Rinae Munyae, 34, from Protea Glen in Soweto, south of Johannesburg was diagnosed with inflammatory bowel disease in November 2022. This led to him needing a stoma while he recovered from surgery. A stoma is a small opening in the abdomen which is used to remove body waste like faeces and urine into a pouch or ostomy bag. 

The stoma was a temporary measure. Munyae was meant to get a stoma reversal operation to close the opening in his abdomen in mid-January 2023, six weeks after his original operation. Stoma reversal operations reconnect the bowel and restore the normal flow of waste through the digestive system. 

“My heart sank when the nurses told me after the ostomy operation that I had to wait for a year for the reversal operation because I was number 200 in the queue [of patients waiting for a stoma reversal]. The nurses said I was going to live with a stoma bag for the time being,” he says. 

It’s only recently that Munyae’s life went back to normal. He is one of 100 patients who got a stoma reversal operation in early March.

The stoma reversal operations were part of a campaign to conduct surgical marathons introduced by the Gauteng health department in July 2023 to clear up a backlog which, at the time, stood at 37,000. 

According to the department, the backlog of surgical cases has now been cleared.  

Gauteng health department spokesperson Motalatale Modiba says, in addition to the backlog, 20 800 surgeries that were performed between January and March 2024.

Regarding the categories of surgeries, Modiba says most were general surgeries (over 22 000), approximately 8000 surgeries were orthopaedic surgeries and over 5000 surgeries performed were cataract surgeries.  

But Democratic Alliance spokesperson for health in the province, Jack Bloom, says there is no way that surgery backlogs have been eliminated. 

“Every day I get calls from patients about delayed surgery. They are giving misleading figures because of the upcoming election. We need good management at all hospitals, with proper staffing and functional equipment to cut the surgery backlogs which cause immense suffering,” he says.

The department says the backlog was a result of multiple factors. One is the COVID-19 lockdown when elective surgeries were put on hold, and only emergency operations were allowed. Beyond COVID-19, loadshedding and frequent water interruptions also cause delays in surgeries being done. 

Consequences

Munyae tells Health-e News that the year-long wait for a stoma reversal operation was difficult. The freelance photographer was unable to work and had no source of income. 

Even more challenging was the added cost of living with a stoma. At times he would travel from his home to the Chris Hani Baragwanath hospital to find that there were no stoma bags. Faizel Jacobs, the general manager at the South African Society of Stomates ( SASS), an advocacy organisation formed by ostomates, says the number of people living a stoma in South Africa is unknown. 

“Now with no real registry as such, we can only speculate as to how many ostomates there are in the country,” he says. The organisation has been sounding the alarm over the shortage of stoma bags in various hospitals across the province since last year.  

“I’d be lucky to get two stoma bags. Most of the time I would be told there were no bags. I had to get money from my parents to buy from the pharmacy at a cost of R1000 for 10 bags,” Munyae tells Health-e News. “Remember I had no income coming and depended on my parents for everything. You can imagine the embarrassment it caused me to ask even for toothpaste from my parents.” 

To deal with the shortage of stoma bags, Munyae decided to limit what he ate to avoid upsetting his stomach.

“One bag can last for three days. But if you sweat it loses [the adhesive] glue and you have to change it. As a result I spent most of my time at home doing nothing. I also made sure I stayed away from food that upset my stomach. My life just revolved around the bag.” 

Faizel Jacobs, the general manager at SASS says it’s mainly public health facilities that experience delays when it comes to stoma reversal operations. 

Faizel Jacobs, the organisation’s general manager at SASS  reversal operations. “Patients with medical aid can afford decent healthcare in the private healthcare sector which is different for those in the public health sector. The state does not have a minimum standard of care for ostomates,” he says. 

But without medical aid cover, people have little to no options. Munyae and his parents looked into private care despite not having medical aid. They were told that a stoma reversal operation could cost them around  R55 000. 

“I had no choice but to wait for a date from Baragwanath hospital,” he says. 

Getting back on track

Munyae is happy to have his life back now that the operation is done. His first priority is to get back to work.  “I have recovered very well.  As I am talking to you now, I am working shooting at a wedding. I also have a TV gig that I am working on.”  – Health-e News