No single gunshot was fired. 100 corpses picked up. Still counting. Secret graves. The “worst hospital massacre” in South Africa since the end of apartheid in 1994 continues to unfold.
This is the horrific tale of 100 mental health patients whose corpses, hidden at first, have now been counted in South Africa.
Generally 0, 4 % of all deaths in SA are due to mental health diseases. This group has a higher death rate due to care or surgical difficulties, says Professor Malegapuru Makobga, South Africa´s Public Health Ombud and publisher of an explosive inquiry.
This tale of blood, mistruths, starvation and secret burials would make a grim plotline in a Stephen King horror novel.
Professor Malegapuru Makobga lays out the calamity into open. Patients were ruptured from hospital sick beds, ferried in open-air trucks designed for cattle; dumped in unlicensed care homes, malnourished to death, corpses laced with bizarre bruises and death certificates forged to fool their families.
This is a dark scandal of illicit transfers of vulnerable mental health patients to unlicensed for-profit homes, unlawful medics and a disgraced health minister who is accused of hiding up to 100 deaths “because corpses are political.”
Revelations by the inquirer show that hundreds of mental health patients were forcibly, secretly seized from a well-equipped hospital and sold “like cows at an auction” to unlicensed care homes where starvation, beatings, untrained medics and fraudulent documents led to dozens of mysterious deaths.
Today, some of the victims’ families are still combing mortuary after mortuary scouring for hidden corpses of loved-ones.
Death spiral begins:
The death spiral begun in this manner. In 2015, the health minister of Gauteng which South Africa´s wealthiest province, Miss. Qedani Mahlangu, gave notice to one Life Esidimeni Healthcare. Life Esidimeni Healthcare is one of the biggest private contractors that takes care of mental health patients on behalf of the South African government.
The notice spelt out the minister´s desire to begin a five year gradual process where mental health patients from the hospitals would be transferred into home/family environments.
The minister process was termed ‘deinstutionalisation’. Based on the 2002 South Africa National Mental Health Act, this meant the gradual removal of mental health patients from South African healthcare giant Life Esidimeni, which accommodates and treats mental patients on behalf of the South African government, charging a daily fee of approximately 322 rands (US$20) per patient.
According to Mahlangu, moving the patients into community-based care homes would allow patients to be closer to their families while reducing the government’s mental care expenditure by an estimated 50 per cent.
“I am taking my patients away, I have more luxurious care homes,” the minister boasted to the contractor Lifecare Esidimeni Hospital, the inquiry reveals.
But experts healthcare professionals, families, surviving victims – describe the moves as chaotic and the facilities as unfunded, poorly equipped and run by untrained nurses where patients were underfed, beaten and in some cases, death certificates were forged.
“We warned the minister [Mahlangu] as early as January 2016 that the process of transferring patients was flawed seeing as the care homes were not staffed with trained nurses,” says Lerato Madhumo, national coordinator of Young Nurses Indaba (YNI), a South African human rights nurses’ association that is helping the families affected by the scandal in their quest for justice.
“The health department chose to ignore our advice. We sensed that things like nutritious food and treatment monitoring facilities were absent in those so-called care homes. As professionals we knew this would end badly,” she tells this reporter.
Shockingly, a five year project was forcibly accelerated in six months. This has left the public, courts and media to wonder if South Africa´s rampant cash-for-state contracts scams plunged 94 patients to inhuman deaths.
Qedani Mahlangu, the minister in the storm of deaths, says, “It was a project to cut costs. Putting mental health patients into community homes would reduce state expenses.”
Project of madness: a rush to death
Instead, lives were reduced in this “project of madness” as Professor Makgoba, the inquirer describes it.
“This was a rush to death,” says Ms. Bharti Patel, head of The Voice of SA Federation for Mental Health, the largest mental health workers trade union in South Africa. She calls it, “Criminal recklessness.”
“This project was carried when expert medical advice to stop was ignored by the minister,” says Jack Bloom a lawmaker for the Democratic Alliance, South Africa´s biggest opposition party.
Mr. Bloom was the first legislator to raise alarm about the scandal when he challenged the minister in a parliament session to reveal the death toll in September 2016.
In November 2015, the health minister and his aides (two trained doctors) began to pluck away 1400 mental patients from the hospital and deposit them into 24 community care homes. All of the 25 care homes under accusation were operating unlawfully and unregistered, according to Professor Makgoba.
The sequence of events was chaotic and merciless on patients’ safety.
The newly-established care homes, were mysteriously and poorly selected, poorly prepared, and not ready. Their staff was not trained, not qualified nurses.
Patients were transferred far off from families without family knowledge – also making it a deliberate financial burdern for families or to hide them.
The tribunal reveals these chilling accounts. “Patients were transferred in inhumane cattle lorries with drips removed, some with epilepsy, hypertension, sores oozing puss, disabled patients not in wheelchairs tied with bed sheets so they won’t fall off. Patients were treated like “cattle auction” shuttled around several care homes in hot weather at night.”
Care homes like concentration camps:
These new care homes were ‘like concentration camps’, overcrowded with in-kept and hungry patients, families of the dead say. Several relatives reported severe weight loss visible on their patients. Rotten bread, meal of cabbage and porridge and only one meal a day – was the order of the day. Some patients had smaller medical files and IDs than the proper ones they used to have at the hospital.
The care homes plead innocence saying the health minister did not pay them subsidies as promised. This drove them into debt and patients into hunger and death. George Maluleke, a manager at Precious Angels, one of the unlicensed care homes under accusation for the deaths says, “It is unfair on us. We didn’t even have money to buy headache pills for patients.”
One Marie Kotz 58, a widow to Freddie Kotz (61) a depression patient who died mysteriously when forcibly transferred from the hospital to the unlicensed Mosego Home in Krugersdorp town, a town 56 kilometer west of Johannesburg, into an old age home for psychiatric patients says: “His corpse had unexplained bruises. Freddie had wound to head, sore on nose, bruises on ankles two hours before his death. We asked why wounds on his head and ankles. Carers said he fell on lawn.”
One of the dead is Mrs. Charity Ratsotso who died on 11th July 2016. The family was not notified until 20th December 2016, when by sheer accident one relative paid a visit to a care home.
As a result, 94 patients died between 23 March to 19 December 2016, the tribunal says.
When asked in parliament in September about the number of deaths, the minister made an astonishing claim “only 36.”
“When she said 36, in fact, 77 patients had died by then,” the inquirer says.
When cornered on why her figures appeared dodgy the minister shocked the tribunal: “I didn’t want to reveal correct numbers of deaths in parliament because it has become a political game. Institutions would be characterized as killing people.”
“This is criminal,” says Jack Bloom the lawmaker. “94 deaths is no small matter in the life of any country. Why was the minister keen to hide deaths and protect unlawful care homes? I smell a fish.”
In more chilling revelations, one of the unlicensed care homes contracted by the minister to take in mentally ill patients from Life Esidimeni reportedly carried out private burials for the dead without their families knowing.
According to Jack Bloom, the whistleblowing lawmaker from South Africa´s Democratic Alliance NGO, six mental patients were buried secretly.
“The name of the care home is Tshepong and is located in Pretoria, the capital city. Its director, one Ms. Karina Morale, has admitted that her organisation secretly buried six of the 10 patients who died there.”
“She says the health minister is aware they gave them private burials rather than pauper burials so they could point to any family members where they were buried. She refuses to reveal the spot where burials took place however.”
Ms. Karina, the care house director says secret burials proceeded when she could not locate the families of patients who died because they were put into her care without their medical records available.
However, South Africa´s health ministry scoffs at Ms. Karina claims and denies charges of okaying secret burials. “This is very false. We have never approved secret burials,” says Mr. Joe Maila, a spokesperson for South Africa´s health minister. "In fact these shocking allegations should be probed and prosecuted.”
The South African police is frantically working to identify 19 patients whose unclaimed bodies remain at secret mortuaries that have been discovered.
South Africa´s health minister, Dr. Aaron Motsoaledi says in one case‚ fingerprints tied a body to a family. “When police visited the family‚ they denied knowing the deceased. The family declined to give the police DNA samples to help identify the body.”
Fight for justice:
The victims’ families, some of whom are still confronting the grim reality that their loved ones were buried in unmarked graves or lie unclaimed in mortuaries, are demanding millions of rands in compensation and want to see the criminal prosecution of the health minister, Miss. Mahlangu (who has been suspended from her job along with two of her key aides) and those running the care homes.
Miriam Monyane, whose 32-year-old son Thabo died following a fatal bout of diarrhoea in October 2016 at the Cullinan Care and Rehabilitation Center, is still grieving.
Miriam’s family is one of the many being supported by the South African human rights organization, Section 27. The NGO calls for a review of mental health provisions across South Africa and the closure of unregistered institutions.
It also called on the implementation of the remedial actions outlined in the report and official inquests into the deaths of all patients: “The Life Esidimeni Case has demonstrated that the province´s Gauteng Health Department, under the leadership of the the health minister, acted in clear violation of its own well-articulated mental health policy,” said Section 27.
The minister, Ms. Mahlangu has already been sacked from her job. She and her senior health managers face multiple lawsuits and possible prosecution over her acts. She touches her face and says. “I am sorry. I accept responsibility that things went wrong. The deaths are giving me sleepless nights.”
The province, Gauteng, now has a new health minister, Gwen Ramokgopa, who has promised to fix its broken mental health services. She has started with the roll out of a 24-hour hotline for affected families. “I want to account for each and every patient that was transferred from Life Esidemini,” she says and pledges: “Never again should a tragedy of this magnitude occur”.
On his part, Dr. Pali Lehohla, South Africa´s Statistician General remarks, “This scandal shows the devastating outcome when public data and statistics are poorly kept. Data, clean records can help end impunity.”
(Picture caption: The picture shows Miriam Monyane, mother of one of the victims, protesting at the health minister´s office over death of her son Thabo, 32)
(Picture by: Ray Mwareya)
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