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Judge rules former health MEC Qedani Mahlangu can be held criminally liable for 9 Life Esidimeni deaths

Judge rules former health MEC Qedani Mahlangu can be held criminally liable for 9 Life Esidimeni deaths
Family members of the Life Esidimeni victims at the Emoyeni Conference Centre, where the Life Esidimeni arbitration took place in January 2018 in Johannesburg. (Photo: Joyrene Kramer)
Takudzwa Pongweni
By Takudzwa Pongweni
10 Jul 2024
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Judge Mmonoa Teffo found that former Gauteng Health MEC Qedani Mahlangu and mental health director Makgabo Manemela can be held criminally liable for the deaths of some of the 144 mental healthcare users who were moved from the Life Esidimeni health facility to non-government organisations in 2016.

After an eight-year wait for justice, judgment has finally been handed down in the Life Esidimeni inquest.

Judge Mmonoa Teffo found that former Gauteng Health MEC Qedani Mahlangu and mental health director Makgabo Manemela can be held responsible for the deaths of nine Life Esidimeni patients. Due to the length of the judgment, Teffo read only the conclusion.

The purpose of the inquest, which began in July 2021, was to determine the cause of and possible liability for the deaths of 144 mental healthcare users who were moved from the Life Esidimeni health facility to unsuitable non-government organisations in 2016. 

They were part of a group of more than 1,500 patients who were transferred out of Life Esidimeni when the Gauteng Department of Health terminated its long-standing contract with the service provider.

The ruling


While the inquest investigated the 144 deaths, the portion of the judge’s ruling that she read on Wednesday focused on nine of those deaths where she could make a finding of criminal liability.

Teffo said: “I have come to the conclusion that the deaths of the deceased – namely Matlakala Motsoahae, Virginia Machpelah, Terence Chaba, Frans Dekker, Charity Ratsotso, Deborah Phetla, Lucky Maseko, Josiah Daniels, and Koketso Mogwerani – were negligently caused by the conduct of Ms Dorothy Qedani Mahlangu and Dr Makgabo Manemela.

life esidimeni A family member of victim Johannah Nqgondwane at the Life Esidimeni arbitration in 2018. (Photo: Joyrene Kramer)



“Ms Mahlangu proceeded to terminate the contract between the Life Esidimeni care centre and the Gauteng Department of Health, despite numerous expert advice and warnings from the professionals in mental health and stakeholders.”

“The deceased were further moved out of the Life Esidimeni care facilities to NGOs which were not equipped and inexperienced to give proper and adequate care in providing the requisite mental healthcare. Her conduct led to the regrettable and unfortunate deaths, some of which could have been avoided.”

Teffo said Manemela “hastily facilitated the implementation of the termination plan against expert advice from professionals and stakeholders”.

“She could have saved many lives as she visited the NGOs and could see that they were not adequately equipped and some of the personnel were not adequately qualified to care for the mental healthcare users. Some of the NGOs were licenced to care for the mental healthcare users without following the prescribed process protocols,” said Teffo. 

“Effectively, Qedani Mahlangu and Dr Manemela created the circumstances in which the deaths were inevitable.”

The National Prosecuting Authority will now consider Teffo’s ruling and decide if anyone is to be charged.

Justice partly served


Andrew Peterson, whose uncle Victor Truter survived the Life Esidimeni tragedy, said he had mixed feelings about the ruling. Truter, ​who suffers from chronic schizophrenia, was missing for two months after being moved from Life Esidimeni to a non-government facility.

“We have mixed feelings. We are feeling vindicated that what we said was true, that these people indeed were negligent and a crime was committed. We always said this was a crime… it was premeditated, it was negligence and now it’s been proven,” said Peterson.

The judgment provided a level of closure as some of the deaths could be pinned down to two individuals, he said.

life esidimeni Ntombifuthi Dhladhla and her late brother, Joseph Gumede. Joseph loved to draw and listen to old jazz music on the radio. Ntombifuthi, his younger sister, says: ‘He loved to draw Mandela. Joseph said there was nothing we couldn’t do when Mandela was leading us.’ (Photo: Mark Lewis)



life esidimeni maretele Daniel and Lydia Maretele and his late sister, Maria Mpabane Maretele. (Photo: Mark Lewis)



life esidimeni legwabe Lesiba Legwabe doesn’t have a photograph of his late brother Mothofela. He is photographed with a portrait of his late wife Salamina. (Photo: Mark Lewis)



“I understand the fact that where there’ve been no autopsies and so on. It was hard for the judge to link those to any form of negligence, but she could make that connection between the circumstances those people were in and the fact that they died – they died because they were neglected, they died because they didn’t get medication, they died because they didn’t get food or water,” he said.

“They were wrongfully and knowingly sent to NGOs that were unlicenced and the judge made that connection for us – we felt quite good about that.” 

Peterson said justice had partly been served.

“I think this is only the beginning before we can see people locked behind prison doors, so it’s a long road ahead. But every layer of victory that we get brings more vindication, brings more closure and a sense of peace,” he said.

Peterson said he was apprehensive that the next phase could be another prolonged process.

“Hopefully it won’t take another 10 years or 15 years. So that’s where the apprehension comes in, what if it never happens? So there’s a sense of achievement, of victory, but there’s also a sense of apprehension that the road ahead is so long, and the wheels of justice are grinding very slowly in this country,” he said.

Peterson said he hoped the government would draw lessons from the tragedy.

“It is also there [government] that the wheels are grinding very slowly. We’re not seeing the changes we want to see. We’re not seeing massive investment into health. There’s a need for new infrastructure related to mental health as well. So there’s a long way to go and one wonders where the political will is… that’s the discussion we need to have as a country,” he said. 

‘It can’t end here’


Christine Nxumalo lost her sister, Virginia Machpelah, due to the tragedy. 

Life Esidimeni Christine Nxumalo and her late sister Virginia Machpelah, a Life Esidimeni victim. (Photo: Mark Lewis)



“I am beside myself, I am honestly beside myself. This is just the halfway mark. We needed the judge to tell us this so that criminal charges could be laid because it can’t end here. We’ve reached the halfway mark, and we finally got what we wanted, so now we need to proceed to the next level,” said Nxumalo.

Machpelah suffered from early-onset Alzheimer’s and had lived at Life Esidimeni Randfontein Care Centre for two years before being moved to Precious Angels NGO. Nxumalo said she hoped the full judgment mentioned the owner of Precious Angels, Ethel Ncube.

Public interest law firm SECTION27, which represents the families of those who died, called on Teffo to recommend that charges be brought against Ncube.

“My sister died in her care, and 21 others died in her care. It cannot be okay,” Nxumalo said.

She said one lesson from the tragedy was that political heads should not interfere in administrative duties.

“Allow the professionals and experts and qualified people to make decisions… they (political heads) must heed the advice that they are given because these people went to school for this. They are politicians, they are not experts of anything, and accountability must be a thing. That’s the only way we’re going to fix our country. That’s the only way we’re going to fix the government,” she said.

Nxumalo said there was more work to be done when it came to providing mental healthcare in the country. 

“The reason Life Esidimeni has survived for so long is because government has not pulled up their socks. We shouldn’t be using private facilities to provide mental healthcare services,” she said.

“Government is not doing what it’s supposed to do. Not enough care is taken to treat people with mental illness, and that goes for people with physical disabilities as well.”

Nxumalo shared fond memories of her sister.

“My sister was the best. She was the eldest of five and she was my go-to person. My mom died before my 16th birthday and my sister took over as our parent. When I got married my sister was there; when I finished school my sister was there… there was never a time she wasn’t there,” she said.

“Her suffering from a mental illness did not mean that I loved her any less, and me putting her in a facility did not mean I loved her any less. In fact, that was me showing care because I said, ‘as your sister I have to work and I have little kids, I can’t look after you so I am going to take you to the best place that I can’, and that was Life Esidimeni. What happened after that is not in any way what we wanted.”

Read more in Daily Maverick: After an eight-year battle, justice for Life Esidimeni 144 hinges on inquest judgment

Lucas Mogwerane’s brother, Christopher, was schizophrenic and had lived at Life Esidimeni for around 10 years. Christopher was moved to Rebafenyi Care Centre and died within two weeks of being transferred. 

“This (judgment) is what everyone has been looking forward to, although it took eight years – at least there is something done to restore dignity and justice,” said Mogwerane.

“As a family, we did not expect this tragedy. It devastated the family. We still have the memories of him. He was just a jolly person, full of jokes, energetic… we never expected something like this to happen to him because we trusted the place where he was before he was moved.”

Mogwerane said he hoped criminal prosecutions would get under way shortly.

life esidimeni Family members of the Life Esidimeni victims at the Emoyeni Conference Centre, where the Life Esidimeni arbitration took place in January 2018 in Johannesburg. (Photo: Joyrene Kramer)



SECTION27 noted that it’s now up to the NPA to decide whether to prosecute Mahlangu and Manamela.

“We trust that… Ms Mahlangu and Dr Manamela will be prosecuted for culpable homicide,” it said in a statement.

“Whilst the judgment from the inquest cannot restore lost lives and dignity, the outcome is a bold statement in favour of accountability and honours the mental healthcare users who suffered and died in this tragedy.

“For the families of mental healthcare users who died after being transferred from Life Esidimeni, and indeed for the many people who have watched as the different legal processes relating to this case have unfolded over the past nine years, it has been a long wait for justice and this outcome is an end in itself and a vital step on the path towards criminal accountability.”

Calls for systemic healthcare reform


Puseletso Jaure, CEO of Life Healthcare’s Life Nkanyisa, said this had been a long, heartbreaking and difficult process for everyone involved, especially the affected families.

“The Esidimeni tragedy and today’s judgment should make us all reflect on how our healthcare stakeholders can work together to bring about systemic reform that prioritises the needs of the most vulnerable patients in our society,” read Jaure’s statement.

AfriForum’s private prosecution unit released a media statement taking note of the inquest findings, adding that it would await a written judgment before deciding how to proceed. 

The unit and Solidarity Helping Hand represented Sandra de Villiers whose brother, Jaco Stols, died in 2016 during the Life Esidimeni tragedy. Stols was relocated to a facility where he is believed to have starved to death.

Government officials failed to get permission from Stols’ next of kin to relocate him. De Villiers was initially barred from visiting him at the new facility. He was only hospitalised at De Villiers’ insistence after he weighed 39kg, and by then it was too late to save him.

“The verdict is a small step towards the justice we’ve been seeking for so long. We are grateful that those in prominent positions who were directly responsible have been held accountable. The victims who couldn’t help themselves died of dehydration, starvation and neglect,” said René Roux, managing director of media at Solidarity Helping Hand.

The Democratic Alliance also welcomed the ruling, noting that it was a pity that the lack of autopsies for the other Esidimeni victims precluded a firm negligence finding for the other deaths.

“Charges should also be laid against all those who can be identified as causing the suffering of the Esidimeni patients. These include contraventions of the Mental Health Care Act and the National Health Act, as well as fraud in licensing the NGOs, and other matters.

“The criminal charges should be formulated as soon as possible and a court date expedited so that justice is seen to be done without further delay,” said the DA’s Jack Bloom in a statement. DM

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