Section 27 – Life Esidimeni and The Premier of Gauteng

Dear friends,

For those of you who didn’t hear or read it yesterday, below is an extract from the opening of the Gauteng Premier’s State of the Province address:

Please join me in acknowledging the presence of members of the Family Committee representing the bereaved families of the Life Esidimeni tragedy in which more than a hundred mental health patients lost their lives.

Madame Speaker, we have been working very closely with the Family Committee as we implement the remedial action outlined by the Health Ombud, Professor Malegapuru Makgoba, in his report released on 1 February 2017.

On Saturday 18th February, we held a Healing Ceremony at the Freedom Park, at the request of the bereaved and affected families. At the Healing Ceremony families made an impassioned plea that as we mourn the tragic death of the mental health patients and take decisive corrective action, politicians and political parties must be advised not to use this tragedy as a political football because this prolongs their pain and anguish.  I hereby appeal to this House to honour the wishes of the families.  This is my humble appeal.

As we implement the recommendations of the Health Ombud Report, every step we take will be guided by the wishes of the families and the advice of the panel of sixty experts appointed by the Minister of Health, Dr Aaron Motsoaledi.

The pace at which we move in implementing all the recommendations of the Health Ombud is determined strictly by the wishes of the families and the advice and opinions of experts. We are also collaborating with civil society in this process.

As the Premier of this province, I have publicly stated my deep regret and profuse apology for the tragic death of so many of our vulnerable citizens who were under the care of the Gauteng Department of Health.

I want to reiterate the commitment I made to the families on Saturday: I will spend the remainder of my term over the next two years, to ensure that there is restorative justice and healing for the families and take every executive action possible to restore confidence in our public health system.

I would like to state categorically that the decision to transfer Life Esidimeni mental health patients to NGOs was not made in consultation with the Provincial Executive Council.  The Executive Council and I would have never approved a plan to outsource mental health, a primary responsibility of the state to care for the vulnerable in society, to NGOs. What is even worse is the fact that such NGOs didn’t meet appropriate standards and legal prescripts.

The Provincial Department of Health had repeatedly reported that, as a result of the new hospitals and community health centres, they had enough beds in public health facilities that could accommodate public patients from private health facilities such as Selby Hospital and Life Esidimeni centres.

As the Provincial Executive Council, we do not interfere in the appointment or retention of service providers by various departments, in strict observance of the laws of our land.  We dare not be found on the wrong side of the law.

I have always emphasised to all MECs and HODs reviewing contracts with any service provider must never compromise service delivery, especially the most vulnerable groups which depend entirely on the state for the well-being. Cost considerations can never override the imperative of the quality of care.

It is common cause that the ill-fated transfer of patients to the NGOs compromised the wellbeing of mental health patients. At the very least, the Department should have placed all patients in public health facilities or retained the services of private facilities in case there was no sufficient space in the public sector. As the Head of Government, I am deeply aggrieved by the extent to which those responsible for this tragic and ill-fated transfer of patients to unlawfully operating NGOs, have tried to hide the facts from me, the Minister of Health and the Health Ombud.

Together with the Minister of Health and the newly-appointed health MEC, Dr Gwen Ramokgopa, we are taking swift action to implement all the recommendations of the Health Ombud, the most urgent which is to relocate the mental health patients to appropriate facilities. We will provide regular updates to the Legislature, the Health Ombud and the public on the progress.

We are also working very closely with the families to deal with all the issues in the Health Ombud Report. On Saturday, we hosted a Healing Ceremony for the affected families and this was a heart-rending moment for all of us. We will erect Memorial Stones at the Freedom Park in honour of all those who passed on.

Learning from this tragic death of mental health patients, I have decided to institute a wide-ranging inspection and condition assessment of all centres that care for the most vulnerable – the elderly, people with disabilities and children – whether they are operated by the public, private or NGO sectors.

It is our responsibility as the state to care for the weak. Every institution that provides services to the most vulnerable must meet appropriate standards. We cannot wait for another tragedy before we take wide-ranging action.  The Life Esidimeni tragedy must spur us into action over the next two years to restore the dignity and human rights of mental health patients and all vulnerable groups in our communities.  I am determined to lead this mission over the next two years of my term of office as the Premier of this province.  I will appoint the Premier’s Mental Health Advisory Panel to assist in this mission.

Clearly, this is a moment we should seize in the manner suggested by Crick and others. SECTION27 is ready to give any assistance we can to your endeavours and under your leadership as experts in this field of health care and human right

Mark Haywood

Tender, Loving Greed: The Medical Marikana of the Life Esidimeni Case – News24

First published on MyNews24 written byMichael Simpson, Cybershrink on Health24 03 February 2017, 

Cybershrink considers the outrageous and fatal neglect of the needy

Dr Malegapuru Makgoba, the Health Ombudsman, has done the nation a service in exposing some of the horrific story of the many vulnerable people allowed to die from dreadful neglect,  due to shocking negligence and sheer carelessness of health officials.  Penny-pinching in the name of saving money,  while still enjoying their own generous salaries and perks,  they allowed more than 90 helpless individuals to die terrible deaths by being handed over to groups unable or unwilling to provide even very basic care.

At least 94 humans,  dependent on the help of others,  died of neglect after transfer from institutions capable of providing such aid,  to others that were not properly registered,  not competently run,  and without any due supervision.  We’re not talking of a lack of highly sophisticated treatment : but a lack of food, water, warmth and safe shelter.  Neglect on a scale most of us find hard to imagine.  These people died needlessly,  in most unpleasant and easily preventable ways.  Dying of dehydration, cold,  or hunger, is very unpleasant indeed.  And dying of pneumonia or other easily treatable conditions is careless in the extreme, and implies a sense of euthanasia,  of allowing people to slide away from neglected illness,  because someone decides their lives are not worth preserving.

If the same neglect had been imposed on dogs,  the SPCA would have been able to prosecute the perpetrators ; but with humans,  our reactions are far less efficient.

It’s essential that bureaucrats must not be allowed impunity,  and everyone involved in the decisions to move people to such inadequate facilities, in the failure to monitor their well-being,  and in the failure to act promptly to rescue them,  should be rapidly investigated and prosecuted.  The well-known and over-used South African tactic, of allowing people to simply resign and then escape all consequences for their actions and inactions, must no longer be tolerated.  Too often,  falsely, in the name of “providing the survivors and families with closure” the system instead provides perpetrators with closure and immunity.   What is being closed,  and for who’s benefit ?

Apparently, the disastrous moves were not just stingy,  but made in the name of “deinstitutionalization”, a dangerous weasel word.  It makes sense,  where possible, to try hard to avoid making people dependent on the care of comprehensive institutions, such that their ability to care for themselves, or to retain as much care in the community as practical, is impaired.  But to suddenly dump people who are totally dependent on the care of others,  on people eager to be paid for taking them on,  but reluctant or unable to actually provide even minimal care,  is plain wicked.  Don’t call it “community care” where the community patently does not care.

Don’t rely on any NGO just because of what they claim they can do : assess carefully their track record of what they actually DO,  especially what they do when nobody’s looking.  They should never ever be accredited or licensed for mere convenience,  and without evidence that they reliably meet proper criteria.

It is alleged by some that the transfers did not include what was the absolute duty of all doctors, nurses and administrators previously involved in their care,  to ensure that all patient records,  and relevant information about their needs, was transferred with them.  Indeed, where very sick or fragile patients are concerned,  it would be appropriate for caregivers to make contact with those who took over from them,  to check that the people are being properly cared for.

Not providing families with information,  before and after the deaths,  adds a fresh layer of needless cruelty.

But to make it worse still,  these deaths were foreseen ; there were protests and warnings,  from professionals and experts, families and advocacy groups.  All this was stonily ignore by apparently relentless and arrogant officials,  certain that they knew best and should not be challenged.  Such petty tyrants should never be allowed to believe they are impregnable and or be able to ignore challenges and protests.

If the officials responsible for this debacle knew so little about what they were doing,  or about the cruel results of their commands : what have we been paying them for ?

Does such gross and callous negligence amount to culpable homicide,  or some other serious crime ? Such questions need to be asked and answered,  and soon.  If such suffering were imposed on duly convicted prisoners,  there’d be talk of torture.  These were not civil servants : they were never civil, and not sufficiently servants of the people.

Maybe these could be some of the first cases Gerrie Nel could tackle in his new post ?

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.