Health officials have inspected NGOs named in the health ombudsman’s report and are making plans to move 700 patients. Leaders at the Gauteng department of health, responsible for more than 100 deaths, have been removed. Despite interventions, patients moved from Life Esidimeni keep dying. Moving patients to NGOs created a murderous system, not easy to undo. By GREG NICOLSON.
Ike Tlholwe got a call on Friday. His 60-year-old brother, Michael, had suffered from “certain delusions” and became a patient at Life Esidimeni in 2011. In 2016, Michael was moved by the Gauteng department of health to an NGO called Shammah, in Cullinan, near Pretoria. A Shammah official said Michael was constipated and would need to go to hospital.
Michael had come to stay with his brother for two weeks in December. “He was alright,” said Ike. He suffered from diabetes, but Esidimeni had managed it, and over the festive season Michael had no apparent physical health problems. At 16:00 on Friday, Shammah called Ike to say the ambulance had arrived.
Then Ike got a call saying his brother had died.
“Michael passed away before he entered the ambulance,” he said.
Michael Tlholwe died over a week after Health Ombudsman Professor Malegapuru Makgoba released his Life Esidimeni report. He died almost five months after it was known that at least 36 patients had died at the NGOs patients had been moved to. Gauteng Premier David Makhura and Health Minister Aaron Motsoaledi have committed to saving patients who remain at risk, but the death toll continues to rise.
“To me it looked like the condition had been there for over a week,” said Ike Tlholwe. His brother’s stomach was severely distended. “Probably Shammah doesn’t have the skill or equipment to have to deal with this situation.”
The health ombudsman on Wednesday said that while the numbers are still being confirmed, more than 100 patients in Gauteng have died since being moved out of Life Esidimeni and into NGOs and hospitals last year. His report, which said “94+” patients had died, blamed the Gauteng department of health for failing to plan, organise, consult and properly implement the plan to move severely mentally ill patients into community-based care. None of the NGOs where patients were moved was licensed. They were grossly ill-suited to providing the necessary care.
“We are above 100,” said Makgoba in Parliament on Wednesday. “I can’t say if that is the end but from the data that is coming one is quite confident that the figure has now gone above 100.”
Speaking to Daily Maverick on Wednesday, the ombudsman said his team was looking into Tlholwe’s recent death, but could not yet confirm whether he had died from ongoing negligence on behalf of the NGOs. Makhura’s spokesperson Thabo Masebe confirmed the death at Shammah.
The Gauteng premier and health minister have been working with relatives of Esidimeni patients and made it a priority to first ensure the safety of those who remain in NGOs. Briefing Parliament on Wednesday, Motsoaledi said there were difficulties in moving patients out of the NGOs, such as a lack of data on patients, and that to avoid a repeat of the move out of Esidimeni it must be done with care.
“It must be done meticulously,” said the minister. “The families said please don’t do a hurried job.”
The 700 patients still to be moved will go to government facilities and back to Life Esidimeni, the only private facility able to provide the necessary level of care. It will take eight weeks to move all the patients, he said.
“Did they not pick up on this? Did they not think that some cases need more urgent transfers?” said the DA’s Jack Bloom. So far, seven of the 27 affected NGOs have been closed by government. “People are still at NGOs that are going to be closed. They’re not suitable and terrible things could happen.”
Bloom acknowledged the scale of the challenge, with 700 patients having to be moved from 27 NGOs, including a total of 42 facilities.
“The reality is this is a rescue operation and there are a large number of patients still in danger,” he said.
It’s still unclear who will be held to account. Gauteng Health MEC Qedani Mahlangu resigned hours before the ombudsman’s Esidimeni report was released. Gauteng department of health boss Dr Tiego Selebano has been suspended and provincial head of mental health services, Dr Makgabo Manamela, has been notified of an intended suspension. Motsoaledi said the health department was co-operating with police investigations but it would be up to the NPA to decide on prosecutions. The minister said lawyers for Selebano and others indicated they planned to challenge the ombudsman’s report.
Democratic Alliance leader Mmusi Maimane on Thursday called on President Jacob Zuma to launch a commission of inquiry into the Life Esidimeni deaths.
“Many questions remain unanswered and in the name of justice for the deceased and their loved ones, we implore the president to establish such a judicial commission of inquiry without delay,” said Maimane.
He noted allegations that national government officials might have known of the plan to transfer patients out of Life Esidimeni but failed to intervene and asked the crucial question: Why did MEC Qedani push the plan and did anyone receive undue financial benefit?
“Many people ask me the motive,” said Motsoaledi on Wednesday. “I still don’t know it. All we know is that there was a concerted effort to do things by force and hide all the things that were not supposed to be done. Was the motive money? The NGOs are too poor to give anybody money so I still cannot make up… What makes a human being do something like this?”
Tlholwe said the plan to move his brother and around 1,300 other patients from Life Esidimeni was disastrous from the beginning. Relatives were ignored and lied to by Mahlangu, he said.
“She seemed to be enjoying our pain,” he said on the meetings with the MEC before patients were moved.
He has heard the government’s commitments but worries that more people will follow his brother and die before they are moved to safe, caring environments. “I think it’s a complete blunder because people are going to continue to die in those NGOs.” DM