Mahlangu Told Makhura About The Deadly NGOs, Records Show – Bhekisisa

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The tragedy has revealed the Gauteng government’s inner workers, leading one doctor to say, 
‘If this is how things are 
run … God help us all’

It has been called a tragedy. A calamity. A scandal. But this was no accident, no rash decision made under pressure, no force of nature.

It was sheer arrogance, political manoeuvring, incompetence, indifference and possibly greed and corruption that sent nearly 150 of the most vulnerable patients to their deaths.

Some analysts have branded the 
#Life Esidimeni tragedy mass murder.

The department was repeatedly warned against doing so by professionals and organisations with on-the-ground experience. But they were brushed aside.

Civil society and health organisations who spoke out were treated as the enemy.

Opposition politicians were vilified for doing their job. The Democratic Alliance’s Jack Bloom, a long-standing thorn in the side of the ANC in Gauteng, was called a racist and chauvinist when he repeatedly raised questions about the project in the legislature.

“Now we are told nobody — not the MEC, not the officials, not the premier — knew anything about it,” says Mzukisi Grootboom, chairperson of the South African Medical Association (Sama). “For goodness sake, if that is how things are run … God help us all.”

At least one woman was allegedly raped.

And some — between 45 and 62, depending on whose list you check — simply went missing. No one knows whether they’re dead or alive.

Finally, there are people like Guy Daniel Kanza. His family has been searching for him since he was removed from a Life Esidimeni facility in Waverley in northern Johannesburg in 2016.

His name appears on no Gauteng health department list. He is just gone.

A father speaks out about the terrible conditions his son died in after being removed from state-funded hospital care at Life Esidimeni.

 

Sama, a fierce critic of the department of health and often the politicians in charge, has long warned that there are problems across the public health system.

“When we raise concerns, it is not because there is a political decision to question government,” Grootboom says. “It’s is because we are dealing with patients and have an obligation to represent them. We work in the poor communities.”

However, Sama’s remarks are rarely embraced by the government. “We should be treated as allies, as government’s eyes and ears on the ground. Yet, we’re treated as troublemakers,” Grootboom argues.

Had it not been for the work of civil rights groups like Section27 and professional bodies like the South African Depression and Anxiety Group (Sadag), more lives would undoubtedly have been lost. It could have taken years for the disaster to come to light.

“The failures were quite simply due to government’s persistent failure to heed the advice of experts, families and everyone else who could see that this was going to end in disaster,” Charlene Sunkel, who represents both the South African Federation for Mental Health and South African Mental Health Advocacy Movement, told Bhekisisa.

“Civil society often has the experience and knowledge that government officials lack and the government would do well to pay more attention to how this expertise could positively influence and inform their processes.”

Grootboom says the disastrous failures that led to patient deaths are the culmination not only of failing health systems but because there is also no way to address problems once they are raised. “We often see that politicians announce there will be an intervention. Then it is as if the job is done.”

The families of Life Esidimeni patients walked out en masse after the testimony of former Qedani Mahlangu at the arbitration.

The question left unanswered during the past two months’ arbitration hearings in Johannesburg is why the terrible trio of Qedani Mahlangu, the MEC in charge during the Life Esidimeni project, the head of her department, Barney Selebano, and the director of mental health, Makgoba Manamela, were so adamant to push through the transferrals of patients. Was blind resistance to their critics’ advice the only factor, or was there corruption, greed and political gain involved?

Gauteng Premier David Makhura connected financial irregularities to the payment of NGOs and vowed that the government would continue to investigate the reasons for Mahlangu’s decision. The Special Investigating Unit is investigating possible corruption related to project, he said.

But did Makhura know the details of Mahlangu’s plan and, if so, why did he not prevent the tragedy from happening?

Not one of the health department’s senior leaders took personal responsibility and instead claimed that no one in government works in a silo, and the department, therefore, needs to take collective responsibility. Mahlangu alleged her senior staff never informed her of the details of the project, while Selebano and Manamela claimed the exact opposite — that their boss bullied them into it.

“At the start of the arbitration hearings, we had very high expectations to help us answer our questions of why, why why,” says Sadag’s Cassey Chambers. “But we were very disappointed and frustrated by Manamela, Selebano and Qedani’s testimonies. Both at their stall tactics, blaming everyone else — even NGOs like us who were trying to help and doing the work that they should have been doing.”

A teary and clearly frustrated Health Minister Aaron Motsoaledi, who referred to Mahlangu’s behaviour as “criminal conduct”, took the stand on Wednesday. “I have been asked why I don’t fire MECs,” he said. “But I cannot do that. The premier hires and fires MECs.”

Mahlangu’s tone-deaf appearance at the hearings certainly made it easy to cast her as the pantomime villain. She has done nothing to endear herself to either the patients’ families or the public, who have taken to social media to vent their anger against the former MEC.

One by one, officials drove the nails into her political coffin and distanced themselves: from the expedient (officials in the department trying to shift the blame) to the factual (a credible Barbary Creecy dismantling Mahlangu’s defence as MEC for finance) and the political (Makhura and an emotional Motsoaledi).

“There was a clear intention that officials wanted to hide this from the minister and the premier. But for what reason?” Motsoaledi asked.

“When I read the ombudsman report about how people were bundled in vans and tied with sheets, and how they are chosen … like cattle at an auction…” Motsoaledi said, unable to finish his sentence.

“For human rights to be breached in such a manner that is reminiscent of our apartheid era in our democracy is very painful that’s why I feel personally betrayed.”

Watch: Motsoaledi breaks down on the stand

For now, Mahlangu’s political career is over — at least as far as public office is concerned. While South Africa has the dubious track record of rewarding scandal-ridden politicians, anger over her transcends the ANC factions, and she will have to take the fall for government’s worst human rights failure since the end of apartheid.

Makhura has probably done enough to survive the political fall-out. At the hearings, he was the opposite of Mahlangu — he accepted personal accountability and came across as humble and sincere. Crucially, the family members of patients warmed to him.

But the premier’s insistence that he was misled by his former MEC is disputed by Bloom. Makhura repeatedly testified that he did not know patients were being sent to NGOs. Bloom produced the Hansard record of the Gauteng legislature sitting on 15 March 2016, where the premier was greeted by the speaker and answered questions. Later in the same session, the written record reflects, Bloom raised specific concerns about the NGOs. “I speak to mental health NGOs, and they tell me that there are no the facilities [sic] that, it simply has not been done.”

Mahlangu explicitly mentioned NGOs several times in the sitting. “The NGOs have hired the staff,” she said, and then, astonishingly, admitted some had not been licensed. “They have also been given licences.”

What set these proceedings apart from many others into government failings is the warmth, compassion and incisiveness of retired chief justice Dikgang Moseneke, who presided over the hearings. “We finally felt like someone was listening to us. We need more people like the justice in our country’s leadership,” Chambers says.

The testimonies ended on Wednesday. The final legal arguments in the Life Esidimeni arbitration are expected to be delivered on February 8 and 9. An arbitrator will then announce a compensation package for the victims’ families. 

94 Mentally Ill Patients dead – health Ombudsman Report into Life Esidimeni

A damning report by health ombudsman, Professor Malegapuru Makgoba revealed yesterday that 94 mentally ill patients died while under government care. This is 61 more than the originally stated 36 deaths. Gauteng provincial health minister (MEC) Qedani Mahlangu resigned in the wake of the disastrous relocation of patients from Life Esidimeni Hospital to cheaper places of care.

The travesty of the report goes further to lay shame on the appalling circumstance with which this matter was handled. At the time of the minister’s public statements on 13th September 2016 of that there had been 36 deaths, in reality 77 patients had already died. The deaths occurred between May and September 2016. Furthermore, it shows that the 27 NGOs to which the patients were moved had invalid licenses issued by the Department. 94 of these deaths occurred at NGOs while another three deaths occurred at hospitals. It must be noted that 81 of these deaths were patients from Life Esidimeni.

This extract shows the worst of the NGO facilities “75 (79.78%) patients died from 5 NGO complexes (Precious Angels 20, CCRC/Siyabadinga/Anchor 25, Mosego/Takalani 15, Tshepong 10 and Hephzibah 5).

The tragedy grows grimmer as the circumstances of these deaths can only be described as inhumane. Only 1 patient died from natural causes due to their mental illness. Many these patients died from pneumonia, dehydration and diarrhoea in the hastened movement to care facilities. Showing an utter disregard for their well-being and care.  Many of these patients were collected and moved in bakkies in the hast. The tales of woe from the families about the conditions in which their loved ones were kept under has been likened to concentration camps, including malnutrition and underweight.

The relocation of these patients was a cost cutting and saving measure for the department that went ahead despite many warnings and appeals from civil society and experts. The facilities to which patients were transferred were ill-equipped, under-staffed, untrained or unfit to provide care.  The report notes that facilities could not distinguish between making money (profit) and a structured, non-stop care facility. Additionally, the patients were often moved without the families consent or knowledge and in many cases to facilities far from their families and communities.

The night before the report was released Gauteng minister of Health Qedani Mahlangu resigned from her position under the enormous weight of the report and public anger. This, however, is only the start of the battle for these patients and families. The number of deaths and findings is likely to grow as further investigations are done. Moreover civil legal ramifications are likely. At first this lost was likened the number of lives lost at Marikana miners massacre. However, this is three times the Marikana death toll to some of our society’s most vulnerable people.

To download the full report click the link below.

Mental Health – A Glaring Light on 36 Deaths in Gauteng- Comment

stx-depressionThe sad and disturbing deaths of 26 mental health patients during relocation to another facility.  Bringing the total of mentally disabled deaths in Gauteng to 36 over recent months.

The Department of Health has launched an investigation into the deaths stating that the cause and appropriate people responsible are to be held accountable for the tragedy of some of some of our societies most venerable people.

We want to know why the money was pulled and what the department and the province is going to do to take action against this deplorable state of mental health in Gauteng.

 


This article was originally published by Bhekisisa, the Mail & Guardian’s Centre for Health Journalism. To read more health stories from across Africa, go to bhekisisa.org

Life Esidimeni patient deaths are a wake up call that came too late

South Africa is reeling from the news that 36 mental healthcare patients have died since March after they were relocated from Life Healthcare’s Esidimeni facility to nongovernmental organisations in Gauteng.

The question many are asking is: “How could something like this happen?”

The question we should be asking is: “Why did it take 36 deaths before anyone reacted to this tragedy?”

In October last year, the South African Federation for Mental Health issued a statement expressing concerns about Gauteng health MEC Qedani Mahlangu’s  announcement that the provincial government would be terminating its contract with private hospital group Life Healthcare. As part of this, almost 2 000 patients at Life Esidimeni would be discharged or moved to various community-based NGOs. This would take place between October 2015 and March 2016. No prior preparation seemed to have taken place.

The reasons for our concern were simple: there were not enough community NGOs to absorb such a large number of patients. Mental health NGOs that did offer residential facilities were already full and their resources overstretched. Many of the residents of Life Esidimeni needed high-level, specialised care. Even if organisations did have beds available, the NGOs approached to take the patients in did not, in most instances, have the staff or resources to provide this.

The family members of the patients held a march to protest against the relocation. The federation, along with public interest law organisation Section27, the South African Depression and Anxiety Group and the South African Society of Psychiatrists, approached the Johannesburg high court for an interdict to stop the relocations until better provisions had been made.

This failed and the relocations continued.

Then family members began to say that they had not been told where patients had been moved to and that patients were dying after being moved out of the Life Esidimeni facilities.

And now we find ourselves here. It has taken the deaths of 36 vulnerable people for the government and society to wake up and realise that something is wrong with the way we treat mental healthcare users.

The deaths are a disgrace and raise questions about whether the value of human life is being placed at the centre of decisions about where to cut costs.

Mental health has not been a priority in the general health agenda or budgets. The 2015 Rural Mental Health Campaign report notes that there has never been any systematic tracking of mental health expenditure. Only three of the nine provinces were able to report mental health care budgeting in a 2007 World Health Organisation report, which may offer the most comprehensive data available. At the time, the Northern Cape, Mpumalanga and the North West spent an average of about 5% of health budgets on mental health care, largely on specialised psychiatric facilities.

It is not surprising that, when budgets need to be cut, mental health is often the first to be put on the chopping block, although we know that these service users are among the most vulnerable.

People living with psychosocial and intellectual disabilities are often marginalised because of the stigma and discrimination attached to these conditions. This stigma and discrimination frequently leads to human rights violations. In a 2013 federation surveyconducted among 140 mental health service users, 50% of those surveyed in Gauteng, KwaZulu-Natal and the Western Cape reported being emotionally, verbally or physically abused. A large number of those experiencing human rights violations don’t report it or don’t know how to. Others who do report abuses often find authorities unresponsive.

In response, the federation has implemented its Mental Health Watch reporting system, which allows people living with mental illness and their families to report abuses by SMS, WhatsApp, email and post.

The South African Human Rights Commission had been made aware of the Life Esidimeni victims’ plight before the deaths but remained silent while healthcare service users’ constitutional rights were being threatened.

Despite assistance offered by the federation and others to ensure the Esidimeni patients’ transitions were conducted in a dignified, patient- centred manner, the Gauteng department of health implemented the relocations with little to no consultation and with no respect for the rights of these individuals or consideration of their vulnerability.

It took the deaths of so many people to act as a wake-up call for action. It is paramount that mental healthcare users or persons with mental disability be involved in decision-making or supported decision-making about all aspects of their lives. As far as possible, service users must make their own decisions. In instances where a per- son is unable to participate in mak- ing a decision, a caregiver or support person should respond on behalf of the person.

The disability sector’s slogan “Nothing about us without us” must always be applied.

Our society needs to focus on the protection and wellbeing of the individuals who once called Life Esidimeni their home to ensure that the places they are moved to can also be called home — where they can be happy, loved, cared for and safe.

The fate of the remaining Life Esidimeni patients now lies in the hands of duty bearers legally obligated to protect their rights and prevent more deaths.

Charlene Sunkel is the advocacy and development programme manager of the South African Federation for Mental Health. Marthé Viljoen heads the federation’s awareness and information programme.

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Gauteng Health NCDs committee shows the way

Gauteng leads the way by holding regular intersectoral NCD prevention and control co-ordination meetings.  Its goal is to co-ordinate and facilitate action and planning for NCDs in the province.

At the  second meeting at Helen Joseph Hospital on August 28 2015.  Holding the first provincial NCD prevention and control committee meeting.

The Gauteng DoH is the first province to bring together members from multiple government sectors  (all of government) – Education, Social Development, Sports and Recreation, Rural Development, and NCD stakeholders (all of society.) These include NCDs NGOs including SA NCD Alliance, CANSA and Love Your Nuts and the industry. The aim is to create and focused inclusive plan to combat NCDs.

Gauteng DoH is applauded for bringing together all relevant members to discuss and formulate a plan to make a positive change in the approach to fighting NCDs.  This is a great example for us all to follow especially at the critical provincial level.

The next meeting is on 23 September 9:00 to 13:00 at Ann Latsky College.  RSVP to Ms Dudu Mthombeni

Gauteng Health NCDs committee shows the way

Gauteng leads the way by holding regular intersectoral NCD prevention and control co-ordination meetings.  Its goal is to co-ordinate and facilitate action and planning for NCDs in the province.

At the  second meeting at Helen Joseph Hospital on August 28 2015.  Holding the first provincial NCD prevention and control committee meeting.

The Gauteng DoH is the first province to bring together members from multiple government sectors  (all of government) – Education, Social Development, Sports and Recreation, Rural Development, and NCD stakeholders (all of society.) These include NCDs NGOs including SA NCD Alliance, CANSA and Love Your Nuts and the industry. The aim is to create and focused inclusive plan to combat NCDs.

Gauteng DoH is applauded for bringing together all relevant members to discuss and formulate a plan to make a positive change in the approach to fighting NCDs.  This is a great example for us all to follow especially at the critical provincial level.

The next meeting is on 23 September 9:00 to 13:00 at Ann Latsky College.  RSVP to Ms Dudu Mthombeni