By Tegan Bilse, Netcare Garden City Hospital

We have a saying that we use colloquially here, in response to any number of difficulties. We say “TIA, this is Africa”. It usually refers to a struggle, a difficulty or our government officials, and reminds us to do the best with what we have. With an over-burdened government sector serving the majority of the population, scarcity of resources and skills are unfortunately all too common.

Here, oncology is a specialty that kind of happens to you, it is seldom something you pursue from a university level. We can’t do residencies, we have little access to overseas courses, and most of what we learn we get on the job. To this end, the knowledge that we pass down as professionals is the key to improving the quality of care and practice in our region.

Slowly but surely, a handful of us are reaching out for opportunities to further our oncology education, and in doing so, raise the level of care we can give our patients. These include both ISOPP and ESOP masterclasses, attending conferences and sharing our learning with colleagues back home.

Our fledgling South African society has some very determined and passionate individuals, who are using these opportunities to slowly improve working conditions and practice standards across the country. The University of the Witwatersrand is developing an Oncology Admixing short course, which will be easily accessible locally, and one of the first standalone modules available for professionals currently practising. We enjoy the ESMO Africa congresses which are held annually in Cape Town, and focus on topics relevant to our practice which often don’t make the international stage. These include topics like the impact of immuno-oncology on our population with co-morbidities like TB and HIV/AIDS, how traditional African medicines and attitudes towards Western medicine impact compliance, and our not quite first world setting which leaves us leaps and bounds behind a lot of the world in terms of medicine availability and leading treatments.

The more exposure we can get as professionals, the more momentum we will gain in dragging our healthcare system kicking and screaming into the century of innovative and personalized oncology treatments. We will have to start with small battles, like getting all our practices to wear the correct personal protective equipment (PPE), and overcoming drug shortages due to high costs of medicines.

We also must not forget that although we ARE in Africa, our people are strong and resourceful. The fact that patients who walk many kilometres to get tamoxifen at the clinics suffer fewer side effects than those that drive themselves in private cars shows that benefits may be found through the hardships and in the most unexpected places.

We can use the bridges we are building with both our African neighbours, and with our international partners, to better our knowledge to provide the best possible care to those who need it most.

Then we will be able to say without shame that this is, indeed, Africa.