Tears of loved ones flowed in a room filled with disbelief as a damning report was released on Wednesday by the health ombudsman, who lambasted the Gauteng health department for negligence resulting in the “silent deaths” of 94 mentally ill patients while under the care of NGOs last year.
Apart from this staggering figure, ombudsman Malegapuru Makgoba further revealed these numbers would rise because many corpses had not yet been identified.
Of the 94, only one person died from a mental-related illness. The rest died due to, among other things, dehydration, diarrhoea, heart attacks and epilepsy.
More than 1 300 patients were last year transferred from the Life Esidimeni facility to hospitals and 27 unlicensed nongovernmental organisations (NGOs) operating unlawfully, the report found.
During the briefing, news was delivered about the sudden resignation of Gauteng health MEC Qedani Mahlangu.
She, too, had been fingered in the report for not stipulating the correct figure of those who died. Makgoba said when Mahlangu said on September 13 that 36 patients had died, 77 patients had already lost their lives.
“I met the MEC on November 29 last year and asked her how many patients had died, she answered ‘40’ … I asked the head of department and he said ‘37’… I asked the director and he said ‘48’.
“These are three of the most senior people and they don’t know how many patients died?”
Makgoba said three key players in the project were Mahlangu, her head of department, Dr Tiego Ephraim Selebano, and her director, Dr Makgabo Manamela.
“Their fingerprints are peppered throughout the project. The decision was reckless, unwise and flawed, with inadequate planning and a chaotic and rushed or hurried implementation process,” Makgoba’s report read.
Health Minister Aaron Motsoaledi said the matter “goes beyond embarrassment”.
“I’m distressed and very angry… something like this should have been avoided.”
Makgoba said some executions of the project showed a total disregard of the rights of the patients and their families, including the right to human dignity.
Makgoba said several actions were negligent or reckless, including:
- Overcrowding in the NGOs.
- The inadequate transfers of frail and sickly mental patients.
- NGOs had no qualified staff and skills; improper heating during winter; lack of food where patients became emaciated; licences without legal or delegated authority; and transferred patients without the knowledge of their families.
- “The manner, the rate, the scale and the speed of transferring such large numbers of patients were reckless,” Makgoba said.
- Some of the 27 NGOs to which the patients were transferred operated under invalid licences.
- This meant all patients who died in those NGOs died in unlawful circumstances.
Recommendations by ombudsman include:
- The Gauteng Mental Health Marathon project must be cut.
- Disciplinary action must be instituted against Dr Tiego Ephraim Selebano and Dr Makgabo Manamela for gross misconduct.
- They must be suspended for tampering with evidence.
- Corrective and ethical action must be taken against five deputy directors, the chairperson of the MHRB and the CEO of the CCRC.
- All remedial action must be instituted in 45 days and progress reported to the CEO of the Office of Health Standards Compliance.
- The ombudsman said the police findings must be shared with the appropriate agencies.
- The department must review all 27 NGOs and deregister those that do not meet healthcare standards.