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Gauteng Health ducks and dives on higher death toll and more missing patients

Wooden Cross with a Bright Blue Sky and Sun
Wooden Cross with a Bright Blue Sky and Sun

Gauteng Health is trying to evade responsibility for verifying the deaths of 12 additional people names by activists as perishing in the Life Esidimeni tragedy, which would bring the death toll to 156. Gauteng officials also dispute the accuracy a Democratic Alliance list of an additional 62 people who remain missing.

Gauteng Health said it was not their job to verify 12 more casualties from the Life Esidimeni move, shifting the responsibility onto Health Ombudsman Professor Malegapuru Makgoba. But, says a Health-e News report, when contacted about this on Thursday morning Ricardo Mahlakanya, communications director at the Office of Health Standards Compliance, confirmed that investigating the additional 12 deaths is not Makgoba’s role. “I’ve spoken to the Health Ombudsman and he’s not verifying any names or numbers. From our side we are not involved in this,” he said.

The report says Section27 advocate Nicky Stein had earlier brought a list of 12 additional names to the Life Esidimeni arbitration hearing, raising the death toll from 144 to 156. State advocate Tebogo Hutamo objected to the list, citing that the 12 additional names had to be verified as Life Esidimeni patients who had been moved out of care and then subsequently died as a result. Hutamo said that they have “made contact with the office of the Health Ombudsman” to undertake this verification. But Mahlakanya said his office hasn’t “received anything” and “we don’t have anything in our possession to verify”.

Retired deputy Chief Justice Dikgang Moseneke instructed the state to verify the names before next week Thursday, when final legal argument is heard, or see all 12 added to the official death toll – increasing the number of families eligible for the compensation award to be determined by Moseneke.

Stein said Section27 had sent the list to the GDoH on 7 December, 2017 but had been ignored. “This information has not been sprung on our colleagues this afternoon,” she told the arbitration hearings.

State ‘incapacity’

When asked why it has taken the GDoH almost two months to verify the names with no success, Gauteng provincial government spokesperson Thabo Masebe said that “it was decided that Professor Makgoba would take the names, verify them, and come back to us with a report… We are waiting for that report.”

The report says despite the media attention and national outrage caused by the tragedy which saw just over 1,700 mental health care users in Gauteng moved from Life Esidimeni facilities to 27 non-governmental organisations in a rushed and traumatic manner, the provincial government appears to still be fumbling to take responsibility.

Jack Bloom, the Democratic Alliance’s shadow MEC for health, said “it is ridiculous that we are still disputing the death toll and we still don’t know the full tally, 18 months after the move. This shows the state’s incapacity, which led to this tragedy, continues.”

Up to 62 more patients may still be missing after a list of names – emanating from the GDoH – was circulated on Monday. However, Gauteng Health MEC Dr Gwen Ramokgopa told the arbitration hearings that the total number of missing psychiatric patients is in fact 55.

“Who really knows?” asked Bloom casting doubt on all GDoH figures. “If we are honest we still don’t know the fate of many of the patients. They might be all alone in the world or, even worse, dead.”


Bloom writes in a report on the Politicsweb site: “It is distressing that the Esidimeni arbitration hearing has concluded, but we still don’t have accurate figures for the dead and missing patients. The police have confirmed 144 dead, but Section27 says they have submitted affidavits concerning a further 12 bodies and Legal Aid lawyers say they have at least two more as well. This would push the total death tally to 158, but it could be even higher as many of those who are missing could be dead as well.

“I have opened 62 missing person cases with the police based on a list sent by the Gauteng Health Department to some NGOs last week. But Gauteng Health MEC Gwen Ramokgopa disputed this list at the hearings, saying that there was a list of 59 missing patients that has been reduced to 55, and that 7 of these may have been found in NGOs. This would bring the missing list to 48, which is still a high number. The confusion over lists should be cleared up as soon as possible.

“But it is difficult to see how the list could be further reduced as details are missing for many patients, including names and ID numbers in some cases. In one case, for instance, a person is described merely as ‘Female number 1’, born in 1976.

“Justice Dikgang Moseneke has given the state until Thursday next week to finalise the names and numbers of the deceased.

“I agree with Health Minister Aaron Motsoaledi that there should be an investigation into the possible abduction or kidnapping of patients from Esidimeni as they were not properly discharged.

“Every effort should be made to ascertain the fate of all those vulnerable patients whose human rights were so tragically trashed by the state.”


Breaking down in sobs‚ Motsoaledi apologised to the families of the tragedy. "It’s one of the most painful and horrible events in the history of post-apartheid South Africa‚" he is quoted in Business Day as saying. Motsoaledi was testifying‚ as the arbitration hearings draw to a close.

"As minister of health‚ I wish to apologise unconditionally to the families and to all those who are still living. We have wronged them in a way unimaginable." He said whenever he went overseas‚ people asked him about the tragedy. "It has tarnished us in a way unimaginable … wherever you go they ask you about this."

He said people abroad didn’t understand that he did not have the power to make the decisions of the provincial health departments. Speaking of the chain of events that led to at least 144 deaths‚ he said: "I regarded this as a crime scene."

The report says during cross examination‚ Motsoaledi was told that the Precious Angels NGO was paid R1m by the Gauteng Health Department‚ much of it after patients had been removed. A total of 18 patients died at this illegally licensed NGO‚ which consisted of two houses. It was closed down by the national Department of Health.

Motsoaledi said that the Special Investigating Unit (SIU) "must come in". He also said the Gauteng Health Department needed an overhaul, speaking of "blatant criminality" in the department.

Legal Aid Advocate Lilla Crouse asked if he knew why the Life Esidimeni contract was ended and chronically ill patients moved into NGOs. He didn’t know. "I keep thinking about it. I think maybe with the wisdom of Justice Dikgang Moseneke we will arrive there and say ‘this’ was a motive."

The report says Moseneke wrapped up by thanking families for their participation and calling the process "remarkable". He appreciated their "commitment to see open justice". "I know I fought with (some of you) a good few times when you heckled." He then jokingly imitated their heckling‚ shouting "unamanga" (You are lying)‚ to laughter. "Heckling witnesses‚ battling to keep you calm … yet you remained focused‚ and we shared a lot of pain together and heard a lot of stories together."

The report says after more than 40 days of testimony‚ families started singing. Next week‚ lawyers will present arguments over two days. Moseneke has 30 days to determine a financial award for families of the dead and survivors.


Gauteng Premier David Makhura has, meanwhile, vowed to fight corruption after testimony at the hearings further exposed the levels of financial mismanagement in his government. “The financial position of the health department is indeed a matter of great concern,” Health-e News reports Makhura said during his testimony. “If there is a matter that threatens the financial stability in our province it is what is happening in the Department of Health.”

Section27 advocate Adila Hassim, representing the majority of affected families, pointed out that since 2010 there has been almost R7bn of irregular spending by the GDoH, R1.6bn of which has been referred to the SIU. Yet, she said, even after Treasury’s instructions, between 2015 and 2017 millions continued to be spent on hiring consultants with “outrageous” fees.

For instance, almost R60m was paid to attorneys Ngcebetsha Madlanga Inc and Mdlulwa Nkhulu Inc for 10 months of work – equating to R300,000 per day. “This alone is more than the saving the department hoped to make terminating the Life Esidimeni contract,” she is quoted in the report as saying. A further R13m was paid to BMGI consultants for 12 weeks of work to do a comprehensive diagnostic of Chris Hani Baragwanath Hospital in Soweto. “That’s more than a million a week,” Hassim said, to gasps from the arbitration’s audience consisting mostly of affected family members.

The report says the South African Institute of Chartered Accountants (SAICA) was employed for seven months at a cost of R6m to deal with the GDoH’s accruals problem. And although the problem was not solved the GDoH subsequently signed a two-year contract with SAICA at a cost of R59m.

According to the report, Moseneke pointed out that it was in this context that Life Esidimeni was shut down, and 143 people lost their lives, presumably on the auspices to save the GDoH money. Hassim said this shows that there “is a real mess in the department of health when it comes to money and adhering to procedures” and ultimately of “complying with the law”. “For (GDoH officials) to make a decision about money the way they did with Life Esidimeni is of deep concern to us when there is this very deep-rooted mess,” she said.

The report says Makhura agreed with Moseneke that the internal disciplinary processes in the provincial government are “amazingly superficial” and needed revision. “The disciplinary processes in public services are just a sham,” said Makhura, referring to the lack of accountability faced by the GDoH officials implicated in the Life Esidimeni tragedy. He said he and Motsoaledi have appointed an intervention team to address the financial mismanagement in the GDoH and are also looking at revising the processes for disciplinary action for officials especially when their actions have led to “citizens being harmed”.

Makhura said his government is embarking on a “turnaround strategy” to “crack all the areas of corruption in the GDoH” with the help of the SIU. “The issues that have arisen here will be followed up. We will go for health… and for other departments…. We will work systematically with the SIU and go for corruption and there will be consequences.”

[link url=""]Health-e News report[/link]
[link url=""]Report on Politicsweb site[/link]
[link url=""]Business Day report[/link]
[link url=""]Health-e News report[/link]

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