The Life Esidimeni tragedy is without doubt one of the worst human rights abuses of post-apartheid SA. At least 144 people lost their lives in the shambolic, degrading and dehumanising transfer of more than 1,700 state mental patients from the safety of a well-established private healthcare provider to unlicensed and ill-equipped nongovernmental organisations that deprived them of their most basic human rights.
The move was so chaotic that records were mislaid, patients were loaded on to trucks like animals, and officials lost track of where they were. To this day, 44 patients are still missing.
Harrowing testimony from officials and their families during the arbitration process that followed an investigation by the health ombudsman revealed how patients were deprived of food and water, vital medication and warm clothing.
As retired deputy chief justice Dikgang Moseneke so forcefully put it in his 100-page arbitration award on Monday, these patients were subjected to a barbaric ordeal that no human being should endure, least of all at the hands of the very people entrusted to care for them
They died of starvation, neglect and ignorance at the hands of unqualified and callous personnel. As retired deputy chief justice Dikgang Moseneke so forcefully put it in his 100-page arbitration award on Monday, these patients were subjected to a barbaric ordeal that no human being should endure, least of all at the hands of the very people entrusted to care for them. His eloquent ruling reminds us that people with mental illness are human beings with rights equal to those more healthy and highlights the deep prejudice and stigma that surrounds mental issues.
His decision to order the state to pay the families of the victims R1.2m in damages, build a monument and provide them with counselling highlights the broader devastation of the ill- conceived project. Relatives used their own resources to try to track down missing patients and endured heartache and loss.
At the same time, his ruling exposes how a group of senior state officials lost touch with their own humanity and exhibited a blatant disregard for their professional and official duties.
Former health MEC Qedani Mahlangu, former head of health Tiego Selebano and former head of mental healthcare services Makgabo Manamela all chose to ignore repeated warnings from patients’ families, doctors and activists that lives were in jeopardy. Not one of the three has provided a plausible explanation for the hasty transfer of the patients, nor accepted direct responsibility for the consequences of their actions. All three claimed the move was intended to save money, but the health ombudsman concluded the move would push up costs and this argument was also contradicted by Gauteng finance MEC Barbara Creecy. Moseneke found Mahlangu was ultimately responsible for the project and was quite aware of the risks but had brushed them aside.
This kind of institutional deafness is not unique to the Gauteng health department. Education is equally delinquent. Four years ago, six-year-old Michael Komape drowned in a school pit latrine. Despite repeated pleas from lobbyists and parents for improvements to school infrastructure, too little has changed. And so last week two more young children died in unsafe schools: Lumka Mkhethwa drowned in a pit toilet in the Eastern Cape and Vhuthuhawe Madala was electrocuted in Limpopo.
Basic Education Minister Angie Motshekga is, meanwhile, resisting Equal Education’s attempts to get the High Court in Bisho to compel her to fix the norms and standards that govern school infrastructure.
Monday’s arbitration award, while it may bring some relief for the victims’ families, is far from the end of the matter. The hearings steered clear of probing potentially corrupt activities, but several references in Moseneke’s ruling hinting at improper processes and relationships warrant further scrutiny.
The onus is now on the professional bodies that regulate doctors and nurses, the South African Police Service and the National Prosecuting Authority to play their part. It is not enough to pay damages, say sorry and promise that Life Esidimeni will never happen again. Justice must be done and the individuals who were responsible for the tragedy must be held accountable.