Maverick Citizen


‘I’m the scapegoat’, says Gauteng health department’s Makgabo Manamela

‘I’m the scapegoat’, says Gauteng health department’s Makgabo Manamela
Former head of the mental health directorate at the Gauteng Department of Health, Dr Makgabo Manamela. (Photo: Gallo Images / Sowetan / Thulani Mbele)

A former director at Gauteng Mental Health claims she is being blamed by officials ‘trying to save their own skins’ over their role in the deaths of 144 patients at Life Esidimeni.

The inquest into the 144 deaths that occurred when 2,000 mental healthcare patients were transferred from Life Esidimeni facilities to ill-equipped and unprepared NGO facilities in 2016 has concluded its work for the year.

The inquest, which aims to determine if anyone can be held criminally liable for the deaths, will resume in the Gauteng High Court on 30 January 2023. Dr Makgabo Manamela, the former director of the Gauteng Health Department’s mental health directorate, is expected to take the stand again ahead of the much-anticipated testimony of former Gauteng Health MEC Qedani Mahlangu.

Advocate Adila Hassim is acting on behalf of 44 families of the deceased mental healthcare users and the South African Depression and Anxiety Group.


Manamela testified in her cross-examination that her department had been aware of deaths at NGOs and community-based centres and that she had sent deputy directors to follow up.

“If we just look at the number of people who passed on at the NGOs and Cullinan Care… Did you follow up in relation to the deaths?” Hassim asked.

“Yes, we sent some people and our board to go investigate what the problem was,” Manamela responded.

Approval of licences

She conceded that she had been responsible for approving licences for NGOs and that the NGOs could not operate without licences. She also agreed that a service-level agreement (SLA) was required before a licence could be approved and that SLAs were written by the district.

“It was obvious that when the documents were brought to me to issue licences that everything was complied with,” said Manamela. “I didn’t personally go to NGOs. There were two people who went to the NGOs and if there was a request for a licence, it would come from the NGO identifying team.”

Hassim put it to Manamela that Hannah Jacobus, the former deputy director-general for mental health services who reported to Manamela, had testified that SLAs had not been in place when the patients were placed.

But Manamela insisted only one SLA-related issue had been brought to her, and that it concerned Sharma NGO not returning its agreement in time.

Hassim asked Manamela to comment on why Jacobus had repeatedly testified that Manamela had stopped the collection of paperwork from NGOs, saying it could be done afterwards.

‘Shifting the blame’

“That is not true, I never said so. I have studied health and in my field of study it is impressed upon one that one should record everything that they do, it cannot be put off until the next day,” Manamela said. She added that everyone was shifting the blame on to her.

Read more in Daily Maverick: “Life Esidimeni — seven years of indignity and injustice

Hassim told Manamela that Rochelle Gordon, a former nurse with the Gauteng Department of Health, had also testified that Manamela had interfered with licensing.

Manamela responded that Gordon “was merely trying to save her own skin. How possible is it that four districts can comply and that the only one I interfered with is Tshwane?”

Hassim told the inquest that Nonceba Sennelo, the former Gauteng deputy director of mental health, had testified that “Dr Manamela was always domineering and didn’t want to listen to us.”

Manamela responded: “When a person is domineering, does that mean they [do] not do their work accordingly?”

“Would you agree that the licensing process was rushed?” Hassim asked.

“Yes, I can agree with that,” Manamela responded.

Healing ceremony

Hassim then read from a record that showed the first nine patients died in July 2016, and six others in August at Precious Angels. Hassim said Precious Angels had been allowed to continue to operate despite the deaths and the department had signed another SLA with it on 16 August.

Manamela insisted she did not issue SLAs and said she was not part of the team that decided where patients were allocated to.

She denied having any role in the deaths from severe neglect, starvation and dehydration of the 144 patients during their marathon transfer from Life Esidimeni facilities to ill-equipped NGOs.

Visit Daily Maverick’s home page for more news, analysis and investigations

At a healing ceremony hosted by the Johannesburg Holocaust and Genocide Centre on Saturday, 26 November, the affected families called for legislative changes that would hold public officials more accountable for their actions.

“You can’t be an official in a health facility and just be lawless and just do as you please when there are lives that matter for the survivors and for the people in those facilities,” said Christine Nxumalo, the head of the Life Esidimeni families’ committee.

“They must trust that those people are so afraid of being held accountable for wrongdoing that they will do right even when no one is looking.” DM/MC


Comments - Please in order to comment.

  • Fanie Rajesh Ngabiso says:

    Hopefully the first of many “scapegoat” braais – the species is out of control.

  • Paul Zille says:

    Yes, you are the scapegoat. Hopefully one of many. It is called A.C.C.O.U.N.T.A.B.I.L.I.T.Y. It is a strange concept which holds that people who are in positions of responsibility (and draw fat salaries associated with this) are held accountable for the consequences of their (in)actions.

  • Beyond Fedup says:

    Well said Paul!👏. And this concept is so foreign to our politicians, cadres and many public servants who are on a joyride second to none, getting huge salaries and perks, milking the system and raiding the public purse. Let’s start with the diabolical Zuma and his hideous state capture gang of scumbags and REThieves. Rapacious greed, gross corruption and theft is the order of the day, with total impunity. It is never their fault, they are the victims of a WMC witch hunt and a political conspiracy.

  • virginia crawford says:

    No, you are not a scapegoat but the director in charge of what happened? It seems you were unwilling to listen or take advice, so you are responsible for what happened! Vulnerable people died in appalling circumstances: do you feel nothing? Clearly not – draw the salary, enjoy the power and status, but refuse to be accountable.

  • Matsobane Monama says:

    Medical Hippocratic Oath : first do no harm. As the HEAD, she is responsible for the death of all those patients. If a doctor cozy’s up to Politicians and Business people, he or she runs a risk of putting the lives of patients under his or her care in great danger. Remember Dr Wouter “the soldier”Basson and the two Drs who left Steve Biko in a cold cell to die. Basson should have gone to jail for a long long time.

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