Dikgang Moseneke’s award in the Life Esidimeni arbitration is a recognition of the horror of psychiatric patients in South Africa. But it is not a solution.
Any government has the responsibility to protect its people.
Year after year, we vote, petition and protest in order to secure this protection against poverty, oppression and crime. However, some require more protection than others, and some are less able to force government to provide for them. It is to these vulnerable people that government owes its greatest responsibility, and for whom, in the absence of anyone else, our government stands as the sole defence against the cruelty of the world. Yet the actions of this same government resulted in the loss of 144 mentally ill patients lives in 2016.
Instead of prioritising the care of these people, the Gauteng provincial health department decided that 1 711 psychiatric patients deserved to have their lives endangered, moving them from specialist facilities at Life Esidimeni to NGOs without sufficient infrastructure, funding or expertise. It is the equivalent of moving a patient out of ICU to be treated by a first-year medical student, against their will. It is cruel, it is inhumane and it is an absolute betrayal of the promise of a democratic society that cares for all. On the 19th March 2018, retired Deputy Chief Justice of the Constitutional Court, Dikgang Moseneke, found that the patients had indeed been treated with cruelty, and had their rights violated.
In his arbitration award, Moseneke awarded R1,2 million to each of the claimants, in recompense for burial fees, suffering and constitutional damages. In total, government will pay R162 million to survivors and families of the deceased. Further, Moseneke compelled government to provide counselling to all those affected and erect a monument to the plight of the mentally ill. This is no small gesture of apology. It is meaningful, and there is some measure of satisfaction afforded by the resignations that have followed, and the hurt this will impose on government’s pockets. Nonetheless, Premier David Makhura acknowledged this too, and said that, “there is no amount of money that can compensate for loss of life.”
Those who died of neglect and starvation will never have that money, and one can say with confidence, that their families would rather have them than that money. Shocking as it may seem to the Gauteng health department, the lives of mentally ill people are more valuable than that money. The 1 400 patients who underwent “torture” as a result of that department will never have those scars erased because of a monument nor because of that money. For their sake, I hope it hurts our money-loving officials even one hundredth as much to give away that money.
According to the World Health Organisation, approximately one quarter of the world’s population will meet the criteria to be diagnosed with a mental disorder at some point in their life. That estimate has grown exponentially as the stigma around mental illness continues to be challenged, and it may grow further yet. Disregard for the wellbeing of even one person in this country should be shocking, but the willingness of the Gauteng government to endanger one in four constituents is abhorrent, and terrifying.
I say that it is terrifying, because I am a mentally ill person. I know full well the ways in which we are denied care, understanding and support. I have learned not to expect these, even from those closest to me. Where I cannot expect support, my consolation is in the rights that protect me, and compel others to. The knowledge that my government would rather save money than save my life should not surprise me, but it does terrify me. It removes my surety. I have at times begged my university to understand: I have cried and performed my illness, I have shown my scars and detailed my thoughts and been met with sympathy and pity, if not understanding. But I have acted in the confidence that I am guaranteed this sympathy by inalienable rights. Now, with a government so callous, who knows when I will be refused? Who knows when my execution will not be stayed, when no-one will come to my rescue the next time I try to end it?
Those at Life Esidimeni did not need to do anything to engender our sympathy. Whether or not I should have to perform my illness is a question for another time. These patients did not need to prove their illness further. They had been diagnosed, and their needs were set out by capable professionals. The department knew the facilities at the NGOs they selected to be insufficient in providing for these needs – some were not even legally registered. That in so many cases families were prevented from being informed, and from communicating with their relatives, is a damning indictment of the deliberateness of the department’s decision. The subsequent refusal of senior officials Makgabo Manamela, former director of mental health, Barney Selebano, head of department, and Qedani Mahlangu, provincial health MEC, to accept full accountability for the disaster is deeply shameful for the integrity of our country’s public offices. The action itself, and the aftermath, are a negation of the humanity of the mentally ill.
Compensation in this case will never be enough. This is a crime against all who live in South Africa, and a humiliation to all of us who have allowed it to happen. Despite his greatest efforts, Moseneke can only intimate this through a financial award. It is up to this entire country to prevent another Life Esidimeni. Mentally ill people are some of the most vulnerable people in this country, and yet we are treated like worthless liabilities to those who have to care for us, be that government, universities, families or friends. It cannot be acceptable. It cannot be tolerated. It cannot be paid off.
To those responsible for this tragedy: to government, to my fellow South Africans: please treat us like human beings.
Here follows the Justice Dikgang Moseneke reading the names of the deceased: