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Life Esidimeni: Waiting for justice is an injustice

Esidimeni means “place of dignity”. It has proven to be nothing of the sort. By the time it was done, the Life Esidimeni tragedy had claimed four times the number of lives that died in the first massacre in democratic South Africa — Marikana.

In 2015, Gauteng health MEC Qedani Mahlangu announced the province would terminate a decades-old contract with the private hospital group Life Esidimeni to provide state-subsidised care for about 1 700 mental health patients. Many of these people had spent most of their lives in institutions, their families unable to manage the high level of care they needed at home.

But the contract, Mahlangu argued, had become too expensive

Gauteng health officials decided these patients could now be sent home, to other state facilities or community-based NGOs. Patient families, civil society and professional bodies cautioned that patients were not well enough to go home and that “NGOs” were ill-equipped.

Ultimately, at least 144 mental health patients would die in state facilities and NGOs that were eventually found to be unlicensed.

On 18 March 2018, Justice Dikgang Moseneke ordered the government to financially compensate the victims and families of the Life Esidimeni tragedy. The judge also ordered that the dead be memorialised

To date, reportedly only R6.5-million of the R120-million budgeted has been paid out. Families involved directly in the arbitration have received compensation, but others are still waiting. “The difficulty according to the premier’s office is that they are verifying the applicants and won’t pay out until this happens,” said the Democratic Alliance’s spokesperson for health, Jack Bloom.

In November 2017, the South African Human Rights Commission convened a national consultative hearing on the status of mental healthcare in South Africa. Although it was catalysed by the Esidimeni tragedy, the focus of the hearing was on capturing “a picture of the lived experiences of all people with psychosocial and intellectual disabilities in South Africa” and the effects of systemic, social, cultural, political and economic concerns that affect mental health and the realisation of human rights.

Many human rights violations were brought to light in the investigation. They arose, the commission said, from the “prolonged and systemic neglect of mental health at the level of policy implementation”. Under-resourcing and lack of professional expertise in the sector were the result of “system-wide failures to protect and promote the rights of this group”, the commission concluded.

An independent study in 2017 found that a mere 5% of the general healthcare budget was allocated to mental health. Before 2017 the amount allocated to mental health from the overall health budget was unknown and most probably quite a lot less, said Melvyn Freeman, a mental health consultant formerly with the department of health. “This is partly because expenditure in mental health is often integrated into general health budgets and, therefore, not calculated into estimates of mental health costs.”

It’s been labelled a tragedy. A scandal. But this was no freak accident, no rash decision made under pressure. No one has been criminally charged for the deaths despite Moseneke’s arbitration award finding that the Gauteng health department’s decision to move the patients stemmed “from the arrogant and irrational use of public power”. Now, finally, might the victims see justice? Maybe … but first we’re going to have an inquest.

The National Prosecuting Authority (NPA) has announced a formal inquest hearing into the Life Esidimeni tragedy will begin on 19 July in the Pretoria high court.

The date was finalised on Monday after a meeting with Judge Mmonoa Teffo, the NPA and representatives of the affected families.

The families can only hope the inquest will lead to criminal prosecutions.

In the meantime they might rightly wonder why it has taken so long. We are a nation of inquests, commissions and ad hoc committees. Not action. This is very much a South African problem that affects all spheres of life. It is an issue, however, that will always disproportionately affect the marginalised.

We also excel at denial when we are confronted with the truth. Denial is, in fact, a very important part of our political make-up. Perhaps if the victims of this tragedy had some social capital we wouldn’t be here waiting. 

Those 144 people were invisible in life and may have come to understand how paltry their lives were perceived to be. We don’t have to prove them right, again. Verdicts will not bring them back and are a measure of individual accountability. For justice to be served, transformation and accountability are a must.

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Kiri Rupiah
Kiri Rupiah is the online editor at the Mail & Guardian.
Luke Feltham

Luke Feltham runs the Mail & Guardian's sports desk. He was previously the online day editor.

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