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Durban moves to lead fight against cancer
Tony Carnie, IOL
2009-04-24

Durban is planning to become the first city in the country to set up its own environmental cancer surveillance unit. The move coincides with a national process to declare cancer a reportable disease and improve data collection on the disease, which kills or disfigures several thousand South Africans every year. Ten years ago The Mercury uncovered evidence of potentially high cancer rates in children in Durban's southern industrial area. Official figures suggest that at least 50 000 new cases of cancer are diagnosed around the country every year, although these statistics are recognised as an underestimation of the true picture. The aim of the new surveillance unit (or registry) is to monitor the number and different types of cancer cases in the Durban area by gathering accurate information on where, how and why the disease occurs, and the extent to which air pollution and other environmental risks might add to the cancer burden. Siva Chetty, the deputy head of pollution control for the eThekwini Health Department, said the plan was to start collecting information on cancer cases in Durban by next year.


Plans to declare cancer a reportable disease should improve the state of cancer surveillance nationally as the health profession would be required to tell state health officials of new diagnosed cases when they are diagnosed. It is understood that a draft notice on the cancer notification plan will be published for comment soon in the Government Gazette in the near future. Although South Africa has a partly functional national cancer registry, its effectiveness is limited because it relies on limited data given voluntarily by private and state pathology laboratories. Sources say there are major information gaps because few private labs forward information to the national registry. Along with funding limitations, the lack of compulsion to report the disease has hindered plans to analyse the links between cancer, environmental pollution, diet and a wide range of other disease factors more effectively.

The plan to set up a cancer and environmental surveillance unit in Durban follows long-standing concern about airborne pollution in the city's southern industrial area and anecdotal reports about elevated cancer rates in some communities. In September 2000, after extensive interviews in several residential areas in South Durban, a survey by The Mercury estimated the rate of leukaemia to be 24 times higher than the national average in children under the age of 10 in Merebank, while the incidence of other types of cancer in this age group was also higher than normal. Although these estimates were based on a very small number of cancer cases found only in Merebank children, public health specialist Dr Duane Blaauw said the results were unlikely to be a fluke, and he called for more in-depth studies by scientific researchers.

Widespread publicity and community concern soon led to the establishment of the so-named Multi-Point Plan, a high-level government project to tackle industrial air pollution countrywide, with Durban as the national pilot project. Since then, Durban has established one of the most comprehensive air pollution-monitoring networks in the country and also pioneered plans to lower air pollution levels for petrol refineries and other heavy industries. Local community groups have been critical about the pace and level of change, but there have been measurable reductions in some types of air pollution from Durban's biggest industries.

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