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94 Psychiatric Patients Died Due to Government Negligence in South Africa

Martie Coetser is a freelance writer from South Africa. She has a keen interest in a variety of topics.


Botched Transfers Non-Government Institutions

In the Gauteng Province of South Africa, ninety-four (and still counting) psychiatric patients died since March 2016 due to government negligence. The report into their deaths, authored by the Health Ombudsman, Professor Malegapuru W Makgoba, released on Wednesday, February 1, 2017, reveals a national crisis that could have been prevented by Gauteng Department of Health MEC (Member of Executive Council), Qedani Mahlangu, and the Premier of Gauteng, David Makhura.

According to the Health Ombudsman, Professor Malegapuru W Makgoba, who was tasked by the Premier to investigate the reported deaths, the transfer of about 1,300 mentally ill patients from Life Esidimeni Hospital to twenty-seven non-government institutions (NGOs), also known as “residential care homes”, was chaotic, shambled, rushed, and in a hurry.

Many of the NGOs were not registered or properly equipped. None of the NGOs received proper identification and files of the patients who were dumped on their doorsteps. Professional psychiatric services, medicine, beds, blankets, food, and financial support were not provided as promised by the Health Department. Staff of the NGOs was not properly qualified to take care of mentally ill patients.

"It's remarkable that only one of the ninety-four known patients died from a mental health-related illness, while the rest died from other things like dehydration, diarrhea, epilepsy, heart-attacks, etc.," reported the Ombudsman.

This is another national tragedy precipitated by agents of the state.

— Faranaaz Parker, Associate Editor, Huffington Post.


Why Did 94 Psychiatric Patients Die in South Africa?

Accurately explained by the Huffington Post, the tragedy started in October 2015, when the MEC (Member of the Executive Council) for Health, Qedani Mahlangu, announced the termination of a contract between the Department of Health and the Life Esidimeni Centre, which is a private chronic care facility in Johannesburg that ran mental healthcare centres as part of a plan to move people from what are regarded as old-fashioned asylum-like institutions into community-based care. About 2,000 patients, who received free health care in accordance with South Africa Constitution and the government's promise to take care of the poor, were receiving specialized chronic psychiatric care at the Life Esidimeni Centre.

The moving of the patients to NGOs was not only an effort of the Department of Health to cut costs and save money, but also an effort to adhere to a government’s decision to de-institutionalize mental health. This decision, however, stipulated that it would be a process over several years, and only after the establishment of well-equipped and well-staffed residential care homes.

The need to cut costs led to the termination of the contract with Life Esidimeni Hospital, and suddenly the de-institutionalize policy was a matter of urgency. Three people took the decisions that led to the deaths of ninety-four people:

  1. The MEC of Gauteng’s Health Department, Qedani Mahlangu, who resigned on Tuesday, January 31st.
  2. The Head of Gauteng’s Health Department, Dr Barney Selebano,
  3. The Director of Gauteng’s Mental Health Services, Dr Makgabo Manamela.

After some of the patients were sent home where they would be able to live a normal life thanks to caring relatives and prescribed medicine (which they were most of the time not able to obtain), and seriously ill patients were sent to hospitals, 1‚317 patients were left to be sent to NGOs. The discharge of all 2000 patients from Life Esidimeni lasted four months, from March 2016 to June 2016.

Three months later, in September 2016, the deaths of thirty-six former Life Esidimeni patients were reported to Parliament. Several of these deaths happened in the same NGO.

The reasons of their deaths, as described in the report of the Ombudsman, reveal unforgivable breaches of human rights under the Constitution of South Africa and the Mental Health Care Act.


Many Tried in Vain to Stop the Tragedy

Repeated advice and entreaties from relatives, experts, and activists—all of it thoroughly exposed by the Ombudsman and summarized by the Huffington Post—were in vain. Not to talk about the protest marches, the name-and-shame television and radio programs, the countless reports in newspapers, and the live broadcasting of deceased patients’ funerals. The Department of Health, led by MEC Qedani Mahlangu, as well as the Premier of Gauteng, David Makhura, simply failed to realize the consequences of their actions and inactions.

Of course, Policies and Procedures were followed. The Premier appointed an Ombudsman to investigate the ‘matter,’ then he waited for the report to be released in order to make informed decisions. In the meanwhile, the death-roll grew from 36 to 94 so far, as many corpses collected at NGOs are still unclaimed in funeral parlors.

The Way Forward

Mental patients still at NGOs are being transferred to hospitals.

Several organizations have opened cases of culpable homicide against former Health MEC Qedani Mahlangu.

Gauteng government has confirmed that disciplinary processes will be taken against officials implicated in the Health Ombudsman's report.

The Opinion of an OWFMA-SA

The Report Into the Circumstances Surrounding the Deaths of Mentally ill Patients, authored by Professor Malegapuru W Makgoba, reads like a horror!

I don’t know words that can describe my awful emotions about this trend of events. Horrifying, painful, frightening, unbelievable, shocking, dreadful, terrible, traumatizing —all of this is not enough to describe the state I am in. I absolutely can't believe that something as inhumane as this has happened in my homeland in the name of 'saving money'. While the salaries of those government officials who have the power to cut costs are so ridiculous high, each member could give half of their monthly income back to Treasury without dropping from rich to upper middle-class. Why, I keep on asking myself, is it necessary for the government to pay salaries that exceed the normal needs of a human being with thousands of rands, while more than half of the country's citizens live below the breadline?

Go figure: People suffering from one or another mental illness, and therefore not even able to know what they need, were dying like castaways of ancient societies, while well-paid, well-fed dignitaries sat in their air-conditioned offices, healthy and strong, dressed in their expensive outfits, fully informed, waiting for an official report!

Should we blame “The System” with all its Policies and Procedures, and say it is a monster that turns so-called highly intelligent and refined human beings into uncompassionate, inhumane zombies? Or should we find alternative reasons for the shortcomings of South Africa’s dignitaries who are finding themselves for some reason or another in a position of leadership?

I will rather refrain from airing more of my opinions, as anything said by an Ordinary White Female Middle-Aged South African could be held against me.

May the guilty gets their just deserts, may the souls of the ninety-four and still counting deceased rest in peace, may their relatives and friends find peace and closure, and may all mentally-ill patients hence receive the treatment they need and deserve in a country that calls itself a modern democracy.

This content reflects the personal opinions of the author. It is accurate and true to the best of the author’s knowledge and should not be substituted for impartial fact or advice in legal, political, or personal matters.


Martie Coetser (author) from South Africa on March 12, 2017:

bodylevive – This is truly heartbreaking! Families are still discovering members in mortuaries. Of course, in some cases this indicates that they have ‘dumped and forgotten’ their relative, and now, knowing that they may sue the government for compensation, they remember that they, too, have a relative among the mentally ill.

BODYLEVIVE from Alabama, USA on March 10, 2017:

My God! This breaks my heart and it's senseless for all those patients to die. Be blessed in what you can do.

Martie Coetser (author) from South Africa on March 07, 2017:

bravewarrior – Dumping mentally ill people in illegal and poorly equipped ‘homes’ where they have to depend on unqualified and financially-disabled caretakers, is truly an unforgivable crime. I hope the guilty will get their just desserts. No excuses are acceptable. I am waiting for the next chapter of this horror. Thank you for agreeing with me, Sha!

Shauna L Bowling from Central Florida on March 07, 2017:

Martie, there is simply no excuse for these actions. What ever happened to respect for human life? I feel for the families of those who died because of neglect. I can't even imagine the impact of learning a loved one died because he was denied the simple basic needs of the human body.

Martie Coetser (author) from South Africa on February 10, 2017:

Nadine May – Yes they are better off. No more pain and troubles. But the mere thought that they have died in miserable circumstances due to the carelessness and heartlessness of others, makes me sick.

Martie Coetser (author) from South Africa on February 10, 2017:

kallini2010 – Sometimes I am convinced that the distance between mental wellness and mental illness is only one thought. Maybe two. It takes only one step to fall into a hole. The rest follows automatically.

Nadine May from Cape Town, Western Cape, South Africa on February 09, 2017:

What shocking Martie I never knew that. But I have to admit I just do not watch the news. It seems that our South African leaders are not practicing what they sometimes preach due to greed. How incredibly sad for the people that are closely involved and tried to help. All I can add is that the people who died are better off.

kallini2010 from Toronto, Canada on February 08, 2017:

I just thought of the song "the love is all around you" and changed it to "the crime is all around you" - things will change for sure (not sure for better or for worse), but they will change.

I'm hopeful that this is just a stage - creating more mental illness than there is - sensitive people are not necessarily mentally ill - like songbirds or frogs are not necessarily weak - they are what they are - sensitive to the change in the environment. Birds and frogs die before they could be medicated into some theory about depression and ill-adjustment.

Sad? Maybe. I'm trying "to die before dying" - it's quite a challenge, let me tell you. It's hard to keep on track. Unlike a songbird or a frog, I'm way too heavy so I'm here to stay = hopefully to see which direction mental illness will take = towards mental wellness or mental hellness?

Martie Coetser (author) from South Africa on February 08, 2017:

kallini2010 – I sense sadness in your comment. Tranquilizing mentally ill people may one day be regarded as inhumane, cruel, and a breaching of human rights. Take care, dear Svetlana!

Martie Coetser (author) from South Africa on February 08, 2017:

Genna East – I’ve heard that health care is free and of high quality in England. Not sure how true this is. Now and then we hear of someone suffering a rare condition going to the USA for treatment… and therefore the intensive fundraising.

Excellent health care was offered by the previous Apartheid’s regime to the poor and less fortunate, but this, and even the fact that doctors and nurses were educated and trained according to the high standards of England, and the management and administration of hospitals were superb, mean nothing in the light of the regime’s unjust apartheid’s policy.

Today you have to pay if you want to experience compassion in a hospital, and this is also sad. Some doctors and nurses exploit people's need to be healthy and pain-free.

Martie Coetser (author) from South Africa on February 08, 2017:

vocalcoach – I believe everything we write will be read at the right time by the right people. Decades from now it will be indisputable history and evidence. I just heard on the news that Gauteng’s Director of Health is suspended. Sadly, being suspended means “getting paid to enjoy a very long holiday”, as suspended officials still receive their full salaries while their ‘never-ending’ cases proceed from one level to another.

kallini2010 from Toronto, Canada on February 07, 2017:

As usual I find myself at a loss for words. "Banality of evil"? or the only things are done that CAN be done. Why this or that happens? Why not?

Who will stop what is happening? Mentally ill people occupy one of the lowest rung of the others are willing to take care of - it's difficult after all.

I don't name-blame & shame - I would not know where to begin. All I know that "evil" does not have to be fatal - millions? mentally ill or mentally challenged live a "zombied" life, life that is crippled by medication. Who is to be named and blamed? I don't know.

It's just when people die - it calls for attention - all that happens prior remains outside, behind an hidden. I am unfortunate or fortunate? to see this world a bit too close.

It's important that you raise our awareness about what happens in South Africa even if it's only a glimpse.

Genna East from Massachusetts, USA on February 07, 2017:

Hi Martie...

I have to echo the above comments -- especially Bill's in that we have a deplorable situation with the elimination of social programs for health services through funding. I keep hearing that America has the best health care system in the world. What they don't say is, "only if one can afford it." Disgraceful. Where is the compassion?

Audrey Hunt from Idyllwild Ca. on February 06, 2017:

This is outrageous! What is wrong with the leaders of our countries? Your reports will make a difference - I'm convinced of this. We need more Marties to take a stand and fight for the rights of others. I really believe it's all about money. How very sad. Thank you.

Martie Coetser (author) from South Africa on February 06, 2017:

FlourishAnyway – If the leaders of a country only make an effort to study the history of other countries, they would learn so much. The problem is, those in charge of SA refuse to learn anything that is regarded as ‘Western Civilization’. They want to de-colonize all knowledge. Therefore they are rapidly making the same mistakes that were made by Europeans and Americans. And so Africa will forever be one to three centuries behind Western countries. But they don’t care as they compare themselves to China where dogs and cats are food, and rhino horns and donkey skins are medicine. Unfortunately, this is reality.

Martie Coetser (author) from South Africa on February 06, 2017:

AliciaC – Indeed! “…the test of a civilization is the way that it cares for its helpless members,” are some wise words said by Pearl S. Buck and some others.

Martie Coetser (author) from South Africa on February 06, 2017:

Nell Rose – According to history, the rise and fall of civilizations have a specific pattern. We can only go with the flow. Important, however – whatever happens in the current flow determines the character and power of the flow(s) still to come. Hope the current flow washes me up on heaven’s beach.

FlourishAnyway from USA on February 05, 2017:

How unconscionable that they could not be bothered to provide not even basic care. My aunt is long term mentally ill as well as indigent, and this could be her if she lived there. Of course, in our country during the 70s there was a major push to deinstitutionalize. People were basically dumped as walking wounded and many without social safety nets found themselves on the streets. May karma remind your government bureaucrats of the dignity of even those who cannot decide or care for themselves.

Linda Crampton from British Columbia, Canada on February 05, 2017:

This is such a sad story, Martie. It's terrible that the patients died and that they never received the help they required. As is true for a physical illness, taking care of people with a mental illness and helping them to recover whenever possible is a mark of a civilized and compassionate society. I am so sorry for the patients who died.

Nell Rose from England on February 05, 2017:

Hi Martie, that's awful! but as you said, best not say anymore, but we totally understand. there are no words are there? well there are but......! take care.

Martie Coetser (author) from South Africa on February 05, 2017:

always exploring – I have heard many horrible stories about brutal attacks on mentally ill and even mentally challenged people by evil bullies of all sorts. I am glad our constitution and laws don’t allow this. The MEC has been charged with murder, and we expect charges will be filed against all involved officials. This will be another ongoing case that may last up to 5 years.

Trump was absent when tact and discretion were handed out. I am following your news with great interest, praying that everything will turn out for the best. Fortunately, miracles still happens!

Take care, dear Ruby!

Ruby Jean Richert from Southern Illinois on February 05, 2017:

This is a sad report about innocent lives not receiving a God- given right to medical care. The mentally ill is treated badly in many areas, including here in America. Many institutions have been closed here and many of the patients are on the streets where they are left to fend for themselves. Bullying the street people has become a fun pastime for the so called sane people. I fear it will be getting worse with our new president since he made fun of a crippled reporter who was only asking him a question. Stay on it, with your reporting maybe some good will emerge. The voting booth is a golden opportunity for change. Take care and stay safe. Hugs...

Martie Coetser (author) from South Africa on February 05, 2017:

billybuc – Thanks for the sympathy and empathy. I believe since the beginning of time people are victims of their government. Down here, as in the USA, we whites are being accused of stealing the land of the natives. We would not have done this if there was not a government who had encouraged us to leave in the first place, and another, or the same, government who had encouraged us to settle elsewhere. Governments are the initiators of all trends of events. “If 94 mental patients had died from official negligence in a ‘normal democracy’, the entire national government would have been forced to resign,” is one of the many significant tweets I saw on Twitter.

Martie Coetser (author) from South Africa on February 05, 2017:

PegCole17 – Incidents like these deprive us from hope and positive expectations. I honestly believe that salaries of government officials should be severely cut. Serving the country and its people, and not earning enough money to live like a king, should be the only reason for people to become politicians and managers of state departments.

Martie Coetser (author) from South Africa on February 05, 2017:

marcoujor – Indeed, politicians and aspired business(wo)men used and abused the least competent individuals as if they were merely rabbits in the library of one or another scientist.

Apparently this move was also seen as a government-given opportunity for entrepreneurs to establish home care-centres and to create jobs. Obviously, the MEC & Kie thought mentally-ill patients are not worthy of professional treatment in proper-staffed and proper-equipped facilities. The stories told by the relatives of the deceased are heartbreaking! Investigators found corpses with suspicious bruises still lying unidentified in funeral parlors!

And all our president has to say about this: “Zuma thanked Health Ombudsman Malegapuru Makgoba for his report and investigation into the circumstances of the deaths. He said this would help the government ensure that such a tragedy does not recur in the health sector". No condemnation of incompetent and unacceptable conduct?!?

Thank you, dear Maria, for sharing your involvement with a similar situation in the USA. Hopefully the next generation down here will be better qualified, better trained, and more competent.

Bill Holland from Olympia, WA on February 05, 2017:

This happens quite often in the States as social programs are eliminated due to misplaced funding. We have a political war on our hands here, and I can sympathize and find empathy in your struggles.

Peg Cole from North Dallas, Texas on February 05, 2017:

This sad commentary about how money is misappropriated in terms of salaries versus the health of citizens is appalling. I'm feeling sad for those institutionalized people who didn't get the care they desperately needed. Reading this reminded me that so many things can go wrong in the hands of corrupt government officials. Thanks for sharing this part of the world with us.

Maria Jordan from Jeffersonville PA on February 05, 2017:

"The discharge of all 2000 patients from Life Esidimeni lasted four months, from March 2016 to June 2016."

I've been directly involved in the closure of two state hospitals and the humane transfer of the seriously and persistently mentally ill to other hospitals or community facilities that were best suited for their diagnoses. In both situations, there were hundreds of patients to be considered and an interdisciplinary team worked 18 - 24-months. To the best of my knowledge, any reported deaths were age / disease related (eg. cancer).

This week's Noteworthy News breaks my heart and infuriates me at the same time. This is an example of politics and business taking over the business of humane medical treatment with a resultant loss of precious life.

May we all learn from and do better with the horrific example that has been set. Thank you for sharing this - as awful as it is to contemplate.

Hugs and love, mar

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