The fear of challenging authority, coupled with the reluctance to take accountability, is what led to the deaths of 118 patients under the care of the Gauteng provincial government. This is according to Health Ombudsman Malegapuru William Makgoba, who was the first witness to present evidence to an arbitration committee set up to probe the deaths of the patients, notes a Business Day report.

The committee is chaired by retired Deputy Chief Justice Dikgang Moseneke. In June 2016‚ the Gauteng Department of Health moved more than 1 400 patients from Life Esidimeni psychiatric homes to NGOs and 108 died‚ it emerged at yesterday’s hearing. Another 10 died as they were moved from Cullinan Care Centre‚ where they had lived for years‚ and placed in unlicensed NGOs to make space for Life Esidimeni patients. So at least 118 died‚ but it could be more.

The number of dead patients increased from 94 as reported in February, to 118 following clarity provided by the ombudsman’s verification team.

Makgoba said that during his investigation, employees in the Gauteng Health Department acknowledged that they knew the 'de-institutionalisation' process and cost-cutting operation – which has become known as the Life Esidimeni tragedy – was defective but were too afraid to speak out. The former head of department told the ombudsman that the culture in the department was one of fear, with everyone referring to their seniors as ‘chief’ and never by name because of the pervasive anxiety experienced by all.

However, former Gauteng Health MEC Qedani Mahlangu, who resigned from her post the day before the report was made public, was seemingly aloof to the significance of the fear in her department. She told Makgoba that she had assumed everyone had agreed with her on the matter as no one had raised issues about it in meetings.

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Makgoba said the actions that led to the deaths showed ‘a total disregard for human dignity and human respect’. He said the department’s decision to move patients to other facilities – which weren’t equipped to deal with them – resulted directly in their deaths, notes a News24 report. ‘Many families didn’t know where their loved ones were. It was very traumatic and very frustrating for them,’ he said. He said more than 80% of the patients died in only five of the NGOs to which they were moved. Makgoba said the overarching reason for the deaths was the lack of food, while other contributing factors included overcrowding as well as poor financial resources and facilities.

While patients from Life Esidimeni were moved to a facility in Cullinan, 10 patients from that facility were moved to an unlicensed facility which didn't have the resources or staff with the necessary qualifications. ‘They moved some of the patients to an unlicensed NGO… They were sacrificed for the people who came from Life Esidimeni,’ said Makgoba. ‘The quality and qualifications of the carers isn’t something we should be proud of as a country,’ he said. Makgoba also said it was ‘very obvious that some of the NGOs were very economical with the truth’ during his investigation into the circumstances surrounding the deaths.

Full News24 report