- On 10 July, Judge Mmonoa Teffo handed down judgment of the inquest into the deaths of 141 mental health patients of the state who died in 2016 and 2017 when they were moved from Life Esidimeni facilities. She has found that former Gauteng Health MEC, Qedani Mahlangu and the former head of mental health in the Gauteng health department, Makgabo Manamela, can be held responsible for deaths of at least nine Life Esidimeni patients.
- One of these patients is Virginia Machpelah, the sister of Christine Nxumalo, who died in August 2016. Machpelah was moved without the knowledge of her family, and died in the process.
- Nxumalo was one of the first family members who spoke out publicly and demanded an investigation. But it came at a high cost. Read more here.
- The National Prosecuting Authority now needs to study the judgment and decide if it would criminally prosecute Mahlanga and Manamela.
ICYMI: View the judgment of the Life Esidimeni inquest
Useful resources
- A report by Malegapuru Makgoba, South Africa’s health ombud, was released in February 2017. He concluded that the transfers and the actions of key decision-makers involved were “most negligent and reckless and showed a total lack of respect for human dignity, care and human life”. Read the full report here.
- An arbitration hearing before Deputy Chief Justice Dikgang Moseneke ran for 45 days from 9 October 2017. He had to decide what would be fair compensation for victims of the transfer project. Read the outcome here.
- Following the Life Esidimeni tragedy, the South African Human Rights Commission’s investigation into care for mental health patients in South Africa highlighted “chronic and systemic neglect, coupled with mismanagement and a dire lack of resources”. Read the full report here.
- In the opening statement to the inquest, Adila Hassim, for Section 27, who represented 44 families of victims, said that the organisation will state their case that there is enough evidence to support that key decision-makers of the Life Esidimeni transfers be criminally charged. Read the full opening statement here.
- Here’s a timeline of how events unfolded.
- In an interview with Mia Malan for Bhekisisa’s monthly TV show, Health Beat, Malegapuru Makgoba said that he believes, based on the ombud report’s findings “the government admitted that they had dropped the ball on the whole system”. Find the interview here.
- Following the findings of the inquest announced on 10 July, Gauteng Premier Panyaza Lesufi says the province’s government “fully accepts the judgment”. Read the full press release here.
- In the health ombud’s report, the province’s health department was ordered to draw up a recovery plan for mental healthcare after the Life Esidimeni tragedy. Here’s the progress report.
- Life Healthcare, the private hospital group from where the state’s mental health patients were moved to unlicensed non-governmental organisations, issued a media statement after the judgment of the inquest was handed down. Read it here.
- The National Prosecuting Authority (NPA) says it study the inquest judgment to determine whether the NPA will institute criminal prosecutions against Mahlangu and Manamela. Read the press release.
How it all happened
In September 2015, the Gauteng department of health decided to end a contract with Life Esidimeni, a group of specialised private psychiatric care hospitals. The decision was part of a wider plan to deinstitutionalise mental healthcare users in the province by placing them into non-governmental organisations (NGOs) in communities. It was also to cut costs.
What transpired was a poorly planned, hastily executed tragedy that led to 144 people dying and 44 going missing.
More than eight years later, no one has been charged for what happened to 1 606 people with serious mental health conditions after they were transferred from Life Esidimeni’s facilities to 27 non-profit organisations, most between May and June 2016.
Three high-ranking Gauteng health officials resigned from their posts as a result of their involvement in the Life Esidimeni tragedy between 2017 and 2018:
- Gauteng MEC for health Qedani Mahlangu, who, according to Section27, made the decision to transfer the patients from Life Esidimeni
- Barney Selebano, head of the Gauteng provincial government’s health department
- Makgabo Manamela, the department’s director of mental health, who, according to Section27, was responsible for implementing the transfers.
The findings of the inquest released today will say whether there’s enough evidence for key people involved in the transfer project to be prosecuted.
Looking for justice
In August 2016, Christine Nxumalo went looking for her sister, Virginia Machpelah, and discovered that she and eight other former Life Esidimeni patients had died at one of the non-profit organisations, Precious Angels, not long after they had been moved there.
In September, the health minister called for an inquiry by the health ombud, Malegapuru Makgoba. By October, Makgoba had called for Life Esidimeni patients sent to the Cullinan Care and Rehabilitation Centre (CCRC)/Anchor complex to be helped urgently, writing that “relatives of patients are complaining about the poor quality of care of loved ones in terms of nutrition and medication. Some patients are simply wasting away and some are reported to be staring death in the eye in front of relatives.” (CCRC is a public psychiatric hospital. Two NGOs, Anchor and Siyabadinga, were housed in unused wards of the hospital, according to Sasha Stevenson, executive director of Section27, the human rights organisation that represented victims and their families in the later inquest into how the transfers unfolded.)
The ombud found that the non-profit facilities were not well prepared for receiving patients and didn’t have the right staff, proper infrastructure and funding to care for patients.
“Mental healthcare users were tortured, abused, punished and in some cases deprived of food, water and adequate shelter and sanitation at the (often overcrowded) unlicensed NGOs,” notes Section27 on their website. They were not given the medication or treatment they needed and many became dehydrated, developed secondary infections like pneumonia or had uncontrolled seizures.
‘Chaotic’ implementation
At the time of the health ombud’s report, 75 of the (then 94 known) deaths occurred at five of the nonprofits:
- CCRC/Siyabadinga/Anchor 25
- Precious Angels 20
- Mosego/Takalani 15
- Tshepong 10
- Hephzibah 5
The health ombud’s report noted that the “rushed implementation” was “chaotic”: a policy change of this size could have taken “up to five years”, but instead was executed over nine months, rapidly scaling up in the last three months, it said.
The move, touted as a cost-saving measure, allocated only R112 per day per patient at the 27 NGOs, compared with the R320 Life Esidimeni facilities could spend on each patient a day. Moreover, some of the organisations received funding from the provincial health department only three to four months after Life Esidimeni patients arrived.
Hope for healing
On 9 October 2017, arbitration hearings started before former Deputy Chief Justice Dikgang Moseneke, who had to decide what would be fair compensation for victims of the transfer project. Over the next 45 days (until 9 February 2018), 60 witnesses testified, including 12 government officials.
By this time, the known death toll was 144 people and 44 were missing; 1 418 of the transferred patients survived, Moseneke’s report said.
Moseneke ordered the Gauteng health department to pay the victims and their families who participated in the arbitration, R1-million in constitutional damages plus other costs (some received a total payout of R1.2-million) as restitution for their treatment during the transfers.
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