Eastern Cape cancer patients face more delays in getting critical chemotherapy
Patients, doctors and medical personnel face more chemotherapy disruptions after the Eastern Cape Department of Health said it would settle outstanding accounts with pharmaceutical companies only on Friday.
The struggle for chemotherapy medication in Nelson Mandela Bay's state hospitals and at Frere Hospital in East London is likely to continue until at least the weekend, after the Eastern Cape Department of Health confirmed it would pay pharmaceutical companies that are owed millions of rands, only on Friday.
With stock running dangerously low, oncologists, pharmacists and nurses have had to make excruciating decisions about who receives treatment and who does not, with some oncology units left with just one vial of the potentially lifesaving treatment.
Medical staff have spent hours phoning across the province in a bid to source the drugs, particularly for children, to avoid cancer patients' treatment being interrupted.
Patients' caregivers, who asked to remain anonymous, said they had been turned away when bringing children for chemotherapy. They said they had been told they would have to make a second trip when the chemotherapy drugs became available.
On Monday, the Eastern Cape MEC for health, Ntandokazi Capa, promised that outstanding bills would be paid immediately; however, patients have been turned away and treatments halted.
The South African Human Rights Commission (SAHRC) has launched an investigation into the repeated interruptions of cancer treatment for public healthcare patients in the Eastern Cape due to unpaid accounts.
Dr Eileen Carter from the SAHRC said the Democratic Alliance (DA) had laid a complaint with them about the matter.
On Monday, Capa's spokesperson, Sizwe Kupelo, said R200-million had been set aside for the procurement of essential specialist medicines, including for cancer treatment. He said R43-million of this would be used to settle debts with pharmaceutical companies.
However, on Tuesday he said this payment would probably only be made on Friday.
Salomé Meyer from the Cancer Alliance said they were deeply concerned about cancer services in the Eastern Cape.
'Livingstone Hospital (this includes the two cancer units at Port Elizabeth Provincial Hospital), now for the third time this year, does not have oncology medicines, and this is barely two months after the start of the new financial year. Should this trend of non-payment of invoices to suppliers continue, the lives of cancer patients will be impacted severely,' she said.
Meyer said the head of the Eastern Cape Department of Health, Dr Rolene Wagner, had committed to meeting with them to find workable solutions for cancer care services in the province.
The oncology units in Gqeberha previously ran out of chemotherapy medication in January after the Eastern Cape Department of Health's account with a supplier was suspended due to a delayed payment..
At the time, the medicines that were in short supply were Docetexal injection vials and anastrozole tablets.
There was a similar shortage in 2023, which was blamed on a stock-out at suppliers. DM
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Daily Maverick
2 days ago
- Daily Maverick
When we think about hunger we don't think about peace — here's why we should
Hunger isn't just about food. It's about power. It's about who gets to eat, who decides and who is heard. If we're serious about justice, then no one should be hungry. In South Africa, hunger is not just about empty stomachs, but also about unequal systems. It exists in crèches that exclude children whose parents can't pay fees, in homes where grant applications fail quietly, and in the lives of people with disabilities navigating systems that overlook their most basic needs. The student who is excluded from funding because they are considered too poor to afford university, yet not poor enough to qualify for state assistance, caught in the gap of eligibility. The woman who sits at the traffic lights with her child asking for small change or food. The problem is not that the country does not produce enough food, the problem is about who eats and who does not. Hunger is not just about food, it is about power, it is about peace, and it is deeply gendered. Women, especially Black women, carry the heaviest load in South Africa's food crisis. They cook, stretch budgets, sell in the informal economy and absorb the emotional violence of food insecurity. They go hungry so children can eat. And when food runs out, so does safety. As we've seen time and again, from the Covid lockdowns to the July KwaZulu-Natal unrest, scarcity breeds violence and is expressed against Black bodies. Despite producing enough food to feed everyone, South Africa has more than 63.5% of households facing food insecurity. We live in a country with one of the world's most progressive constitutions, in which section 27 guarantees the right to food and water. Yet every day millions go hungry. And too often we forget who exactly is being left behind. Hunger is a multidimensional crisis that undermines health through malnutrition, poor disease resistance and skipped medication. It fractures social cohesion, creating stigma, shame and desperation, worsening economic outcomes, especially for women and young people already at the margins. Women in informal settlements skip antiretrovirals because they can't take them on an empty stomach. The missing population that is not reported on include those not in employment, education or training, outside of the Not in Education, Employment or Training (Neets) active or inactive. There are people who are not in employment who are not receiving social grants and are not in the youth category, including children who are not in early childhood development, and are left without resources to access food. Despite policy interventions such as school feeding schemes, social grants and the 2023 SAHRC-led right-to-food study commissioned by the Department of Agriculture, significant structural gaps remain. Many interventions are not reaching those outside formal systems – such as children excluded from early childhood development programmes or people with disabilities navigating inaccessible services. These omissions reveal a deeper issue: our food security mechanisms are not designed with the most marginalised in mind, reinforcing cycles of invisibility and exclusion. This is not just a failure of delivery. It is a failure of vision. If we think of hunger only as a developmental or nutritional issue, we miss its full impact. Hunger is relational. It creates shame, fuels desperation and destabilises communities. We need to stop treating hunger like an economic inconvenience and start addressing it as a political and peace issue, one that is deeply gendered. The Centre for Social Justice, under the leadership of Professor Thuli Madonsela, has reframed hunger as a constitutional crisis. In the recent expert symposium I attended on 10 April in Pniel discussions rightly rooted the right to food in section 27 of the Constitution, making the case for structural change that is systems-based and a rights-driven approach to food insecurity. The research on Gendered Dimensions of Hunger and Peacebuilding by the Centre for the Study of Violence and Reconciliation and University College Dublin drives the conversation further, urging for a widened lens where food security is a catalyst for peace. Because hunger, when it intersects with gender, exclusion and poverty, becomes something even more dangerous – a disruptor of peace. A participant in the ongoing research said that in one of the dialogues they conducted a man asked: 'How do you expect me and my people to engage on peace when we are hungry?' Let's be clear: we have the policy tools, we have the research and we have the constitutional mandate. What's needed now is a shift in mindset from hunger as a welfare issue to hunger as a peace and justice imperative. When hunger intersects with gender inequality, disability and exclusion, it fuels gender-based violence, erodes trust in the state and drives protests, looting and resentment. As the UN Security Council warned in 2025, hunger isn't just a consequence of conflict. It's a cause. We must act like it. That means embedding gender, peace and inclusion into every food policy. It means tracking how hunger affects social cohesion, how it exacerbates violence, how it chips away at democratic trust. It means giving voice and space to those most affected not after the fact, but as architects of the solutions. If we are serious about building a future rooted in justice and peace, then we must start treating hunger as both a political emergency and a moral failure. This means going beyond food parcels and short-term aid. We need women-led food and peace councils that place care, equity and lived experience at the heart of decision-making. We need disability-sensitive food access tools that acknowledge the everyday barriers disabled people face in reaching nourishment. And above all, we must ensure that no child goes invisible simply because their stomach is empty outside of school hours. Hunger is not just a symptom it is a warning signal. And ignoring it now means paying the price in conflict, unrest and fractured futures. Hunger isn't just about food. It's about power. It's about who gets to eat, who decides and who is heard. If we're serious about justice, then no one should be hungry – not a mother, not a child, not a person navigating hunger with a disability. Because food justice is peace work. Because peace doesn't start in Parliament – a place where conflict should be dealt with – it starts in homes where children eat, with women who aren't forced to trade their bodies for bread, and with the ability of persons with disabilities to access food without stigma. Where food security is not a charity but a human right. So, what would it look like to build a hunger strategy rooted in gender justice and peace? We are at a turning point. With the National Food and Nutrition Security Plan (2024-29) in development, and a government of national unity on the table, the political moment is ripe. But the question remains: will we continue with business-as-usual? Or will we reimagine hunger as the crisis of dignity, justice and peace that it is? As one working at the intersection of gender, hunger, and peace, I say this: until hunger is addressed as a breach of peace and women are recognised as leaders in healing it, our democratic promises remain half-written. We don't often think of food when we talk about peace. But we must – because in every empty stomach lies a silent protest against injustice. If we want peace to flourish, it must begin with food security, dignified women and inclusive food systems. DM Naledi Joyi is a gender programme officer at the Centre for the Study of Violence and Reconciliation. Her work focuses on the intersections of gender-based violence, food systems and structural inequality. She has conducted research across rural and urban South Africa and post-conflict Liberia, exploring how violence is embedded in institutions, economies and everyday survival.
Mail & Guardian
2 days ago
- Mail & Guardian
From Jan Smuts to Gareth Prince: The struggle for the liberation of cannabis continues
The South African Human Rights Commission's discussions with the Rastafari and cannabis communities raised its concerns about stories of systematic and personal violations. Photo: Delwyn Verasamy As Africa Month ends, the South African Human Rights Commission (SAHRC) wishes to draw attention to a key struggle for African self-determination, remembering and 're-membering'. That struggle is the struggle for the full liberation of cannabis. Cannabis is a plant which has been used by indigenous South African people in medicinal and spiritual practices for centuries. The struggle for the right to grow, trade and use cannabis can thus be seen as a decolonial one — to reclaim and re-legitimise indigenous knowledge systems, African religion, spirituality and self-determination. The struggle has continued throughout South Africa's democratic dispensation. On 7 March 2025, the minister of health gazetted a new regulation banning cannabis and hemp foodstuffs under the Foodstuffs, Cosmetics and Disinfectants Act 54 of 1972. After widespread contestation and backlash over the constitutionality of the regulations, the minister withdrew them three weeks later. These regulations came unexpectedly, while the Rastafari and cannabis communities were waiting for the draft regulations, which would bring into effect the Cannabis for Private Purposes Act 7 of 2024, from the justice department. The regulation by the minister came exactly a 100 years after cannabis was classified as a controlled drug in 1925 at the Geneva Opium Convention. The classification resulted from a proposal by colonial regimes, including South Africa. Prime minister Jan Smuts was a leading sponsor at the League of Nations, placing cannabis in the same category as cocaine. Cannabis communities thus considered the withdrawn regulations as continued disenfranchisement and suppression of cannabis communities. Less than two weeks prior to the gazetting of the regulation, on 26 February 2025, the SAHRC convened a meeting with other chapter 9 institutions, government departments, civil society and members of the Rastafari community from all nine provinces — the Rights of the Rastafari Roundtable. The Rastafari National Council was also represented. This provided a space for the Rastafari and other cannabis communities to engage in dialogue, to be heard, to affirm their dignity and to find solutions to the structural challenges they experience. The roundtable was precipitated by the SAHRC's discussions with the Rastafari community throughout 2024 where it was troubled by the stories of the systematic and personal violations experienced by this community. Through these sessions emerged accounts of discrimination, criminalisation and persecution — not only because of their cultivation and use of cannabis but because of the general lack of recognition for Rastafari as a community deserving of respect, protection and equal standing in society. The experience of advocate Gareth Prince is one of the better-known examples of the Rastafari struggle. In 1998, the Cape Law Society refused Prince's application to be admitted as an attorney because of his criminal record for possessing cannabis, thereby stripping him of his right to work and earn a livelihood from his profession. Prince is still unemployed and believes members of the Rastafari community are treated as 'third-class citizens' in South Africa. Prince's experience is a reality for almost all Rastafari. At community discussions and the roundtable, Rastafari parents informed the SAHRC of the humiliation at being searched by police officers in front of their children. They believe that their visible Rastafari appearance renders them easy targets for police officials, which amounts to racial and cultural profiling. They endure marital discord when they disagree with their partners on the decision to cut their children's dreadlocks, so that they can be accepted in certain schools, and due to the overt and subtle discrimination against and bullying of Rastafari children. They shared stories of living under precarious employment conditions as they endure regular drug testing by employers because of their visible Rastafari identity and appearance. They suffer unlawful searches of their homes, expulsion from schools, medical neglect at health facilities and social stigmatisation. One Rastafari delegate at the roundtable asked the government stakeholders represented: '… To what extent have your institutions decolonised and transformed? Because, from where I'm sitting, and from your presentations, you are part and parcel of the colonial legacy … because the laws that you are implementing are not the laws that represent us.' They wondered why other religious communities' marriage ceremonies were recognised by the state, but theirs were not. They wondered why their religion, with its African origins, was frowned upon by fellow Africans in an African state. They conveyed their sense of voicelessness in South Africa's democratic culture because they choose not to engage in protest action. They felt 'unseen' and 'unhuman' and carried a heavy sense of non-belonging — pariahs, even under the new dispensation. The unfair discrimination against the Rastafari community and their social position as a marginalised group has largely been left out of the popular discourse about equality and transformation in South Africa's body politic. And yet, the Rastafari community continues to experience some of the worst violations of constitutional rights, including their rights to equality, religion, culture, dignity, health and education. The gazetting of the foodstuffs regulations is an example of the exclusion of the Rastafari from the democratic processes of decision-making in matters that affect them, and is a continuation of paternalistic colonial and apartheid attitudes to this community, and the cannabis plant. Despite a 2018 constitutional court judgment which decriminalised private cannabis use by adults, as well as and the signing into law of the Cannabis for Private Purposes Act 7 of 2024, the Rastafari continue to be arrested for cannabis-related crimes. Police officials conduct these arrests in violation of an August 2023 South African Police Service directive pausing cannabis-related arrests, issued by the national commissioner of police. The Cannabis Act only allows for arrests for dealing in cannabis, where there are reasonable grounds to suspect dealing. Yet, the complaints received by the SAHRC from the Rastafari community suggest that most arrests are still for private possession and use. Because of a lack of regulations from the justice department, which would specify quantities, the definition of 'dealing' has been left to the discretion of individual police officials. Because of the continuing structural and systemic human rights violations which have left the Rastafari community unrecognised, vulnerable, marginalised and criminalised, the office of commissioner Tshepo Madlingozi, at the SAHRC's head office, has designated the Rastafari as one of its two priority communities. The office aims to continue being a partner to the Rastafari and other cannabis communities, to help them regain their human rights. To bring the Rastafari, and other cannabis communities, into the fold of South African society, the state should be more proactive in recognising them as a legitimate community that requires similar protections and measures of redress to other previously disadvantaged and marginalised communities. This includes ceasing all cannabis-related arrests, prohibiting discrimination against children with dreadlocks in private and public schools and expunging all criminal records for persons who have been convicted of cannabis-related crimes. It is imperative that the justice department urgently develops clear and precise regulations on the use and possession of cannabis, including quantities, to guide both cannabis users and the criminal justice cluster. While having been at the forefront of the fight for the decriminalisation of cannabis, members of the Rastafari community feel excluded from the recent rapid commercialisation of the plant. They report that the licensing process is too bureaucratic and expensive, creating artificial barriers to their participation in the formal cannabis economy. In the meantime, 'cannabis shops' are mushrooming in many urban centres, despite their existence in a legal grey area. These and other concerns will be taken forward by the SAHRC in partnership with the Rastafari community and other stakeholders. One such initiative was held on 13 March where SAHRC commissioners Sandra Selokela Makoasha and Philile Ntuli hosted a roundtable specifically for Rastafari women, to provide a safe space for expression and discussion of their specific experiences as a result of their multi-fold identity and intersecting social position as Rastafari, women, wives, mothers, caregivers, workers and cannabis producers and traders. But all interventions such as these, by state and non-state actors, will be rendered ineffective as long as the broader South African society continues to stigmatise and discriminate against the Rastafari. From Jan Smuts to Gareth Prince, the struggle against state overreach and for the valorisation of indigenous cultures and practices continues. Tshepo Madlingozi is a commissioner responsible for anti-racism, education and equality at the South African Human Rights Commission and Naleli Morojele is a research adviser at the commission.
Daily Maverick
5 days ago
- Daily Maverick
Eastern Cape health department is breaking the law in the way it runs Dora Nginza Hospital
In a damning and scathing report the Public Protector has found that the Eastern Cape Department of Health is breaking a handful of laws and regulations in its management of the Dora Nginza Hospital. The Eastern Cape Department of Health has been called out for breaking several of the country's health laws and regulations and violating the Constitution in the way it runs Dora Nginza Hospital in Zwide, Gqeberha. This follows an earlier, unannounced visit to the hospital by the Public Protector, Advocate Kholeka Gcaleka. While the right of access to health is enshrined in the Constitution, government departments are allowed to claim they do not have the budget to implement all measures immediately. However, the Public Protector found that the department failed to use funds allocated for essential equipment. It is well-known to hospital staff that prior to an inspection, an 'advance team' is usually sent to state hospitals in the province to make sure they are clean, equipment is working and overcrowding is under control, but this time Gcaleka did not inform the department's head office in Bhisho of her visit. During the visit in 2024, the Public Protector identified numerous operational shortcomings. These included an insufficient number of security personnel on site and a defective closed-circuit television system. In addition, security protocols for maternity wards – including ID verification and visitor passes – were not properly implemented. Damning report Although the Public Protector visited the hospital in 2024, her report was released just days after two newborns were stolen from Dora Nginza Hospital's maternity ward in May. A 26-year-old woman, Sinovuyo Rabula, appeared in court on Friday, 30 May. Her bail application was postponed to 6 June. Key findings from the Public Protector's investigation include: A critical shortage of staff is negatively affecting healthcare delivery. The hospital is still operating on a 2016 organogram, which has become obsolete, especially considering the additional tertiary services it now provides. The centralised recruitment process at the provincial Department of Health office significantly delays the hiring of both clinical and non-clinical staff. The maternity ward is overcrowded, with some women who have given birth forced to wait on chairs for available beds – a situation that increases their risk of infection and other complications; and There is no privacy during patient consultations. Daily Maverick has been highlighting the crisis in state hospitals in Nelson Mandela Bay for years, including warnings about the unprecedented scale of resignations of doctors from these facilities. The Public Protector echoed what health leaders and civil society groups have been saying for the past 15 years: the absence of a district hospital in the Nelson Mandela Bay District has placed immense strain on Dora Nginza Hospital. The facility is forced to serve simultaneously as a clinic, district hospital, regional hospital and tertiary centre – particularly for obstetrics, gynaecology and paediatrics. The neglect of this key hospital in Nelson Mandela Bay — which provides specialist services to the entire western region of the province — was further underscored in the latest health statistics published in the District Health Barometer in April. Nelson Mandela Bay was identified as one of the worst-performing districts in the country, recording the second-highest number of maternal deaths (35) in the province – an increase of seven from the previous year. The statistics also show that both neonatal and early neonatal death rates at health facilities in the metro have risen year on year, placing the district among the country's poorest performers in this category as well. The report further highlighted the shortage of medical equipment such as blood pressure machines, haemoglobin machines, cardiotocography machines, Dinamaps (patient monitors) in the postnatal ward and infant warmers. Investigators found that the department failed to spend the allocated budget for equipment. 'The low level of spending while there is a shortage of critical medical equipment suggests that there is a serious structural problem in the Eastern Cape Department of Health, which renders the provision of basic healthcare services less reliable or not delivered in a progressive and effective manner as contemplated in the Constitution and the law,' Gcaleka said. She ordered national Minister of Health, Dr Aaron Motsoaledi, to 'take cognisance of the report and ensure that the remedial action is implemented'. Eastern Cape Premier Oscar Mabuyane was also instructed to 'ensure executive oversight so that the remedial action by the Public Protector is implemented', The head of the Eastern Cape Department of Health, Dr Rolene Wagner, was ordered to submit a detailed plan – with timelines – to address critical issues. These include: Improving hospital security; Implementing a plan within four months to convert Empilweni TB Hospital into a district hospital; Addressing severe staff shortages (medical and non-clinical); Relocating Dora Nginza's kitchen and laundry; Finalising recruitment for non-clinical vacancies; Procuring new trolleys and specialised cooking equipment and disposing of the defective ones; and Completing and submitting a finalised organogram At the time of the Public Protector's visit in 2024, Wagner was not in control of the department as she had been moved to the Office of the Premier in October 2023 to form part of his 'crack' team to solve the pressing problems in the province. She only returned to her job in August 2024. Other findings included that the province's health department was not delivering healthcare services in a 'progressive and effective manner' as contemplated by the Constitution; that treatment of patients, especially of pregnant women, at the hospital 'may be a violation of the national health regulations, which places an obligation on the functionaries of the hospital to maintain an environment which minimises the risk of disease outbreaks, the transmission of infection to other users, healthcare personnel and visitors.' The ongoing shortage of midwives and delays in filling vacant posts since 2017 – along with a lack of nurses in the postnatal ward to manage patient overflow during peak periods – continues to place a heavy burden on the hospital's limited staff and their mental wellbeing, the report noted. 'The delay in implementing intervention measures such as the establishment of a level 1 maternity service at [the] Port Elizabeth provincial hospital, which should have been done in March 2023, and the conversion of Empilweni Tuberculosis Hospital to a district hospital which would also offer level 1 maternity services has negatively impacted the delivery of antenatal and postnatal services at the hospital,' it said. Investigators also found that the outdated 2016 organogram had led to severe staff shortages in key departments, including the kitchen, laundry, theatres, maintenance, surgical units and casualty wards. Other findings include that 30 cardiotocography machines that were ordered in January 2023 had not been delivered. Only one infant warmer was working during the inspection. 'Despite regulation 13(1) of the National Health Act (NHA), placing an obligation on the hospital to ensure that the medical equipment is available and functional in compliance with the law, the functionaries of the facility and the head of Department for Health in the Eastern Cape have failed to ensure that the hospital has essential equipment in all clinical service areas,' Gcaleka said in her report. 'The undue delay in the procurement of medical equipment has [the] potential of endangering and compromising the lives of people who depend on the hospital for healthcare. The responsibility of ensuring that timeous procurement of adequate medical equipment is delivered to the hospital is the responsibility of the department to safeguard the health and safety of all workers and patients,' the report said. The hospital reportedly has only two washing machines, one of which was broken — meaning that its laundry had to be done at Livingstone Hospital. 'This is not sustainable,' the report said, adding that the issue should be speedily resolved to 'mitigate the risk of patients contracting infections and address the serious impact on the operations of the hospital. This negatively affected the availability of linen for the wards, to the extent that the linen provided to the patients was not properly cleaned.' Investigators also flagged long-standing issues with the kitchen at the hospital. These were highlighted two years ago by civil society groups in Nelson Mandela Bay. 'The equipment in the kitchen is dilapidated and very old, has surpassed its life expectancy; [it] constantly breaks down and should be replaced. The breakdown of pots is also caused by the lack of trained staff to operate the pots and over utilisation of the pots which have reached their life span.' The pots, which cost R500,000 each, should have been replaced but Gcaleka said the budget was not used. She added that new pots 'could have been procured to replace the old pots that have reached their life span'. 'The Government Immovable Assets Management Act (GIAMA) provides for the management of an immovable asset that is held or used by a national or provincial department and to ensure the coordination of the use of an immovable asset with the service delivery objectives of a national or provincial department. 'The progressive realisation contemplated by the constitution can only be understood to mean that, no matter what level of resources the department might have at its disposal, it must take immediate steps within its means towards the fulfilment of the right of access to health services, by availing resources to address the challenges relating to the shortages of medical equipment, clinical and non-clinical staff which impacts negatively on the delivery of health care services in a progressive and effective manner. The conduct of the department in not addressing these challenges is inconsistent with the Constitution,' the report added. While the Eastern Cape Department of Health has not yet commented on the Public Protector's report, provincial health minister Ntandokazi Capa's spokesperson, Sizwe Kupelo, said earlier in May that R143-million had been earmarked to improve services at Nelson Mandela Bay's two largest hospitals, Livingstone and Dora Nginza. He confirmed last week that 10 new doctors and a number of nurses had been appointed at Dora Nginza Hospital. DM
