Life Esidimeni: We didn't plan for anyone to die - Makgabo Manamela

Suspended Director of Mental Health says she was devastated by the first death

'We didn't plan for anyone to lose their lives', says Manamela

Johannesburg - Makgabo Manamela testified on Monday that she had told former provincial health MEC Qedani Mahlangu that they were not ready to move patients from Life Esidimeni to non-governmental organisations (NGOs).

"We never planned that anyone should lose their lives," she said, adding that Mahlangu had told them to place mentally ill patients before the end of June 2015.

Manamela was speaking at the Life Esidimeni arbitration hearing in Parktown, Johannesburg.

Justice Dikgang Moseneke had earlier dismissed her application for a four-week postponement in giving testimony on her role.

Over 140 mentally ill patients lost their lives when they were placed in various NGOs, some unlicensed, across the province in cost-cutting measures implemented after the department terminated their contract with Life Esidimeni and shut it down.

"Some problems came up after we placed them. No patient died during transportation. The deaths started after - the first death was at Siyabadinga. I was devastated by the death, I sent my team there to file a report," Manamela said.

She seemed to evade taking responsibility, constantly alluding to the fact that she did not make personal decisions as she worked within a team, and that some decisions were made by a third party.

Closing Life Esidimeni

"The department came up with the idea to close Life Esidimeni. It was a collective decision made by doctors, the executive of the department, my team, and the MEC to place people at NGOs," she testified.

A defensive Manamela said that they started off as a task team with a plan to move patients from Life Esidimeni, which at the time had 1 700 mentally ill patients.

She said that they called NGOs that they knew were already licensed, and those which were in their database, in order to assess and evaluate them. This was part of a strategy she called ‘the NGO project marathon’.

The marathon continued until the end of May 2015. It was made up of a family committee, district members and those from her office who would visit the NGOs, check the bed capacity, infrastructure, and structure of the building. They would then file a report on the status of the NGOs, which she would then review before giving out the licenses.

"The first meeting with NGOs was on 30 November 2015. The plan was for some [mentally ill patients] to go to NGOs, some to be discharged if their family were able to take them in, and some to be moved to the psychiatric ward of hospitals.

"We didn’t place patients where we didn’t assess," she said.

When she was quizzed about the fact that some NGOs were made to take on patients despite not having licenses, being suitable enough for the mentally ill, or being paid by the government, she gave a lengthy explanation about processes.

Medical records

Manamela conceded that not all of the patients were moved with their medical records or medication, but she said that patients were told where they were going. She said not all family members were unhappy but that some ended up toyi-toying, adding that she "cannot see why they would be toyi-toying".

"Where there were problems, we either close the NGO and take them to a better place, or the NGO can identify another NGO and we go there to assess it. Those that took on more people, it was their will to take on more people," she said, referring to an instance where one NGO had to take on more patients than they could handle.

In another instance, 15 people had died by the time a service level agreement was signed with Precious Angels, the government had also not given these NGOs money, exposing the patients to a high level of risk as they did not have bed capacity for 150 patients, decent staff, medication or food.