Life Esidimeni hearings: 'Not my fault they died'

Life Esidimeni project head for the Gauteng department of health Makgabo Manamela was evasive and unapologetic as she testified about the deaths of 143 psychiatric patients on her watch, to the annoyance of former chief justice Dikgang Moseneke, presiding at arbitration hearings on Thursday.

As Manamela spoke, family members of the dead heckled her.

A lawyer for NGO Section 27, Adila Hassim, described her testimony as "evasive" and Moseneke had several angry exchanges with her.

At one point Manamela justified the transfer of 150 adults to the owner of a day-care centre for disabled children by saying that mentally ill adult patients had the minds of children, so they could be classified as children. She said this three times.

As director of the Gauteng mental health directorate, she licensed ill-equipped NGOs to take care of psychiatric patients who had been cared for by Life Esidimeni when the department ended that company's contract, reportedly as an economic measure. As a result, it is alleged, 143 patients died, most of them at underfunded NGOs not experienced or equipped to care for them.

Manamela was one of three Gauteng health department officials leading the Life Esidimeni project.

She refused to take responsibility for her role in licensing the NGOs.

Moseneke said: "Maybe you didn't care; you signed whatever you signed, you forget it was about people who had blood and flesh."

Manamela replied: "I cannot accept when you say I just don't care."

Manamela was forced to admit after detailed evidence was put to her that, when the Life Esidimeni contract was ended in September 2015, there were not enough NGOs or hospital beds for the 1712 patients who would have to be moved from Esidimeni facilities.

She said: "It was a process . we didn't have enough beds."

"Why [then] did you chuck them out?" asked Moseneke.

"We didn't chuck anyone out," she said.

"You did," shouted family members.

She licensed people such as Ethel Ncube, owner of a day-care for disabled children, to look after 150 severely mentally ill adult patients.

Moseneke asked her: "How many people died at Precious Angels after you issued a licence and permitted [Ethel Ncube] to take 150 patients?" She hesitated before replying: "I might not arrive at the right number."

Moseneke told her that 20 people had died.

"You issued a licence to Ethel Ncube, who has no skill for looking after people like this. She had no beds for them. What do you have to say about the consequences of you permitting her to look after people and now people [have] died?" asked Moseneke.

Manamela seemed unapologetic: "The consequences must be assessed. I don't have the postmortems. People died. It was heartbreaking.

"When my team assessed the place, it was suitable."

She then blamed officials under her for certifying the NGOs as suitable after inspections.

"That is what my team did. At my level, I cannot go to each and every NGO [for an inspection]."

Moseneke asked her why NGOs were not given money to care for patients.

"For four months Ethel didn't get a penny from you for her operations," said Moseneke.

Manamela replied: "I am not the one who is giving money," saying that was the finance team's responsibility.

Manamela continued her testimony on Thursday after ignoring the first subpoena because of an error in the date. Then she asked for a postponement on the day she was supposed to appear, and then missed two days of testimony claiming illness. She faced arrest if she did not appear for the hearing on Thursday. 

Section 27's Hassim asked her about her salary, revealing that a government official of her seniority would earn between R900,000 and R1-million a year. He said this indicated how heavy her responsibilities were.

But she continued speaking about decisions made and carried out by "teams". Hassim replied: "I suggest it's better if you don't talk about teams any further."

She once shouted at Hassim: "You need to understand how the government works!"

He shot back: "How government works - what, [by] pointing fingers at each other?"

Often she gave such lengthy answers that Mosekene stopped her, saying: "Can I take you away from all these many words?"

After insistent questioning about the health department's decision to end the Life Esidimeni contract, she admitted to Moseneke: "Yes, I supported the decision."