A historic breakthrough. That's how key stakeholders in breast health in South Africa described a meeting with the Health ministry on March 21, Human Rights Day. By Sue Segar
The significant outcome of the meeting - attended by deputy health minister Dr Gwen Ramokgopa and other departmental staff - was that Ramokgopa has invited breast cancer stakeholders to contribute to a strategy document on cancer that will be announced on April 7 by the department of health.
"The strategic plan will be launched on April 7 - World Health Day - and it is almost ready for publication, but I can commit to give you another ten days ... as we go to print on April 1 ... to look at it and see if you can make contributions," Ramokgopa said during the meeting.
"It was very historic because it was the first time we have ever succeeded in bringing together all breast health stakeholders into one room to talk to the deputy minister and other members of the department," said conference co-ordinator Salomé Meyer.
"We had clinicians - including breast surgeons, radiologists, plastic surgeons, geneticists and pathologists, as well as the full range of breast health NGOs and members of the government and civil society as well as international agencies all in one room," she said of the sometimes heated breakfast meeting which lasted more than two and a half hours.
"It was also a historic breakthrough in the sense that it was Human Rights day, so from the human rights perspective it was the right time and appropriate, because breast health is very much a gender issue. "
Meyer said the purpose of the meeting was for breast health advocates to lobby the national department of health and the ministry for a sustainable and equitable breast health policy for South Africa.
"The problem that we have currently is that there is a disparity in terms of services rendered from one province to the other. So we are asking for equitable services - whether that be in terms of clinical practise, diagnosis or treatment. Even the drugs which are used are not the same from province to province.
Among the issues highlighted in the meeting was the lack of integration of services, the lack of psychological support services, and the lack of lymphoedema services despite the world health guidelines indicating it should be a service available.
"We have no lymphoedema services available for our patients in the state sector," Meyer said.
Additional issues were the "very desperate need" to include palliative care as part of the service continuum, she added.
"Palliative care currently is only provided by one NGO, namely hospice, and there is no way that hospice can deal with all the patients. Thirteen percent of their patient load is currently made up of cancer patients - and that's just a drop in the ocean as there are many people in rural areas who do not get this service and end of life is particularly an issue because it is a taboo we don't talk about."
Meyer said the meeting was organized by Reach To Recovery International to serve as a model for other lower-resourced countries in terms of advocacy and lobbying for breast health policies.
"International experts were invited along with our own South African stakeholders.
Meyer said the group's immediate action, following out of the meeting, would be to respond urgently to Ramokgopa's call for input.
"In the longer term, we must ensure that we make use of the structures that have been created by the department of Health for monitoring, evaluation and auditing of service delivery," she said.
"We will ensure that, through the National Cancer Advisory Committee established by the Health ministry, we make the inputs on breast health issues.
"We will set up a task team from the stakeholders made up of the full range of SA breast health interest groups that represents our clinical professionals as well as the NGOs to ensure that inputs are provided to this committee.
"A further outcome of this is that the breast healthNGOs have to form a Breast Health Focus Group which will fall under the auspices of the Cancer Alliance to ensure that we work in a coordinated and integrated way.
"We will include the inputs from the South African Breast Health Interest Group (BHIG), who represent the clinical experts."
Meyer said the stakeholders were more inspired than ever to take the issues further, with the government in tow.
"It was a benchmark opportunity. The fact that we were able to sit down in one room and talk to the ministry and them being open and inviting us to participate in a meaningful way was a really historic moment for us on Human Rights Day."