On 7 April 2019 the World Health Organisation commemorates World Health Day. This year’s theme is Quality Access to Healthcare for All. The Discovery Fund supports several exceptional initiatives that provide healthcare to the most under-resourced communities.
A shared passion for reducing the tragically high breast cancer prevalence in South Africa combined with the state-of-the-art resources to do so brought the Discovery Fund and the Breast Health Foundation together several years ago. Working innovatively to enhance training and advocacy in the public and private sector, they’ve generated a quantum leap in the detection, diagnosis and referral of breast cancer patients nationally - saving and enhancing a fast-growing number of lives in two short years.
The core partnership aims to address the one in 28 women in South Africa who develop breast cancer during their lifetimes, too many of whom succumb due to late detection, aggravated by the paucity of healthcare professionals with appropriate screening skills. For example, there are around 400 000 registered nurses South Africa, yet less than 1% work in breast care. Research shows that when breast cancer is detected early, nine out of ten women are still alive a decade after treatment. The intervention, anchored at the world-class multi-disciplinary Milpark Breast Care Centre of Excellence in Gauteng, began in 2017 with a Discovery-funded expansion of hospital on-site nurse training. The pilot tertiary hospital training expanded from the Helen Joseph and Charlotte Maxeke Academic Hospitals in Gauteng to the less-resourced Kimberley Hospital in the Northern Cape and Mount Frere Hospital in East London. This training was backed by e-learning via smart phones targeted at public sector nurses and doctors stationed in outlying facilities which refer patients to these tertiary hospitals.
Digitally creating breast health champions
The BHF soon realised that ‘going digital ‘would enhance advocacy and spread detection skills far quicker. So, in October 2018, a newly-crafted web-based training site was launched at Discovery’s headquarters in Sandton, with private and government hospital executives, Nursing Council chiefs and senior staff from the National Department of Health, (NDoH), in attendance.
Explains Louise Turner COO of the BHF, ‘The concept is that those we train become breast ambassadors or champions within their organisations, training more trainers and spreading the safety net.”
Fortuitously, the long-awaited NDoH breast health policy, obliging doctors and nurses to triage and refer patients with breast cancer, was legislated just a few months before the website launch, giving the new initiative a timely boost. The passion and dedication of the BHF team is predicated on empathy; Turner and every member of her staff are breast cancer survivors. Says global award-winning BHF founder and lynch-pin of the Milpark Breast Care Centre of Excellence, Professor Carol Benn, “Giving forward is a useful concept for all who have access to privilege, be it based on intellect, talent, finances or contacts. You can take nothing with you off this planet. Working in the oncology field makes this very real, so contributing to a better planet is important to us. We need to stop blaming government for failing healthcare systems, whether inherited from past structures or any other reason.”
How it works
The BHF website content is split between breast education for public sector health promoters and nurses, with an upscaled version for GP’s, specialists and pathologists, be they in radiation, oncology, plastic surgery or any of the disciplines involved in managing breast cancer. Users go online and register to access the site, using a unique password.
On January 26, 2019, the NDoH flew in 36 of their healthcare staff ranging from nurses and matrons to doctors, from as many tertiary and regional hospitals around the country to a central Gauteng BHF training venue. They were taught how to complete the digital training modules while garnering valuable Continuing Professional Development, (CPD), points.
Early detection and expediting referrals
The envisaged outcome? Turner responds: “To pick up anything suspicious during a woman’s examination at any rural clinic, health centre or district hospital, with immediatel referral to the nearest tertiary hospital, with Professor Benn or a colleague available as on-line back-up at the Milpark Breast Care Centre of Excellence.”
Several private hospital groups have inserted a digital link to the BHF site on their own internal web-based platforms, making it a compulsory part of their in-house training. Top pharmaceutical companies are sponsoring the videos, reducing the BHF’s cost in return for brand-labelling. On completion of the full module, the user receives a Breast Advocate Certificate. The training platform is accessible any time and from any Internet-enabled device, including tablets and mobile phones. Users can also track their progress.
Addressing a dire need and improving equity
Professor Benn says the collaboration with Discovery will help educate healthcare professionals and the public alike. “Most doctors don’t realise the prevalence of breast cancer, particularly in young women. They don’t know how to refer them and to whom, especially if the person concerned is not on medical insurance.” When she started her first clinic at Baragwanath Hospital she had two patients next to a urology clinic. “Within six months I had 150 patients per week – all due to creating awareness in the surrounding drainage areas - that’s how the BHF was conceived,” she adds.
Prof Benn is passionate about creating more pathways and safer access to good quality healthcare and believes more public/private collaboration is vital to ensure quality care is never compromised, regardless of access to funding.
- Website; www.training.mybreast.org.za
- The Breast Health Foundation (BHF) is a non-profit organisation established by Professor Benn in April 2002 with the purpose of increasing and promoting education, awareness and treatment to the public on breast cancer and breast health, and to empower people to have a positive mindset of survival, recovery and quality of life.
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