By Phenyo Selinda
Pretoria – The Pretoria High Court, Judge Mmonoa Teffo has determined that former Gauteng Health MEC Qedani Mahlangu and the then Mental Health Director, Dr Makgabo Manamela, can be held liable for the deaths of Life Esidimeni patients. The ruling, given during the Life Esidimeni inquest on Wednesday, aims to ascertain criminal accountability for the tragically avoidable deaths of 141 mental healthcare patients.
Negligence at the Forefront
Judge Teffo made it clear that the deaths were a direct result of negligence. “I have come to the conclusion that the deaths of [some of the] deceased were negligently caused by the conduct of Miss Dorothy Qedani Mahlangu and Dr Makgabo Manamela,” Teffo stated in her judgment. The judge elaborated that both Mahlangu and Manamela ignored numerous expert warnings and proceeded to terminate the contract between Life Esidimeni Care Centre and the Gauteng Department of Health.
A Harrowing Decision in 2016
In a critical move in 2016, the Gauteng Department of Health shifted patients from Life Esidimeni—a specialised psychiatric care facility—to various unlicensed non-governmental organisations (NGOs). These NGOs were described by Judge Teffo as “ill-equipped” and “inexperienced,” incapable of providing adequate care. The judge lamented that this conduct led to “regrettable and unfortunate deaths, some of which could have been avoided.”
Manamela’s Hasty Actions
Judge Teffo’s ruling pointedly criticised Dr Makgabo Manamela for her hasty decision-making. “She could have saved many lives as she visited the NGOs and could see they were not adequately equipped,” stated Teffo. She described how Manamela’s actions, in conjunction with those of Mahlangu, created circumstances in which deaths were inevitable.
Limitations of the Court
However, the court acknowledged limitations, notably in cases where no autopsies were performed, thus precluding conclusive findings for some deaths.
Origins of the Inquiry
The inquest was initiated following a report by former Health Ombudsman Professor Malegapuru Makgoba, which unveiled appalling findings about the deaths. Released in February 2017, the report disclosed that 94 of the deaths were unlawful and that the causes were unrelated to “mental health.” In addition, it found that all 27 NGOs receiving patients operated under invalid licences.
Commission’s Recommendations
In the aftermath, a commission led by retired Deputy Chief Justice Dikgang Moseneke concluded its findings by recommending the government pay R1 million per family in constitutional damages, R20,000 for funeral expenses, and R180,000 for shock and psychological trauma. The commission concluded its work in March 2018.

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