
A report into the deaths of numerous psychiatric patients transferred out of Life Esidimeni, compiled by Health Ombudsman, Professor Malegapuru Makgoba, revealed that in fact 94 mentally ill patients – as opposed to the originally recorded 36 – had died between 23 March 2016 and 19 December 2016. More recent information suggests that the number of deaths has now surpassed 100, and is growing as more people come forward. Furthermore, the Health Ombudsman’s report acknowledged that patients had died under unlawful circumstances, largely involving neglect. This raises critical questions regarding the failure of institutional leadership and parliamentary oversight. In the case of Life Esidimeni, the neglect of healthcare service delivery was a direct consequence of gaps at the structural level.
South Africa’s National Mental Health Policy Framework and Strategic Plan 2013-2020, recognises that social determinants are an endemic factor of mental health. The Policy states that a “combination of genetic vulnerability, childhood trauma and adverse living circumstances brought about by poverty” may predispose individuals to mental health issues. South Africa’s history of oppression only further ostracises people who suffer from the additional burden of a mental health disorder. Thus, understanding the complex relationship between history, context, and health is particularly important in understanding the scope of the atrocities that happened at Life Esidimeni. The Health Ombudsman’s report makes reference to the connection between poverty and poor health outcomes, stating:
“Decisions, both at the level of policy development and implementation, should envisage the exercise of a greater duty of care for the protection of poor people, particularly, the rights of vulnerable people, which includes elderly people and people with disabilities affected in the LE transfers”.