The deaths of 94 mentally ill patients transferred from Esidimeni centre is the biggest recorded mental health scandal in the history of South Africa.
The transfer of the 1 371 patients was “rapid” and “chaotic”, and the 27 “mysteriously and poorly selected” non-governmental organisations (NGOs) that they were transferred had “invalid licenses”, according to the Health Ombudsman’s report, released yesterday.
Some of these NGOs “rocked up in open bakkies” to fetch patients, while others selected them like “an auction cattle market”, according to the hard-hitting report.
Ombudsman Professor Malegapuru Makgoba has given the Gauteng health department 45 days to ensure that all remaining Esidimeni patients transferred to NGOs are “urgently removed and placed in appropriate health establishments”.
MEC Qedani Mahlangu resigned after being lambasted by the report. It is unlikely that Mahlangu resigned willingly, as she had stalled the release of the report for almost a month, asking for “more time to respond”.
Heads to roll
More heads will roll in the coming days. The report recommends disciplinary conduct against Head of Department Dr Tiego Selebano and Director Dr Makgabo Manamela for “gross misconduct”, including “tampering with evidence” during the investigation. It says they must also be reported to their professional bodies.
The report recommends action against a further nine officials.
Criminal charges may well follow. The report details three-and-a-half pages of legal violations of the patients’ rights.
“Former MEC Mahlangu cannot simply resign and walk away from this. She, and other officials in the department, have to be held accountable,” said Dr Mzukisi Grootboom, Chairperson of SA Medical Association.
Meanwhile, human rights organisation SECTION27, which has acted for the families in the past, is consulting with its clients about possible legal action.
SECTION27 also wants “official inquests into the deaths of all patients”.
Bed sores and hunger
Some of the patients died of dehydration, hunger, septic bed sores and uncontrolled seizures, which indicates that they were not on their epilepsy medication, according to the report.
The worst offender was an NGO called Precious Angels, where almost one third of the patients transferred there died within a matter of months.
According to the report, the NGOs were only given R112 per patient per day and – worst of all – the department took three months to transfer the first payments. At Esidimeni, where patients were getting adequate care, the department was paying R320 a day.
Health-e News has covered the scandal over a number of months, and produced numerous articles and three TV documentaries – one of which, “Dignity Denied” was used as evidence in the Ombudsman’s report.
During our investigations, we witnessed poor conditions, overcrowding, a lack of basic care and no activities – not even radios or TVs to entertain the patients.
One of the patients we filmed, 23-year-old Sophia Molefe, who had moved back home, had become violent towards her family. Shortly after we filmed her, she overdosed on her medication and died.
Jabu Mackenzie, 34, was transferred to Siyabathanda in Braamfischerville, Soweto. “I am unhappy and hungry and can’t sleep. Please, please let me go home,” she begged.
Jenny Mbarati’s bipolar brother, David, was simply discharged with about 10 days’ worth of medication. It was a “very big shock” to his family.
Meanwhile, Caroline Ncube’s aunt ran away from the NGO she was moved to because there were no blankets and she was cold. Although she turned up at Ncube’s home, no one bothered to phone Ncube to find out whether her aunt was safe.
The chaotic transfer of the patients was a slow-motion accident that could have been stopped. SECTION27 brought legal action against the Gauteng health department in April last year on behalf of some of the patients’ families. They reached an out-of-court settlement after the department undertook that patients would receive the same level of care at the NGOs.
Numerous health professionals also warned the department that the transfer was a bad idea.
“In their current structured placement, patients with chronic mental illness are able to cope due to the 24-hour care and supervision they receive – but upon discharge without the same level of structured care and supervision there is a high probability of relapse and disintegration of the rudimentary coping skills, resulting in a need for more intensive mental health treatments than previously required. Ultimately, the cost of care will be higher,” warned Professor Anthony Pillay, president of the Psychological Society of South Africa (PsySSA), in a letter to Mahlangu before the mass transfer.
Meanwhile, SECTION27 has called for a review of mental health care service provision, “in all its forms, not only in Gauteng but the entire country. Those institutions that are found to be illegal must be shut down”.
This must never happen again anywhere in South Africa. – Health-e News Service.