Working in South Africa’s beleaguered healthcare sector can be a daunting and cumbersome task: lengthy patient waiting lists, a lack of resources, overburdened healthcare workers, and not enough hours in the day to get through the giant to-do list. But with a bit of out-of-the-box thinking to “shake things up” and some fellowship, it’s possible to make an enormous difference in the lives and well-being of patients who need it most.
Dr Liana Roodt, the brain behind Project Flamingo at Groote Schuur Hospital (GSH), knows exactly what she’s talking about. Aware of the plight of patients with breast cancer who access public healthcare facilities in the country, and what it takes to get them to an accurate diagnosis, surgery and treatment, Dr Roodt was desperate to help. With a novel idea in mind, she canvassed her network, and in 2010 established Project Flamingo – a lifeline for patients with breast cancer. Fast-forward 13 years and the initiative has touched thousands of lives – bringing renewed hope in the fight against breast cancer.
“There is an urgent need to address the deficit in the distribution and capacity of breast cancer surgical services.”
“Many women will be affected by a breast cancer diagnosis in their lifetime, and we see the devastating effect this diagnosis has every day in our surgical and oncology units at GSH. The reality is that our services and resources cannot keep up with this massive patient load,” she said. “There is an urgent need to address the deficit in the distribution and capacity of breast cancer surgical services in South Africa and to close the cancer care gap we face.”
Roodt was speaking at a cancer seminar organised by the University of Cape Town’s (UCT) Gynaecological Cancer Research Centre. The hybrid event was held on Friday, 10 February, in commemoration of World Cancer Day observed annually on 4 February.
Hinderances in healthcare
According to Roodt, between 54% and 75% of South African patients who seek care for breast cancer present with late-stage disease. This means that their cancer has metastasised (spread) beyond the breast to other parts of the body.
Sadly, the structure of South Africa’s multilayer public healthcare system is one of the reasons patients’ diagnosis and treatment programmes are significantly delayed. Roodt said before a patient even reaches a world-class academic tertiary centre like GSH – one of only two public healthcare centres in the Western Cape that offer cancer treatment – a visit to a day hospital or clinic in the patient’s home district is required first. Patients living in rural communities need to travel long distances at unaffordable rates from home to a local clinic or hospital, and thereafter to a district-level hospital before finally being referred to a regional facility like GSH.
“Here we have steps [in the process that present] obstacles and potential delays that patients need to overcome before they access GSH. This leads to months of delays to get a diagnosis. We’re not even talking about treatment,” she said.
Project Flamingo was established to plug this gap and to provide hope to those in need of care. The initiative provides a catch-up surgery programme that operates on Saturdays when theatre spaces are normally not used. Thanks to its generous donor funding, theatres, nursing staff and medical supplies are covered. Surgeons and anaesthetists offer their time pro bono to ensure patients are operated on timeously. Depending on the nature of the procedure, between four and nine patients are accommodated on a single list.
“What we want to do with Project Flamingo is to try and alleviate some of the pressure points in the healthcare system.”
“These clinicians are willing to donate their skills and time to clear the surgical backlog. There’s this huge disconnect between what patients need and what we are able to offer, and this is what led to the birth of the project. What we want to do with Project Flamingo is to try and alleviate some of the pressure points in the healthcare system,” Roodt said.
To ensure a fair selection process, patients are selected for surgery on a needs basis and project lists are scheduled at least 12 months in advance. Patients’ names are provided by one of four referring hospitals including GSH, Tygerberg Hospital, Livingstone Hospital in Gqeberha, and Cecilia Makiwane Hospital near East London.
Not just a weekend waiting list initiative
The care and compassion extend beyond the Saturday surgery programme. To lift patients’ spirits, Project Flamingo also ensures that patients receive pamper packs filled with a few essentials, snacks and other thoughtful extras to boost morale during a stressful and emotionally draining cancer journey. Similarly, the project also ensures that patients receive a food parcel to help provide them with a healthy and nutritious meal during chemotherapy and to ensure that they don’t attend treatment on an empty stomach. To date, thousands of pamper packs and chemotherapy food parcels have been distributed.
“We need to penetrate the system that we have, and we need to try and change it gently, slowly and kindly from the inside.”
“What are we as humans capable of when restrictions and resource constraints force us to think differently about a situation? We need to create a functional system of support within our existing framework. We can’t reinvent the wheel. We can’t do it from the outside and we can’t keep complaining. We need to penetrate the system that we have, and we need to try and change it gently, slowly and kindly from the inside. But we should never not do nothing,” Roodt said.
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