Mthatha's R416m cancer centre opens, bringing radiotherapy closer to four Eastern Cape districts

Cancer patients in the north-east of the Eastern Cape have until now been sent hundreds of kilometres for radiotherapy. That should change with the R416 million oncology centre at Nelson Mandela Academic Hospital in Mthatha, which Premier Oscar Mabuyane and Health MEC Ntandokazi Capa opened on Thursday, 29 October.

The provincial government said the centre will serve patients from the OR Tambo, Alfred Nzo, Chris Hani and Joe Gqabi districts. Those needing radiotherapy were previously referred to oncology centres in KuGompo City (formerly East London) or Gqeberha.

What the centre has

The centre has two linear accelerators, the machines that deliver external-beam radiotherapy, and offers chemotherapy, brachytherapy and specialised inpatient care. It has 68 inpatient beds: 30 for women, 30 for men and eight for children and newborns with cancer.

There is an outpatient department with consultation and counselling rooms and resuscitation capacity, and an oncology pharmacy where chemotherapy is mixed and dispensed. The building also holds chemotherapy treatment areas, isolation and procedure rooms, nursing stations and recovery areas.

A suspended bridge connects it to the hospital's radiology department, laboratories, theatres and central sterile services. The provincial government said the structure was designed to take two more floors later.

The machines and the beds are the parts a patient can count. Two linear accelerators. A brachytherapy service beside chemotherapy. Sixty-eight beds, split 30, 30 and eight. The eight are for children and newborns, which is the capacity the hospital did not have when children with cancer were sent out of the region. The pharmacy mixes and dispenses chemotherapy on site. The bridge is how the new building reaches radiology, the laboratories, the theatres and sterile services without a separate trip across the hospital.

What patients had before

In her budget and policy speech to the provincial legislature on 25 March, Capa said Nelson Mandela Academic Hospital offered only chemotherapy. Radiotherapy patients were referred to Frere Hospital in East London and Livingstone Hospital in Gqeberha, 600km to 800km away. The hospital had no dedicated oncology wards or inpatient cancer services, and because it offered no paediatric oncology, children with cancer were referred out of the region.

Capa valued the two linear accelerators at R42 million each and a brachytherapy machine at R26 million. "This is more than infrastructure. It is access. It is dignity," she told the legislature.

The R416 million is the centre. The R42 million figures are the two accelerators inside that sum, and the R26 million is the brachytherapy machine, on the values she gave in March. The distance she named then, 600km to 800km to Frere or Livingstone, is the trip the four districts were making for radiotherapy. OR Tambo, Alfred Nzo, Chris Hani and Joe Gqabi are the districts the province now says the Mthatha centre will serve.

Those four names are the catchment, not a slogan. Before 29 October, a radiotherapy patient from them was sent to Frere in East London, which the province also calls KuGompo City, or to Livingstone in Gqeberha. Capa's March speech said the Mthatha hospital then offered chemotherapy only. There were no dedicated oncology wards, no inpatient cancer service, and no paediatric oncology, so children were referred out as well. The 18 July date was Nelson Mandela's birthday, and it was the opening she named in that speech. The opening that happened was 29 October, with the premier and the MEC there. More than three months separate those two dates. The extra R96.4 million for 2026/27 is for commissioning and staffing. Commissioning is the step the opening reports do not date.

Opened later than planned, and staffing still unclear

The opening came more than three months after the date Capa gave in March, when she said the unit would be opened on 18 July, Nelson Mandela's birthday. Her department set aside an extra R96.4 million in the 2026/27 financial year for commissioning and staffing.

Neither the provincial government's announcement nor the reports of the opening say how many oncologists, radiation therapists and medical physicists are in post, or on what date the first patients will receive radiotherapy in Mthatha. Radiotherapy machines must be commissioned and run by a trained team before treatment can begin.

The Daily Dispatch reported that the unit is named after the late community activist Dr Laura Mpahlwa. The name is part of the opening report. A start date for radiotherapy is not.

Keep the two sums apart when reading the budget speech. R416 million is the centre the premier and the MEC opened. R42 million is the value Capa put on each accelerator, and R26 million is the value she put on the brachytherapy machine. R96.4 million is a later allocation for getting the service staffed and commissioned in 2026/27. None of those figures is a count of people in post on 29 October.

An opened building and a first treatment are different dates. The province has announced the first. It has not announced the second. The R96.4 million is money set aside for commissioning and staffing. It is not a headcount, and no report of the 29 October opening turned that allocation into a number of oncologists, therapists or physicists on the floor.

If you are already on cancer treatment

Keep your existing appointments and referral letters until your doctor or clinic tells you that your care is moving to Mthatha. If you are unsure, ask at Nelson Mandela Academic Hospital's oncology clinic or at the facility that referred you.