JOHANNESBURG - Dr Barney Selebano admitted that he failed to stop the transfer of at least 143 psychiatric patients who died after they were moved from Life Esidimeni to ill-equipped NGOs in 2016.
"I know how exactly we did things wrong - by not heeding advice, listening to other people," Selebano said at the ongoing Life Esidimeni arbitration hearing after indicating that he was too afraid of former Gauteng Health MEC Qedani Mahlangu to stop the transfer.
The warnings from psychological and psychiatric professionals, advocacy groups and members of Parliament (MP) with regard to the transfer began as early as 2015.
DA MP Jack Bloom raised the issue in a speech in Parliament on 30 November 2015, calling the decision to cancel the contract with Esidimeni a "colossal mistake".
On 3 December, South African Federation for Mental Health (SAFMH) programme manager Marthé Viljoen, released a statement commemorating International Day of Persons with Disabilities and raising concerns about the proposed transfer.
"The manner in which the termination of the Life Esidimeni contract has been managed by the Gauteng Department of Health has raised concerns regarding whether the human rights of the residents of the Life Esidimeni facilities are being protected," the statement read.
"Statements made by The Department of Health regarding the termination of the Life Esidimeni contract seem to suggest that the contract termination is being done in the spirit of deinstitutionalisation. However deinstitutionalisation (or downscaling of institutionalised care) ideally needs to go hand in hand with the upscaling of community-based care, and there is no indication that this seems to be the department's intention."
Professor Anthony Pillay, president of the Psychological Society of South Africa, warned in January 2016 that “upon discharge, without the same level of structured care and supervision, there is a high probability of relapse and disintegration of the rudimentary coping skills, resulting in a need for more intensive mental health treatments than previously required.”
In February 2016, relatives of the patients marched in Johannesburg to the provincial department of health to protest at the transfer.
“The department’s actions are callous, immoral and unlawful. Unless we take action, the department will trample the rights of the most vulnerable amongst us,” said a statement from the march organisers.
“As the 31 March deadline looms, there is no evidence the department has or can soon have a proper plan. We are now forced to ask, what does this mean for our loved ones and their futures?”
The head of the South African Society of Psychiatrists (Sasop), Dr Mvuyiso Talatala fought against the transfer of patients to NGOs and with the SA Depression and Anxiety Group (Sadag), Section27 and the SA Federation for Mental Health had jointly brought the urgent application before the High Court prior to the transfer happening in an attempt to halt it.
"It should not be the society versus the government, we should have sat together, come up with a plan of dealing with Life Esidimeni, and we should all be answering on the same side of the table. We should be owning up to what had happened, we should have worked together," said Dr Talatala.
Sasop cautioned in June 2016, "Reports on the disorganised manner of the bulk transporting of these MHCUs have appeared in the media, while personal reports from families and from involved advocacy groups allude to totally inadequate locations (with MHCUs apparently sleeping on floors with no medication, no heaters or supervision), loss of clothes and possession, no accompanying documentation, etc. This experience in itself constitutes a sufficient level of stress to precipitate the relapse of several patients in this situation."
All their warnings went unheeded as the transfer was approved. Dr Sebelano testified during the arbitration process, he could not have foreseen that people would die when he signed off on the plan to move the hundreds of patients from Life Esidimeni to unlicensed NGOs.