First published in the Daily Maverick 168 weekly newspaper.

There are for me three traumatic blights in my mind that stick out in our country’s recent history as a failure of state that resulted in unimaginable pain for families as a result of the deaths of their loved ones. One is the Marikana massacre, when 34 mine workers were killed by the South African Police Service while on strike for a living wage. Next month is the ninth anniversary of the massacre.

The second is the gruesome death in 2014 of five-year-old Michael Komape from Chebeng, Limpopo, who, on his second day at school, fell into a dilapidated pit toilet and drowned, suffocated by human excrement. It took his family five years to get justice for him in the face of a callous Department of Basic Education. More children fell into pit toilets after Michael’s death.

The third traumatic blight is that of the 144 Life Esidimeni mental healthcare users who died in 2016 during an ill-thought-out, badly planned and careless transfer to other mental healthcare NGOs. I remember hearing about this case as I was travelling with my family between Cape Town and Pretoria, and being floored by the careless nature in which these vulnerable patients had been shunted around and abused as though they were inanimate beings.

When I was growing up, what I knew of people with mental health challenges was that they were either to be hidden away in a room in the house somewhere where no one would see or hear them, or that they would be taken to special hospitals for care. And then there were, and still are, those who roam the streets homeless, in tattered clothes, incomprehensible when they speak and without any form of medical care.

Mental health in SA has only recently become more prevalent in mainstream conversations; there is still a stigma attached to it and people do not generally understand that it can be managed. It has also been reported that, in 2019, the state spent only about 3% of the total healthcare budget on mental health.

It took the tireless work of Life Esidimeni families, civil society organisations, SECTION27 and the South African Depression and Anxiety Group, which for three years waged a campaign advocating that the government needed to account for what went wrong at Life Esidimeni, for an arbitration to be instituted by retired chief justice Dikgang Moseneke.

Describing the incident, Moseneke said: “This is a harrowing account of the death, torture and disappearance of utterly vulnerable mental healthcare users in the care of an admittedly delinquent provincial government.”

In 2017, during the arbitration, I watched and listened to the families’ heart-wrenching testimonies and witnessed them overcome with grief as they talked about the various states they found their loved ones in when visiting them at the NGOs they had been moved to from Life Esidimeni.

The families described their loved ones as having suffered starvation, dehydration, neglect and torture – things no one should have to suffer, especially vulnerable mental healthcare patients. During the move, patients’ medical records, identification records and medication were lost. Some were transported in bakkies and families were not told where their loved ones were being moved to. One family said when they had visited a loved one, the family member was so hungry they were eating plastic just to get something in their stomach.

Section 27 of our Constitution states:

(1) Everyone has the right to have access to:

(a) [Healthcare] services, including reproductive [healthcare];

(b) Sufficient food and water; and

(c) Social security, including, if they are unable to support themselves and their dependants, appropriate social assistance.

This section was undeniably violated by the officials of the Department of Health, whose sworn allegiance is to the Constitution. What then should become of officials who defy the Constitution, never mind moral and ethical obligations?

The motive of this project to move patients was said to be a cost-cutting exercise for the department. However, it ended up violating the constitutional and human rights of the mental healthcare users. It denied our country’s most vulnerable their right to life, dignity and access to healthcare.

The death of the mental healthcare users and lack of accountability of those who sanctioned those deaths indicate the continued impunity of state officials charged with safeguarding the wellbeing of our citizenry.

This is why the current inquest, while opening up the families’ wounds, is a necessary exercise in the pursuit of closure because it will serve to identify the deceased, the cause or likely cause of their deaths, the dates of their deaths and whether the deaths were brought about by any criminal act. The findings will then allow the National Prosecuting Authority to pursue criminal charges.

Mahatma Gandhi, in a speech in 1931, said: “A nation’s greatness is measured by how it treats its weakest members.” South Africa has consistently shown that it treats its weakest with oftentimes fatal contempt. We can only hope that this inquest will be the turning of that tide so that our people do not continue to die at the hands of the state. DM168

This story first appeared in our weekly Daily Maverick 168 newspaper which is available for free to Pick n Pay Smart Shoppers at these Pick n Pay stores until 24 July 2021. From 31 July 2021, DM168 will be available for R25 at Pick n Pay, Exclusive Books and airport bookstores.