We have chosen to give
Tegan Bilse, oncology pharmacist at Chris Hani Baragwanath Academic Hospital, shares what a regular work week entails.
You can listen to this article below, or by using your favourite podcast player at pod.link/oncologybuddies
It’s another day at a public hospital in SA. I dodge crowds of patients on my way in from the entrance, fetching keys for my unit, and eventually heading to my department. I must avoid both the injured in their wheelchairs and the oblivious on their phones or headsets; weave my way through some ambulances, and eventually make it.
Every day of the week has its own delegated group of patients to streamline the work process at the paediatric and haematology section. There will always be a few exceptions, but we know what to expect on most days. Here is a bit of our typical week.
On Mondays, we have the paediatric clinic. We have been blessed with a new building from generous donors, and the kids can play with dozens of toys and books while waiting for the doctors. I receive notifications by WhatsApp that certain children are confirmed or on hold for their chemotherapy; they will be deferred if their white blood cell count is too low, or they are unwell in any other way. They’ll often get chemotherapy the following week.
Many children are admitted on a Sunday and have their bloodwork done by Monday morning, to be able to start a five-day regimen. They will get daily chemotherapy according to a prescribed regimen, depending on their cancer. We see a lot of leukaemia, as well as solid tumours called nephroblastoma (of the kidney) and we use specialised anti-cancer medicines which need to be mixed in a biosafety cabinet and we must wear full gowns, masks, and double gloves. We measure small amounts from 0.1ml, all the way to 100s of millilitres in bags of saline and send these to both the wards and clinic for administration.
The beauty of working with children is that they don’t get as depressed about their diagnosis as adults; we are able to cure many of them, and they go on to live happy lives. This is extremely rewarding and one of the biggest joys of an otherwise challenging job.
Adult haematology clinic
Once it reaches Tuesday, we have the adult haematology clinic. Here we are treating leukaemia, lymphomas and anything else in the basket of things that can go wrong with your blood cells. Not all of them are necessarily cancerous, but we sometimes use the same medication to treat them.
Many of our medications (up to a third of anti-cancer medications) aren’t included on the two-yearly tender, and we need to complete bundles of paperwork to send through a government maze of approvals to get them. When we are lucky enough to have some or all the medicines at our disposal, we mix and dispense them as per the doctor’s instructions.
The patients are most times extremely grateful for our services and medications, which are usually unaffordable otherwise, even to those on medical aids. We do our best, despite staffing challenges, to get medications out as quickly as possible and let their treatments go smoothly. Many things happen behind the scenes between their visit and the package that arrives for them. We have recently started doing allogenic stem cell transplants (from a family member or donor) and are likely to do many more.
Choosing to be there
The rest of the week is a mixture of these two disciplines, as well as covering a handful of other departments that require our services.
We have challenges yes, but the reward of being able to provide these treatments to patients who need it, is irreplaceable. The senior or academic staff you see at a hospital like Bara have chosen to be there, despite easier conditions in private sector or with their own practices. From cancers that can take everything, we have chosen to give.
MEET THE EXPERT – Tegan Bilse
Tegan Bilse is an oncology pharmacist currently working at the Chris Hani Baragwanath Academic Hospital (CHBAH), with experience in both in- and out-patient oncology settings since 2012. She is currently serving as vice-chairperson of the South African Society of Oncology Pharmacy.
Header image by Freepik