Dr Liana Roodt: when the going gets tough, the tough get going! | Photo: Leentjie du Preez/Grace Photography
Eight years ago, South African surgeon Liana Roodt was sitting with her friends, venting. Her frustration? Overlong waiting lists threatening the lives of South Africa’s most vulnerable breast cancer patients. Her friends challenged her to do something about it, and here’s what she did. Intrigued by her story, SHIRLEY FAIRALL tracked her down
Liana was born in Namibia to parents who are both lecturers, completed her medical degree at the University of Pretoria and specialised in surgery at the University of Cape Town. She is 37, and from Monday to Friday works in both state and private practice
‘I’LL NEVER FORGET THE SHOCK of being confronted with my first really ill patient as a medical student. Until then, treating patients was all theory and I could quite easily distance myself. Then suddenly I was facing the human at the other end of the textbook, witnessing very real emotions.
Although doctors are trained not to get emotionally involved because we need healthy boundaries to serve our patients best, stepping too far back does both doctor and patient a disservice. I always seek a human connection. Without it, being a doctor would lose much of its sense of purpose. I want the opportunity for true healing which involves the whole patient, not just the physical body.
Breast cancer patients face so many challenges which begin long before they need surgery. The first challenge is getting a diagnosis, particularly in rural communities where the healthcare system is under greater pressure. Once you have a diagnosis, you face similar challenges over treatment. Everything you take for granted when you have a private medical aid is unavailable to the majority of South Africans. Whether the patient needs surgery, chemotherapy, radiology, follow up, nutritional guidance or psychosocial support, there aren’t the resources to treat them. And so the backlog builds.
Many South African state hospitals have a big backlog of patients needing life-saving surgery | Photo: Leentjie du Preez
Fortunately, most cancers are slow growing so if you catch and treat them early, the prognosis is often good. But that changes when the diagnosis is delayed and it takes months to start treatment. The psychological knock-on effect is huge. Patients are afraid and uncertain, and living with that is detrimental to the whole family.
psychological knock on
This is the conversation I was having one evening at wine club. They’d all heard me talk about it before but this time one of my friends challenged me: ‘So what are you going to do about it?’ I didn’t know it at the time but that question was the seed that became Project Flamingo. I suddenly realised the system wasn’t going to change quickly enough, so it really was up to me.
Ideas whizzed around my head for a while and the one that survived was giving breast cancer patients free mastectomies over weekends and public holidays, thus reducing waiting time. We needed to pay for use of the theatre and the nursing staff, but doctors and anaesthetists would work for free. That was in 2010. One of my friends, Michelle Rennie, was a cancer survivor who raced in a dragon boat with other survivors, and they pledged R10,000 for our first surgery. Michelle became intimately involved in the project and helped shape its trajectory as a non-profit company, becoming its director.
Liana and colleagues give their time and services for free over weekends and public holidays. Project Flamingo rotates 10 volunteer surgeons and five anaesthetists week after week. In October 2018, it celebrated it 500th free surgery
With Michelle’s connections we started fundraising – we never knew where the money would come from but it always came, and it got easier in time. By 2013 we could plan a year in advance and that’s when we knew for sure that it was a long-term initiative.
Groote Schuur Hospital, where Liana and other doctors offer their time for free at weekends, has a proud surgical history and is where the world’s first heart transplant was performed. ‘Big organisations fear change but things started moving once they realised I was proposing a simple, positive solution,’ says Liana | Photo: Leentjie du Preez
Getting the red tape sorted was a battle and I was grateful for the help of fellow surgeon, Dr Lydia Cairncross, who was at Cape Town’s Groote Schuur Hospital at the time. Big organisations naturally fear change, but things started moving once they realised I was proposing a simple, positive solution, not just for patients but also for staff and the hospital. We’d never have been able to do this without the support of Groote Schuur and now Tygerberg Hospital too.
Word of mouth has kept us alive and that’s where most of our funding now comes from: individual businesses or groups hold a fundraising breakfast for us or make a financial contribution. I’m in awe of them. Grateful breast cancer survivors often show up for us too.
‘I always seek a human connection. Without it, being a doctor would lose much of its sense of purpose,’ says Liana | Photo: Leentjie du Preez
We have a steady pool of 10 surgeons and five anaesthetists who volunteer for surgery, and we rotate them week after week. Three of us take the decisions and handle admin, finance and funding, and we have five volunteers who help where we need them. In October 2018 we performed our 500th surgery.
Delays in treatment are detrimental to the entire family, Liana says | Photo: Leentjie du Preez
Every newly-diagnosed patient gets a Project Flamingo pamper pack to keep their spirits up. Bio Oil is a treasured regular sponsor for these packs, we once had a big donation from Dischem, we get donations from book clubs or offices but mostly we purchase the products ourselves from businesses willing to sell to us at cost.
Since 2014 we’ve also been performing free colorectal surgery because quite a high percentage of colostomies can be reversed if you operate quickly. Without timely surgery, these patients will have to have a colostomy bag for the rest of their lives. Many don’t have clean water at home, which gives rise to all sorts of other problems and diseases, so it’s really important to help them.
Waiting game: bringing diagnosis and surgery forward can save a life | Photo: Leentjie du Preez
Throughout this process I pray, asking God for help, guidance, strength and courage before surgery. God in the form of Jesus is the cornerstone of everything for me. Sometimes patients ask us to pray with them and we’re happy if we can help them feel the comfort and power they need, no matter what religion they are.
the cornerstone of everything
My faith has been a journey through personal challenges and events, from something theoretical to a relationship with God. I think people are confused by the dogma and rules which have given religion a bad name. I’ve learnt to put those aside and embrace the loving God I know.
‘God is the cornerstone of everything for me,’ says Liana. ‘Sometimes patients ask us to pray with them and we’re happy if we can help them feel the comfort and power they need, no matter what religion they are’
Our real challenge is ongoing sustainability: the need for surgery is growing but we’re not, so we need to decide how to grow. I’m seeing an increase in cancer diagnosis among younger patients. In about 5% of people we can identify a genetic disposition but we don’t know for sure what causes cells to misbehave and I personally believe we live in a more cancer-prone environment. Our world has altered so dramatically and so quickly, and I can’t help thinking that lifestyle contributes. But we can make changes that will greatly improve our health [see Liana’s video and written tips for staying healthy below].
I need to practise what I preach!
Personally, I need to practise what I preach to my patients: that all-important life balance! One of the good balances I have struck is that I no longer do every Project Flamingo surgery myself. I destress by spending time outdoors, walking, reading, listening to inspirational podcasts and, of course, savouring good wine!
This is very much a calling. I believe that you are me and I am you. By helping you, I’m helping myself, because as we heal others we heal ourselves and find purpose and meaning. Life is pointless if we don’t contribute.’
‘As we heal others, we heal ourselves,’ says Liana. ‘Life is pointless if we don’t contribute’ | Photo: Leentjie du Preez
IF YOU’RE INSPIRED TO HELP PROJECT FLAMINGO SAVE LIVES BY SPEEDING UP CANCER TREATMENT FOR PEOPLE WHO ARE IN URGENT NEED, CLICK HERE
‘Look after yourself’: Liana’s message to women!
STAYING WELL: DR ROODT’S FOUR TOP TIPS FOR UPPING YOUR HEALTH AND LOWERING YOUR CANCER RISK
STRESS Rethink your priorities and learn to manage stress. Our nervous system was designed to protect us from occasional stress – like a buffalo charge – by releasing the hormones adrenaline and cortisol. We rarely encounter buffaloes nowadays, but we do live with constant low-grade stress caused by long hours, poor nutrition and always-on technology. It’s the constant nature of this stress that’s problematic as it puts our bodies in a pro-inflammatory state in which normal cells misbehave. Change this and you change your health!
SLEEP & REST Research increasingly emphasises the negative effects of poor sleep on our health and wellbeing. In our high-stress world, our bodies and brains need to shut down to rejuvenate. We can’t expect health if we never switch off. Do everything you can to rest and sleep well!
DIET A) Eat clean and green. This means increasing your intake of fresh, whole, green leafy vegetables and avoiding food that’s been exposed to toxins, hormones and chemical preservatives. If you can afford organic, so much the better B) Cut out refined sugars. Cancer cells have a different metabolism from other cells: they love readily available energy sources like refined sugars that contribute to the pro-inflammatory state in which they flourish. Eat fruit in moderation but lots of veg is important (don’t eat a fruit salad and think you had a salad!)
EXERCISE Move! You don’t have to become a gym bunny or a marathon runner, but a healthy body gets exercised regularly, even if we’re talking a 20-minute daily walk