The silent must shriek for justice

William Saunderson-Meyer says Marikana pales before the death of 94 mentally ill patients


The Health Ombud’s report is subtitled: No Guns: 94 silent deaths and still counting. The historical allusion is undoubtedly intentional.

Professor Malegapuru Makgoba is conjuring with a collective South African nightmare, one that was triggered by many guns. On a single day in August 2014, at a place called Marikana, police shot dead 34 striking miners in a single incident.

We imagined that we at that moment had hit our post-1994 nadir. The Marikana massacre still poisons our politics, with the victims – some shot in the back – still uncompensated. And those responsible, still unrepentant and unpunished.

But we were wrong. Marikana pales before the death of 94 mentally ill patients following the removal of 1,900 of them that had been in the care of Life Esidimeni, a private healthcare provider, and their ill-fated distribution among 27 dysfunctional, unlicensed community health NGOs. 

It’s not just a matter of numbers. What makes the Life Esidimeni incident a new nadir is the callousness, the cruelty, the astonishing indifference of the Gauteng MEC for Health and her executives to the misery of the indigent people to whom they owed a legally mandated duty of care. 

At Marikana, the minions of National Police Commissioner Riah Phiyega wrought their carnage in minutes, while in fear for their own lives. In this case, the minions of Health MEC Qedani Mahlangu operated from the invulnerability of air-conditioned offices, arrogantly deaf to the warnings of medical professionals of the likely disastrous consequences of their actions.

These bureaucratic leeches sat back on their well padded backsides doing nothing over the period from May last year until the release of the report this week, while the death toll steadily mounted. The Ombud’s expert panel notes that the final death toll is not yet known, since bodies remain unclaimed in scattered mortuaries, while anguished families search for their disappeared loved ones. 

Under what terrible circumstances these poor souls died. The panel found that many of the deaths followed upon prolonged starvation, malnutrition and dehydration. The direct cause was often untreated critical medical conditions, including pneumonia, infections and epilepsy.

The report says that the patients were disrespected and mistreated. Their families were not informed of when or where they were to be transferred. 

The process was shambolic. “Frail, disabled and incapacitated patients were transported in inappropriate and inhumane modes of transport”, some with their wheelchairs left behind, “but tied with bed sheets to support them”.

The “woefully substandard” NGOs to which they were taken were mostly newly set up, presumably with the express purpose of cashing in on the money Gauteng Health would pay them for taking patients. Not only was every single one unlicensed, but Gauteng Health was also aware of this, as well as knowing that they lacked trained staff and facilities.

The lack of compassion is mindboggling. The report says, “Some NGOs rocked up in open bakkies to fetch [patients] while others chose [patients] as at an auction cattle market”. 

Some of the distraught families still don’t know where their relatives are. Gauteng Health is either so incompetent that it doesn’t know or its officials simply can’t be bothered.

So much for the much-trumpeted Batho Pele – People First – principles that are supposed to underpin government service. So much for ubuntu, the ancient African humanist credo that a person is a person through other people. 

There is one welcome difference between Marikana and the Life Esidimeni debacle. The national police commissioner is still contesting her dismissal, while Gauteng’s Health MEC had the grace – an attribute rare in the administration of President Jacob Zuma – to resign. 

That cannot be allowed to be the end of it. Makgoba is unambiguous that the 94 – and still counting – that perished “died under unlawful circumstances”. 

There must be criminal prosecutions of the triumvirate identified as the key culprits: Mahlangu as MEC; Dr Tiego Selebano, the head of the department; and Dr Makgabo Manamela, the director. The latter two should also be struck from the medical role, for they have betrayed their profession.

Gauteng Health collectively, and the officials individually, should be pursued remorselessly in the civil courts for damages.

Marikana was a tragedy, a single event sparked by an explosive mixture of poor leadership, poor police training, and reckless politicking. The Life Esidimeni calamity was preventable and is still playing out after almost a year.

The Health Ombud’s report describes the passing of the 94 as “silent deaths”. We cannot let that be. These were society’s most vulnerable people, the ones most deserving of protection. Through us they shall shriek for justice.

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