The health ombud’s investigation into conditions at the Northern Cape Mental Hospital has laid bare in excoriating detail the inhumane treatment inflicted on some of SA’s most vulnerable citizens.
It is symptomatic of a far bigger problem, suggesting state actors have learnt nothing from the Life Esidimeni scandal and put no guardrails in place to prevent such a tragedy from occurring again. More than 140 people died after the Gauteng health department ignored expert advice in 2016 and transferred more than 1,000 stable mental patients from private provider Life Esidimeni to unlicensed and ill-equipped nongovernmental organisations — all in a bid to save money.
Health ombud Taole Mokoena’s latest investigation report, released earlier this week, sets out the indifference, mismanagement and neglect that faced four psychiatric patients admitted to the Northern Cape Mental Health Hospital, three of whom were subsequently referred to the nearby Robert Mangaliso Sobukwe Hospital for critical care. But the systemic failings and potential corruption that his team exposed go far wider, suggesting no patients admitted to either facility could be sure they were in safe hands.
The investigation found the mental hospital, which cost R2.9bn to construct and opened with great fanfare in 2019, was in a state of utter disrepair. Investigators found broken windows, sewage flowing into showers and dysfunctional electromagnetic door locks because there was no power. There were no blankets or pyjamas for patients, even in the middle of winter, and the facility was so short-staffed that underqualified enrolled nurses were left in charge of patients, in breach of SA nursing council regulations requiring a professional nurse to play that role.
Winters in the Northern Cape are bitterly cold, with temperatures regularly falling below 0°C at night. No surprise then that the health ombud found one of the patients died of hypothermia, while another died from pneumonia worsened by the cold.
The conditions facing the psychiatric patients admitted to the mental hospital, who were effectively incarcerated since they could not discharge themselves, have disturbing echoes of the Life Esidimeni tragedy. In both instances, extremely vulnerable patients were deprived of the most basic necessities because people in power simply did not care.
Take the mental hospital’s electricity problems, which were triggered by cable theft and vandalism in 2022. This is hardly an unusual occurrence in SA and a problem that any competent manager should be able to solve. It took just two days for nearby private healthcare facilities to restore power, but the Northern Cape provincial government’s supply chain management system was so dysfunctional that the mental hospital was still without electricity more than a year later. Nurses were forced to care for patients by the light of their cellphone torches, and vital equipment such as resuscitation machinery was rendered redundant.
The ombud’s investigation raises red flags about the provincial government’s procurement processes, as it found the mental hospital had purchased golf carts and furniture it did not need, yet lacked essential medical equipment. And instead of sourcing clothing from department of employment & labour-approved manufacturers that provide jobs to disabled people, it turned to a little-known business, Tropical Enterprise, which supplied garments that were not fit for purpose.
The probe also raised troubling questions about the lack of oversight by the Northern Cape Mental Health Review Board, which was charged with protecting the rights of mental health patients, yet appeared to be missing in action.
The exposé of the grim conditions confronting mental healthcare patients in Northern Cape hospitals follows a series of investigations laying bare the degrading and wholly inadequate patient care at numerous public hospitals in Gauteng. Independent of these probes, media investigations have revealed a vast array of contracts for suspiciously overpriced goods and equipment, the latest being the R836m oxygen plant tender overseen by the Independent Development Trust.
There is clearly no real political appetite to tackle either corruption or the neglect of patients who rely on public healthcare. And as ever, it is the most vulnerable who pay the price for the state’s indifference.
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