long time.
What does it take to beat cancer?
It takes tenacity. You have to have the will to make a decision and empower yourself. Regroup and come up with a plan – on more than one level. It will need to include your health, spiritual needs and diet.
It also includes fun, your family relationships, a way to deal with emotional baggage, and a plan to deal with your work and goals. Lastly, and without sabotaging your life, you have to prepare to die one day. But always keep in mind that, with the right treatment, you can live a long, full life!
Female cancer survivors need more fertility info
Metformin may reduce cancer death risk in some groups
Cancer diagnosis difficult in rural South Africa
Use GVI Oncology as a link to http://www.cancercare.co.za/
Use People Living with Cancer as a link to http://www.plwc.org.za/home
This article was brought to you by Cipla Medpro South Africa (Pty) Limited and its affiliates. Find out how Cipla is advancing healthcare for all in South Africa.