Former Premier David Makhura, former Gauteng Finance MEC Barbara Creecy and former Gauteng Health MEC Qedani Mahlangu, all at the centre of the tragedy in which 144 mental healthcare patients died, must be held accountable for the tragedy.
This is according to Christine Nxumalo, who is on the Life Esidimeni families’ committee and who was asked by Daily Maverick to share her thoughts on the past few weeks of the inquest.
“As much as … Makhura, cannot be charged criminally… they still need to be held accountable for not doing their part and ensuring that governance and their oversight roles, with early warning processes, (were) in place,” Nxumalo said.
Referring to Mahlangu, Nxumalo said: “She claimed she was going for counselling and had suffered… she does not know what suffering means nor does she understand what it means to suffer. She did not lose a loved one under the most horrific circumstances brought about by a decision that she took and stuck to, despite several warnings. And even when people died there was no care or interest to do the right thing…
“Her apology meant nothing… she showed no remorse and still cannot accept that it’s her decision….”
The indictment by Nxumalo rang through all of last week as outgoing health ombud, Professor Malegapuru Makgoba, reflected on his seven-year term in office as the inaugural health ombud.
According to Makgoba, South Africa’s health system is “a dysfunctional mess”.
He was particularly scathing about the Life Esidimeni tragedy and Mahlangu’s role, saying: “What I found very strange about that was when the MEC and her senior people said it was normal for people to die… I couldn’t believe that.”
Makgoba was appointed by former Health Minister Aaron Motsoaledi in 2016, after a more than 500% spike in medico-legal claims, tasked with enforcing health and safety standards in the department.
The Life Esidimeni tragedy was the first high-profile case by the ombud to enforce consequences for the actions of health officials presiding over the deaths of mental healthcare users.
While the case, now in its seventh year, may appear to be plodding, it is an example of justice in action.
Lack of understanding
Makgoba, a medical doctor himself, described the Eastern Cape as an “embarrassment”, the Free State as having “disorder and no harmony” and Gauteng as “problematic” – in fact, of the more than 10 000 cases dealt with by the office of the ombud, half were from Gauteng.
In March this year, nearing the end of his term, he had just delivered a report on and recommendations for the deplorable conditions at Rahima Moosa Mother and Child Hospital, which were brought to the public’s attention by Dr Tim de Maayer. The report spotlighted a crisis of leadership when it came to the Department of Health, especially in Gauteng.
The Life Esidimeni tragedy demonstrates this exact point, with a leadership cohort that took decisions showing a complete lack of understanding or appreciation of patient needs and well-being.
Political and administrative appointments, particularly in health, still need to have an appreciation of the power they have over people’s lives and have measures in place to ensure these lives are safeguarded at all times.
In her reflections on the Life Esidimeni inquest, Nxumalo said that what happened to the 144 people who died during the transfer of mental healthcare users to ill-equipped NGOs was not only a moral but a systemic failure: “Monitoring and evaluation in each department, especially in Gauteng Health, need to be urgently beefed up. Each region, with its districts, must have a team monitoring and evaluating plans and programmes being implemented, otherwise this type of tragedy will continue to happen.”
Makgoba was rightly appalled at the callousness of health officials’ attitude towards the deaths of mental healthcare patients.
You do not have to be a doctor to value people’s lives and dignity, it is a human imperative.
See more from MedicalBrief archives:
Life Esidimeni: Premier told 40 patients dying every year was ‘normal’
Former MEC claims she was unaware of risks of Life Esidimeni transfers
Life Esidimeni inquest: MEC dodges blame for ending contracts