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On Thursday, the Pretoria High Court ruled that both former Gauteng health MEC, Qedani Mahlangu, and former mental health head, Dr Makgabo Manamela, were responsible for the deaths of some of the psychiatric patients who died in the Life Esidimeni tragedy. The tragedy claimed the lives of 144 mental health patients who were moved from the Life Esidimeni care centre to ill-equipped NGOs.

On 19 July 2021, an inquest to probe whether anyone should be criminally prosecuted for the disaster was initiated before Judge Mmonoa Teffo at the Pretoria High Court. The inquest was recommended by former deputy chief justice, Dikgang Moseneke, and by the Health Ombudsperson’s report into the circumstances surrounding the deaths of the mental healthcare users. In his arbitration award in 2018, Moseneke noted that the reasons that Mahlangu and Dr Barney Selebano and their department had advanced for terminating the service contract with Life Esidimeni were shown to be untrue. “Also, the reasons are not properly related to the outcomes they claim they were pursuing. In short, besides the reasons being untruthful, the decision on which the reasons are based are irrational, and in blatant breach of the law and the Constitution,” the award noted. 

Her conduct led to
avoidable deaths

Delivering the judgement on Wednesday, Teffo said Mahlangu continued to terminate the contract between Life Esidimeni and Gauteng Health despite numerous expert advice and warnings from professionals. “The deceased were moved to NGOs which were not equipped nor experienced to give proper and adequate care in providing mental care. Her conduct led to deaths which could have been avoided,” says Judge Mmonoa Teffo.  

On Manamela, the judge said, “Manamela proceeded with the plan to move the patients, despite the expert advice. She could’ve saved their lives. Both Mahlangu and Manamela are liable for the deaths of the patients.” Judge Teffo said the two could be held liable for the deaths of 9 patients: Virginia Macaphela, Terence Chaba, Lucky Maseko, Josiah Daniels, Charity Ratsotso, Frans Dekker, Deborah Phela, Matlakala Elizabeth Motsohae and Koketso Mogoerane.

A bold statement calling for accountability

Advocacy group, Section 27, which has been litigating on behalf of the families of 44 mental healthcare users who died in conditions of extreme neglect, welcomed the judgement. “The NPA will now need to decide on whether to pursue criminal prosecution, we trust that it will do so, and Miss Mahlangu and Miss Manamela can be prosecuted for culpable homicide. This outcome is a bold statement in favour of accountability. For the families of the mental healthcare users, this has been a long way to justice,” said CEO Sasha Stevenson. 

Christine Nxumalo, sister to one of the deceased, Virginia Macaphela, told Elitsha that this has been an emotionally tiring journey. “I am exhausted physically,  emotionally and mentally. It’s been a long 8 years. As a family, we feel that the 8 years was traumatic, well worth the fight. We will not get my sister and her daughter back, but we have reached the halfway mark,” she said. Nxumalo said Life Esidimeni took a huge toll on her personal and professional life. “The 8-year fight has taken a strain on me and especially on my family. The collapse of my son, twice, the trauma my daughter endured, my husband suffering a heart condition after my niece died in his hands, me desperately needing counselling several times, being traumatised and so devastated and tortured by how she died. It has been a really trying time,” she said. 

Nxumalo said they will be pushing for the NPA to move with speed. “As we did with our constant nagging until the inquest was set up, we will again nag until criminal cases are brought against the two mentioned by the judge and all others mentioned in the rest of the judgement,” she explained. 

National Prosecuting Authority (NPA) spokesperson Lumka Mahanjana told Elitsha that, they will first need to study the judgment to establish if the NPA will institute criminal prosecutions against Mahlangu and Manamela. “There might be additional criminal investigations we first need to conduct. We will work with SAPS in this regard, and we are treating this judgment as a priority and are committed to ensure justice. The director for public prosecutions (DPP) will make a decision after carefully studying the judgment,” said Mahanjana.

In a statement released today, the South African Human Rights Commission (SAHRC), said the Life Esidimeni tragedy represents a dark chapter in the history of the healthcare system in post-democratic South Africa. “The SAHRC sympathises with the bereaved families and hopes that the inquest judgement contributes towards the process of closure and healing for the victims and families affected by this tragedy. These were mental health care users who were supposed to be looked after and cared for, yet they were neglected and subjected to inhumane treatment which tragically led to some losing their lives,” the commission said in a statement.