SA needs new policy after psychiatric patient deaths

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Human rights experts have called for the establishment of a “clear and sustainable” deinstitutionalisation policy and plan of action following the deaths of 37 patients after transfer from a SA-government-funded psychiatric facility, reports City Press.

South Africa must set up a policy framework to guide its deinstitutionalisation process,” the experts said.

This should include, “a plan of action with timelines and benchmarks, the redistribution of public funds from institutions to community services, and the development of adequate housing and community support for persons with disabilities, such as housing assistance, home and family support, and respite care”.

The report says the patients died after being transferred from the Life Esidimeni facility in Johannesburg to numerous non-governmental organisations (NGOs) after the department cancelled its contract as part of cost-cutting measures. Life Esidimeni looked after about 2,000 patients and was funded by the department. Health Ombudsman, Malegapuru Makgoba, was appointed by Health Minister Aaron Motsoaledi to investigate the incident in September.

The UN experts said the relocation had been badly planned and that the Gauteng Department of Health has transferred more than half of the patients “under the care of NGOs with inadequate capacity and resources to assist people requiring high-level, specialised and intensive non-stop care”.

“While deinstitutionalisation is the right approach, when implemented without a plan based in human rights that increases community-based services, and provides adequate housing and financial resources, it can have fatal consequences, as this situation illustrates,” they said.

“Transferring persons with disabilities to unsuitable locations without their consent and adequate support may result in further grave abuses to their right to physical and mental integrity, health and well-being, an adequate standard of living including adequate housing, and places them at risk of extreme poverty, homelessness and loss of dignity.”

According to the report, the experts said it was the state’s duty to protect and guarantee the right to life of people with disabilities by “deterring and preventing abuses by non-state actors”.

The Gauteng Department of Health has started an investigation, but the findings are not yet available. The South African Human Rights Commission and the new Health Ombudsman were also probing the matter.

The report says the UN experts were, however, concerned that the findings of the investigation were not yet available. “We urge the authorities to provide the results of any judicial and other independent investigation as soon as possible, and to explain what measures they have taken to prevent further casualties and protect the rights of those affected by this situation.”

The Office of the Health Ombudsman was not immediately able to confirm the status of the investigation, the report said.

The UN experts are: special rapporteur on the rights of persons with disabilities, Catalina Devandas-Aguilar; special rapporteur on extrajudicial, summary or arbitrary executions, Agnes Callamard; special rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Dainius  Pūras; and special rapporteur on adequate housing as a component of the right to an adequate standard of living, and on the right to non-discrimination in this context, Leilani Farha.


Social Development Deputy Minister Hendrietta Bogopane-Zulu, revealing for the first time that one of the patients was her brother – has labelled the ill-fated transfer of Gauteng psychiatric patients from Life Esidimeni to NGOs, as an “absolute disaster”, says a Sunday Independent report.

Bogopane-Zulu was speaking at the International Day of Persons with Disabilities held at Constitutional Hill in Johannesburg. Remembering the 37 psychiatric patients, Bogopane-Zulu urged South Africans to hold their government accountable for their failures and how to improve care for persons with disabilities.

She said her family was also hurting like all those who lost their loved ones during the transfer of patients from Life Esidimeni. “I have been to the funeral, (my brother) also got transferred illegally like all the families and later died, so when they count the 37 deaths, one of them is my own brother,” she said.

Bogopane-Zulu said the reality of people with mental disability was that they’re treated like they did not exist and their inherent rights and dignity disregarded. “So I can give comfort to the families not only those from Esidimeni group, but to the many families that continue to lose disabled people in institutions with different disabilities,” she said.

“As the government, we acknowledge upfront what happened in Gauteng was wrong, the intentions were good but the execution was a disaster, absolute disaster,” said Bogopane-Zulu. “Patients’ medical assessments were not done the referrals were not properly done.”

The report says her strong comments came on the back of the UN health experts’ reactions and are likely to put pressure on Gauteng MEC for Health Qedani Mahlangu, who has repeatedly faced calls from civil society and families to step down.

Andrew Pietersen, a representative of the Esidimeni families, lamented that Mahlangu had not responded to the families’ memo of demands delivered to her office a month ago. He asked for an emergency intervention by the departments of health and social development to appoint curators to each former resident of Life Esidemini to assess them and help guide decisions on what is best for their care.

South African Disability Alliance director Marina Clarke called for a commission of inquiry into the state of mental health services and the memorialising of the lives lost.

City Press report
The Sunday Independent report

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