I warned them‚ says specialist psychiatrist on Life Esidimeni tragedy

Family members of psychiatric patients who died earlier this year hold an ‘Esidimeni 37’ prayer vigil outside Gauteng Health MEC Qedani Mahlangu’s offices. The 37 patients died after being transferred from Life Esidimeni into the care of NGOs. Findings of the investigation into the tragedy would be released next month, health ombudsman Professor Malegapuru Makgoba said.
Esidimeni Family members of psychiatric patients who died earlier this year hold an ‘Esidimeni 37’ prayer vigil outside Gauteng Health MEC Qedani Mahlangu’s offices. The 37 patients died after being transferred from Life Esidimeni into the care of NGOs. Findings of the investigation into the tragedy would be released next month, health ombudsman Professor Malegapuru Makgoba said.
Image: Antonio Muchave ©Sowetan

 An expert witness told the Life Esidimeni arbitration hearing that he wrote two letters‚ took the Gauteng department of health to court twice‚ and had meetings with them in an effort to warn them of the dangers of closing the mental facility‚ but was ignored.

Dr Mvuyiso Talatala‚ a specialist psychiatrist who was the president of the South African Society of Psychiatrists (SASOP) at the time‚ told the hearing that they wrote letters of caution to different government stakeholders and organisations to rally support and emphasise the threat but had received no response since March 2015.

“We addressed both our letters to the provincial and national departments of health. We did not get a response until we presented it to the Ministerial Advisory Committee in August 2016. The letter was written in October 2015. We never got a response from the officials we sent it to. We were actually a nuisance to raise those concerns. The department of health has a culture of not listening to professionals.” said Talatala.

Talatala was responding to questions raised during the evidence in chief presented by Advocate Adila Hassim on behalf of Section27.

In the first letter‚ Talatala highlighted the severity of the illnesses and the level of care at NGOs compared to that of Life Esidimeni. He also raised concerns about the need for proper staff to receive the patients at NGOs.

Talatala said that mental institutions in the province already had a backlog due to the forensic use of placing suspects awaiting trial for crimes possibly committed due to mental illness.

“We already had a system in a crisis. To close the chronic beds would put pressure on acute beds‚” Talatala submitted.

Talatala‚ who provided extensive clarity on the process to be taken when discharging patients‚ said that the department of health had a culture of ignoring professional opinion.

“Probably they [the department] don’t care about mentally ill patients. In my view‚ had society not spoken out‚ the deaths wouldn’t be highlighted. The deaths would have been swept under the carpet‚” said Talatala.

In his view‚ the department was looking for an excuse to spend more and not cut costs since its plans to build 900 new beds.

“On another level they wanted to create an infrastructure crisis. The government wants to spend‚ in an easier way‚” he said.

Referring to the ethical oath taken by doctors‚ Talatata said those doctors who took part in the transfers should have said “no”.

“Working with the department of health is difficult. I think they should have refused to sign the discharges. They should have left it for the government to do it. They had an ethical obligation to refuse. Absolutely‚ I would have refused‚” Talatala said.

“These doctors are hired guns by Section 27. Their independence is questioned”

Talatala said that the Takalani Home for the Mentally Handicapped‚ where a high number of deaths occurred‚ was not equipped to look after adult mental patients.

“We wanted to interdict the discharge of patients to Takalani. The application was unsuccessful. The department lied to court and convinced the judge. They argued that if you are discharged it means you are well‚ you should go home. They argued that those patients were discharged by doctors. They are just being housed at Takalani and will not be receiving further treatment‚” said Talatala.

Talatala presented a report stating that a Salmonella typhoid outbreak was detected at the facility and that the living conditions were unfavourable.

He said that Chris Hani Baragwanath admitted a patient with a typhoid infection‚ “something that should have been investigated. It could cause a crisis. It’s a notifiable condition. It could spread fast‚ and kill too. This reflects on the kind of hygiene we keep.

“Six patients shared a room; there was not enough personal space. The dining hall area had a foul smell. The kitchen had very dirty floors and poor illumination. There was poor housekeeping. Dishwashing water was reused. A dirty basin and hot water was not provided‚” Talatala said.

Before he took the stand‚ the state had objected to his testimony as evidence as they questioned his objectivity‚ claiming that he once litigated against the state.

“These doctors are hired guns by Section 27. Their independence is questioned‚” said state attorney Tebogo Hutamo. 

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