Nearly a year after a high court inquest found former Gauteng Health MEC Qedani Mahlangu and former Director of Mental Health Makgabo Manamela criminally negligent in the deaths of 140 mental health patients, families and advocacy groups are growing increasingly frustrated over the lack of prosecution.
The Life Esidimeni tragedy, one of South Africa’s worst human rights violations in recent history, unfolded in 2016 when over 1,700 mentally ill patients were unlawfully moved from Life Esidimeni facilities to unregistered NGOs as part of a cost-cutting measure. Many died from starvation, dehydration, and neglect, with autopsies revealing horrific conditions—including patients with paper in their stomachs.
Inquest Findings Ignored?
In July 2024, an inquest judge ruled that Mahlangu and Manamela bore responsibility for at least nine of the deaths due to gross negligence. Yet, the National Prosecuting Authority (NPA) has yet to decide on criminal charges, leaving victims’ families in limbo.
Sasha Stevenson, Executive Director at Section27—a public interest law center representing the families—expressed dismay at the delays. “The inquest was meant to establish accountability, but without prosecution, it risks being another empty process,” she told Michelle Craig in an interview. “It’s been eight years of pain for these families, and justice cannot wait any longer.”
A Broken System, A Culture of Impunity
Stevenson highlighted the systemic failures that allowed the tragedy to occur, including the lack of proper patient records and the dehumanizing transfer process. Many survivors suffered severe trauma, while some patients remain unaccounted for to this day.
The NPA’s silence has raised concerns about political will to hold officials accountable. “This case is a test for our democracy,” Stevenson said. “If we allow those responsible to evade consequences, what message does that send about the value of vulnerable lives?”
Calls for Urgent Action
Section27 and families are urging the NPA to:
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Prioritize prosecutions against Mahlangu and Manamela without further delay.
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Expand investigations to include other officials and NGO owners implicated in negligence.
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Ensure accountability to prevent future violations of mental health patients’ rights.
As the mental health review boards prepare to convene, advocates warn that without justice, the Life Esidimeni tragedy will remain a dark stain on South Africa’s commitment to human rights.
“We cannot move forward without accountability,” Stevenson emphasized. “The NPA must act now.”
Background:
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2016-2017: Patients relocated; deaths reported. Ombudsman investigation confirms negligence.
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2018: Arbitration awards families compensation but no criminal charges.
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2023-2024: Inquest concludes with findings of criminal negligence.
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2025: Still no prosecutions.
For now, the families continue to wait—hoping that those responsible will finally face the consequences of their actions.
