Eight years of horror and heartbreak
Section27 director satisfied emotional toll case took on her and colleagues was all worth it
Over the past eight years, Sasha Stevenson has endured graphic details of cruel and agonising deaths, and autopsy reports vividly detailing horrendous cases of gangrene, sceptic bed sores and asphyxiation.
She has tried to console families who lost loved ones in heartbreakingly unjust circumstances.
This week, however, the executive director of public interest law centre Section27 — the NGO that took the Life Esidimeni case to the Pretoria high court — was satisfied the emotional toll the case took on her and her colleagues was all worth it.
“There were just so many stories. Evidence of dehydration, starvation, septic bed sores, aspiration of food and blood — all of them speaking of total neglect,” Stevenson told the Sunday Times.
“Both the individual stories and the totality of the evidence were terrible — compounded by the fact that it was predicted. People were warned and they went ahead anyway.”
Stevenson said the NGO first got involved after families of mental health-care users started approaching the South African Depression and Anxiety Group (Sadag), who in turn contacted Section27 in October 2015.
“We then also heard from Sasop [the South African Society of Psychiatrists] who had been concerned about an earlier plan by the [Gauteng] health department to cut the number of beds they were funding at Life Esidimeni — not the entire contract,” she said.
“Many people were worried about the plans to start discharging patients because there was no available capacity for community-based care.”
After hearing more concerns and complaints, Section27, Sadag, Sasop, families of patients and the South African Federation of Mental Health approached the health department, but with no success.
Together they began fighting what became the department’s 2015/16 Gauteng Mental Health Marathon Project. This was a decision by the department to terminate its long-standing contract with service provider Life Esidimeni, and to relocate more than 1,500 psychiatric patients into the care of NGOs. “It’s been difficult,” Stevenson said.
“In 2015 there was a settlement agreement and we thought that would resolve the issue, but it didn’t. So we tried so many things. We engaged with the authorities, we protested, we litigated, we raised stories in the media ... We tried so many things to stop it, but nothing worked.”
The battle was arduous and the work endless. “We went through four legal processes and each was incredibly long, and each unearthed more evidence of the horror of the Life Esidimeni disaster.”
But there were elements of vindication along the way when people, including judge Dikgang Moseneke, who presided over the arbitration hearing, “so clearly articulated the extent of the human rights violations”.
Moseneke, in ordering compensation for the victims, told the families: “Every human being, regardless of their condition, deserves to be treated with dignity and respect. The actions that led to the deaths of the Life Esidimeni patients were a gross violation of this fundamental principle.
“The families of the victims have been left to grapple with unimaginable pain and loss. Their loved ones died in conditions that are simply unacceptable in any humane society.”
Another person to acknowledge the damage done was then health ombud, Prof Malegapuru Makgoba, whose report on the tragedy was released on the day that then health MEC Qedani Mahlangu resigned from her post.
He did not mince his words when he declared: “This was a mass murder of mentally ill patients, resulting from gross negligence and a lack of accountability.”
This week Pretoria high court judge Mmonoa Teffo found that the deaths of some of the psychiatric patients were “negligently caused by the conduct of Mahlangu and [former head of mental health services] Dr Makgabo Manamela”.
“Effectively, Mahlangu and Manamela created the circumstances in which the deaths were inevitable,” she ruled on Wednesday, saying there was, indeed, a criminal case for them to answer.
In September 2019, the National Prosecuting Authority (NPA) announced there was not enough evidence to bring criminal charges against anyone. The ball is now back in its court, and on Wednesday it said in a statement it was considering the judgment.
Spokesperson Lumka Mahanjana said the office of the director of public prosecutions would now re-evaluate the situation.
“Now it’s for the NPA to decide. They’ve got the court’s decision, they’ve heard all the witnesses and they have 56,000 pages of evidence,” Stevenson said, hopeful that prosecutions will follow.
She draws light from the good things she has seen along the way.
“In the beginning the families were just a big group of individuals who didn’t really know each other. But they have drawn together into a community of activists and that has been incredible to witness,” she said.