Naledi Ngqambela
Image: IOL
The calamitous deaths of over 100 mental health patients at Life Esidimeni in Gauteng Province uncovered the province’s insensitivity and complete disregard for the dignity and rights of the most vulnerable members of our communities and society at large in South Africa – the mentally ill.
The Constitution of South Africa advocates for equal rights to dignity, privacy as well as healthcare, food, water, and social security in this country, and this includes people living with mental illness.
However, the then MEC of Health, Qedani Mahlangu, and her team chose to ignore this as well as the dire implications of moving patients to other NGO facilities that were not well equipped to care for these patients. The NGOs were also not licensed according to the Mental Health Care Act.
It is safe to mention that the Life Esidimeni tragedy showed and put into the spotlight what is truly happening in South Africa’s healthcare system, not only for capable people but also for mentally ill people living with us in our communities and society at large.
While writing this, I thought of our healthcare system generally in our country and how this incident may not have been an isolated one, but rather part of the effects of our ailing public healthcare system. Not only this, but this incident also highlights the attitude and overall approach by our government to care and support adequately for people living with disabilities in South Africa.
Challenges in the Healthcare Sector
The Constitution has played a very important role in ensuring adequate healthcare services for people with disabilities. However, in the new democratic South Africa, adequate healthcare for people with disabilities has been inefficient, even with policies that have been implemented to ensure good healthcare services for people with disabilities.
The healthcare sector faces challenges of lack of funds from the government, lack of financial management by senior management of the public sector, inadequate facilities that will ensure good and quality care for people with mental illnesses, provision of the necessary support from people of society, and good, healthy, and clean environments.
People living with disabilities at Life Esidimeni Centre were at a higher risk than people living without disabilities as they face barriers to access to good transportation, healthy environments, and money to be admitted to good and well-equipped facilities that will accommodate them fully.
Healthcare workers also face challenges such as lack of knowledge and skills in working with people with disabilities, lack of adequate training, and good facilities and resources to provide services.
The decision to move mentally ill patients from Life Esidimeni to unregistered NGOs and under-equipped facilities as a means to save government costs from R320 per patient per day to R100 per patient per day at local NGOs, as the Department mentioned in 2016 during investigations, sent shocking waves and brought shame, disgrace, and disrepute to the Department of Health.
Where was the Department’s conscience at the time this careless decision was taken? What about how their families felt following the deaths of their loved ones at Life Esidimeni?
Patients should not be treated better simply because they can afford to pay more.
NGOs Facing Financial Struggles
Since the start of the financial year, hundreds of NGOs in Gauteng are currently in a difficult position as they face possible closures due to the lack of funds and subsidies from the provincial government.
Organisations such as Tshwane Child Welfare, Child and Youth Care Centre, Rata Social Services, and many other similar NGOs that provide critical services and protection for the vulnerable in our communities have been left in the dark without any confirmation from the provincial government of social development that they will receive funds.
These NGOs not only nurture and fend for persons living with disabilities, but they also provide crucial services such as residency, mental health support, psychiatric evaluation, personal development workshops and activities to equip them to live their daily lives, as well as support in counselling services.
Many of these organisations depend on these government subsidies to not only preserve people’s lives but to fulfil the mandate of the constitution to protect human rights and ensure access to dignity, privacy, and healthcare to the most vulnerable and probably the most deserted in our communities.
Did the Department take necessary, thorough consideration to prevent this or secure more funding considering the crucial role played by NGOs to nurture, fend, and provide good services to the most vulnerable in our society?
The deaths of 144 mentally ill patients came as a shock, disgrace, and distasteful and put the department in disrepute. No one should ever die in that manner, at any point in their lives.
NGOs in South Africa and anywhere in the world play a crucial role in ensuring gaps are filled in providing social services as well as contributing adequately towards our development as a country. We have NGOs across various sectors, including healthcare, skills development and education, nurturing and providing food, psychological support, and even counselling.
These institutions also support a variety of people across the country, from the elderly, youth, infants, and even children. Often times, people who are located in NGOs are usually vulnerable and need extra care for their wellness and development, much like the mentally ill patients at Life Esidimeni.
NGOs in South Africa have many functions, some ranging from providing services, initiatives, and programmes to advocacy as well as development functions.
They are often well respected, entrenched in many parts within society, and contribute immensely to the well-functioning of a democratic South Africa. It is important to mention that the overall success and the ability for NGOs to deliver the services also lies in their organisational structure and culture.
Despite the many functions NGOs provide in the country, there are several challenges that prevent them from providing services to their full potential.
These challenges include poor government prioritisation of these facilities, neglect across the sector, and little political will to ensure that the most vulnerable in society are fully catered for.
However, these challenges have not deterred NGOs from ensuring that people who need these services continue to benefit, even under the most challenging conditions.
Will Justice Be Served?
Will the families of these patients see former MEC Qedani Mahlangu and her team finally prosecuted?
On 11 July 2024, Wednesday, the Pretoria High Court handed a judgement on the Life Esidimeni Inquest, which was fully accepted by the Premier of Gauteng, Panyaza Lesufi.
This inquest was established in 2021 to investigate the criminal liability that caused the tragic passing of 144 mental healthcare patients who were removed unlawfully from Life Esidimeni.
This judgement by Judge Mmonoa Teffo, even though it was unable to assign liability for some of the deaths, mentioned that former MEC Qedani Mahlangu and former mental health head Dr. Makgabo Manamela are responsible for the deaths of at least 10 patients.
This judgement has paved the way for further investigations for possible arrests. It is critical for the National Prosecuting Authority (NPA) to prioritise this matter.
Not only for South Africans’ public trust, but for the families that are still waiting for justice to be served too. There is a serious need for the government to be held accountable for its failures, negligence, and constitutional violations of the patients’ rights to dignity, privacy, and adequate healthcare.
This judgement should also be the start of preventing such horrific deaths as the incident at Life Esidimeni from happening in the future.
“There is no greater disability in society than the inability to see a person as more.” - Robert M. Hensel
* Naledi Ngqambela is a writer and a researcher
** The views expressed here are not necessarily those of Independent Media
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