When she finally stepped into the packed white tent pitched in the parking lot of an old Parktown mansion turned conference centre, the tent erupted into a chorus of Senzeni Na (What have we done?).
The singing gave way to the distraught sobs of a woman, crying into her hands, in the audience. The country and nearly 2 000 family members alike, of which this woman was one, had been waiting for this moment for four months.
As former Gauteng health MEC, Qedani Mahlangu, the woman at the centre of what is arguably the greatest miscarriage of the right to health in South Africa since Aids denialism, took her seat at the Life Esidimeni arbitration hearings, the crying grew louder and more intense.
People were desperate for answers. And they were angry.
Mahlangu was purportedly so busy as a full-time post-graduate student after her resignation as MEC that she could not appear at the hearings in November and December.
Listen: What is the arbitration all about?
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Laura Lopez Gonzalez speaks to Tim Modise about who might be held accountable for the tragedy.
She was the political head of the provincial health department when 1 700 long-term mental health patients were removed from state-funded care at private Life Esidimeni facilities in 2016. The move, which spread patients between 122 community nongovernmental organisations (NGOs) and to a lesser extent state hospitals, was supposed to save the Gauteng health department money.
Instead, it cost 143 people their lives.
Why were their mentally-ill loved ones taken from private psychiatric facilities, transported like cattle on the back of open bakkies, to ill-equipped and unlicensed NGOs, where unqualified staff had no idea how to care for them, families want to know. And why did officials, including Mahlangu, ignore protests, pleas, warning after warning, and even court action by activists?
But there were few answers.
Instead, families encountered an arrogant, dismissive politician, who refused to accept personal blame for the tragedy and portrayed herself instead as the one who has been treated unfairly.
When retired deputy chief justice Dikgang Moseneke, who is presiding over the hearings, asked Mahlangu, if she had to charge anybody, who she would hold responsible, she shifted the blame to her subordinates, whom she claims never informed her about the dire conditions in which patients were kept.
“The mental health director [Makgabo Manamela], the head of department [Barney Selebano] and the project manager,” she said.
Would she charge herself? Moseneke asked. Mahlangu responded: “That’s why I resigned.”
The next day she declared: “I cannot carry personal blame because I wasn’t working for myself. I was an elected official.”
In Mahlangu’s world, she’s the victim — of a mysterious drone she said was hovering over her house in Johannesburg’s Bedfordview, of her underlings (Selebano and Manamela) deceiving her and lying to her, of health ombudsman Malegapuru Makgoba’s investigative report on the matter, and of having to take political responsibility for a “collective” decision.
Listen: Go inside the ombud investigation
The health ombudsman has found 94 mental health patients died because of state negligence. Laura Lopez Gonzalez tells Mia Malan what happened.
Indeed, Mahlangu’s political career took priority over the lives of patients. When news of the deaths surfaced, she was “busy with political work” as head of the ANC’s elections team in Gauteng, according to the health ombudsman’s report on the catastrophe.
This week she admitted she was on the ANC campaign trail for three months in 2016 while patients were dying. She said she was doing “MEC work in between”. “I am a member of the ANC,” she proclaimed.
Long considered a rising star in the ANC, Mahlangu has built up a reputation as being a valuable and tireless worker on the campaign trail and an important fundraiser.
Ironically, says Jack Bloom, the Democratic Alliance’s MEC for health in Gauteng, the disaster might have been as a result of Mahlangu’s efforts to cement her standing within the ANC. She’s a member of the party’s provincial executive committee.
“She was fixated on cancelling the Life Esidimeni contract. I think she wanted to prove the state can provide the services better and cheaper and that this could be one of her great accomplishments. Instead, it turned into a great tragedy,” he argues.
During last year’s hearings, both Selebano and Manamela painted their former boss as an MEC who would not take advice from anyone and who ruled by fear.
The pressure to move patients to NGOs came from the MEC, Selebano testified. When he did raise concerns, she allegedly asked him if he was a spokesperson for Life Healthcare. Selebano said he was too scared to stand up to her. “There was no space to differ with her. Going forward, your relationship would be difficult.”
Manamela, a weak witness who angered the families with rambling and conflicting accounts, refused to accept any responsibility for the tragedy. She fingered Mahlangu and Selebano, saying she merely followed her superiors’ orders.
Many people told the health ombudsman that Mahlangu had said her decision was “final and non-negotiable and the project had to be done”, Makgoba’s report stated.
And, it wasn’t the first time.
Project manager Levy Mosenogi was tasked with overseeing patient transfers and managed to stop the planned move of child patients. He and others describe a climate of fear in the department.
Last year, City Press reported that former staff members pointed to Mahlangu’s oversight of the closure of tuberculosis hospitals in 2010, which had also resulted in “chaos”.
Her critics provided the newspaper with a letter she had written to the Gauteng Gambling Board in 2011 (as MEC for economic development) as an example of her high-handedness. This was when the board did not want to use offices she had allocated to them.
“May I suggest that you speed [up] the process of moving before I lose my cool with you,” she wrote. “The board has no role nor responsibility on this matter and, if they want to get involved in admin work, I will remove all of the board ASAP.”
Ironically, Mahlangu hasn’t received overt support, at least publicly, from the ANC. Gauteng Premier David Makhura was furious when the extent of the Life Esidimeni scandal became known, according to sources, not only because of the lives lost, but also because of the reputational damage to his leadership and ultimately fears that the scandal may contribute to the ANC losing power in Gauteng in 2019.
He sought to distance himself from Mahlangu and, some say, pushed her into resigning.
Makhura has repeatedly denied any knowledge of plans to move Life Esidimeni patients to community-based organisations. “I would like to state categorically that the decision to transfer Life Esidimeni mental health patients to NGOs was not made in consultation with the provincial executive council,” he said in his 2017 state of the province address.
But the DA and Economic Freedom Fighters say the premier must have known and could have intervened.
Since news of deaths broke in 2016, Mahlangu has maintained that the Public Finance Management and the Public Service Acts preclude MECs from becoming involved in the day-to-day management of the department.
“The law is very clear what my responsibilities are. The administrative things done on a daily basis are the responsibility of the heads of departments and the managers. Of course, to the extent that [issues] impact on the patients, I have interest in that,” she told Bhekisisa in 2016.
She repeated this argument several times during this week’s hearings.
Mahlangu’s interpretation of the Public Finance Management Act is correct, says Rural Health Advocacy Project’s Russel Rensburg. Under the legislation, departmental heads such as Selebano are tasked with, for instance, ensuring departments follow procurement procedures and projects are fully vetted.
But Rensburg points out that, in practice, MECs have been known to take over a range of administrative functions, such as signing off on key appointments and approving budget expenditure.
At the Parktown hearings, during a tea break on Thursday, family members gathered in a circle on the lawn outside the tent in which the proceedings take place to pray. With their eyes closed and hands up in the air, they pleaded: “Let the truth win and the Devil be defeated. We will triumph, Devil. Lead Qedani to speaking the truth.”
Their prayers are yet to be answered. Mahlangu’s arrogance remained visible, if somewhat subdued, at the hearings. She wore black, which had some wondering if she wasn’t playing the part of grieving politician, like an ordained head mourner.
But cracks in her armour could be showing. In the months that followed her resignation, the WhatsApp status attached to the cellphone number Mahlangu widely circulated during her time in the office read like a morning affirmation.
It bore a quote attributed to the American agony aunty Ann Landers (real name Eppie Lederer), who doled out socially liberal but morally conservative advice in a syndicated column for more than 40 years. Her work by her own admission was more the stuff of cuttings hung on refrigerator doors than of Pulitzer Prizes.
It read: “Maintaining self-respect in the face of a devastating experience is of prime importance.”
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