94 and Still Counting: Psychiatric Patients Died due to Government Negligence in South Africa

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^st, 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 (NGO’s), also known as “residential care homes”, was chaotic, shambled, rushed, and in a hurry.

Many of the NGO’s were not registered and properly equipped. None of the NGO’s 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 NGO’s 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.

Accurately explained by 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 NGO’s 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 31^st.
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 NGO’s. 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.

Repeated advice and entreaties from relatives, experts, and activists - all of it thoroughly exposed by the Ombudsman and summarized by Huffingtonpost - 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 and still counting, as many corpses collected at NGO's are still unclaimed in funeral parlors.

Mental patients still at NGO’s 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 Report Into the Circumastances 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.