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patients lost after closures1

patients lost after closures2

The Gauteng Department of Health recently decided to close down four mental hospitals, evicting over 1 700 patients. What's in store for these vulnerable people and their families? BY PETER VAN ZYL 1 T TAKES a while for the gates to open. Three women in their late thirties sit on plastic chairs in the pale winter sun. They show no emotion. About 13 women stay here at the non-governmental organisation (NGO), Siyabathanda, which means "we love them, we care for them". It's located on the outskirts of Dobson-ville, Soweto and all of the women were moved here from the Life Esidimeni Psychiatric Hospital in Randfontein, one of four psychiatric hospitals that have recently closed down. And the same might soon happen in other provinces - the closure of hospitals forcing the integration of mental health patients into the community. On paper, it might sound like a good move, but in practice it's turning into a stressful time for the more than 1 700 state patients and their families. NGO workers have been pushed into the deep end. "We don't know their diagnoses' says a worker at Siyabathanda. At the time of our visit, conditions at the NGO are dire. One of the patients jumps up to go and hide in the single bathroom inside the two-roomed house. Rows of beds fill these rooms. There is a dining room with a TV and a single heater working overtime. The tin roof is bare and there are also two outside rooms with beds and a toilet. Instead of getting their medicine on-site as they would in a hospital, these patients will have to take a taxi to the nearest clinic about 5 km away at least once a month. "There should be a sign informing the community about the centre and the patients who are living here:' says Quanita Mlotshwa, a member of a committee that was set up to support all the families of the patients that were moved. "And the walls are not high enough for safety; keeping people out and in: THE South African Depression and Anxiety Group (Sadag) created a joint taskforce of stakeholders, including a family committee, psychia- g,), trists and other mental healthNGOs. Together they're seeking legal advice and representation for patients 6 from the closed-down hospitals. g" We visited Quanita's sister, Nina* (48), at the San Michele Home near Brakpan. She was moved there from Life Esidimeni t, 7 Waverley Care Centre in Germiston. Nina has been in care since the age of 5 12. Af first she was in the Lentegeur g Hospital in Cape Town, and Quanita brought her closer to the family in i Johannesburg 20 years later. "There is nothing wrong with her brain. It's more behavioural:' Quanita explains. "She breaks things. She pulls curtains down and electric cords from the wall. When I ask her why she breaks things, she says: 'I don't know'. Nina sometimes needs medication to calm her down:' Quanita and other family members of patients expect to be kept informed about where their loved ones are taken to and why, and how they're doing. More worrying, though, is the deaths of patients since the closing down of the hospitals earlier this year. The most recent is an elderly woman who died at the Takalani Centre near the Chris Hani Baragwanath Hospital in Soweto. She was apparently moved there without the family being notified. During our visit to Takalani, new mattresses were stacked on top of each other near the entrance. They were expecting about 180 patients from the Life hospitals to be transferred there. Gaba Mogati's 32-year-old daughter, Thina*, has intellectual difficulties and is wheelchair-bound due to cerebral palsy (a condition marked by impaired muscle coordination and/or other disabilities, typically caused by damage to the brain, before or at birth). "What worries me is the security. Adults and children are here together:' Gaba says. While we were there, we see some of the adult patients moving freely from their side of the centre to the area where the kids are housed. This is against the Child Protection Act. \OMVULA NONJABE'S 25-year-old sister was diagnosed with paranoid schizophrenia (a mental illness in which the patient has delusions). She was at We skoppie s Psychiatric Hospital in Pretoria but was discharged in 2010 and took her medicine home. But after she tried to strangle Nomvula, she was taken in by an NGO in Berea. She constantly escaped and ended up in dangerous situations - until she was taken in by Life Esidimeni in Waverley last year. Her family was very happy with her progress, but now an unsure future lies ahead. "I have a four-year-old son at home. I can't take her in:' Nomvula says. Elizabeth Jafta from Bosmont, Johannesburg, has similar concerns. Her 42-year-old brother, Kent*, became psychotic after continued drug abuse. After his three brothers - his carers - died (one from cancer, the other in a car accident and the third murdered) his episodes became worse and he had to be admitted to Weskoppies and later Sterkfontein Psychiatric Hospital in Krugersdorp. When he was at home in Bosmont, he disappeared for days. About eight years ago, he was almost killed on his way home from the neighbouring Newclare when people were upset by his behaviour. It's because of incidents like these that an urgent interdict application was brought by Sadag, the South African Federation for Mental Health and the South African Society of Psychiatrists (SASOP) to try and postpone the closure of the hospitals. Together with the families, they demand to know what will happen to 1 726 State patients after the Gauteng Department of Health decided to remove them from private hospitals run by Life Healthcare Esidimeni. According to the Department of Health's media release on the subject, the contract termination is in line with the Mental Health Care Act 17 of 2002, which seeks to treat mental healthcare users in the least restrictive environment. Chapter Two of the Act is cited as reason for this service termination: care, treatment and rehabilitation services must be provided in a manner that facilitates community care of mental healthcare users, respects human dignity and privacy, and develops every mental healthcare user's potential to be integrated in the community. In 2014/5, the Department paid Life Healthcare Esidimeni R323,7 million to care for 2 378 patients - roughly 1 % of its total budget of R31,5 billion. The Department had planned to slowly reduce this number of patients until 2020, but "financial pressures" have intervened. "Deinstitutionalisation or downscaling of institutionalised care ideally needs to go hand in hand with the upscaling of community-based care, and there is no indication that this seems to be the Department's intention:' says Dr Mvuyiso Talatala, President of SASOP. "A patient's health and wellness affects more than just their own life:' says Sadag's Cassey Chambers. "When an institutionalised patient is released with-out care or support from professionals, how many lives are impacted?" *Not there real names. • WHAT GOVERNMENT SAYS: "The Department is trying its best to look after the patients. We have no death reports, except for the only two out of 1 442 patients placed. These two were sick and on a chronic general illness treatment. One death is one too many and cannot be taken lightly:' Dr Makgabo Manamela, Director of Mental Health Services in Gauteng, said in a statement. MAIN PICTURE: More that 1 700 psychiatric patients in Gauteng had to be transferred to other hospitals after four Life Healthcare Esidimeni psychiatric hospitals were closed down. ABOVE: Family members of the patients protested and handed over a memorandum of grievances to the Gauteng Department of Health. INSET: Nomvula Nonjabe talks about her sister, who suffers from schizophrenia.Get help: Contact Sadag on This email address is being protected from spambots. You need JavaScript enabled to view it. or 011-234-4837.

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