Harrowing details of Life Esidimeni deaths laid bare

Pretoria high court judge Mmonoa Teffo released her full judgment for the Life Esidemeni inquest on Monday, setting out in harrowing detail the evidence underpinning her conclusion that former Gauteng health MEC Qedani Mahlangu and the department’s head of mental health services can be held criminally liable for the deaths of nine patients eight years ago.

The inquest heard evidence about the chaotic transfer of more than 1,700 state mental patients from private facilities managed by Life Esidimeni to ill-equipped, unprepared NGOs between 2016 and 2017. At least 141 patients are known to have died.

Mahlangu made the decision to terminate a decades-long contract between the Gauteng health department and Life Esidimeni, and the transfer was implemented by the department’s head of mental health services, Makgabo Manamela.

Many of the patients who died had spent years at Life Esidimeni facilities, where they were stable and well cared for. After they were moved to NGOs they died in conditions of dire neglect, deprived of food, heating, medication and basic care.

Her judgment reflects the testimony of dozens of witnesses, including medical experts who described dead patients who were emaciated, dehydrated and suffering from bedsores. Testimony was also heard about patients who were found to have eaten paper and plastic.

“Everything that happened after the termination of the Life Esidimeni contract until the deaths was a continuous process. Ms Mahlangu was warned against the decision to terminate the Life Esidimeni contract. She did not heed the warnings and the [department] proceeded to implement the decision, which resulted in the transfer of the mental healthcare users to the NGOs who were not ready and could not care for them,” said the judge.

“The evidence is clear that most of the mental healthcare users who died, if not all of them, died of poor care,” said Teffo. 

While Teffo held only Mahlangu and Manamela accountable for the deaths, the National Prosecuting Authority (NPA) has the discretion to institute criminal proceedings against a wider group of parties involved in the scandal, such as other government officials or the people who operated the NGOs to which the patients were transferred, said Section27 CEO Sasha Stevenson.

The office of the director of public prosecutions said last week that it would study the judgment to make a determination on whether the NPA will institute prosecutions against Mahlangu and Manamela, noting that the judge had not found anyone liable for the deaths of the other 133 patients.

Teffo noted in handing down judgment most of the deaths had been attributed to natural causes and there were therefore no autopsies in these cases. Autopsies were conducted only on those patients who had been deemed to have died of unnatural causes.

Stevenson. said: “The detail the judge went into on each of the deaths [for those who had autopsies] is welcome, and she makes clear findings. People were moved without a proper plan, the department failed to pay NGOs, and the NGOs were not properly assessed — they were never going to be able to do the job properly.”

kahnt@businesslive.co.za