Esidimeni deaths; a symptom of insane policies driven by the inept

It’s a tried and tested cynical tactic used by less credible regimes world-wide – when the politically-accountable risk being exposed for corruption, dishonesty or ineptitude, they find something in the aptly-named ‘rule book’’ to fire an underling with. Thus, when the unions disrupt service delivery in your hospital, frightening or risking starving or killing patients due to insufficient care (or as cited historically below, you actively organise the union troops to back your cause), you simply fire or suspend the CEO or doctor in charge. At Esidimeni Life Hospital we’ve seen what could be up to 100 mentally ill patients die in unsuitable and unlicensed facilities to which they were transferred with less dignity and care than sacks of potatoes, in the name of a policy to decentralise care and meet budget. The country’s top psychiatric leaders have long criticised national Mental Health policy which, in line with international trends, wants to decentralise care. Their complaint is that our political whizz kids haven’t re-allocated budget for the decentralised facilities, so the Esidimeni tragedy is symptomatic of a country-wide crisis. People with mental health challenges are wandering the streets, begging at car windows, or worse still, posing a threat to themselves and others – when they should be under full-time compassionate care. Or their families are burdened with an impossible financial and logistical task in caring for them. There’s just no-where else to go. In the Esidimeni case, the people transferred also happened to be the most physiologically-challenged, hence the tragedy. When Ubuntu disappears, the most vulnerable suffer. Even in war, the women, children and most vulnerable are supposed to get priority. Here, in our simmering peace, our captains abandon ship – first. – Chris Bateman

By Ed Herbst*

Esidimeni déjà vu – recalling the GRIP scandal

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.

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.  – William Saunderson-Meyer The Silent Must Shriek for Justice 3/2/2017

Reading about the arrogant intransigence of Qedani Mahlangu and the Gauteng government spokesperson Thabo Masebe during the evolving Life Healthcare Esidimeni scandal took me back to the exposé of baby deaths in the Frere Hospital in August 2007 by the Daily Dispatch, then edited by Phylicia Oppelt.

Zapiro on the death of 94 psychiatric patients in Gauteng. More work available www.zapiro.com

The reaction of the ANC, then led by President Thabo Mbeki, was swift. The article was a pack of lies, the ANC declared, the story just racist propaganda perpetuated by the hated whites.

I wrote about this – and the subsequent baby deaths all over the country – in my March 2015 article From Frere to the Free State – a Media Chronology.

If anyone in the ANC apologised for the death of those infants I am not aware of it. It was just the usual maunderings about ‘challenges’, the de facto manifestation of routine ANC denial in action.

The Life Healthcare Esidimeni story reminded me of another example of ANC denial in action – that of the then Mpumalanga Health MEC and fervent anti-retroviral treatment denialist, Sibongile Manana.

Ed Herbst

Concerned about the lack of care for rape victims at risk from AIDS, Dr Malcolm Naude, a community service doctor at the Rob Ferreira Hospital in Nelspruit at the time (2001) started prescribing anti-retrovirals and provided office space for GRIP (Greater Nelspruit Rape Intervention Project) which provided post-exposure prophylaxis (PEP) for rape victims.

Manana dismissed Naude and two other State doctors who were assisting in such work and evicted GRIP from the rooms they were using at the Rob Ferreira and Themba hospitals.

Naude took his case to the Labour Court and won and I would like to recall that judgment via a December 2008 article Manana’s Costly Machinations: Naude Vindicated by Chris Bateman who now writes for this website but was then the news editor of Izindaba, the monthly journal of the SA Medical Association:

Acting Judge Cagney Musi praised Naude, saying he (Naude) felt strongly that it was not government’s place to decide what kind of treatment a doctor should give a patient.

‘It was his view that the government was not in favour of any form of HIV drug-based therapy, because at the time beetroot, garlic and olive oil took precedence over medication.’

Musi described Manana as a tyrannical and dictatorial manager, with those daring to oppose her becoming victims of her wrath. The evidence of those who testified in her favour was ‘improbable, disingenuous, unhelpful, not true and had to be rejected for lack of credibility’.

When the controversy first broke, a rampant Manana gave instructions that GRIP no longer be supplied with the laboratory results of baseline HIV tests of rape survivors, some of them children (from whom GRIP obtained written permission). This effectively sabotaged their work, conducted from a room each at Rob Ferreira and Themba hospitals.

Ironically GRIP was one of the NGOs used at the time by the national AIDS directorate as a feedback site for operational issues in the government pilot study for the roll-out of PEP for rape survivors.

Manana also fired Rob Ferreira’s medical superintendent, Dr Thys von Mollendorff, for allowing GRIP tenure and, although she denied it, helped to organise an ANC Women’s League protest. Protestors waved posters reading ‘GRIP: Agents of Wouter Basson’, outside the Themba Hospital, handing over a rhetoric-filled memorandum.

Manana also summonsed GRIP workers to her office, threatening them with ‘charges and jail’, and accusing them of contravening government policy. She told them ART drugs were ‘dangerous’, that they should apologise to President Thabo Mbeki and immediately stop working for GRIP.

An affidavit by a GRIP worker said Manana’s promise of alternative jobs at a local clinic never materialised

Former Gauteng health MEC Qedani Mahlangu

More than 300 000 AIDs-related deaths later and, to the best of my knowledge, we have yet to see a press release on an ANC letterhead apologising for an official policy which did immense reputational damage to this country and saw too many people, many of them the poorest of the poor, dying lingering, painful and unnecessary deaths. Deaths which echo the demise of the Life Healthcare Esidimeni victims – more than a hundred and counting – on the watch of Qedani Mahlangu.

Profitable sinecure

When Luthuli House is faced with such a ‘challenge’ it has a pragmatic and de facto policy of simply deploying the person causing the problem to a less ‘challenging’ but hopefully more profitable sinecure.

The latter is important because at the time that Sibongile Manana was deployed sideways and made MEC in the Department of Culture, Sport  and Recreation in Mpumalanga, the news broke that she had – surprise, surprise – suppressed a report about significant snouting in the department she controlled.

Money that should have been spend on preventing AIDS-related illness and treating its victims was spent on ‘soccer matches, plays, prayer days, and a local chief whose unregistered “charity” organisation requested just over R1-million to build traditional dwellings on his farm.’

The redeployment of Sibongile Manana after the GRIP scandal is hardly an isolated instance. Ask the senior ANC deployees implicated in the Buffalo City Metro Nelson Mandela funeral scandal – they’ll tell you. The alleged mastermind, Pumlani Mkolo, was re-elected unopposed as the ANC’s regional secretary in November 2015.

When the Democratic Alliance asked for a moment of silence in parliament for the Life Healthcare Esidimeni victims prior to President Jacob Zuma’s 2017 SONA speech, the request was denied by the Speaker of the National Assembly, Baleka Mbete.

It was, as Gwede Mantashe later acknowledged, a mistake which did not redound to the credit of the African National Congress.

Hopefully, the ANC will not compound the Life Healthcare Esidimeni infamy by redeploying Qedani Mahlangu to a less-‘challenging’ and more profitable sinecure as it did in the case of AIDs-denialist Sibongile Manana.

To do so would be to add cynically contemptuous insult to extreme injury.

  • Ed Herbst is a retired veteran journalist who writes in his own capacity.