South Africa has one of the most liberal constitutions in the world. It is a document which was written in consultation with the people of South Africa. Chapter two of the Constitution includes the Bill of Rights. It states very clearly that “Everyone has the right to have access to health care services”. We explained that right here. It also states that “The state must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of each of these rights.”
In other words, all people living in South Africa have the right to equal access to breast health.
The words are inspiring, but the reality is less so. We may all have the right to equal access, but we do not all get it. If you read Boitumelo’s story on this blog (link to post) you will get an idea of the reality of the journey for many people with breast cancer.
So what do we mean when we talk about access to healthcare?
Access can be limited by financial, organisational and social or cultural barriers. In other words, it is not enough to supply a health service, it must also be affordable and acceptable to the people who would use it, and they must be able to physically get to the place where the service is offered.
Services available must be relevant and effective if the population is to ‘gain access to satisfactory health outcomes’. In other words, more cancer treatment facilities must be established so that the people who need treatment do not have to travel far from their homes.
We need to take other factors into account. Are people experiencing transport problems? Are they afraid of leaving their families? Are there other cultural issues to be understood?
In our communities we cannot say that there is equal access to services until service delivery is improved. Poor service delivery, such as not having the medication that is needed, puts people off going to state clinics. People with breast cancer are reluctant to leave home for weeks in order to attend specialist clinics, Poor maintenance of treatment facilities results in delays in treatment.
In other words, access to care is not just about whether a particular service is available. It includes whether the people who need the service are able to make use of it. Is transport available and affordable? Is the population educated about their options? Do people understand what steps to take if they find a breast lump or are experiencing pain?
We know that we cannot answer yes to any of those questions, and until we do we will not be able to say that there is equal access to breast health care in our country.
- How do you think we can deal with the barriers that limit equal health care services ?
- Tell us you story of how you battled to get to the services you need?
- What would you like to change so that “the right to access to health care”, enshrined in our Constitution, will become a reality?
Please join in the conversation in the comments.