South Africa's Shame

More than 100 people have died and the death toll is still rising after a government decision to transfer psychiatric patients from hospitals to unlicensed private care homes in South Africa.  Senior officials were repeatedly warned of the risk of the patient-transfer scheme, yet they pushed ahead with it anyway.  

South African health ombudsman Dr. Malegapuru Makgoba's investigation found a range of troubling factors in the scandal: a government cost-cutting campaign that went wrong, private homes that saw the psychiatric patients as a business opportunity, appalling living conditions that sometimes resembled those of a concentration camp and senior officials who ignored all warnings of looming disaster. The senior officials who pushed for the patient transfers “knew of the risks before embarking on this project and watched as the tragedy unfolded,” said Section27, a public-interest law centre in South Africa.“They did nothing to stop it. They should be held to account to the fullest extent of the law."

Some patients were transferred to the private homes in the back of pickup trucks or were tied with bedsheets during their transfer, the report found. They were sent to homes without doctors, nurses or other qualified staff. Some of the homes lacked proper food, water, medicine and even heating in the winter. Many patients died of dehydration, heart attacks, diarrhea and pneumonia. Some had become emaciated from hunger. In many cases, the causes of death are still unknown.

Some of the facilities were just double-storey houses, and some were run as a business venture, the ombudsman said. None of the homes had valid licences, and many were overcrowded and lacked the resources to care for the influx of psychiatric patients, he said.

South African Health Minister Aaron Motsoaledi said the private homes chose the patients “like a cattle auction,” without regard to the specialized care that the patients would need. “How could they take patients without medical records into their care?” he asked.

 The Treatment Action Campaign, said it was shocked by the “inhumanity and callous disregard for the lives of others”  The report “paints a picture of a government with no regard for the lives of some of the most marginalized people in our society – people with severe mental-health problems,” it said. “The report also paints a picture of a health-care system that is grossly mismanaged and has been entrusted to people incapable of effectively serving the public interest.”