Life Esidimeni psychiatric patients in Gauteng Province, South Africa: Clinicians’ voices and activism – an ongoing, but submerged narrative

Abstract

After the first 45 days and beyond, the Life Esidimeni (LE) debacle may be slipping from public awareness. Despite ample evidence of clinicians’ attempts to communicate their concern about this, as well as active steps to try to prevent it prior to the termination of the contract with LE, the question to South African doctors of ‘What have you been doing about this?’ has again been raised by some role players. This made it necessary to consider the notion of a ‘submerged clinicians’ narrative’ in terms of the facts regarding: (i) the actual involvement of individual clinicians and professional societies collectively; (ii) individual doctors’ responsibility as clinical decision-makers; (iii) other examples of clinicians’ ongoing and repeating narrative; and (iv) possible conflict of interest between clinicians’ relationships with their patients, and as employees, with a third party, whether a state or private employer or funder. Considering the evidence available, it does seem that despite a sustained level of communication and action by clinicians, and in particular by psychiatrists, on this matter, their communication and activism largely remained submerged, and as such, outside of public awareness and acknowledgement by politicians and managers, who were in all instances the final decision-makers on clinical matters pertaining to these patients.