Health-e (Cape Town)

South Africa: Boy May Lose Leg Due to Treatment Delays

A Limpopo teenager was sent from pillar to post for three months while a cancerous tumour in his leg continued to grow. He now faces the very real possibility of amputation.

When fist meeting him, Simon (17)* presents like any other teenager. Living and growing up in Louis Trichardt in Limpopo, he loves playing soccer and listening to house music. He dreams of one day becoming a sound engineer.

However, Simon’s dreams are in the balance.

Earlier this year his leg started swelling, coupled with intense pain. Doctors initially thought it was an infection, but none of the treatment they administered had any effect. In fact, Simon’s leg became more painful and swollen.

In April this year Simon’s brother Chester took him to a private doctor for x-rays, and they discovered that he had a cancerous osteogenic sarcoma (bone tumour). Because he doesn’t belong to a medical scheme, the doctor referred him to the local Elim District Hospital where they scheduled an appointment to do an x-ray in early May. When he arrived for his appointment, hospital staff sent him home, telling him to return the following week. But his appointment was delayed again and after complaining he was referred to the Pietersburg Provincial Hospital in Polokwane for a computer tomography (CT) scan to confirm the cancer diagnosis and determine the extent of the tumour.

On May 16 Simon woke up at 3am, boarded a taxi his brother hired to take him to Elim Hospital in from where he was transported the 110km by ambulance to the Pietersburg Hospital for his CT scan. However, when he arrived he was told that the CT machine was out of order and that he should come back in three weeks’ time.

While hospital staff were sending him from pillar to post to try and confirm a diagnosis, Simon received no treatment for the growing cancer, nor any medication to treat the excruciating pain associated with this disease.

Three months after the initial diagnosis by the private doctor Simon eventually had a CT scan at the Pietersburg Hospital that confirmed the bone tumour in his leg. However, in order to initiate treatment doctors first had to do a biopsy and magnetic resonance imaging (MRI) procedure after which he would be admitted to an academic hospital for chemotherapy. These specialist services are not readily available with long waiting lists and because the hospital didn’t have a bed for him , Simon was again sent home.

At great cost to his family and discomfort to him, Simon travelled back and forth between Louis Trichardt and Polokwane several times over the next month for biopsies, MRI’s and CT scans – some of which were done, and some not.

Because the process was taking so long, Simon’s family volunteered to take him to a private doctor volunteering to pay for an MRI to speed up the process. However, the doctors refused saying that they can’t accept scans from any private facility, giving the family no option but to wait several weeks until the hospital could accommodate Simon for an MRI.

Out of frustration and desperation Simon’s brother contacted support organisations for cancer patients, and with the help of the Campaigning for Cancer on he was finally admitted to the Children’s Cancer ward at Steve Biko Academic Hospital in Pretoria on July 20 where he started chemotherapy.

In the four months it took from the initial diagnosis to the point where he eventually started treatment, Simon’s leg has swollen to three times its size, which most likely indicates progression of the cancer tumour.

Simon is currently receiving chemotherapy, and although the tumour has stopped growing, it has not shrunk either. Doctors are now considering amputating the leg below the hip, but Simon is not ready to to give it up.

“Four months is a long time,” said Chester. “We can’t help but think that had he gotten help in that first month, he might have been fine.

“Do they [the Department of Health] know what it means to a patient if the machines aren’t working, or they can’t honour an appointment? Do they even care?”

* Not his real name

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