“Shoni had a strong character. He was humble and strong-willed.” This is how Patricia Lethole, mother of 34-year-old entrepreneur Shonisani Lethole, described him recently. She lamented the loss of her son, who died from Covid-19-related complications at Tembisa Provincial Tertiary Hospital on Gauteng’s East Rand on 30 June 2020, and expressed her sorrow about what his untimely death meant for the family’s future generations.

Despite denial by Dr Lekopane Mogaladi, the hospital’s CEO, an investigation by the Health Ombudsman revealed that Lethole’s death was “avoidable and preventable”. 

Lethole had been referred to Tembisa Hospital by the Kempton Park Clinic on 23 June 2020 with chest pain, difficulty breathing and general weakness. He was not given the urgent medical intervention his condition required. He was not given any meals for more than 100 hours and was denied a wheelchair to get to the toilet. Had senior doctors and staff acted according to healthcare guidelines – or at the very least with simple humanity – his path would have been different. 

Almost a fortnight ago, the ombud, Dr Malegapuru William Makgoba, released his report on “circumstances surrounding the care and death of Mr Shonisani Lethole at Tembisa Provincial Tertiary Hospital” seven months after his passing.  

As highlighted by the Treatment Action Campaign (TAC) national chairperson at a press conference, we welcome the findings. The results of the ombud’s investigation brought some relief to Lethole’s family and friends. The almost immediate suspension of the CEO was something we celebrate. 

However, we do not believe it is nearly enough. We stand by the call made by the #Justice4Shoni campaign that Mogaladi be fired, and we call for tough measures to be taken with regard to all the medical personnel who were involved in Lethole’s ill-treatment. 

A group of about 150 of Shonisani Lethole’s friends and family have created the JusticeForShoni campaign. (Photo: Supplied)

The sad reality, however, is that there are many Letholes, most of whom are not as well known and connected as he was, as the public outcry after his death attests. Where the campaign could draw on his social capital and influential friends in many spheres, many people die without so much as a whimper, forgotten by all but their immediate loved ones (if they are fortunate).

The press conference, ably organised by his comrades who never gave up the fight for justice, brought together other families whose loved ones had also perished and/or suffered as a direct consequence of their time at Tembisa Hospital. 

The families gave harrowing accounts of the experiences their loved ones had before dying at the facility, such as being made to sleep on wheelchairs; being denied food, water and medical attention; having to sleep on cold floors; being dumped in the deadly Covid-19 ward without receiving positive Covid-19 results; and dying lonely deaths without their families being notified for days afterwards.

The need to broaden the fight is something his comrades also recognised through their use of the hashtag #FixTembisaHospitalNow.  

More than anything, we are concerned about patient rights which are being violated every day throughout the country, despite the Constitution’s clear promise of access to quality healthcare for all. Tembisa Hospital is a microcosm of the health system crisis in South Africa. 

Tembisa Hospital in Johannesburg. (Photo: Gallo Images / OJ Koloti)

The broader issues plaguing the hospital have been well chronicled over the years, including but not limited to reports of overcrowding in 2019, a dire shortage of medical staff, infrastructure issues and the death of 10 babies after an outbreak of Klebsiella pneumonia in January 2020. As such, the unnecessary deaths of Lethole and others should be read for what they are: the tragic consequences of a health facility in crisis. 

The Lethole family were robbed of the life of their son in the prime of his life, as was the case with the aforementioned families. It would be naïve, however, to assume that patients are only dying unnecessarily at Tembisa Hospital. Other families have suffered similar fates in healthcare facilities in Gauteng, particularly the Ekurhuleni district. For instance, who can forget Kathrina Tsotetsi, who died outside Phutanang Clinic in Tsakane while waiting for healthcare services? 

As an organisation, the TAC has been engaged in community-led monitoring since its inception. We firmly believe public healthcare users should play a pivotal role in monitoring public health services, because they are the first to feel the consequences. Data published by community-led monitoring system Ritshidze, in a report on the state of healthcare services in Gauteng, certainly support the arguments of many patients, and Lethole’s family.

The TAC has received complaints about terrifying and painful cases of patients who have been ill-treated, abused and even chased from healthcare facilities in the district since it started this monitoring. The most common challenge is the negative attitude of staff, which has a wide ripple effect. Patients tend to avoid seeking crucial healthcare due to fear of the abuse, forgetting the increased chances of death. For instance, one lamented: “I think it’s better for me to die than to face the insults of those nurses at that clinic.” Sadly, this patient did die.

Finally, despite waning media interest, it is important for us to realise the battle is not over. We ought to remind ourselves of the demands that the #Justice4Shoni campaign laid out in the immediate aftermath of the ombud’s report:

1. Remove the CEO pending disciplinary action, and strengthen the board to improve the management and governance of the hospital;
2. Investigate the senior medical staff who failed in their responsibilities regarding Lethole’s care;
3. Ensure all hospital management and staff follow all Covid-19 and critical care protocols, maintain patient record keeping and ensure families can speak to patients and/or receive daily updates from staff;
4. Work with the Gauteng Department of Health to improve Covid-19 track-and-trace systems;
5. Ensure that community-based Covid-19 primary healthcare support in Tembisa is strengthened with effective community screening and testing, Covid-19 health information dissemination and other preventative measures;
6. Ensure that hospital management, including staff at all levels, are trained in promoting ethical leadership, so that they develop courage to tell the truth;
7. Provide a report on progress to the Lethole family on the last day of each month until these changes have been implemented; and
8. Publicly acknowledge the pain and suffering of other families whose loved ones have died at Tembisa Hospital in circumstances that need clarity, and where they received substandard care.

The road ahead to fixing the health crisis is still long and we need to get behind the demands of the #Justice4Shoni campaign. We need to sign the petition, get involved through sharing our personal stories and get involved in actions, as much as Covid-19 restrictions allow. DM/MC

Makhosazana Mkhatshwa is the Treatment Action Campaign’s research officer. She writes in her organisational capacity.

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