‘I don’t want pity, I want radiation’ – how Gauteng health department failed cancer patient Thato Moncho

Thato Moncho (left) marched to the Gauteng Department of Health, alongside other patients living with cancer, on 30 April 2024 to demand that the GDoH spend the R784m set aside by the Gauteng Treasury in March 2023 to outsource radiation oncology services for more than 3,000 patients. (Photo: Lerato Mutsila)

By Lerato Mutsila

31 Jul 2024

With a pep in her step, a spark in her eyes and a wicked sense of humour, one would not think that Thato Moncho has endured a years-long battle not only with progressive cancer, but with the Gauteng Department of Health.

‘I’m sitting here today knowing that I’m not going to be able to get radiation and praying every night that the chemo tablets continue to work on me. The minute they stop working, what will happen to me then?”

These are the words of Thato Moncho, a 40-year-old mother and cancer patient whose one prayer is that she lives long enough to see her 15-year-old daughter grow up.

Aside from taking oral chemotherapy to ensure that her cancer doesn’t spread, prayer is one of the few options Moncho has left in her fight against cancer as a result of the Gauteng Department of Health’s (GDoH’s) failure to timeously provide live-saving radiation oncology treatment.

gauteng health thato moncho Thato Moncho is one of the 3,000 patients who have been failed by the Department of Health in Gauteng. After fighting for four years to receive life-saving radiation treatment, Thato found out in May 2024 that her cancer had metastasised, rendering her ineligible for radiation treatment. (Photo: Lerato Mutsila)

Moncho is one of 3,000 cancer patients who have been let down by the GDoH after it failed to use the R784-million allocated by the Gauteng Treasury in March 2023 to clear the backlog in providing radiation treatment at Charlotte Maxeke Johannesburg Academic Hospital and Steve Biko Academic Hospital.

The money was meant for outsourcing radiation oncology services. In April, more than a year after the allocation was made, not a single cancer patient had received treatment through the intervention.

After four years of fighting her breast cancer, Moncho was told the cancer had metastasised, rendering her ineligible for radiation treatment despite her fighting tooth and nail with the GDoH for her right to just and equitable access to healthcare.

Daily Maverick asked the GDoH for comment but had not received a reply by the time of publication.

‘No time to cry’

When Moncho was diagnosed with cancer at the height of the Covid-19 pandemic in September 2020, she was fully prepared to fight the cancer and win.

Sitting in the back room at her family home overlooking the Soweto Highway in Orlando, Moncho told Daily Maverick about the diagnosis that forever changed her life. An avid runner, Moncho noticed during one of her runs that something was amiss with her right breast.

After a series of mammograms and a biopsy, Moncho was told she had Stage 2 inflammatory breast cancer (IBC).

“I remember arriving at Helen Joseph Hospital, where the doctor sat me down and gave me the news. After telling me that I had IBC, she kept asking how I was doing, and I just said, ‘I’m fine. What is the way forward from here?’ That was my reaction. I just wanted to hit the ground running [with treatment],” said Moncho.

Moncho recounted that the doctor was shocked by her reaction, expecting her to break down in tears on receiving the diagnosis. “When I cry, will the cancer go away?” she asked the doctor.

“The doctor said, ‘No, so.’ I said, ‘Then there is no time to cry, I just need treatment.”

Moncho was optimistic that with the proper treatment she would beat the disease. She hit the ground running, starting chemotherapy at the Charlotte Maxeke hospital in October 2020.

Before Thato Moncho (front left) found out she was no longer eligible for radiation treatment, she marched to the Gauteng Department of Health, alongside the Treatment Action Campaign, Section 27 and Cancer Alliance on 30 April 2024, demanding that the government roll out the treatment. (Photo: Lerato Mutsila)

Over the next few months, Moncho received nine cycles of chemotherapy, which took a toll on her body, and had a lumpectomy to remove the cancer from her breast. The treatment was going well and Moncho was ready for the next step — radiation therapy that could ensure the cancer would not return.

This treatment was meant to signal the end of her battle with cancer but, as it turned out, it was when the trouble with receiving adequate healthcare began.

In 2021, parts of the Charlotte Maxeke hospital were gutted by a fire. This meant that Moncho, who had finished her chemotherapy the week before the fire broke out, could not receive radiation therapy at the hospital.

Alternative arrangements were made, and she was sent to Nelson Mandela Children’s Hospital and then to Chris Hani Baragwanath Hospital, where she was told that she could not receive radiation therapy because there was a long waiting list for it.

“I stayed a month without any treatment, without anything, without knowing when I would get my treatment. Every time I went back to Chris Hani, they kept telling me that I needed to rebook, and I was like, ‘Seriously, you guys know that I need to get radiation within six weeks of having surgery, right?’ but they still made me wait,” said Moncho.

The delays were driven by severe shortages of operational radiation oncology equipment and staff within the public sector.

Harrowing news

After being sent from pillar to post, waiting to get the call that her name had moved up on the list, in September 2021, Moncho got the harrowing news that the cancer had returned just as she was about to receive radiation therapy.

“I got the call around 1 September and finally went to book radiation. The doctor saw me and said, ‘There’s something wrong with your breast. There is redness on your skin and the surgery site is now turning orange.’ Those were the signs that the cancer was back. I had to go through the process of getting chemotherapy and surgery again.”

While waiting to receive radiation, Moncho’s cancer came back three times. With each recurrence of cancer and each round of chemotherapy, the toll on her body worsened.

“Each time I went back to the oncologist, I remember the doctor saying to me, ‘Thato, all you need is radiation. If you do not get radiation, the cancer will keep coming back,’” said Moncho.

Frustrated with the years of back-and-forth, Moncho finally went to the office of Gladys Bogoshi, the CEO of Charlotte Maxeke, to confront her about not receiving the treatment she needed.

“I was literally crying, begging her for radiation, crying, ‘I need radiation’, and all she said was she was sorry. I’m like, ‘I don’t need your sorry. Pity is something that I don’t need. You were supposed to give me radiation. You failed me,” said Moncho.

Read more: Civil society drags Gauteng Department of Health to court over failure to spend allotted R784m on cancer treatment

In 2024, after years of being shuffled from chemotherapy to surgery and back again, Moncho learnt the cancer had spread to her lungs and she would no longer benefit from radiation oncology treatment.

“I went to the radiation department on one of my check-ups, and the sad news is that they told me … cancer had spread to my lungs. The cancer has moved to other organs in my body, and [that means that] radiation is no longer an option for me.”

Moncho said her only option now was the hormonal medication that she was currently taking in addition to chemotherapy tablets. In essence, Moncho was told that she must live with the cancer for the rest of her life.

“The doctor told me that I could have got radiation at the time that I needed it, and it was a necessity for me, but because of delays from the higher-ups, I could not get it. I simply said to her, ‘You are agreeing with me that they are doing maladministration,’” said Moncho.

“They have simply said to me, ‘Wait for your cancer to spread and your time to die.’ That is what the department did to me.”

Moncho’s gripe is not with the doctors, but with the GDoH for failing to spend the more than R700-million allocated to it to clear the backlog.

“If you have 3,000-plus patients dying of cancer, and you’re supposed to use the money on them, why are you not using that money?” asked Moncho.

“They’re the ones who failed me when it comes to radiation. They simply want us to die. I am not going to be their stats of death, they must forget. If they’re not going to be able to give me radiation, as they say, then they will give it to other patients.”

Moncho and civil society seek justice

Moncho’s years of fighting for treatment have made her the case study for the Cancer Alliance’s case against the GDoH. Cancer Alliance, represented by Section27, has launched a court application against the department to force it to provide radiation treatment to the patients on the backlog list and to have the department’s delay declared unlawful and unconstitutional.

“It is too late for me now. All I can do is take the chemo pills and hope the cancer doesn’t spread,” said Moncho.

“Radiation is no longer an option for me, but I will continue to fight the department up until they get those people radiation and there is a zero number on the backlog list. Then that’s when I’ll say I have won the battle,” said Moncho.

Read more: Open letter to Gauteng Health MEC — R784m goes unspent as cancer patients continue to die

Moncho is not the only cancer patient the department has failed. For the 40-year-old mother, one of the hardest parts is losing friends to the disease, knowing that radiation may have saved their lives.

“It’s sad to have a cancer patient die right in front of your eyes when you have been fighting this journey together. There are a few patients that have passed on while waiting for radiation.

“Mpho passed in May, just after her birthday. The cancer came back on her spine and it was too severe. Just three weeks ago, Amanda passed away. We are just waiting for her sister to come from overseas to bury her. There’s another lady who they just buried who was waiting for [radiation],” said Moncho.

“You understand that we live in fear that the cancer has spread with every ache and pain. We can’t be living in fear just because they’re not willing to do what they’re supposed to be doing.”

SowetanLive reported that GDoH spokesperson Motalatale Modiba said the department remained committed to providing essential healthcare services for the people of Gauteng.

“The department takes these allegations seriously and is dedicated to maintaining transparency and accountability,” said Modiba.

Modiba said the Cancer Alliance took legal action against the department because its preferred service provider was not awarded the tender to roll out radiation oncology treatment. DM

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‘No time to cry’

Harrowing news

Moncho and civil society seek justice