This week’s arbitration hearings into the Life Esidimeni tragedy started on a bleak note. According to health ombudsman Malegapuru Makgoba, the number of lives lost so far totals 128. The hearings will provide some much-needed introspection for the country at large on how it treats its most vulnerable and marginalised citizens. In most cases, the vulnerable find themselves at the mercy of the state, which, as Mark Heywood of Section27 puts it, should be the primary custodian of people’s social and human rights. Unfortunately, in our context, so much of what the state ought to do for its citizens has been outsourced to private enterprise due to a chronic lack of state capacity. The Life Esidimeni tragedy was precipitated by the Gauteng health department’s desire to cut down on outsourcing costs paid to Life Healthcare. However, once the department realised it did not have the capacity to take care of the patients, it took the morally indefensible decision to allocate the patients to ...

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