Radioisotope GFR measurement is recommended as part of the standard of care guidelines for renal function assessment in paediatric oncology practice as it impacts the dosing of platinum alkylators. As such standardising methodologies is critical (33). Rates of formal GFR assessment (even in the absence of radio-isotope instruments) and also audiology assessment were infrequent, which is related to the lack of availability of or access to these services at all POUs across the country, as well as the large burden of patients presenting with advanced disease, whose poor performance status (renal or pulmonary) may preclude radioisotope testing at the time diagnosis. Similarly, the use of calculated GFRs was low in the absence of formal radio-isotope testing. In a more recent study calculated GFRs were found to either over or underestimate the GFR. The recommendation was that radioisotope GFR determination should remain standard of care for platin dosing to ensure accuracy (34). Unfortunately, this may not always be possible in our setting and calculated GFRs may be the best alternative. The value of calculated versus radioisotope GFR measurement can be prospectively tested in the context of a national protocol and calculated GFRs as a surrogate for more accurate renal function evaluation could become standardised practice. In addition, to renal function assessment, significant numbers of hearing-impaired children may have evaded detection because of low rates of routine audiology testing which has the potential to impact school performance and subsequently employability. This is notable because the unemployment rate for the hearing impaired in South Africa ranges from 21.2% - 35.3% with low average annual household incomes of approximately USD 2000 for the moderately hearing impaired and USD 1500 for those with severe deficits (35), placing them close to the upper limit poverty line of USD 800 per household per year (36).