While Paralympian murder-accused Oscar Pistorius was applying in Pretoria for a relaxation of his bail conditions, including permission to travel and drink alcohol, Ronnie Fakude – a 50-year-old, nappy-wearing paraplegic fraud accused – was begging Bloemfontein magistrate Rashid Mathews to grant him bail. However, before reaching his decision last Monday, Mathews had to determine whether Fakude was indeed paraplegic, or simply shamming.
Sitting in a new, donated wheelchair and dressed in a grubby bathrobe over his striped pyjama pants, Fakude, previously referred to as "Prisoner A", listened while Grootvlei prison doctor Margaret Bikane and private practitioner Reggie Mabuye proffered diametrically opposed diagnoses of his condition.
Bikane told the court she had seen Fakude walking on crutches in the corridors of Grootvlei, where he has been an awaiting-trial detainee facing charges of fraud and racketeering since December 2011. However, Mabuye, who examined Fakude in early March at the behest of the Wits Justice Project, concluded that Fakude was a paraplegic with urinary and faecal incontinence.
Fakude contacted the project for help because of his inability to access adequate medical attention in prison. Mabuye said: "He had acute bronchitis, gastritis, peptic ulcers and bed sores on his buttocks oozing pus. He was genuinely ill. He's a person of diminished ability to care for himself and depends on others."
Fakude has no bowel or bladder control, a damaged lung resulting from prison-acquired tuberculosis and is prone to infection because of his compromised lung. He has one kidney and his intestines are sutured because of injuries from the hijacking that caused his paraplegia. He also suffers from depression.
Bikane, a Cuban-qualified doctor who is married to a Grootvlei director, sees things differently. She had no compunction about discharging Fakude from the "hospital" where he has remained since his March consultation with Mabuye.
"I want him to go back to the cells," she said. "He's been there before and he survived and I don't see anything to make him not continue [sic] …"
Fakude was previously accommodated in a cell designed to house 32 men. He shared it with 87 others.
Bikane added that she also diagnosed "delusions of the grandiose type" and referred him to a psychologist but the prison was unable to provide one.
To resolve the doctors' differences, Mathews referred Fakude to Dr Frans Kruger, a Universitas neuro-surgeon, for a third opinion. After an examination and magnetic resonance imaging scan, Kruger's report confirmed a lower motor neuron injury. The report said that Fakude had "no function of his lower limbs, his paraplegia was permanent and the soles of his feet were soft with no signs of recent weight bearing".
To complicate matters, Mathews had to determine the suitability of Grootvlei facilities for a person with disabilities – an inquiry that highlighted the inadequacy of prison medical services and facilities. For example, when Fakude's lawyer Herklaas Venter asked Bikane to describe the toilet and bathroom facilities, she said: "I don't know. I haven't seen them … I don't go into that section."
Not convicted yet
A crying Fakude told the court how hard it was for him to cope with the limited bathroom facilities and how difficult it was to keep his wounds clean.
The prison and its hospital, Mabuye told the Wits Justice Project, is completely unsuitable for paraplegics: "The 'hospital' is a converted cell and doesn't even have proper examining facilities. They couldn't even provide me with medical gloves, a working blood pressure machine or a thermometer. I had to rely on experience to deduce my patient's condition.
"Ronnie hasn't been convicted yet. I don't believe he should be kept in prison until, if and when he is charged. Keeping him there is denying him his constitutional rights and this amounts to a kind of torture."
Nonetheless, Mathews refused Fakude's bail application in the light of his previous fraud and theft convictions and the possibility of him becoming a repeat offender.
"If I compare myself to Mr Pistorius," said a despondent Fakude, "I fail to understand what equality before the law means …"
Carolyn Raphaely is a member of the Wits Justice Project