The Tragical Story of Life Esidimeni

SITUATION SYNOPSIS

Considered one of the worst human rights violations in South African history, the ‘Life Esidimeni scandal is a tragic story that could have been avoidable. Life Esidimeni was a government,  in-patient mental health community in the Gauteng Province of South Africa, until it closed in June 2016. Between October 2015 – June 2016, 1,711 patients were transferred from the community to other nongovernmental organizations (NGOs) ones.  The transfer happened due to the Department of Health terminating the 40 year contract between South Africa and Life Esidimeni and not having a proper plan in strategically moving patients or communicating to families about the transfer..  After numerous reports were sent to the Office of Health Standards Compliance (OHSC) about medical malpractice and neglect, the OHSC requested that The Office of the Health Ombud conduct an investigation.  An Ombudsman is a third-party advocate for patients and families in long-term medical facilities. They also address complaints, concerns and conduct investigations of malpractice and abuse. In South Africa, they are an independent body that works alongside the government but is able to also investigate any medical allegations against the government or government figures.

A full investigation was conducted and it was found that due to the ill equipped NGOs, 144 patients died after the transfer, 1,418 were starved, and not properly cared for and 44 were missing.  Many of the NGOs were not licensed to provide provisional medical care, and were not properly functioning community settings.  The Ombudsman’s report call, ‘The Circumstances Surrounding the Deaths of Mentally Ill Patients: Gauteng Province’, stated that, “95% of the deaths that occurred were considered unlawful” and continued to state that “the decision to terminate the contract with Life Esidimeni contradicted South Africa’s National Mental Health Policy Framework and Strategy, as the cost rationale for termination of the contract was not acceptable because it failed to respect the fundamental rights of the patients”.  The overall conclusion from the investigation was that disciplinary action should be taken against government officials for their complicity in the deaths of these patients.  Ultimately an arbitrator ordered the government to provide compensation to the families of the patients who had died within three months. Besides the compensation, the government was required to offer counseling and support services to all claimants that requested it.  Several government officials were forced into resignation that had been placed in charge of the patient transfer.  The Office of the Health Ombud was also ordered to provide a strategic recovery plan to address the systemic changes needed in mental health care within six months. 

STRATEGIC COMMUNICATION / PUBLIC RELATIONS CORRELATION

It is incredibly sad to see that the entire Life Esidimeni situation was mismanaged from the start.  While it is still unclear if there were ulterior motives behind the government’s actions, the lack of basic communication does raise a red flag or two.  A strategic plan of transfer should have been created prior to anything else.  This would have allowed all parties (government, Life Esidimeni, NGOs, families and patients) to understand and actively participate in the transfer process.  NGOs would have been able to share that they were lacking resources prior to receiving any patients.  While families could have helped patients before, during and after the transfer to get settled into their new surroundings.  Care plans could have been reviewed together by Life Esidimeni providers and NGOs to ensure levels of care would continue to be met.

While compensation does not bring back your loved one, the entire arbitration process was handled well.  Particularly the part of having the Office of the Health Ombud to provide a recovery plan within six months.  Even though it was not the Ombudsman’s fault, they took accountability to ensure that this was never going to happen to anyone else or their families again.  It was a strategic move to gain some positive public opinion and to show that people were not afraid to stand up to the government.  No one will ever know all the answers but my question to the South African Government, why was this given such a short timeline for the transfers to be completed?  Up front communication could have prevented the torture and lives of the individuals. 

COMPARE & CONTRAST

Another government tragedy that affected a vulnerable population is part of Canada’s dark history.  For decades Indigenous children were taken from their families and forced to go into boarding schools.  Sadly many children never returned to their families, and families were given little to no information on what happened.  Recently a mass grave was found on one of the former boarding school grounds, suggesting what many had feared for years.  Former students recall tales of neglect, lack of food, physical abuse and overall poor living conditions.  Considered “cultural genocide”, these schools or rather “assimilation camps” were used as a way to ingrain certain morals and lifestyles into young Indigenous children.  The schools operatedfrom 1860 – 1970s and only in 2007 did the government of Canada step up after enough public outcry occurred.  They started to take accountability in their actions with the largest class-action settlement in the country’s history.  The government paid more than $72 million to support the newly formed Truth and Reconciliation Commission (TRC).  There is still much work to be done but the Canadian government is committed to a renewed relationship with Indigenous peoples and is committed to never letting anything like this happen again or brush aside this part of their history. 

PERSONAL REFLECTION & CLOSING REMARKS

Vulnerable populations sadly are at high risk for being mistreated and need to continue to be protected.  Most governments are put into place to provide and protect their citizens, as creating new legislation is often required to protect these vulnerable individuals.  In the tragic case of Life Esidimeni, had proper clear and honest communication happened at the start of the transfer process, there is potential that lives could have been saved.  Taking accountability and providing actionable next steps, are also strategic steps to slowly shift back into positive public opinion after a crisis.  Both South Africa and Canada’s governments, after some pressure, took accountability of their actions and included steps to ensure something like the tragedy would happen again.