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The Gauteng Provincial Health Department had refused to cooperate with police investigations into the Life Esidimeni deaths – dubbed the “marathon project”, the Life Esidimeni arbitration process heard on Friday.
Major General Charles Johnson, head of crime investigation service, highlighted in his testimony the difficulties that police encountered when they tried to get to the root courses of the deaths of psychiatric patients. Health officials were not keen to cooperate and the SAPS had focused on the deaths but failed to bring the project leaders to book.
He said before the release of the health ombudsman’s report there were already four cases filed at different police stations that were under investigation. The deaths were reported after bodies were sent to government mortuaries with questionable circumstances.
For example, in February this year, Johnson met with Dr Richard Lebethe, deputy director general for clinical services in the Gauteng Health Department to request documentation pertaining to the deaths.
Lebethe had committed to present police with information within a week. When asked a few days later, he told the officer to make a written request for the information to the director-general of health in Gauteng. Johnson admitted he never submitted such a formal letter.
Johnson said he then met with Health Ombudsman Malegapuru Makgoba after he released his report to discuss the matter and he was provided with documentary evidence in the form of names of the deceased and a copy of the report.
After noticing the seriousness and the situation with over 90 deaths and the report warning that more deaths could still be discovered to be related to the ombudsman’s probe, the police established an investigating task team comprising initially five detectives in May this year.
“Currently the team can account for 127 deaths of patients which emanated from direct and indirect transfers from Life Esidimeni to NGOs and other health institutions,” Johnson explained.
Of the 127 deaths, 38 case dockets of the inquest were registered in terms of the Inquest Act and 89 were being investigated by the task team. He added the 38 bodies were released to government mortuaries as being unnatural deaths with only 30 autopsies conducted while the other 8 were not done. Of the 38, only four more post-mortems were subsequently conducted and the pathologists provided no reason why others were excluded.
“In the 89 inquiry files we don’t have any autopsy reports because families and some of the NGOs obtained death certificates that indicated natural causes as the cause of death and the bodies were buried,” he said. Police have decided to regard all these deaths as “unnatural causes” and will investigate until they can “prove it otherwise”.
“If we obtain info that people didn’t die of natural causes, we will change the files into inquest and approach a prosecutor who is working with the task team. We will ask for advice from a pathologist on whether bodies need to be exhumed,” he explained.
Justice Dikgang Moseneke drew Johnson’s attention to the urgency of investigating the culprits in the Life Esidimeni debacle.
“We are dealing with reeling families who have lost 141 loved ones. There’s a fear among them that nobody will be criminally held accountable for the deaths. It is important to assure the grieving families that if a crime is committed, people must be arrested,” he said.
“It’s critical that we get patients’ records because many of the patients had been under the care of Life Esidimeni for a very long time. Medical history and clinical records will help us ascertain the possibility of negligence,” Johnson emphasised, adding that the police task team was expected to compile a report into their investigations by the end of November this year.
He said the task team has experienced challenges that would delay the completion of the report and possibly miss the deadline. However, three more members have been assigned to join to augment the team to expedite investigations in conjunction with the Special Investigating Unit.
Due to frustration with the health department, the police approached a senior public prosecutor to help with the summons in terms of Section 205 of the Criminal Procedures Act to force some health officials, including Dr Ernest Kenoshi, acting head of the Gauteng Health Department, to respond to police enquiries and surrender the relevant documents.
Meanwhile, suspended chairperson of the Gauteng Mental Health Review Board, Dumi Masondo, faced tough questions during her testimony this week. She was appointed board chair in January 2016 and by October, they received news that 36 patients had died.
During her testimony, the evidence leader brought it to her attention that her board was independent of the health department and therefore it should not have taken instructions from the department or the Health MEC Qedani Mahlangu.
The board was excluded from the Life Esidimeni patient transfer programme and this contributed greatly to the unnecessary loss of life. She was not aware that the board was responsible for reviewing documents relating to among others admissions, transfers and deaths of patients. She testified that the board did not play any part in the process but they had met with Dr Makgabo Manamela, the now-suspended director of mental health review board, who gave an overview of the project saying the board would be involved at a later stage.
Masondo reiterated that she waited for health department staff to update her on the state of patients and she was given positive feedback. She insisted that Manamela had prevented them from visiting Life Esidimeni to witness the patients’ transfers.
Moseneke said he could not fathom why Masondo, as a mental health review board chairperson, allowed Manamela to give her instructions.
“You allowed mental healthcare users to be treated in a degrading manner,” he said.
He pressed for answers on why there was no action even after the deaths were reported; she said they eventually moved some patients to Weskoppies Psychiatric Hospital.
The health ombudsman’s report into the Life Esidimeni deaths uncovered how Masondo failed to report the health crisis earlier to authorities. It found that she violated the Mental Healthcare Act by failing to exercise her independence and oversight powers as board chairperson.
