Life Healthcare Esidimeni Scandal

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The Life Healthcare Esidimeni Tragedy involved the deaths of 143 people [1] at psychiatric facilities in the Gauteng province of South Africa from causes including starvation and neglect. It is named after Life Esidimeni, a subsidiary of Life Healthcare, the private healthcare provider from which patients were removed by the state.

The incident has been called "the greatest cause of human rights violation" in democratic South Africa.[2]

In October 2015, the Gauteng department of health terminated an outsourced care contract with Life Esidimeni in order to save money and give effect to a policy to "deinstitutionalise" psychiatric patients. Some 1 300 patients were transferred to the care of their families, non-governmental organisations (NGOs), and other hospitals. The process was subsequently found to have been in total shambles.

In September 2016, Gauteng health head Qedani Mahlangu first reported that several of the transferred patients had died.[3]

Later investigation revealed many attempts to warn the health department of the consequences of transferring patients to NGOs incapable of providing the specialised care they required. These warnings were ignored, and in one instance the department was found to have misled a court in order to prevent it from being interdicted.[3]

By October 2017, post-mortem examinations had been conducted on only 26 of the deceased.[4]

According to death certificates patients died of causes including hypothermia and dehydration, although many certificates listed natural causes.[5]

Family members of deceased patients reported seeing patients walking around naked,[6] that one NGO gave the same standard set of medication to every patient,[7] and that bodies were badly decomposed.[8]

Official report[edit]

A report into events requested by the Minister of Health was finally released on 1 February 2017, after it was delayed by Mahlangu who wanted time to peruse the document, as well as an extension of time to provide feedback.[9] The report concluded that:

  1. A total of ninety-one (94+) and not thirty-six (36) mentally ill patients died between 23 March 2016 and 19 December 2016 in Gauteng Province.
  2. The ‘high-level decision’ to terminate the Life Esidimeni contract was precipitously taken, followed by a ‘programme of action’ with disastrous outcomes/consequences including the deaths of Assisted MCHUs.
  3. The ‘programme of action’ transfer process was often described as ‘chaotic or a total shamble’ which contributed and precipitated to the accelerated deaths of mentally ill patients at NGOs.
  4. The NGOs where the majority of patients died had neither the basic competence and experience, the leadership/managerial capacity nor ‘fitness for purpose’ and were often poorly resourced.
  5. That certain officials and certain NGOs and some activities within the Gauteng Marathon Project violated Human rights of mentally ill patients.
  6. A combination of 2, 3, 4 & 5 above contributed to the different pattern of deaths and to more deaths experienced in some NGOs.
  7. The Premier of the Gauteng Province must, in the light of the findings in this Report, consider the suitability of MEC Qedani Dorothy Mahlangu to continue in her current role as MEC for Health.
  8. The Gauteng Mental Health Marathon Project (GMMP) must cease to exist.

The Report was the culmination of the Ombudman's investigation and interrogations as well consideration of the Ministerial Advisory Committee on Mental Health Report.[10]

Arbitration award[edit]

In March 2018 arbitrator Dikgang Moseneke ruled that families of the affected patients must each be paid R1.2 million, made up of R20,000 for funeral expenses‚ R180,000 for shock and psychological trauma, and R1 million in constitutional damages.[11] By December 2018 several hundred families said they had not yet received any payments.[12]


  1. ^ "Life Esidimeni death toll continues to rise". Retrieved 22 October 2017.
  2. ^ "Life Esidimeni: The greatest cause of human right violations since democracy". News24. Retrieved 22 October 2017.
  3. ^ a b "Report into the circumstances surrounding the deaths of mentally ill patients: Gauteng Province" (PDF).
  4. ^ "Of the 141 deaths at Life Esidimeni only 26 postmortems were done - reporter". 702. Retrieved 22 October 2017.
  5. ^ "Esidimeni: Doctors erase 'unnatural' deaths". Health-e. 4 September 2017. Retrieved 22 October 2017.
  6. ^ "Life Esidimeni: Some patients were walking around naked". News24. Retrieved 23 October 2017.
  7. ^ "I've been having nightmares - daughter of Life Esidimeni patient". News24. Retrieved 23 October 2017.
  8. ^ "Life Esidimeni victim's sister: 'I cried. I did not believe what I saw'". News24. Retrieved 23 October 2017.
  9. ^ "Report into death of mentally ill patients to be released". News24. Retrieved 24 April 2017.
  10. ^ "The Life Esidimeni disaster: The Makgoba report - DOCUMENTS | Politicsweb". Retrieved 24 April 2017.
  11. ^ "Government must pay R1.2-million to Life Esidimeni families". Retrieved 7 January 2019.
  12. ^ Lindeque, Mia. "Families of Life Esidimeni victims seek legal advice over govt payouts". Retrieved 7 January 2019.