National director-general of Health Precious Matsoso this week personally intervened with a large police contingent to secure access to a Pretoria 'private mortuary' where relatives of the Life Esidemeni tragedy had had to scrabble through piled up bodies to find their family.
According to a Health-e News report, Phumzile and Zandile Mashego had found the body of their brother – an ex-patient from Life Esidimeni – in a pile along with other unclaimed bodies in a rundown building in Atteridgeville.
They say the place looked as if it was once a butchery, but it is now registered as a private mortuary with the Tshwane municipality. “After we heard that Solly had passed away, we were told that he was at the funeral home called ‘Put U 2 Rest’ but his body was not there,” said Phumzile. “They directed us to this place that looked like old butchery.”
Inside, the sisters were given gloves and told to look through bodies that were stacked one on top of the other inside a large fridge. They found Solly’s unmarked body in the pile – and were told that they were lucky he hadn’t been given a pauper’s burial as had happened to others.
Solly, who died last September, had been sent to the now-notorious Atteridgeville NGO, Precious Angels from Life Esidimeni after the Gauteng Department of Health decided that it could no longer cover the cost of care for mentally ill people at Esidimeni.
The report quotes a ‘Put U 2 Rest’ staff member who would only identify herself as Erica, as saying that, as the funeral home lacked refrigeration, they used the Atteridgeville mortuary to store bodies. Strangely, ‘Put U 2 Rest’ is a registered funeral home in Tshwane yet it only has a mortuary facility in Groblersdal in Mpumalanga.
The report says when trying to get access to the face-brick building, a man dozing in a station wagon outside confirmed that various local funeral homes used the building to store bodies but said that there were no unclaimed bodies inside. The man, who would not give his name, said he was a driver for the mortuary, which he said was called Redford. However, the building, which had a large metal door big enough for a vehicle to drive through, did not have any signage. It is in a rundown shopping complex just off Cindi Street.
The report says that after Phumzile Mashego told her story at a vigil hosted by the Gauteng Health Department, the national Director General of Health, Precious Matsoso, went to the premises with a large police contingent and demanded access. She was later joined by the new MEC for Health, Dr Gwen Ramakgopa.
After waiting for six hours outside the building, the owner still had not pitched up. Matsoso left the premises at 10.30pm and instructed police to remain there overnight. She then returned at 8am the next morning. “I told the police that no one goes in or out until I arrive,” said Matsoso. “I can confirm that the place is licensed as a mortuary by the Tshwane municipality, and there were nine bodies inside but none were from Life Esidimeni.”
“I suspect that, at a stage last year, there were a lot of bodies there from Esidimeni but that is not the case now. It has been cleaned up because of all the attention.”
Matsoso has committed to investigating “every single death of Esidimeni patients” to “get to the bottom of what has happened”. She confirmed the claim made by DA MPL Jack Bloom that the Hammanskraal NGO, Tshepong, had buried six former Esidimeni patients privately without their families being informed. At the time, Bloom said: “It is highly irregular and suspicious that private burials were done as it is usually the state’s responsibility, and it would be illegal if done without a valid death certificate.”
Meanwhile, Matsoso said that human rights organisation SECTION27 “deserves an award” for their work in exposing the Esidimeni scandal. “I salute them for never giving up. They have my utmost respect for fighting for patients’ rights and sharing information with us in the way that they did. If it wasn’t for them, we might not have known about this until there were a thousand deaths,” said Matsoso.
Health Ombudsman Malegapuru Makgoba reported recently to Parliament that over 100 patients were known to have died at the 27 unregistered NGOs, many from hunger and dehydration. Conditions at Precious Angels, where the most deaths were recorded, were particularly bad, as the place was overcrowded, cold and lacking in recreational facilities.
DA leader Mmusi Maimane has called for a judicial commission of inquiry into the deaths. Maimane is quoted in News24 as saying that the "cruel, inhumane and degrading" deaths in Gauteng between April and June were as a result of a "litany of judgement errors by the ANC government".
"This will remain a stain on the conscience of government for a long time to come."
Maimane said he has written to President Jacob Zuma requesting he establishes the inquiry, as allowed by section 84 of the Constitution. He said the country deserves to know what exactly transpired, how it was allowed to happen, what the national government's role was and how to the shortcomings in the health system can be fixed.
He said that if an inquiry was deemed necessary for the Marikana massacre in 2012, then it was also warranted in this case adding that that Makgoba's report did "not go far enough, or deep enough".
The report says among other things the party wants investigated are: the final number of patients affected, after it was revealed last week that the number is now above 100; that several NGOs tried to obtain a court interdict to stop the transfer of some patients, but were persuaded to abandon legal action by Matsoso; that the Gauteng Health Department underspent R24.4m of its mental healthcare budget in the last financial year; that the cluster manager never briefed the minister on the matter; and that according to email chains, Health Minister Aaron Motsoaledi knew about the plan to move patients as early as March 2016. He blamed poor data and no surveillance.
DA MP Wilmot James said Makgoba's report was an excellent piece of work, but could only go as far as he could, given the brief from the national department. He said the report focused on Gauteng, and there are aspects about the responsibility of the rest of government that "we just don't know".
"We don't know why MEC Mahlangu did what she did. What was the motive? What happened exactly? What drove that practice?" He said it is unclear if the MEC was trying to save money, or had an alleged corrupt relationship with some of the NGOs in question.
The public also does not know the extent to which Motsoaledi was aware of the events, he said. According to the report, James said an inquest will not only establish the causes of the deaths, but also the legal and social implications, as well as the lack of a paper trail. He said a police and Hawks investigation, as recommended by Makgoba's report, will establish inquest dockets into each and every death as a result of "suspicious circumstances", and will be overseen by a magistrate.
Motsoaledi says the national department was deliberately kept out of the loop by "somebody" in the Gauteng Health Department about the deaths of 94 mentally ill patients, reports News24. Motsoaledi and Makgoba were briefing Parliament on Makgoba's report into the deaths of the now more than 100 patients.
Motsoaledi said the province did not co-operate with the National Health Department and the ombudman's requests for information until the first 36 deaths were announced publicly.
"It may look like somebody was deliberately making sure that nobody in the national department knew what was being planned," he told the portfolio committee on health.
He said his National Mental Health Framework and Strategic Plan, which all parties agreed was a "credible plan" to de-institutionalise mental healthcare, was not followed at all when patients were transferred in April and June 2016.
"Somebody within the Gauteng Department of Health deliberately torpedoed that, which means there was a big betrayal to all the plans and agreements we had made."
Makgoba earlier told the committee of the "shambolic and chaotic" nature of the transfers to 27 unlicensed NGOs. He said that the transfers were solely handled by the provincial health department and was one of the main causes of the problems.
He supported Motsoaledi, saying the law currently leaves the minister out of the handling of certain mental healthcare provisions in the provinces. "It's a very important thing that the national minister doesn't get blindsided, but when things happen we ask: 'Where is the minister?'" Makgoba said.
He said certain powers in the Mental Health Care Act need to be handed back to the national department, as the situation is now a national problem. The minister should appoint the provincial health MECs, not the premiers, he said. The laws around the awarding of NGO licences also need to be reviewed.
He also warned against politicians trying to politicise the issue, and attempts by lawyers to gain financially through lawsuits on behalf of affected families. He said the key now is to ensure those patients still at the unlicensed NGOs are protected going forward.
Meanwhile, Motsoaledi said certain individuals within the Gauteng Health Department have registered their intention to take Makgoba's 1 February report on review. They have yet to file an official appeal, but have requested information and data from the ombudsman. He did not name the individuals, but will do so when the official appeal is filed. They have 30 days within which to appeal the findings from the date of the report's release.
According to the report, Motsoaledi said the Gauteng health department has 45 days to implement Makgoba's 17 recommendations. He also said it is up to the National Prosecuting Authority, and not himself or Makgoba, to launch criminal charges.
Learning from the tragic death of mental health patients at Life Esidemeni, the Gauteng province will institute an inspection and condition assessment of all centres that care for the vulnerable, says an HR Pulse report. The wide-ranging inspection and condition assessment will target centres that care for the elderly, people with disabilities and children – whether they are operated by the public, private or NGO sectors.
This report says this was announced by Gauteng Premier David Makhura during his State of the Province Address. “It is our responsibility as the State to care for the weak. Every institution that provides services to the most vulnerable must meet the appropriate standards. We cannot wait for another tragedy before we take wide-ranging action,” Makhura said.
The bereaved families of the Life Esidimeni tragedy were also present when the Premier assured restorative justice and healing for those affected by the tragedy. “I will spend the remainder of my term over the next two years ensuring that there is restorative justice and healing for the families and take every executive action possible to restore confidence in our public health system,” said Makhura.
The report says the Gauteng Provincial Government has been working very closely with a family committee to implement remedial action outlined by the Health Ombudsman in his report. Makhura explained that as the recommendations of the report are being implemented, every step will be guided by the wishes of the families and the advice of the panel of 60 experts appointed by Motsoaledi.
A Premier’s Mental Health Advisory Panel will also be appointed to assist in this regard, especially in the urgent move which is to relocate the mental health patients to appropriate facilities.
“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,” the premier said.
He said the decision to transfer Life Esidimeni 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 the appropriate standards and legal prescripts.”
To honour those who passed on, Premier Makhura announced that the provincial government will erect memorial stones at Freedom Park.
Ramokgopa said the department was at an advanced stage of removing mental health patients from NGOs and into government care facilities. She is quoted in a report in The Times as saying that she would prioritize the care for the mental health patients and has established a dedicated help line for families to contact regarding their loved ones.
To the department's knowledge‚ she said‚ 1‚398 were discharged from the Life Esidimeni facilities of which 789 patients are still in 22 NGOs. "A dedicated team of managers and experts have been established to ensure that the relocation of patients from the NGOs to appropriate facilities. The transfer of patients will not be rushed and will be carried out properly‚" said Ramokgopa.
The MEC‚ a medical doctor by profession‚ was appointed after former health MEC Qedani Mahlangu resigned following the health ombudsman report on the death of an estimated 100 psychiatric patients under the care of government.
Ramokgopa said the team of experts that will assist in the move of patients will include mental health specialists. "If these specialists were involved in the process‚ we could have avoided this tragedy. We need to take a step back and reflect on how the system could have failed to safeguard the vulnerable‚" she said.
Ramokgopa said the department is in the process of obtaining data from Life Esedimeni that would show how many patients were discharged under the project and the department is collating a list of unclaimed bodies and those buried as unknown.Health-e News report News24 report News24 report HR Pulse report The Times report