After years of investigation, and a decade of excruciating delays, buck-passing, heel-dragging and institutional resistance, senior health officials implicated in the deaths of at least 141 mental health patients in the Life Esidimeni saga are to finally come before the courts.
The Daily Maverick reports that the announcement this week that the National Prosecuting Authority is to go ahead and prosecute those implicated in the tragedy marks – for the families and activists who refused to give up – the beginning of the final chapter in their fight for justice.
The decision comes after a decade of investigation into the deaths of the vulnerable psychiatric patients, who died between 2015 and 2016 after being unlawfully transferred from licensed care facilities to unregistered, ill-equipped NGOs.
The NPA has described the event as “one of the most serious human rights violations in democratic South Africa”.
NPA spokesperson Lumka Mahanjana said families were desperately seeking justice after years of delays.
“These delays were occasioned by the complexity of the case, the scale of the evidence, and the necessity of ensuring a thorough and legally sound process. The NPA acknowledges the pain and frustration experienced by affected families during this period,” said Mahanjana.
The final decision, taken by the acting Director of Public Prosecutions, required endorsement from the National Director of Public Prosecutions (NDPP). The incoming NDPP, Advocate Andy Mothibi, had to be briefed on the matter before the decision could be communicated to the public.
The move to prosecute follows a formal inquest presided over by Judge Mmonoa Teffo. The court concluded that several deaths were caused by negligence and systemic failures within the Gauteng Department of Health.
The inquest identified individuals whose conduct may give rise to criminal liability, including former Gauteng Health MEC, Qedani Mahlangu, and former Director of Mental Health in Gauteng, Dr Makgabo Manamela.
After reviewing the findings and supporting evidence, the NPA determined there was sufficient basis for prosecution.
The charges are expected to include culpable homicide against those deemed responsible for the unlawful and negligent actions that led to the deaths.
“This decision marks a critical step toward accountability and justice for the victims and their families. The NPA reiterates its commitment to upholding the rule of law and ensuring that those responsible are held accountable in a court of law,” said Mahanjana.
The NPA will provide updates on court dates and specific charges as they become available.
Historic victory for accountability
The public interest law centre SECTION27 said the NPA’s decision to prosecute was a historic victory for the victims’ families.
Sasha Stevenson, executive director of SECTION27, said: “It’s an important step forward in accountability and justice in this case, and it’s really down to the families and their allies fighting for this for so many years.”
On the NPA’s explanation that the years-long delay was due to the complexity of the case, Stevenson acknowledged the sheer volume of evidence, adding that the wait had taken a heavy toll on those seeking closure.
“It is a complex matter, and there are a lot of pages that need to be read. The delay has been frustrating for families and for SECTION27, who have been calling for this for years.”
She welcomed the NPA’s intention to prosecute a mass human rights violation, saying it set a vital legal precedent for the entire South African public health system.
“It’s important that public officials recognise they cannot be negligent in the decisions they make and the actions they take in public office, and that they will be held to account personally when their negligence causes death.
“The inquest judgment demonstrates quite clearly how the negligent conduct of both Qedani Mahlangu and Dr Makgabo Manamela caused the deaths of at least nine patients…. It’s important that is recognised and that there is a prosecution to hold people to account.”
Warning to public officials
Mark Heywood, an activist and SECTION27 co-founder, said the NPA’s decision marked a bittersweet milestone.
“It’s been a very long wait for the NPA to make this announcement. It is justice of sorts that there are to be criminal prosecutions, as the families and SECTION27 have always argued there should be.
“We await the charging of those people as a matter of urgency. It begins a new, and perhaps the last, chapter in the struggle for justice in this tragic issue.”
Heywood expressed concern over the notoriously slow pace of South Africa’s criminal justice system, but pointed out that simply bringing the charges bore massive weight.
“The mere fact that several high-profile individuals are going to have to live for at least a few years with the title of ‘accused of culpable homicide’ hanging around their necks is a step forward. They should carry that stigma, and they should carry that stigma always,” he said.
Heywood lamented that mental healthcare services had “not fundamentally improved” since the tragedy, but views the impending prosecutions as a testament to the sheer tenacity of civil society and the victims’ families.
“The lesson is: don’t give up. Where an injustice has been done, particularly an injustice on this scale, you have to stick with it until the end.” He credited Stevenson and family representative Christine Nxumalo for keeping the matter alive over the past decade, and hopes the upcoming trial will serve as a stark warning to politicians and public servants.
“It potentially sets a very big precedent … it says to officials: behave in a manner that is lawful, that is humane, that listens to good advice, and that heeds warnings when those warnings are made sensibly,” he said.
‘A good shock’ for the families
For Christine Nxumalo, who lost her sister Virginia Machpelah in the tragedy, the NPA’s decision to finally pursue criminal charges was met with disbelief.
“It’s been nearly eleven years. After the arbitration, there was a long period before we could get the NPA to even look at it. Eventually, we got the inquest, even though the inquest had initially been requested before the deaths started occurring.”
She hopes the trial will send a definitive message to politicians and public servants about the consequences of playing politics with human lives.
“They should act ethically. They should do what they are hired to do, but they must also understand that there are consequences. It may come today, it may come tomorrow, but ultimately it will come,” she said.
Daily Maverick asked Qedani Mahlangu and Makgabo Manamela for comment, but they had not responded by the time of publication.
Parties want justice
While hailing the NPA’s decision to finally go ahead with the prosecutions as a necessary step, the DA and ActionSA have slammed the tardiness of the entire process, saying that justice had been delayed for too long, reports Polity.
The DA wants those identified by the inquest to be prosecuted on the full range of possible charges including culpable homicide, with shadow Health MEC Jack Bloom saying politicians should not escape accountability for gross negligence that leads to suffering and death.
“Successful prosecutions will serve as a deterrent by showing real consequences for those who abuse vulnerable patients,” he said.
ActionSA MP Dr Kgosi Letlape described the tragedy as a catastrophic failure of leadership, ethics and governance.
The party pointed out that the 2021 inquest had already identified Mahlangu and Manamela as accountable for the deaths, and Letlape said prosecutions must mark the beginning of accountability.
“South Africans deserve a healthcare system that protects the most vulnerable, not one that exposes them to harm through negligence and mismanagement, and those who enabled this tragedy must be charged for criminal negligence,” he stated.
ActionSA reiterated its call for stringent consequence management for all those responsible and institutional reform in public healthcare to prevent a recurrence, as well as improved oversight mechanisms to ensure similar incidents never happen again.
See more from MedicalBrief archives:
Life Esidimeni officials to be prosecuted for just two of the deaths
NPA yet to pursue Life Esidimeni prosecutions
Life Esidimeni inquest: MEC dodges blame for ending contracts
Health managers point fingers at politicians in Life Esidimeni inquest