SAFMH Calls On Government To Show Commit To Mental Health Care

Every year the 3rd of December is commemorated as International Day of Persons with Disabilities (IDPD). As part of the Disability Month activities that have been taking place over the past few weeks, Government has been drawing attention to the fact that this year marks the 20th Anniversary of the Release of the White Paper on an Integrated National Disability Strategy and the 10th Anniversary of the Ratification of the UN Convention on the Rights of Persons with Disabilities. Although the fact that these policies have been part of the South African disability sector for many years now is indeed something to be celebrated, the SA Federation for Mental Health (SAFMH) feels it is important to acknowledge all the ways that these and other policies, like the Mental Health Policy Framework and Strategic Action Plan (MHPF), are not being implemented, and are currently failing persons with mental disabilities as a result.

On IDPD last year, which was declared a day of mourning for those who lost their lives as a result of the Life Esidimeni tragedy, SAFMH and the South African Mental Health Advocacy Movement (SAMHAM), delivered a report regarding the state of Mental Healthcare in Gauteng, specifically focusing on the issues that had unfolded with Life Esidimeni, to the Gauteng Department of Social Development. The aim of the report was to show how a better implementation of the MHPF was needed to improve the services and care offered to mental health care users. In the report, SAFMH made the some of the following recommendations:

  • Mental health services need to be prioritised and developed with an equal level of (high) importance across all provinces in SA, and across rural and urban areas
  • Services and resources at community level should be developed in consultation with mental health care users, their families, NGOs and other key partners to ensure that the development of such services are done in an informed and collaborative way
  • The prioritisation/resourcing/implementation/monitoring of the Mental Health Policy Framework and Strategic Action Plan at provincial level is essential, and provincial Departments of Health need to be held accountable for failure to do so
  • Savings generated through budget cuts in tertiary Psychiatric Care Facilities (such as what happened with the termination of the Life Esidimeni contract) need to be transferred to support community-based care
  • Government needs to address the widely pervasive shortfalls in resources needed to adequately facilitate deinstitutionalisation policy requirements
  • There is a need for NGOs to become more recognised as key partners in the delivery of mental health services and to be respected and treated as such. Government needs to recognise that without the upscaling of and provision of community-based services SA’s commitment towards deinstitutionalisation will never be realised
  • SA requires more consistent and more comprehensive subsidisation of community-based services, with adequate increases and timely payments of subsidies to ensure continuity in community-based mental health service delivery
  • There is a need for more family empowerment programmes to ensure that MHCUs who return to their homes are able to receive the support they require from their families and those family members are sufficiently equipped with the necessary skills to help them take care of mental health care users within their homes

Not only was there no response to the report or any of its findings or recommendations, but since then the scale of human rights abuses that mental health care users faced has was sadly highlighted in the Ombudsman’s report on Life Esidimeni, which was released two months after the SAFMH report.

Today the number of people known to have lost their lives as a result of the Life Esidimeni tragedy stands at 143, and with the arbitration hearings currently taking place, more disturbing details emerge on a daily basis of the gross neglect and abuse that the patients suffered at the hands of those who were responsible for their care. Despite the severity of these claims, those responsible for the project, such as former MEC Qedani Mahlangu, have been using every method to try an avoid testifying at the hearings.

Celebrating the existence of legislation and policies aimed at improving the lives of those living with mental and physical disabilities, while not prioritising the implementation of these legislations and policies, leads to a system that values the lives of persons with disabilities in word but not indeed.

Government has not been able to ensure that those responsible for the tragic and preventable deaths of Life Esidimeni patients face justice, nor has Government been able to ensure that the MHPF and other important legislation is implemented in a timeous and correct fashion. Until such important things start taking place, IDPD will remain a reminder of the horrific treatment and abuse that vulnerable persons with mental disabilities experienced because of Government’s lack of action.

SAFMH will continue to put pressure on provincial government departments to commit towards developing a plan to implement and monitor the allocation of resources for the successful implementation of the MHPF in all provinces. SAFMH will also be hosting the Movement for Global Mental Health Summit from 8-9 February 2018, which will provide mental health care users with the opportunity to share their experiences and lead the call for improved mental health care services in line with the Sustainable Development Goals.

SAFMH calls on Government to prioritise the implementation of legislation like the MHPF and the UNCRPD and to recommit to upholding the rights of persons with mental disabilities.

Statement from the South African Mental Health Advocacy Movement (SAMHAM) on IDPD–

We as mental health care users (MHCUs) have historically been living our lives in silence while decisions have been made about our lives without our participation. Our lives have value and our views and opinions matter, and we can help to create a society where people celebrate diversity. We want to see an end to the complete disregard for our fundamental human rights – when we speak, we demand to be listened to and when decisions are being made that affects us, we demand to be involved in making those decisions. Contrary to common beliefs, we as MHCUs can add value to society and we can achieve recovery to our full potential, provided our rights are respected and protected.

 

FOR ENQUIRIES INFORMATION PLEASE CONTACT:

Marthé Kotze – [email protected]

Programme Manager Information & Awareness

SA Federation for Mental Health

011 781 1852

Truth Over Justice – Life Esidimeni Arbitration

On Monday, October 23rd during the arbitration hearings in the tragedy at Life Esdimeni, a family member of one of the victims suggested that amnesty is given to the NGOs.

The Life Esidimeni tragedy claimed the lives of 141 patients from the facility. They were moved to NGOs who falsified documentation and left the patients in an appalling condition and left to die

This was suggested in the hopes of “getting answers” in the words of Christine Nxumalo, whose sister died at the notorious Precious Angels NGO facility. She further suggested that the officials not be held criminally liable for giving false testimony they made at the arbitration.
Further, she stated that everything that was said in the hearing by Precious Angels founder, Ethel Ncube Nxumalo “I can tell you that everything she said was a lie”

Christine’s sister was reported to have died on 17th of August 2016 while in a statement from the Founder of Precious Angels. This contradicts a paramedics report showing she actually passed away two days earlier on the 15th August.

While she critical of the department and their actions she wants answers and the truth rather than prosecution for the sake of the families. While she is still waiting on answers from the SAPS on an open case and autopsy report from them.
Going further Christine had said that on numerous occasions they had contacted the Health Department to warn them of the implications of ending their contract with Life Esidimeni. To which they received no response from the department.

This has raised the question over truth over Justice with the obvious moral complex involved. Yet, this would allow for all the answers to be given to the families and the full story finally told of what transpired over the months leading to the deaths of 141 mentally ill patients.

 

Timeline of events

Image Credits: www.ewn.com

Health-e Journalist Wins Award for Documentary on Life Esidimeni

Kyla Hermannsen a former journalist for Health-e has been part of the winning entries at the Vodacom Journalist of the Year awards for the Northern Region, for her documentary on Life Esidemeni, Dignity Denied.

Health-e in a statement has said that the documentary was partly produced while she was Hermannsen was still working at the organization. The new outlet has commented on how proud they were of the announcement and commends the journalist and the team comprised of Ashley Market, Tshepo Dhlamini, Tshidi Lechuba of eNCA’s Checkpoint, and freelance cameraman Shamiel Albertyn.

In a comment from the judges of the awards, “Journalism can influence awareness of what is happening in our country and drive public discourse. Months of investigation resulted in a series of reports that were thoroughly researched, poignantly told, well shot and edited – and exposed conditions contributing to the death of one of the subjects. This impactful reporting was subsequently even used during the official investigation.”

The documentary aired 16th August 2016 on Checkpoint a show on eTV and eNCA.

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.