Gauteng’s suspended director of mental health, Dr Makgabo Manamela,was described in her four days on the stand by advocates as being “evasive”‚ “defensive”‚ “deflective” and taking “no responsibility”, says a Sowetan report.
She first asked for a postponement‚ then took sick leave. Finally‚ she appeared and frequently rambled on the stand. Arbitrator, former Deputy Chief Justice Dikgang Moseneke described her testimony at one point as: “many words”.
The report says the five times that Moseneke put Manamela in her place are:
1. Leaders take responsibility – on day three of her testimony‚ Manamela was asked by Section 27 advocate Adila Hassim about her responsibility for the tragedy. Manamela replied: “Even if you are working at a project and there are problems‚ it doesn’t mean it was (just) you (to blame). I cannot take responsibility alone.” Moseneke interjected: “Leaders take responsibility‚ that’s why they are given the power to (give) orders to others.”
2. Don’t just say anything that comes to mind – on day four of her testimony‚ Manamela was questioned by Legal Aid advocate Lilla Crouse about why 59 mentally ill patients who stayed at Life Esidimeni were still unaccounted for. Manamela did not give a clear answer. Moseneke said: “You are a public servant‚ you can’t give us any answer that comes to your mind … you owe us a duty‚ an explanation. You were paid every day to do your work. It was work to look after people. What happened to the 59 people?”
3. You are wasting our time – on day three of her testimony‚ Manamela was told by advocate Hassim that she would not take responsibility for her role as a leader in the tragedy. Moseneke raised his voice‚ something he had not done previously in the five-week-long arbitration hearings. He said: “When are you going to admit (responsibility) for once? You are wasting so much of our time.” A bit later‚ he said angrily: “And you come and waste so much of our time for three days and you never take responsibility for what happened.”
4. Manamela given a grammar lesson – Manamela was asked why she was recalled from Natalspruit Hospital before finishing her term as CEO. She replied: “A letter was sent.” Moseneke was tired of her using the passive tense‚ in which people’s identities were hidden. He wanted to know who sent the letter. “You know me by now. We have spent four days together. (Don’t say) a letter was sent. I need a sentence with a subject‚ verb‚ object‚” he said.
5. You just don’t get it! – Moseneke tried to tell Manamela that her decision to move patients to underfunded‚ ill-equipped‚ unskilled NGOs cost people their lives. She was being cross-examined by Solidarity Helping Hand Advocate Dirk Groenewald about a “procedural error” because she wrote the wrong date when signing licences. Moseneke said: “This is not about the centrality of the licences. You were making a decision about other people’s lives … I am not asking questions about the date and the error. I want you to appreciate that you were given power by a law … to make … certain decisions that would affect the lives of mental health care patients.
“You exercised that power and the result is that the patients died. Can you see that connection?” Manamela responded: “My response is even if there is a procedural error‚ the NGO was assessed.” “The procedural error I am not disputing‚” she said‚ admitting the dates recorded on the licence were incorrect. Moseneke‚ responded: “You do not get it.” Later he continued: “It still blows over your head what a big omission it is that led to … deaths.”
As Manamela spoke, family members of the dead heckled her. And, says a report in The Times, at one point Manamela justified the transfer of 150 adults to the owner of a day-care centre for disabled children by saying that mentally ill adult patients had the minds of children, so they could be classified as children. She said this three times.
She licensed people such as Ethel Ncube, owner of a day-care for disabled children, to look after 150 severely mentally ill adult patients. Moseneke asked her: “How many people died at Precious Angels after you issued a licence and permitted (Ethel Ncube) to take 150 patients?” She hesitated before replying: “I might not arrive at the right number.” Moseneke told her that 20 people had died. “You issued a licence to Ethel Ncube, who has no skill for looking after people like this. She had no beds for them. What do you have to say about the consequences of you permitting her to look after people and now people (have) died?” asked Moseneke.
The report says Manamela seemed unapologetic: “The consequences must be assessed. I don’t have the postmortems. People died. It was heart-breaking. “When my team assessed the place, it was suitable.” She then blamed officials under her for certifying the NGOs as suitable after inspections. “That is what my team did. At my level, I cannot go to each and every NGO (for an inspection).”
Section 27’s Hassim asked her about her salary, revealing that a government official of her seniority would earn between R900,000 and R1m a year. He said this indicated how heavy her responsibilities were. But she continued speaking about decisions made and carried out by “teams”. Hassim replied: “I suggest it’s better if you don’t talk about teams any further.” She once shouted at Hassim: “You need to understand how the government works!” He shot back: “How government works – what, (by) pointing fingers at each other?”
The report says often she gave such lengthy answers that Mosekene stopped her, saying: “Can I take you away from all these many words?”
After insistent questioning about the health department’s decision to end the Life Esidimeni contract, she admitted to Moseneke: “Yes, I supported the decision.”
Answering a question from Democratic Alliance (DA) shadow MEC of health in the province Jack Bloom in the provincial legislature, The Citizen reports that Gauteng Premier David Makhura could not directly answer why former Gauteng MEC of Health, Qedani Mahlangu was not on the original list of witnesses at the Esidimeni arbitration hearings.
He said that as representatives of the state, which included himself, Health Minister Aaron Motsoaledi and Health MEC Gwen Ramokgopa, they decided who would appear at the hearings not as witnesses, but to “give their side of the story and answer questions”. Makhura also did not comment on why Gauteng ANC provincial executive committee (PEC) had given Mahlangu leave of absence to study abroad over this period.
When it was pointed out that ANC chief whip Brian Hlongwa had said in an interview on Power FM that he had spoken to Qedani Mahlangu and told her to “leave the country, going into exile for two years”, Makhura dismissed as “fairytale” suggestions that ANC Gauteng PEC did not want Mahlangu to testify at the hearings, as it would discredit them before the elective conference.
The report says reacting to Makhura’s responses, Bloom said he was “sceptical” on the “claim that everything was being done to ensure that the families of the deceased patients can receive closure through the arbitration process”.
During his response, Makhura mentioned that the intention was that the alternative dispute resolution process, or the arbitration hearings, would be concluded in October 2017, but the absence of the former health MEC has delayed this to next year.
Delivering her medium-term budget in the legislature earlier this month, finance MEC Barbara Creecy allocated an additional R24m to the office of the premier, more than R13m of which has been given to the Esidimeni arbitration. According to the budget, the amount will cover the venue, transport, catering and other costs.
“Makhura should have ensured that Mahlangu was on the original list of witnesses, as he surely could not have thought that the families of the Esidimeni victims would have been satisfied without hearing from her as the key instigator in this matter. Meanwhile, the families continue to suffer because the prolongation of the hearings could have been avoided,” Bloom said in the report.
Suspended Gauteng Health head of department Barney Selebano’s urgent High-Court bid to challenge the subpoena forcing him to appear at the Life Esidimeni hearings has, meanwhile, been postposed until today (Wednesday). The Times reports that Johannesburg High Court Judge Daniel Berger said he was postponing the matter because he had two other urgent matters to hear in detail on Tuesday.
The case will be televised – as permission has been given by Berger for television cameras in court.
Selebano has been subpoenaed to appear at the Esidimeni hearings on the 4th of December. Makhura‚ Ramakgopa and the hearing judge‚ Moseneke‚ are cited as respondents in Selebano’s application.
The report says as he left court‚ Selebano was surrounded by journalists‚ but didn’t answer questions. His lawyer whispered‚ “No comment.”
The report says that Selebano has argued that in terms of the Arbitration Act‚ the Esidimeni hearings are not technically arbitration hearings‚ as there is no dispute between the parties – and therefore‚ there is no legal basis to subpoena him.
An arbitration is usually to clear up a dispute‚ his papers claim.
In this case‚ Gauteng Health has conceded that the state was negligent in the actions that led to the deaths of 143 mentally ill patients. The arbitration is to give emotional and financial closure to victims’ families. Selebano has also made a technical argument‚ that the subpoena was sent from the wrong court.
He is also arguing that he may face criminal proceedings‚ and thus has a right to a fair trial – so he should not to be forced to testify in the hearings and give “self-incriminating” evidence.
The report says Manamela’s lawyer‚ Lerato Mashilane‚ raised the same argument when asking for a postponement of the former Gauteng director of mental health’s testimony‚ but it was dismissed at the Esidimeni hearings. Section 27’s Hassim responded that Manamela had not yet been criminally charged‚ and therefore couldn’t argue that appearing at the hearings would compromise her right to a fair trial.
In 1997, Zola Skweyiya wrote the foreword to the White Paper on Transforming Public Service Delivery. “I want to turn words into action. I want the needs of our people to come first and be satisfied. I want people to view and experience the public service in an entirely new way,” he said. The white paper introduced the civil service to one of its defining principles – Batho Pele. People first.
Greg Nicolson writes in a Daily Maverick report that testifying over four days Manamela was an example of the disdain some officials and their departments have for citizens and what happens when they put people last. They are denied the dignity and services they’re entitled to. They die.
The arbitration was established to promote healing for the relatives of the 143 patients who died as a result of the department’s plan. As Mahlangu and Selebano both delayed their appearances, Nicolson writes that relatives were keen to hear from Manamela.
Health Ombudsman Professor Malegapuru Makgoba found Manamela was one of the architects of the plan to move the patients, supposedly to save costs and implement a national plan long before it was meant to be implemented. She had approved licences for the deadly NGOs, which she didn’t have the power to do. The NGOs didn’t have the resources or skills to manage chronic psychiatric patients. The patients were eventually sent to facilities where many died as a result of neglect, both by the NGOs and the department.
Nicolson says that Manamela was an evasive witness from the moment she took the stand, refusing to answer questions directly and bending basic notions of truth and logic. She frustrated even Moseneke.
Multiple parties said she was lying. Monday was her last day of testimony. Last week, she told Moseneke she had not been requested by SAPS to give a statement. Moments before Manamela was due to leave the stand, Advocate Hassim introduced a letter Manamela’s lawyers had written to the acting Gauteng director of mental health on 2 November 2017 saying she could not meet the police as requested. Manamela had already been reminded that perjury was a crime. She said the request “slipped my mind”.
Nicolson writes that she maintained that the NGOs she had issued licences to were adequate to treat patients when they were inspected. Groenewald presented her with evidence that the NGOs Precious Angels and Anchor received their licences before there was a service level agreement with the state, a requirement for a licence.
“I didn’t know they would be dying, and in our plan we didn’t plan for anybody to die,” she said. Groenewald said she was “reckless and negligent”, but Manamela would only concede that others thought her plan was wrong. “I know now from you, but then it was not wrong.”
Nicolson writes that three witnesses have testified that she instructed NGOs to take patients even when they couldn’t care for them. Manamela denied their claims and said it was their word against hers. “Are you okay, doctor?” Moseneke asked, saying she offered a “barrage of words”. Groenewald said, “I put it to you that your testimony now makes no sense at all.
She was repeatedly questioned on why she didn’t speak out earlier. Relatives and psychiatric professionals had warned that the plan would end in disaster. “It was not my call to make,” she said. “The plan was not to plan that people would pass on.” She claimed that no one said the move should be halted, but during meetings she forced the plan on dissenters. She was warned of the plan’s potential consequences and was aware when the bodies started to pile up, but she maintained she never had the power to speak out.
Manamela claimed she was “saddened” by the deaths, but, Nicolson writes, she placed her own interests at the centre of her testimony and ignored repeated requests to tell the truth to help the families find closure.
He says Batho Pele was originally targeted at front line civil servants, committing them to being courteous and respectful to citizens and delivering services effectively. It has become a catch-all slogan for state employees to put people first. Moseneke is the epitome of the value. He remained respectful to Manamela, even when her answers were incomprehensible, and primarily has at heart his responsibilities to the families to find truth and closure.
Between her deflections and denials, Nicolson says, Manamela revealed her own priorities. “I believe that somehow, somehow during these proceedings I became an accused,” she said in her closing statement. She said the proceedings were biased and Section27 was out to get her. “Everybody who testified before me, their evidence was taken as correct,” she said earlier. “History just repeats itself in this country.”
Manamela claimed the media had also vilified her and violated her privacy. “What I know is that the media was out to tarnish the department about the project,” she said, oblivious to the irony that it was the media and Section27, along with relatives and civil society, who warned the department about the plan. Under tough questioning from Advocate Groenewald and jeers from the audience, she said she and her family’s lives were at risk.
Nicolson writes that Manamela had no regard for the patients or their families, not when the plan was implemented or on Monday. Last week, Andrew Peterson from the Life Esidimeni family committee testified that the department had told families opposed to the plan they were being used by the DA in political battles and they should stay away from white people. That attitude has become entrenched under President Jacob Zuma and elements of the ANC.
Nicolson writes that instead of listening to constituents, Manamela was clear on Monday that she still believes there is a witch hunt against her and continues to vilify those who warned her that patients would die. This is after 143 patients have died. Acting out of self and political interest, putting propaganda over the interests of citizens, she ignored the calls of those she was appointed to serve, and refuses to accept responsibility or to be held accountable. She sent society’s most vulnerable to die and believes she is the victim.