It was an autumn Monday in Parktown, Johannesburg. The heat felt like mid-summer temperatures. Seats in the room are quickly filling up — from Gauteng’s number one citizen to family members to lawyers and the media trying to find space for the perfect shot.

The anxiety in the room cuts through the heat. The nation is on standby. On this day, former deputy chief justice Dikgang Moseneke delivers his long-awaited judgement. After months of heartbreaking testimonies and denial from government officials fingered as the ones responsible for the tragic deaths of 144 mental health patients — the moment of truth is finally here.

Moseneke sets out the R1,2million award in constitutional damages and funeral expenses that the Gauteng government should pay as compensation for the deaths of the patients and the trauma caused to their loved ones. 

Christine Nxumalo, who lost her sister Virginia Machpelah, tells the media that this is only a halfway house to justice.

Health-e News put together this timeline to commemorate the start of the Moseneke-led arbitration on 9 October 2017. 

October 2015

Despite warnings and letters from mental healthcare experts, former Gauteng health MEC Qedani Mahlangu announces the termination of contract with Life Esidimeni. The private healthcare group-housed almost 2000 mental healthcare patients funded by the state.

November 2015

The SA Depression and Anxiety Group (SADAG), SA Society of Psychiatrists (SASOP),  SA Federation for Mental Health (SAFmh) and families try to engage the department about their concerns regarding the termination of the Life Esidimeni contract.

December 2015

Concerns of families and lobby groups are not adequately addressed. Public interest law organisation SECTION27, which represents families, launches litigation against the department. A settlement is reached between the two parties. The department agrees not to move any patients until all parties have an agreement on the process and facilities.

February 2016 

Gauteng health department announces that all mental healthcare patients will be moved out of Life Esidimeni by the end of June 2016.

March 2016 

The department attempts to move 54 people to Takalani, a home in Soweto. SADAG, SASOP, SAFmh and families — represented by SECTION27 — litigate against the provincial health department to prevent the move. The court rules in favour of the department. 

The arbitration heard the department misled the court to allow the transfer of patients to a facility that was unable to meet their needs.

March 2016

The first Life Esidimeni patient dies. Deborah Petla was transferred to Takalani. According to her mother, Maria Petla’s testimony, she was moved to the home on the 23rd. Six days later, she receives a phone call to inform her Deborah was no more. She passed away on the 26th. Her post mortem results revealed she died from drowning in her own blood and that her stomach contained two bottled up plastics the size of a fist. Several pieces of brown papers were also found in Deborah’s stomach along with partially digested food that resembled samp with beans.

June 2016

All mental healthcare patients are moved out of Life Esidimeni. Many are sent to unlicensed non-governmental organisations (NGOs). 

September 2016

• Mahlangu reveals that 36 former Life Esidimeni patients have died since their move. She was responding to a question that was put forward to her by the Democratic Alliance’s Jack Bloom, a member of the Health Portfolio Committee in the Gauteng Provincial Legislature Committee. 
• Former Minister of Health Dr Aaron Motsoaledi requests a meeting with Mahlangu. Motsoaledi asks the Health Ombudsman Malegapuru Makgoba to investigate the deaths.  
• A request is made to the South African Police Services (SAPS) to conduct inquests into all the deaths of former Life Esidimeni patients. 

February 2017 

• Makgoba releases a damning report titled “94 silent deaths and still counting”.  The ombud found that 27 of the NGOs that patients were sent to were unlicensed and ill-equipped to take care of patients’ needs. In the report, the ombud says that the “evidence identified three key players in the project: MEC Qedani Dorothy Mahlangu, Head of Department Dr Tiego Ephraim Selebano and Director Dr Makgabo Manamela. Their fingerprints are ‘peppered’ throughout the project.”
• Gauteng MEC for Health Qedani Mahlangu resigns.

In the wake of the ombud report, Health-e profiled 10 Life Esidimeni patients including Deborah Phehla (pictured on the left) and the circumstances around their deaths. This provides a glimpse into the dignity denied to both mental healthcare patients and their families before, during and after the fatal move.

October 2017

To avoid legal dispute between the state and families of Life Esidimeni victims, the Gauteng government set up an arbitration led by former deputy chief justice Dikgang Moseneke. The arbitration is projected to be three weeks long, but it was later extended into a 44-day sitting with an additional two days of closing arguments and a day for Moseneke to deliver his judgment.

December 2017

Gauteng health department reports Selebano to the Health Professionals Council South Africa (HPCSA), 10 months after Makgobo recommended that the department reports him.

January 2018

• After months of avoiding appearing before Moseneke and families, Mahlangu sits before the arbitration. She testifies that she was not to be blamed because her role was political, and not operational. 
• Families stage a walkout as she tried to apologise at the end of her testimony.

March 2018

Moseneke hands down the historic award. Families received  R1-million in Constitutional damages. Government should pay  R20 000 to cover funeral costs and R180 000 for shock and psychological trauma.

In his judgment, Moseneke says: “ The transfers (of the patients) were degrading and inhumane. Many of the destinations were plainly treacherous and some were death traps and sites of torture.”

Moseneke recommends that government reports implicated officials to their professional bodies. This includes Selebano being reported to the HPCSA as a medical practitioner, former head of mental health Makgobo Manamela and her deputy Hanna Jacobus to the South African Nursing Council (SANC).

August 2018

• SANC says only one has been reported to the body since the ombud’s February 2017 report. The nursing council says it cannot reveal the name of the reported person.
• The National Prosecuting Authority (NPA)  says it will know whether it can prosecute the 45 Life Esidimeni-related cases by mid-August.

May 2019

• HPCSA says Selebano’s inquiry will take place in mid-September 2019.
• SANC says there are delays in acquiring supporting documents for cases to go ahead.
• NPA says it’s still probing the 45 cases.

September 2019

• HPCSA informs Health-e that Selebano’s case is postponed once again.
• NPA says that it does not have enough evidence to prosecute officials and open a joint docket of all the deaths. “After careful consideration of all the facts, reports and available information, acting director of public prosecutions, advocate George Baloyi, decided that a formal and joint inquest into all deaths related to the Esidimeni tragedy be held in the high court of Pretoria before a judge,” said NPA spokesperson Phindi Mjonondwane in a statement.

October 2019 

• After weeks of chasing SANC, Health-e has not received any comment from the body regarding the progress of the officials that were reported to the nursing council.
• HPCSA tells Health-e that Selebano’s case has been postponed as it awaits transcripts of the Moseneke led arbitration. Although the transcripts are available online, the body claims that the online versions are not complete and that it needs the official transcripts. “In order for the record to be admitted or accepted as evidence, the company that transcribed must give us a certificate confirming the records are a true reflection of what was recorded,” says Communications Manager Priscilla Sekhonyana.

It’s been two years since the journey of justice for Life Esidimeni victims — those who died and those who survived — started. It’s been more than three years since Mahlangu announced the deaths of at least 36 patients in the province’s legislature. But it’s been a road filled with officials refusing to take responsibility. There have been no arrests,  but 144 lives were lost. 

Will families ever get the justice they seek? Will this journey to justice ever end? Will South African ever know the real reason behind the Gauteng health department’s decision to move patients?

During his ruling, Moseneke said: “All we can hope for is that one day, the true reason for the conception and project will see the light of day.” – Health-e News