Nine years after the Life Esidimeni tragedy, which resulted in the deaths of 144 mental health patients and in which more than 1 400 others were exposed to severe violations of their human rights, criminal charges have yet to be lodged against those who were responsible, reports Daily Maverick.
A year ago, on 10 July 2024, Judge Mmonoa Teffo issued a ruling in the Life Esidimeni inquest, stating that former Gauteng Health MEC Qedani Mahlangu and former director of mental health in Gauteng Dr Makgabo Manamela, could be found criminally responsible for the deaths of nine of the patients.
The case was handed over to the National Prosecuting Authority (NPA), with the expectation that the body would consider Teffo’s ruling and decide if the pair would be criminally charged.
The NPA has yet to decide on whether Mahlangu and Manamela will face prosecution.
One of the victim’s relatives, Christine Nxumalo, who reflected on the loss of her sister Virginia Machpelah in the tragedy, said: “When you think of how she died and how the others died… you can’t just say, ‘We’re never going to find the person, we’re never going to prosecute’. It doesn’t sound right.
“To leave somebody unattended, knowing the person is incapable of looking after themselves … To leave her in the cold, in a strange environment – no food, no water, no nothing, until she dies – if that’s not cruelty, then I don’t know what is. That is torture.”
Machpelah suffered from early-onset Alzheimer’s and had lived at Life Esidimeni Randfontein Care Centre for two years before being moved to Precious Angels NGO.
According to Nxumalo, for two months after Machpelah was moved, her family was unable to confirm where she had been placed. The search ended on 25 August 2016, when Nxumalo received a call from Ethel Ncube, owner of Precious Angels NGO, to tell her that Machpelah had died eight days earlier.
Machpelah was one of 20 of the patients to die at the Precious Angels NGO in a seven-month period. The NGO was unlicensed, and patients kept in conditions that public interest law centre SECTION27 would later describe as “squalid and inhumane”. Many of those who lost their lives showed signs of emaciation, dehydration and pneumonia.
Nxumalo said the long wait for the NPA’s decision on whether to pursue criminal charges was “very frustrating”.
“We’ve been trying to follow up… the responses from NPA initially were that they… had looked into the matter. They had… submitted a document for senior (individuals) to approve, and we’ve been waiting for a while for these seniors to actually sign and approve,” she said.
The families of the victims will not allow the NPA to give up or walk away from the situation, said Nxumalo. However, “it’s not like we are getting anywhere, and it’s sad”.
NPA spokesperson Mthunzi Mhaga told Daily Maverick that the prosecuting authority appreciated “the seriousness of the Life Esidimeni case and the importance of accountability for the tragedy, and closure for the families”.
“On receipt of the findings by Judge Teffo, the Acting Director of Public Prosecutions (DPP) North Gauteng Division considered those, with the transcript of the inquest proceedings, and assembled a team of prosecutors to consider the matter and possible options for prosecution.
“In view of the … complexity of the issues involved, the NPA leadership, including the Acting DPP, commissioned an independent legal opinion from Senior Counsel. This opinion will be finalised by mid-July, and it will be considered and guide the decision-making process of the DPP and her NPA prosecutors.”
Mhaga said the NPA was engaging with the victims’ families on the matter.
Long wait for justice
During the inquest, which ran between July 2021 and November 2023, SECTION27 represented the patients who had died in tragedy, the proceedings including almost 150 days of court hearings and 60 000 pages of evidence, said Executive Director Sasha Stevenson.
“This latest one-year delay in hearing from the NPA about prosecution adds to the many delays for families,” she said, adding that it was particularly frustrating, given the finding of the judge, that on the face of it, Mahlangu and Manamela caused the deaths of nine people.
“That finding was made after an exhaustive consideration of a huge amount of evidence, and really laid the groundwork for the NPA to make the decision to prosecute.”
Three months after Teffo’s ruling, relatives of Life Esidimeni victims and survivors picketed outside the NPA’s offices in Pretoria, calling on the NPA to prioritise the prosecution of those implicated in the case.
“The families have had to wait far too long for justice. It’s important for them, but it’s also important because there is so little accountability within a health system that continues to fail vulnerable people…this would be a really important and valuable signal to everyone within that system that you cannot treat vulnerable people’s lives with such disregard,” Stevenson said.
Cassey Chambers, operations director at the South African Depression and Anxiety Group (Sadag), said it was difficult to “trust the system” in the Life Esidimeni case because of previous instances where victims, families and other stakeholders had been let down by authorities.
Both SECTION27 and Sadag were among the organisations that took the Gauteng Department of Health to court before the tragedy, in an effort to prevent the rapid and poorly planned relocation of patients.
“We have to keep pushing, we can’t forget, because we still have those 144-plus people on whose behalf we need to advocate,” said Chambers.
“It’s also for those surviving patients who are left behind. We’re trying to make the system better for them and the future patients who are going to use it, because if we let this disappear, we’re saying that it’s okay to treat mentally ill patients like this.”
Activist and SECTION27 co-founder Mark Heywood told Daily Maverick that various processes leading up to this point, including the Life Esidimeni arbitration and inquest, had raised expectations about the potential prosecution of those responsible.
“In the case of the inquest, actually pinpointing two people… who are held as considered criminally negligent… has dangled out the prospect of justice and then pulled it away again. And I do think, knowing some of the families, that ultimate closure will come with accountability and punishment of those people who closed Life Esidimeni, having been fully forewarned that it would cause loss of life and harm,” he said.
The prosecution of Mahlangu and Manamela would mark the first time senior political officials were held criminally responsible for loss of life and harm incurred as a result of their actions while they were in office, Heywood added.
“That’s symbolic, legally, morally, publicly – it’s hugely important, and it really would send a signal to a lot of other people.”
See more from MedicalBrief archives:
Life Esidimeni judgment opens door for prosecutions
Health bosses guilty of Life Esidimeni deaths
SECTION27 seeks culpable homicide charges against Life Esidimeni trio
Former MEC claims she was unaware of risks of Life Esidimeni transfers
Life Esidimeni inquest: MEC dodges blame for ending contracts