We should hang our heads in shame over those 94 needless deaths, writes Tinyinko Maluleke.
Sometimes the news is so rotten, the evil so banal, the trauma so profound and the cost in human life so enormous that our mental, cultural and spiritual resources fail to come to our rescue.
South Africa is battling to digest the facts and circumstances in which, under the watch of our democratically elected government, an estimated 94 mentally ill patients were allowed to die within the space of 271 days. They died needlessly, prematurely and, as the health ombuds report, puts it: “They all died silently.”
They died in places which have names far removed from their experiences. Instead of happiness in Takalani (meaning “be happy”), the deceased found death. Where were the precious angels of the NGO called Precious Angels when they were found dead? What confidence and faith can the relatives of the deceased derive from Tsephong Care Centre (place of faith)?
The 56-page long report of Health Ombudsman Professor Malegapuru Makgoba is a devastating read. Late in 2015, a “high-level” decision to terminate the LifeEsidimeni contract was made. Subsequently, the Gauteng Mental Health Marathon Project was pushed through and implemented resolutely.
Grievance, advice and dissent were not brooked. Some interlocutors likened the ruthless implementation of the project, and the failure of their leaders to listen to being enlisted in an army battalion at war.
To signify this, the report quotes Alfred Tennyson’s The Charge of the Light Brigade: “Theirs not to make reply, Theirs not to reason why, Theirs but to do and die”.
In terms of this project about 2000 mentally ill patients at Esidimeni had to be moved and distributed across 27 NGO health facilities, each of which were operating illegally - some were newly established, and most utterly ill-equipped for the task at hand. For the Gauteng Health Department this was apparently a cost-cutting measure and part of the process of “de-institutionalisation of patients”. As the health ombudsman report says, for many of the 27 NGOs, this was a “business opportunity”. The report also points out that the patients were “transferred rapidly and in large numbers from a non-stop caring environment to an unstructured, unpredictable, substandard caring environment”.
All this was done in a chaotic hurry. It all reads like a horror movie script starring Qedani Dorothy Mahlangu in the role of MEC for Health, Dr Tiego Ephraim Selebano as head of department and Dr Makgabo Manamela as director of the mental health directorate.
The report into the “Circumstances Surrounding the Deaths of Mentally Ill Patients: Gauteng Province” lifts the lid on several uncomfortable South African truths.
One is that whatever South Africa is, it is no country for the mentally ill.
The government sanctioned and supervised a project of patient relocation in which some NGOs were reported to have dispatched open bakkies to load the mentally ill allocated to them.
Others jostled for patients as if they were at a cattle auction. Some family representatives testified before the ombuds that to them the unspoken but clearly demonstrated attitude of the government seemed to be “mentally ill patients do not matter”.
Mentally ill patients, on whose behalf trained professionals must make informed decisions, are some of the most vulnerable in society. What happened to the 94 shows us up - all of us - as a ruthless society, led by a government for whom the mentally ill are second-class citizens, without rights and without dignity. Nelson Mandela said “there can be no keener revelation of a society’s soul than the way in which it treats its children”. He should have added mentally ill children.
The other truth relates to US Senator Robert C Byrd’s The Arrogance of Power speech delivered to Senate in March 2003. He starts with the famous line: “I weep for my country.” His grievance with the the US government was the way it ws throwing its weight around in the world.
My grievance is that some MECs, directors, ministers, and party bigwigs have become so swollen-headed with power that it is a wonder we have not had a few heads exploding.
The scale of violations of the legislative provisions of the national health systems, the disdain shown the dignity of fellow human beings, the evasiveness of government officials and predilection for political spin even as the body count was piling up, all speak of an incredible level of arrogance shown by the Gauteng government - the arrogance of power.
Even in the wake of the ombuds’ report, the former MEC for health feels the need to remind us in her statement of resignation that she has “been in the public service, without blemish, for the past 20 years” and initiated the ombuds probe. Most jarring is her euphemistic description of the deaths of the patients as”unfortunate loss of life”.
I do not doubt Premier David Makhura’s sincerity but like many I ask myself where was he when Mahlangu needed to be prompted to answer to the 36 patient deaths in September last year? We now know the actual number of the deceased at that time was 77, thanks to the ombudsman’s report.
In his statement, Makhura refers to his December 6 condemnation of the way the de-institutionalisation project was handled and his meeting with bereaved families on December 15. That was more than a year after his own government took the de-institutionalisation decision. That was 94 deaths later. The premier must look into his heart and seriously consider a resignation.
Ninety-four precious lives have been lost.
As well as considering a resignation, the premier, should explore a respectful way of remembering the 94 and more South Africans who died when they did not have to.
* Maluleke is a professor at the University of Pretoria and an extraordinary professor at Unisa. He writes in his personal capacity. Follow him on Twitter @ProfTinyiko
** The views expressed here are not necessarily those of Independent Media.