Through you, Mr Chairman, allow me to address members of this House on this occasion as brothers and sisters, because when we approach a theme like this we must look upon one another only as brothers and sisters. Cancer knows no political differentiation, class differentiation, ethnic differentiation. And, as we approach a theme like this, we must recognise and appreciate how that which divides us as South Africans - and I am an adoptive South African - is so much smaller than all that which unites us as human beings; united in the tragedy of real life, united in the tragedy of being sick, united in the tragedy of feeling the brunt of a disease which has long been forgotten and ignored by this government, much more so than other governments.
Cancer has become the Cinderella priority of our health system and of our society, when, in fact, cancer is not just a health emergency. It is a societal emergency. We must train and educate our communities, our families, our workplaces to provide their contribution to the individual collective struggle of people against cancer.
We have developed in our society a very pernicious attitude which is, in itself, a cancer, and this is the attitude that cancer cannot be beaten. It's like the bad weather; the plagues. Those who are affected by cancer need to be isolated, and left alone to die, when, in fact, we need an individual response motivated by a collective and societal response, which proceeds from the fundamental awareness that cancer can be beaten first and foremost by the individual and in the collective psychology. So if there is one thing that this debate must do, it is to motivate, control and master the psychological energy for a renewal of attitudes, for a new solidarity which proceeds from the realisation that cancer is not only a physiological disease, but also turns into an emotional and psychological one which requires the support of all beyond any existing divide.
We must create the space for therapies to take place. The reality is that cancer is a pandemic which is bound to grow. We have no reliable figures in South Africa. The cancer registry has not been updated since 2005, and was faulty to begin with. Many cancer data are ascribed to the terminal aspect of death, whether it is renal failure, heart failure or an overdose of morphine.
We can guess that 800 000 people, perhaps a million people - a million South Africans, a million brothers and sisters - die from cancer every year. And that number is bound to increase. We cannot have a governmental response, a health response which is based exclusively on the trinity of surgery, chemotherapy and radiotherapy. People are dying of cancer, but they also die because they are not allowed to have equally effective treatments. Chemotherapy has been proven to be ineffective in 95% perhaps 97% of cases, in which it does not lengthen life expectancy and does not improve the quality of life. Think what you would do with your cellphone if it did not work 97% of the time. And this is all we are making available. There are other treatments, like mistletoe injections, ozone therapy, bicarbonate of sodium, Chinese artemisia annua, the cannabis oil - dagga - hyperthermic therapy, the Oxley therapy, the Ketogenic diet, silvestrol, nutritional supplements ranging from turmeric to fenugreek, alkalising diets, hyperbaric oxygen therapy, stem cell therapy and many others.
People are dying of cancer, but are also dying from a lack of therapies which we have made illegal. People are dying of bad policies, bad laws and lack of government attention. We are not going to have a national health system if we rely on chemotherapy alone for the very simple fact that there is not enough money in the budget to provide chemotherapy for all those to whom chemotherapy will be prescribed.
A great deal of public attention has been given to my call to legalise marijuana, which is part of the Bill I introduced. But it is small segment of what our government can do and what our government must do.
None of the treatments that I have mentioned is a silver bullet, but neither is anything else we have. We need to create centres where these treatments can be administered under controlled conditions, because they are now administered to thousands of people under conditions which are not controlled. Regarding home care, we are facing a situation of thousands of people self-medicating, because doctors cannot prescribe these treatments and cannot monitor their effectiveness.
The world is changing to new types of therapies, and for once we must be leaders and not followers. And, I hope, Mr Chairman, that this debate will open the policy space for making this happen. I understand that my time has expired, if I read the clock correctly. Thank you, Mr Chairman. [Applause.]
Hon Chairperson, hon members, hon Ministers, Deputy Ministers and hon Oriani-Ambrosini, let me start by saying that anything that is claimed to be and could be used for medicinal purposes can be used. But what becomes important is, is it safe to be used by people? I think that's an important question that we need to answer.
Let me start by saying that when we debate things that pertain to health, emotions are inevitably involved. Let me continue by saying that do not lead; I may not follow. Do not follow; I may not lead. Let us walk side by side and we will achieve more.
In discussing and debating this matter I think it's a very emotional topic. I would like us to move together. We can do this with humility, honesty and integrity and cool down our emotions and face reality. Humility is defined as patience when you have nothing and a good attitude when you have it all. Let us commend the ANC for bringing this debate to everybody and being the government of the people by the people for the people. Well done, ANC. Let the people decide.
South Africa has got a problem of increasing morbidity of noncommunicable diseases. One of the conditions that occur with noncommunicable disease is cancer. Cancer is something that can be handled. When it's there, it is very difficult to cure, but it can be managed especially when you get it quite early. It is on the increase. There are several reasons why it is on the increase. One of the reasons is that our life expectancy has gone up, and it is going up. The older you become the more your body has difficulty in clearing abnormal cells in your body. The second one is that we have HIV and Aids pandemics which lower your immunity. If your immunity has gone down, your body has difficulty in clearing whatever abnormal cells that are in your body.
Poverty leads to malnutrition; malnutrition leads to low immunity; and low immunity leads to a situation where you can't clear abnormal cells in your body. There are environmental factors that are changing everyday, the ultraviolet radiation and all those things contribute in changing the mitotic structures of our cells. Certain chemicals and micro-organisms directly affect our nuclei and cause some of our cells to become cancerous.
The consequences of cancer are that our budget goes down because we have got to manage, investigate and treat those patients who have cancer. Secondly, the later cancer gets diagnosed the higher the morbidity rate, which reduces our human resources. The absence of people from work because of illness contributes to and brings down our economy. I can supply figures and statistics relating to this, but because of time I cannot now. I will however make it available to whomever wants access to it. This means that we have to be vigilant in making sure that cancer is under control. The sooner we diagnose it, the better.
Chairperson, please allow me to turn to cannabis as it has been claimed that it is antimitotic. The plant does not cure cancer itself, but it can alleviate the vomiting and nausea, especially from the drugs that are used in chemotherapy. It has a sedative effect on those who are conscious about their cancerous situation. There is a question about whether it is antimitotic or not.
Cannabis is a natural plant which occurred around the Genesis time. This is a plant that was created by God. In fact I want to remind people and say something that I have said before that, interestingly, God created two important departments. All the other departments that we have are man-made. The two departments that were created by God are the departments of Health and Agriculture. The Garden of Eden was agricultural and I think we know that. God created the Garden of Eden and there were plants that were medicinal for health. At the same time God operated on Adam to create Eve. That operation had to be performed on Adam while he was asleep. These are the two departments that were created by God.
Let me go back to the plant itself. The plant has ingredients that are called cannabinoids. There are about five to six or more of them. Let me mention the five cannabinoids that are the ingredients: Delta-8 THC or THC; cannabidiol; cannabinol; Tetrahydrocannabivarin; and Cannabichromene. All these are cannabinoids that are found in cannabis sativa. But nobody knows which one causes the effects that I am going to talk about. I am mentioning this because there is going to be a catch towards the end. No one is sure which active ingredient does what, but what we know is that the plant can be used orally, rectally, or you can smoke it. It is a lipid soluble substance, which means that, if you take it orally, it will take a long time to act compared to smoking it.
The bodies of human beings have what we call cannabinoid receptors, which receive those cannabinoids that I was talking about, but the reaction to cannabinoid is not the same in different individuals. That's why if I smoke dagga it may not have the same effect when it is smoked by somebody else. The reaction differs in different people because of the cannabinoid receptors.
Cannabis sativa, when taken, makes individuals excited and agitated. They usually have an ataxia, they start shaking, and get tremors. They have euphoria and a pleasant sensation and visual imagery. It may affect their perception of time and space. They have hallucinations and illusions. Their eyes become congested and red. Their pulse rate increases. Some individuals get high and sometimes it may urge people to commit regrettable deeds. The reactions differ from one individual to the next. As I've mentioned, because of the cannabinoid receptors, some people use it for recreational purposes and abuse it, especially for the euphoria and the excitement part.
Despite all of the above, it has been found to have medicinal effects. Maybe I need to explain what I mean by medicinal effects. Using medicinal plants for medicinal effects means that, if you use that particular plant, it can alleviate the ailments or the incapabilities that you have. That is what we mean by medicinal.
Let us look at the medicinal effects of cannabis. It is known that it alleviates vomiting and nausea, especially vomiting and nausea that is caused by the chemotherapy treatment of cancer. It sedates with minimal dependency. By dependency it means that you are not going to get hooked on it and there is no tolerance - that is dagga as compared to other drugs that could do that, for example morphine. It reverses the high intraocular pressure in your eye and it can be used in treating people with glaucoma. These are the things that have been proven.
It has been used with success in multiple sclerosis, to treat spasms that come from amyotrophic lateral sclerosis. It is used in people who are stiff because of strychnine poisoning. It can improve the spasticity caused by tetanus and in other similar conditions. It can be used as an antibiotic, especially in gonorrhea. When you have gonorrhea, you can use dagga and it will actually cure it. It causes bronchodilatation in those people who have bronchoconstriction. What I am trying to say is that in asthma you can use cannabis and it will alliviate the symptoms. When the effect of cannabis is finished, it will come back again, but actually it improves it. It causes general vasodilatation of the body - that is why your eyes become red and congested. It lowers your blood pressure at that time. Even in diabetes it has some effect, but the only thing that we are not sure about is whether it has an antimitotic effect. An antimitotic effect means that it stops cells from growing, especially the cancer cells that are growing fast. It is claimed that there is that effect, but it has not yet been proven.
Let me go on to say that cannabis sativa has been there from Genesis - the time when God created the world. It is a plant. Since it has been there, there has never been research work until the 1800s. Even before the 1800s in places like China and India they used it before it was researched. It is not only in these places that I have mentioned where they used it, but even in South Africa the Khoi people used it without research. The Xhosa people in the Pondoland, in the Eastern Cape, used it. Fortunately, they are still using it even now. Let me not say fortunately, but they are still using it. [Laughter.]
The research work goes back to 1840s by Prof O'Shaughnessy, who was a professor of physiology and chemistry in Calcutta. He graduated in Edinburgh. He did a lot of work around cannabis to find how it works. Having done that, they thought that it was a plant that came from India and they called it cannabis Indica. It was in the 1840s. Having found that and also graduated from Edinburgh, he tried to convince the western countries of the various uses of this plant.
The research went on for almost 100 years and cannabis was used as a medicinal plant by the whole world for 100 years. At that time the only sedatives that we had in those 100 years were opiates. Opiates are drugs like morphine. The side effects of opiates were more than the side effects from cannabis. That's why it was easy to use cannabis at that time. What happened later, after the 100 years the world started inventing new drugs such as paraldehydes and barbiturates. Although cannabis worked very well you could not use it subcutaneously or intravenously. As I said, it is a lipid soluble and it was not effective. These new drugs were effective and they did not have the same side effects as opiates. The world went with them because of the recreational problems with dagga and cannabis sativa.
Politically and professionally people went with the new drugs and they got worried about the side effects or the problems related to cannabis and they tried to make sure that it was made illegal. Around the 1940s it was made illegal. While it was made illegal, in Czechoslovakia it was found that it could work as an antibiotic and it was used to treat gonorrhea. But whatever study they did was shot down even though they confirmed that it could work as an antibiotic. In 1941 it was said that it could not be used because of the abuse of it. Everybody left it for the new drugs and it was illegal to use it.
Subsequently, there was some work that was done around cannabis, but they could not do it properly because it was illegal. They could not do proper research, hence there are still a lot of questions around cannabis. It is a plant that we know can alleviate certain problems. There are many drugs that could be used over and above cannabis. We have not thoroughly researched the cannabinoids, either the receptors or the cannabinoid themselves in the plant, because it is very difficult to do the research. This makes it a bit difficult to say that this one can be used and that one cannot be used, especially knowing that there are some of those cannabinoids that cause problems and can be abused. [Time expired.] [Applause.]
House Chairperson, today I dedicate my speech to my friend, Dr Krishna Nair, who passed away on Sunday. To Lulu Yash and Michaela, I want to say that the details of his death are not relevant. What is relevant is the legacy he left as a specialist in palliative care and the huge role he played as the Chairperson of the Chatsworth Hospice.
Every one of us sitting here in the Chamber today knows of at least one person who has had cancer and who either has passed on or is a cancer survivor. We know that cancer knows no prejudice, race, colour or creed and affects people of any gender and economic status. When the diagnosis of the big C is confirmed, it is usually accompanied by fear.
Cancer is indeed a formidable opponent. But it is a fact that 30% of cancers could be prevented. We welcome the regulations for the compulsory reporting on cancer cases because it is vital for treatment and planning. However, South Africa has yet to include cancer control in its health and development agendas.
Early detection means access to treatment which means a longer life. However, the Department of Health needs to do more; we can't depend on God- given. The SA National Cancer Registry has not been updated in eight years. The question to ask is: why? Is this sheer negligence? I challenge the Minister of Health to do something about it.
The social impact on a family where the diagnosis is positive is huge. Immediate options of surgery, chemotherapy, radiation accompanied by side effects of nausea and hair loss are usually par for the course. Although cancer is a prescribed minimum benefit, not all medical aids cover cancer treatment costs in full. We as Members of Parliament are fortunate that the Physical Activity Readiness Medical Examination, PARmed, has extended its cover to full cover including the use of biomedicals.
The role of the Cancer Association of South Africa, Cansa, cannot be emphasised more, neither can the role of a hospice ever be underplayed. They offer counselling on what the diagnosis means, offer support groups and teach the family how to do specialist care of wounds. We had a lesson on pharmacology just now and the issue of medical marijuana, there is no void in the knowledge of the plant and the effects of the active ingredients in it. Medical marijuana is not new and the medical community has been writing about it for ages.
In fact, in 1993 in South Africa, the government of the day amended the marijuana legislation to allow for it to be grown strictly for bona fide pharmaceutical purposes. Scientists working for the apartheid regime developed a drug using Dronabinol extracted from cannabis, and the tablets at that time cost R100 each.
When Adv Jenny Wild was charged for being in possession of a dagga plant, the patented drug was withdrawn from the South African market and the marketing company delisted. But this drug grown from South African cannabis is still available overseas but is out of the reach of the pocket of a South African suffering from terminal diseases.
Colleagues, instead of emphasising the side effects and the abuse of cannabis, we should be engaging on the beneficial effects of medical marijuana. And I hope this debate is the beginning of that conversation.
In conclusion, I wish my friend Mario strength and lots of love. Thank you. [Applause.]
House Chair, cancer infects us indiscriminately, whether rich or poor, in urban or rural areas. However, the conditions under which people suffer from cancer and die because of it are profoundly different. Also, with respect to cancer, it is the poorest of the poor in rural areas who bear the worst brunt of it. Most cases of cancer in rural areas remain unreported. There is little knowledge on how to manage the pain and the complications associated with cancer. People are left prey to untold sufferings and with no treatment.
It is important that our government begins to roll out a programme of education about cancer in rural areas. We did it in 1995 with respect to HIV/Aids. Our leader, Prince Mangosuthu Buthelezi, was the first to go into the rural areas to speak about the sensitive and difficult facts of human sexuality as they relate to the contraction and spread of HIV/Aids.
He encouraged all Amakhosi to do the same. We had to break a stigma and speak out about things which, in our culture, were not to be spoken about and were a taboo. But we recognised that it had to be done and we did it. We dit it well. We must now speak about the facts of cancer.
Cancer is also an emotional disease which requires enormous emotional strength to be fought at individual and collective levels. We need to educate our communities, families, workplaces and schools to provide moral support to those engaged in the fight against cancer.
Often those who fall prey to cancer are isolated and left alone to cope with their personal tragedy. Many people hide their condition for fear of being rejected, the same way that HIV/Aids patients used to do 20 years ago. Our government gave HIV/Aids patients the courage to reclaim their lives in their communities and workplaces.
It is important that today we launch together and across party-political lines the cancer treatment campaign, first and foremost to give courage to all those who have cancer. We launch this campaign from this Parliament to tell all those with cancer that they are not alone and that their government will gear up to reach out to them with new forms of treatment and with hope.
From this place and time, we need to send the message out in a manner that is loud enough to be heard in the most remote rural areas, that cancer can be beaten. We need to give courage to those who have no prospect but despair and give them the hope that they will not be alone in their tragedy.
Today, we must assume responsibility for our collective tragedy as a people, and give ourselves the strength to give courage to others, because we are all affected by cancer, directly or indirectly.
Sihlalo, ngifisa ukundlulisa lokhu eNdlini, sizwelana kakhulu nelungu elihloniphekileyo, uDkt Ambrosini ezinhlungwini anazo. Silapha eNdlini abanye bethu mhlawumbe babe nenhlanhla yokuzihlola bese kuyavela ukuthi banayo inkinga. Inkinga yona ikhona, isihlasele. Laphayana eMpangeni ngase- Richards Bay, iphephandaba lasekhaya i-Zululand Observer, libhale udaba lapho libonisa khona ukuthi kunabantu abaninganyana abahlaselwe yisifo esifanayo, esingumdlavuza ngenxa yamanzi aphuzwayo ane-chlorine eningi ngokweqile nangenxa yomoya okhishwa yizinkampani.
Ngigcina, ngingasho la ukuthi nami ngingomunye wabantu ... (Translation of isiZulu paragraphs follows.)
[Chairperson, I would like to convey this message to the House: We sympathise with the hon member, Dr Ambrosini for the pain he is enduring. Some of us who are here in the House may have been lucky to have gone for checkups and to find out that they have a problem. The problem is there and it is affecting us. In Empangeni next to Richards Bay, a local newspaper, the Zululand Observer published a story about a large number of people who are suffering from the same disease. This cancer is caused by the drinking water that contains a lot of chlorine and also as a result of air pollution from the industries.
In closing, I would like to say that I'm also one of those people ...]
... who have been diagnosed with cancer, but mine is at an early stage. I thank you. [Applause.]
Hon Chairperson, hon members, as hon Goqwana has said here before me, scientific research is replete with bad impacts of marijuana use. We also need to take lessons from other countries where medical marijuana has been decriminalised. In Colorado more children are ending up in hospital emergency departments after accidentally consuming marijuana.
Researchers from the Rocky Mountain Poison and Drug Centre in Denver wrote that they have to deal with more cases of children younger than 17 years old coming into emergency rooms after consuming candies, soft drinks and baked goods containing tetrahydrocannabinol, the pain-relieving substance found in marijuana.
In the Netherlands many Dutch communities are struggling with how to address the increased crime and negative consequences associated with their drug policies. The growing use of marijuana has widespread social implications. After marijuana became legalised consumption nearly tripled from 15% to 44% among 18- to 20-year old Dutch youth. As a result the Netherlands has reconsidered its legalisation measures.
This proves right the American Academy of Paediatrics' belief that any change in the legal status of marijuana even if limited to adults could affect the prevalence of use among adolescents. This is echoed by the British Medical Association which voiced extreme concern that downgrading the criminal status of marijuana would mislead the public into believing that the drug is safe.
Having said all that, the UDM believes that denying South Africans to get a new lease of life because of criminalisation of marijuana is not fair. If it has been proved by at least three independent experts that the only remedy to save lives is marijuana medication, the UDM submits that it will be a noble thing to use it. We therefore suggest that marijuana medication be legalised with very stringent controls. At least three independent expert opinions about the use of marijuana medication must first be obtained.
The highest schedule control now is schedule 6, subject to correction, Mr Goqwana, we therefore suggest that a higher schedule be created for marijuana medication. We also suggest that there should be one centre of control where all purchases will be forwarded to with all particulars of the patient. Scheduled drugs go out on prescriptions only and the abusers go to one doctor to ask for a prescription and then buy the medication; then they go to another doctor to ask for the same prescription. This control centre will be used as a monitoring mechanism for such abuses. I also wish you well, hon Oriani-Ambrosini, and you, Chief Cebekhulu. I thank you.
Agb Voorsitter, die titel van die onderwerp vir bespreking lui onder meer "Die effek van kanker op die samelewing en die ekonomie." Ek dink die agb lede sal saamstem dat, met ons kollega, die agb Oriani-Ambrosini, in ons midde, sal dat dit darem baie onpersoonlik wees om hier te praat oor die ekonomiese effek van kanker op Suid-Afrika. Ek wil dus spesifiek praat oor die effek van kanker op die samelewing.
Ek dink daar is nie een enkele lid, of bitter min agb lede in hierdie Raad, wat nie op een of ander manier te doene en te make gehad het, hetsy met vriende of geliefdes wat deur kanker geraak is nie. Dit is traumaties. As ons moet hoor dat iemand moet gaan vir toetse, weet almal van ons van die afwagting wat daarmee gepaard gaan, en dan die vreugde en die blydskap as 'n mens hoor dat die toetse negatief was. Ons weet ook van die traumatiese ervaring as 'n mens moet hoor dat die toetse positief was.
Daarom dink ek dat ons met reg kan s dat die effek van kanker op die samelewing en spesifiek op ons mense traumaties is. Ja, ons weet ook daar is ander siektes wat net so traumaties is. Maar, as ons spesifiek praat oor die effek van kanker, dan dink ons daar is meer mense wat daardeur geraak word. Ons kan onsself almal vereenselwig met daardie pyn en die trauma wat daarmee gepaard gaan.
Daarom kan ek nie dink dat enige persoon teen die beginsel sal wees dat daar navorsing gedoen moet word om hierdie siekte, kanker, te probeer genees nie. Ons het die pleidooi gehoor van ons kollega, die agb Oriani- Ambrosini.
Dit is die standpunt van die VF Plus dat ons wetenskaplike, gekontroleerde navorsing steun om te kyk wat die effek kan wees as dagga ook gebruik word in die genesing van kanker. Ek dink nie enigeen kan daarteen wees nie.
Maar dit is ongelukkig ook so dat daar in ons samelewing mense is wat misbruik maak van sulke tipe navorsing. Dit is dus ons standpunt dat die navorsing streng gekontroleer moet wees, en dat al die voordele en al die nadele opgeweeg moet word. Ons moet dan verseker dat die voordele werklik sal bydra tot die verligting van daardie trauma wat ek en u moet beleef as ons 'n vriend of a geliefde het wat deur kanker getref is. Ek dank u. (Translation of Afrikaans speech follows.)
[Mr P J GROENEWALD: Hon Chairperson, the title of the topic for discussion is, inter alia, "The effect of cancer on the community and the economy." I am of the opinion that the hon members will agree that, with our colleague, the hon Oriani-Ambrosini, in our midst, it will actually be very impersonal here to talk about the economic effect of cancer on South Africa. I will thus refer specifically to the effect of cancer on the community.
I am of the opinion that there is not a single member, or very few hon members in this council, that had not in one way or another been affected by cancer with regard to either friends or loved ones. It is traumatic. When we hear that somebody has to go for tests, we all know about the expectation that goes hand in hand with that, and then the joy and happiness when one hears that test results are negative. We also know of the traumatic experience when one hears that the test results are positive.
That is why I think that we can, with good reason, say that the effect of cancer on the community and specifically on our people is traumatic. But, if we are specifically talking about the effect of cancer, then we think more people are affected by it. All of us can associate with the pain and trauma that accompany it.
That is why I doubt that any person will be against the principle that research should be done to try to cure this disease called cancer. We have heard the plea of our colleague, the hon Oriani-Ambrosini.
It is the position of the FF Plus that we support scientific, controlled research to see what the effect could be when marijuana is used in order to cure cancer. I don't think anybody can be against it.
But it unfortunately is also the case that people in our community misuse such kind of research. It is thus our position that the research should be rigidly controlled, and that all the advantages and disadvantages should be weighed up. We should then make sure that the advantages will really contribute to bringing relief of this trauma that you and I have to endure when we have a friend or loved one stricken by cancer. I thank you.]
Chairperson, according to the World Health Organisation, more people die from cancer than from Aids, malaria, and tuberculosis combined. Not being a notifiable or reportable disease in South Africa, very little data was available on cancer for research or to inform policy interventions; but new legislation in 2011 requires all doctors and health facilities that confirm cancer cases to report findings to the National Cancer Registry. This is a welcome development which must not be neglected.
Prostate cancer is the most common cancer in South African males and cervical cancer is the top cancer affecting South African women. The social and economic impact of cancer affects the individual, the family and the community with job loss, economic dependence, social isolation and family tensions, often following the occurrence of cancer.
It is also a difficult subject in some communities, but talking about the disease can help alleviate feelings of shock, fear, anger, sadness and loneliness that come with being diagnosed with cancer. We must ensure that primary health care workers are being equipped with knowledge and skills to recognise warning signs and symptoms of cancer as early detection of the disease makes a significant difference.
However, prevention is recognised as the most cost-effective and sustainable way of reducing the cancer burden. Living a healthy lifestyle, eating a nutritious diet, exercising and not smoking or consuming alcohol can greatly decrease the chances of getting cancer. Obesity is a high predictor of certain types of cancers.
The ACDP notes hon Ambrosini's Medical Innovation Bill - a Bill which aims to legalise cannabis in South Africa for medical, economic and industrial purposes; and we are sensitive to this controversial and complex issue. We do not and will not endorse recreational use of cannabis or any attempts to move in this direction. However, we are mindful that presently morphine - a form of heroine, is used for pain control for terminally ill cancer patients. Morphine is toxic and lethal as it actively speeds up the death of the patients.
The National Cancer Institute of South Africa says substances in cannabis may be helpful for treating pain that is not relieved by conventional medicines; and recent research has shown cannabinoids to have the ability to reduce cancer cells as they have a good effect on the rebuilding of the immune system.
The knee-jerk reaction to legal use of cannabis is based on people's own experience and on many years of studies. Cannabis is known to impair learning capabilities and psychomotor performance in a wide variety of tasks, for as long as 24 hours after smoking as little as 20 mg of tetrahydrocannabinol, THC, in cannabis. Prolonged use can lead to greater impairment, affecting daily life functions and causing cannabis dependence.
Hon Ambrosini, in principle the ACDP supports calls for clinical trials which would either prove or disprove claims being made regarding any potential treatment for cancer patients, but we will be consulting widely, and we are praying for you. [Applause.]
Hon Chair and hon members, cancer is said to be one of the world's leading causes of premature deaths and disabilities, with massive impacts on the global economy. The American Cancer Association contends that the total economic impact of premature deaths and disabilities resulting from cancer is 1,5% of the world's gross domestic product.
The Goldman Sachs Report states that South Africa's contribution to the world's GDP is 0,5% and that Africa's total contribution is 1,5%. This paints a very bleak picture. In fact, South Africa's total contribution to the world's GDP is less than what the American Cancer Association's estimated as global loss due to cancer.
We all know that early detection increases chances of survival. However, optimal early detection can be achieved where there is adequate access to functional health care facilities. Cancer survival in South Africa is linked to the individual's economic status and indirectly to their race profile.
We have reports that white women for instance, have a high incidence rate of certain cancers, in the same breathe we will have black women having an even higher rate of mortality from the same type of cancer. The multitudes that are without medical aids have little chances of having their cancer detected at an early stage; and even a slimmer chance of getting the medical care they need when diagnosed.
It is critical that government removes barriers to cancer detection and treatment. For instance, in South Africa we have statistics that will show a significance increase of cervical and breast cancer amongst women in their 20s, yet when a young woman takes the initiative to have herself checked at a public facility, she will be told that the cervical cancer detection is for women over 30, and that even then they are only entitled to one test every five years.
There are public messages that the incidence of prostate cancer is steadily on the rise in South Africa, but we hardly ever see public campaigns aimed at encouraging men to have themselves checked. If we are to curtail the impact of cancer in our economy and in our society, we need to exhibit commitment towards responding effectively. There are many studies published that contend that marijuana or dagga may be used in treating the side effects of cancer or in treating it.
Therefore, we hope that the stance towards having marijuana legalised for medicinal purposes, is but one of government's responses to the cancer impact. We in the UCDP support the fact that doctors be permitted to innovate and alternate cancer treatment, as different ways and means to assist, help and lead the nation. The UCDP supports the fact that other avenues be tried in order to save lives. I thank you. [Applause.]
Hon Chairperson, cancer is the sixth highest cause of death in South Africa. This indeed is a very worrying statistic because more than half of our population is living below the poverty line; thus, their access to quality health care can at times be limited and compromised. The health care fraternity must be friendly, and must not undermine the quality of health care to the previously disadvantaged communities. We want to laud the efforts of the ANC for progressively delivering health care to the most deserving.
There is a direct correlation between poverty and cancer. Early detection and ultimate treatment of the disease could save millions of lives. We need to make sure that we are disseminating the relevant information to every sector of our society. Firstly, I would like to commend the hon Ambrosini for boldly sharing his personal appeal to the President in this House. Your conviction and passion is an inspiration. You served as a relevant reminder of the millions of people who suffer from this disease. Therefore, the MF would like to take heed of the number of people who are affected. We urge the Department of Health to strengthen their resolve to enhance the prevention, early detection and ultimately the cancer treatment, specifically in poor and destitute communities.
Remember that poverty does not see face or race. It attacks almost anyone who comes in front of it; leading to the other health complications like the challenges we are confronted with. Let us not forget that it is these communities who suffer the hardest. We must not allow them to be further marginalised simply because of their socioeconomic status.
Cervical cancer is one of the most common forms of cancers. Over 16 million women over the age of 15 are at risk. Therefore, we laud the Minister's announcement that government will provide for free the human papilloma virus, HPV, vaccines to young girls between the ages of nine and 10, in the poorest 80% schools in South Africa.
This shows government's commitment to the fight against cancer. The MF treasures the hope of seeing massive improvements in the early detection of this disease. Minister, we must ensure that public awareness of this disease is our top priority; and that all the necessary funds and support are made available, so that we can ultimately deliver as anticipated.
The training of the additional social workers profoundly confirms government's commitments to dealing with the negative impediments that might stagnate the rollout of a good health programme. The MF calls on the Minister to set up a research panel to determine the medical value of marijuana for cancer patients. Based on that research, we believe that a more just and accurate decision can be made in this regard. I thank you. [Applause.]
Mr Chairperson, hon Minister, hon Deputy Minister and hon members, I was diagnosed with prostate cancer in 2010. The urologist who examined me suggested that I undergo a carbon implant. This was the second time that my family was confronted by cancer. My wife was diagnosed with colon cancer in 2002; through surgery, chemotherapy and radiation both of us are at present clean of cancer. [Applause.]
Both of us are fortunate that our cancer could be cured; however millions of others are not so fortunate. Like other diseases, cancer does not only affect a specific individual, but a wide spectrum, parents, siblings and friends. The following views are my own and do not reflect that of the DA or the DA caucus in Parliament.
It is my considered opinion that only medication with a sound scientific base and which is approved by the Medical Council should be administered to cancer patients. We should put more resources into scientifically testing alternative remedies. An individual has two milestones - birth and death. Today, cancer is responsible for the death of millions of people. My considered opinion is that an individual should be allowed to die with dignity. It is the civic duty of society to alleviate pain as far as possible.
A number of NGO's such as the Hospice and other religious and civic organisations provide counselling for terminal cancer patients and after their deaths to their bereaved once they have passed away. This is highly commendable. Alternative medication regarding the treatment of cancer is widespread. However, what is of concern is that a number of alternative medical practitioners charge exorbitant fees, and in some cases create false expectations. The claim that a 100% recovery rate, provided that the cancer patient follow the proper procedures, is often mentioned.
A public representative has a public profile. When word gets around that you have had cancer members of society, in some cases, approach and ask for advice as to whether they should follow an alternative approach if they are diagnosed with terminal cancer. My advice to cancer patients is to decide for themselves in conjunction with their general practitioner and the immediate family.
I can recall an occasion where a patient was so desperate that she persuaded her family to borrow money, which put them in debt, in order to extend her life for a few months, with unbearable pain. The question one has to ask oneself is, is it really worth it to undergo extensive medical care if your chances of recovery from cancer are slim? It is my considered opinion that it is unethical to administer any nonproven medical treatment not approved by the medical council to cancer patients.
To conclude, the general public should know that to be informed that you have cancer is not the end of the world. Get proper guidance and know that cancer can be cured if it is diagnosed at an early stage. Allow me to quote my general practitioner, "Always listen to your body. If it tells you that there is something wrong, then take the immediate proactive steps".
This is my final speech. It was a privilege to have been a member of this august House for more than 16 years. Allow me to thank the Speaker in absentia for his impartiality. Comparisons are odious but our present Speakers are amongst the best. I have made many friends during my tenure as a Member of Parliament. Also allow me to thank the following Chairpersons of committees which I served in: Hon Barbara Hogan, hon Nhlanhla Nene, hon Ben Martins - who is also here today, hon Yunus Kariem, hon Themba Godi and Mrs Coleman of the Economics Committee. Allow me to send a special thank you to my colleague, Dion George, who served with me in the Public Accounts Committee and all the officials who enabled me to perform my role as a parliamentarian. I thank you. [Applause.]
Somlomo, namalungu ahloniphekileyo, mangincome umhlonishwa u-Ambrosini ukuthi eze lapha ukuze sibe nale nkulumo esinayo namhlanje mayelana nesifo somdlavuza. Eminyakeni engeminingi edlule bekuye kuthi uma umuntu ethola ukuthi unomdlavusa athi, "Nkosi yami sengithole isigwebo sentambo." Aqale abale izinto anazo nalezo angenazo ukuze kuthi uma kufika lolo suku lokufa abe esezilungisile.
Ngakho-ke ngiyamncoma uMnumzane u-Ambrosini. Ngincome futhi nokuthi waphumela obala washo ukuthi ngenkathi esezweni lakubo wadla akudlayo ukuze athole usizo, futhi ngenkathi ekuleli zwe ubesebenzisa akusebenzisayo. Siyakuncome ukuthi ukhulume iqiniso.
Sonke siyazi ukuthi umdlavusa uyisifo esingalapheki, futhi siyazi ukuthi njengamanje umhlaba wonke unenkinga ngezifo ezingathelelani. Umdlavusa ungesinye salezo zifo. Umhlaba wonke ukhuluma ngazo futhi kuzoba nokhukhulelangoqo wengqungquthela lapho kuzobe kukhulunywa ngalesi simo.
Njengoba namhlanje, kulolu suku lomhlaka 12 Ndasa, abezempilo base-Mangaung lapho kuhanjelwe khona amantombazanyana amancane asuka eminyakeni eyisishiyagalombili afunda ibanga lesine - uNgqongqoshe uyaye awabize ngokuthi, "Awakazi lutho ngezocansi." Ngakho-ke yibona abaqalwayo ngalo mgomo we-HPV, ukuze kuzanywe ukuthi umdlavuza wesibeletho kanye nalowo otholakala emlonyeni wesibeletho ungababambi empilweni yabo. Lo mgomo umahhala futhi utholakala ezindaweni zikahulumeni. Lo mkhankaso uyaqala ngalo nyaka, futhi uzokwenziwa kuzo zonke izindawo ezikoleni. Le yindlela yokuzama ukuthi uma bekhula bangabi nalesi sifo esiyinkinga esikhuluma ngaso namhlanje, esiwumbulalazwe.
Bonke bayasho ukuthi umdlavuza uwona: ohamba phambili ngokubulala abantu ezweni lonke; ogulisa umuntu isikhathi eside; ongalapheki; eyenza abantu babe nokukhubazeka baze bangasakwazi nokuya emsebenzini. Kuyinkinga enkulu kabi ukuthi umuntu ekade esebenza ondla umndeni wakhe azithole esephethwe yiwo lo mdlavuza.
Mhlawumbe kubalulekile ukuthi singamalunga akule Ndlu sixoxisane nemiphakathi yethu, sonke ngamunye ngamunye - singakhulumi ngokwepolitiki kodwa sikhulume ngokwempilo emhlabeni - ukuthi abantu abaphethwe wumdlavuza basizakale. Nathi sonke kubalulekile ukuthi siyozihlola ukuthi simi kanjani ngasempilweni ngazo zonke izindlela zokuphila. Kodwa-ke, umdlavuza yiwona ohamba phambili ngoba ungumbulalazwe.
Kubalulekile futhi ukuthi iminyango kahulumeni isebenzisane ukuze abantu abaphethwe ngumdlavuza bakwazi ukuphila nayo besekwa ngezindlela eziningi ukuze baqhubeke baye emsebenzini, babe neqhaza abalibambayo ekukhuliseni umnotho. Kubaluleke kakhulu ukuthi sonke njengezakhamuzi zaseNingizimu Afrika sibambisane. Hhayi kuphela izakhamuzi zakuleli, kodwa nabanye abantu esihlangabezana nabo.
Okokugcina okwashiwo la mhla uMnumzane u-Ambrosini ecela ukuthi kugunyazwe ukusetshenziswa kwensangu ... [Uhleko.] ... akuhlekisi empeleni, ngoba ngesintu insangu yinsangu. UNgqongqoshe wezeMpilo nohulumeni bavumelana ukuthi bazokwenza zonke izindlela zokucwaninga, baxoxisane nabanye abacwaningi emazweni onke, ukuze kukwazi ukutholakala kwekhambi lokwelapha umdlavuza.
Phela umdlavuza ngeke nakanye ulashwe ngekhambi elilodwa; ulashwa ngamakhambi amaningi. Okusemqoka ukuthi umuntu, noma ngabe enomdlavuza, makazazi ukuthi uneqhaza elikhulu kabi empilweni uma nje ethola ukuxhaswa ngazo zonke izindlela uzokwazi ukuthi asebenze ngalawo mandla amancane anawo, asebenzele umndeni wakhe, azisebenzele yena aphinde asize abanye abantu. Ngakho-ke uNqgogqoshe woMnyango wezeMpilo wathi ngelinye ilanga ekhuluma lapha wathi uzobhekisisa ucwaningo olwenziwa ngamazwe onke. Mhlawumbe njengoba bezobe beyoxoxa ngalesi sifo, bazobe bekhuluma ngamaqhinga okubhekana nalesi sifo.
Empeleni nanoma kuthiwa kuyisifo esingathelelani, kuba khona ubudedengu ngesinye isikhathi kubantu esiphila nabo, ukuthi baye baphuze kakhulu, babheme kakhulu. Zonke lezi zinto zisisa isifo somdlavuza ukuthi sidlondlobale. Kuthi nanoma besilele kodwa sivuke ngenxa yokuthi umuntu wenza lezi zinto. Ngakho-ke kubalulekile ukuziphatha ngendlela.
Okwamanje uma abantu bexoxisana nodokotela babo, baye besekele lokho okucelwa yiziguli, ngoba phela yonke le mithi iyabiza. Njengamanje izinkampani zezikimu zosizo lokwelapha zigqugquzela ukuba kutholakale imithi engekho kule ngabade, okudingeka ukuze icelwe kwezinye izindawo, imishanguzo eyakhiwe ngazakhi eziphilayo, phecelezi ama-biologicals, ayabiza. Ngesinye isikhathi ngisho nazo izikimu zosizo lokwelapha ziyakhokha kodwa ziphinde zibuye nganeno ngendlela le mithi ebiza ngayo.
Mnumzane Ambrosini, siyazwelana nawe kanye nomndeni wakho futhi siyazwelana nabo bonke abanye abanomdlavuza futhi siyafisa ukuthi sizame ukulekelela labo abanomdlavuza ukuthi noma ngabe begula iyiphi indlela esingabaxhasa ngayo ukuze bakwazi ukusebenza babambe iqhaza emnothweni, nokuthi impilo yabo ibe yinde. Nanoma sazi ukuthi ngeke baphile isikhathi eside kodwa siyelule impilo yabo ngoba umdlavuza ... (Translation of isiZulu paragraphs follows.)
[Ms B T NGCOBO: Speaker and hon members I wish to commend Hon Ambrosini for availing himself to our debate on cancer today. Not so many years ago when one was diagnosed with cancer, one would say, "Poor me! I have been given the death sentence!" One would start putting one's personal business in order and prepare for death.
Therefore, I commend hon Ambrosini. I also commend him for being honest about the treatment that he used when he was in his own country and the one he uses here.
We all know that there is still no cure for cancer and we know that the whole world is faced with the problem of non-infectious diseases. Cancer is one of such diseases. It is a challenge experienced in the whole world and preparations for an international conference are underway to address the situation.
Today, on 12 March, healthcare workers are visiting Mangaung for the purpose of immunising young girls from eight years of age who are doing Grade 4 - the Minister usually refers to them as, "Those who are not yet sexually active." Therefore, they will be the first to receive the HPV vaccine that is meant to protect them from cervical cancer. This vaccine is free and is available at government health institutions. The campaign is starting this year and will include all schools in the country. This is an attempt to try to protect them from getting the cancer we are discussing today which is very prevalent when they grow up.
Everyone agrees that cancer is the number one killer in the whole country. Cancer sufferers get sick for a long time and the disease is incurable. Its sufferers' quality of life is compromised since they cannot even go to work. It is frustrating for someone who was previously employed and a breadwinner to find themselves suffering from this disease.
Maybe it is important for us as members of this House to discuss health issues, especially cancer, with our communities, instead of discussing politics, in order for cancer sufferers to benefit. It is also important for all of us to have regular check-ups. But we should get tested for cancer more often since it is the number one killer in the country.
It is also important for government departments to work together and support their employees who are living with cancer in order to enable them to continue working and contributing to the growth of the economy of the country. It is also important for all of us as citizens of this country and everyone around us to work together.
Lastly, what was said here when hon Ambrosini asked for the legalisation of dagga ... [Laughter.] ... this is actually not meant as a joke, because that in my language is the name of the herb. The Minister of Health and the government agreed on doing research and working together with researchers from other countries with the aim of finding a cure for cancer.
We cannot fight cancer with only one treatment; it is normally treated in a variety of ways. It is important for us to give all the support that cancer sufferers need and make them feel that they have an important contribution to make in society in order to boost their confidence in themselves. They need to be reassured that they can still live productive lives despite their illness, and provide for themselves, their families and also help other people. The Minister of Health made a promise during one of our debates to find out more about cancer research in all other countries. It seems that they will be discussing ways to combat the disease at their next conference.
Even though the disease is not an infectious one, some sufferers of the disease do behave in a very irresponsible manner; they drink and smoke excessively and that makes their illness even worse. Even when their illness is in remission it usually comes back due to this irresponsible behavior. It is therefore important to take good care of one's health.
Doctors usually support their patients when they request certain types of medical treatment from their medical aid schemes, especially since it is generally expensive. At the moment medical aid schemes usually recommend medical treatment which is not available in the country. This type of treatment, known as biological therapy, has to be imported and it is very costly. Sometimes even medical schemes do not provide complete cover for these types of treatment due to the costs involved.
Hon Ambrosini, my heart goes out to you and your family for what you are going through. We also sympathise with everyone suffering from cancer and we wish to try by all means to support them and help them live a longer life in order for them to be able to work and contribute to the economy. Even though we understand that their lives might be shorter than is normal, we must try to help prolong them because cancer ...]
... in honest fact, if the tumor is not removed, is treated palliatively, not necessarily the way hon Ambrosini was talking about. It is treated palliatively to preserve the health of the person being treated and to help an individual to live as long as possible. Thank you, Chairperson, for allowing this discussion to take place in order to talk about this scourge because it is a scourge and South Africa is rated number 50 in the world when it comes to cancer. I thank you. [Applause.]
Mr Chairman, this debate, the last debate of this Fourth Parliament of the Republic of South Africa, I think has proven the strength of this nation and its capability of coming together in unity and in the recognition that what unites us is stronger than all that which divides us when the need arises. I think it is proper and fitting that this takes place as the last word before we go into an election, which is always divisive.
I hope that the spirit of this debate - the fact that we have proven that in the spirit of ubuntu we recognise our shared humanity - can create the foundation for the governance of South Africa after elections, irrespective of whichever party will carry the burden of governing the country.
This debate proves that when it comes to matters of importance, it doesn't matter who raises the issue. Issues are issues. We should never look at the messenger, but rather look at the message. And the message that is being brought here today is that cancer is an emergency, which requires co- ordinated, multifaceted efforts of all segments of society, not just the Minister of Health, not just one therapy - but all therapies, all communities, all families. It is an educational problem; it's a scientific problem. It is first and foremost a societal problem. I think that this debate has lived up to the expectations that many have placed in this Parliament on these and on other occasions. Thank you, Mr Chairman. [Applause.]
Thank you, hon member. Hon Ambrosini, on behalf of the Speaker, the Deputy Speaker and all members of this House, we wish you the very best with your courageous fight against this disease and everything of the best for the future.
Debate concluded.