EDITORIAL: Even historic Esidimeni ruling is not enough
When 144 vulnerable patients placed in the care of state health facilities die, someone has to be held accountable
Esidimeni means "place of dignity". But there was nothing dignified about the manner in which 144 mentally ill patients died after the Gauteng health department transferred them out of the Life Esidimeni facility to ill-funded and badly equipped NGOs in 2016.
The evidence heard by the Life Esidimeni arbitration inquiry, headed by retired deputy chief justice Dikgang Moseneke, revealed that some patients were transported to these new facilities on the back of trucks, like cattle. Many did not get medication. Some appeared to have starved to death, with the post-mortem of one, Deborah Phehla, showing she had eaten balls of brown paper and plastic, causing asphyxiation.
Releasing the findings of the arbitration on Monday, Moseneke awarded the families total compensation per claimant of R1.2m.
The ruling is a significant milestone. This is the first time in SA history that constitutional damages have been awarded for the violation of the rights of mental-healthcare patients.
And though Moseneke also ordered counselling and support services to be provided to families so that they can get some closure to what health minister Aaron Motsoaledi called "one of the most painful and horrible events in the history of post-apartheid SA", this is far from over. Neither is it enough.
A number of questions remain unanswered, most significantly: why were these patients moved in the first place? Suggestions of financial pressure on the department of health were dismissed by Gauteng finance MEC Barbara Creecy‚ who said cost cutting was never supposed to lead to the department stopping essential services.
Then why? Did corruption and kickbacks play any part in this?
Gauteng premier David Makhura says the Special Investigating Unit is looking into possible corruption related to Life Esidimeni and every resource needs to be put at their disposal to ensure that justice is done.
Social factors such as poverty contribute to mental illness, which means a significant number of South Africans are at risk. As the health ombudsman says in his Life Esidimeni report, the state needs to exercise "a greater duty of care for the protection of poor people, particularly the rights of vulnerable people."
Three players emerged from this inquiry with particularly bloodied hands: Qedani Mahlangu, the health MEC in charge during the Life Esidimeni tragedy; her head of department Barney Selebano; and the director of mental health, Makgabo Manamela.
None of them would take responsibility for the decisions taken and simply passed the buck.
When 144 vulnerable patients placed in the care of state health facilities die, someone has to be held accountable.
There are far too many incidents of an insensitive nature everywhere.
From evidence led before Moseneke, officials were warned about the dangers of moving patients out of Life Esidimeni, but they went ahead anyway.
This failure runs much deeper than a glitch in a provincial health department. It also points to a weakness at national level in ensuring there are checks, balances and monitoring in place to guard against such tragedies. The state has a constitutional responsibility to ensure that people’s rights, especially the rights of the vulnerable, are protected.
Mahatma Gandhi is believed to have said the true measure of any society can be found in how it treats its most vulnerable members. The Life Esidimeni tragedy shows we have fallen far short. Criminal proceedings must surely follow.