An investigation by the health ombud into the treatment of state mental patients in Northern Cape has revealed they were exposed to dangerously cold winter conditions and left in the hands of unsupervised junior staff.
The probe was triggered by a complaint laid by health minister Aaron Motsoaledi in October 2024 and scrutinised the care provided to four patients admitted to the Northern Cape Mental Health Hospital, three of whom were transferred in critical condition to the Robert Mangaliso Sobukwe Hospital (RMSH) in Kimberley.
Two of the patients died, and one remains bedridden after a stroke.
The investigation covered the period July to August 2024, among the coldest months of the year.
During this time, the hospital was without electricity, due to cable theft and vandalism of an electricity substation in 2022, and had only one generator, which could not provide power to large parts of the facility despite it being only partially occupied.
Winter temperatures in Kimberley frequently drop to close to or below freezing.
Nearby private healthcare facilities were able to restore power within two days of the cable theft and vandalism, but dysfunctional supply chain management processes within the provincial health department meant the hospital was still without electricity in the winter of 2024, said health ombud Taole Mokoena.
Nurses were forced to work in the dark, using their cellphones as torches, and the facility was unable to operate its heating systems or resuscitation equipment, he said.
The pyjamas and bedding procured by the provincial health department from Tropical Enterprise were thin, of poor quality, and wholly inadequate for winter conditions, he said.
“Patients were freezing to death — literally.”
Releasing his investigation report on Wednesday, the ombud described the hospital — which opened its doors in 2019 — as poorly maintained, and lacking vital equipment and medicines.
Broken windows were not repaired, electromagnetic doors were not working and sewage was emerging from the shower drains. The facility was significantly understaffed, with just 323 of its 593 posts filled.
Mokoena’s investigation found Tshepo Mdimbaza died of hypothermia at the hospital. The lack of electricity meant resuscitation equipment was not charged and available for use, directly contributing to his death, said the ombud.
Cyprian Mohoto was transferred to RMSH with a suspected bowel obstruction and diagnosed with double pneumonia, possibly caused by exposure to extreme cold, said Mokoena.
Mohoto was assessed by an unsupervised junior doctor who failed to prescribe antibiotics, contributing to his death three days later, he said.
John Louw was found unresponsive at Northern Cape Mental Health Hospital and transferred to RMSH, where he underwent surgery for a subdural haemorrhage. He was discharged back to Northern Cape Mental Health Hospital , where he remains bedridden.
Petrus de Bruin was referred to RMSH after collapsing and being found unresponsive. The investigation found the care he received at the emergency centre at RMSH was appropriate but the monitoring provided by nursing staff was inadequate.
The investigation found the provincial health department had procured an array of furniture and equipment that was not required by the two hospitals, including golf-carts and specialised beds.
Both hospitals were acutely short of professional nurses, and had assigned underqualified enrolled nurses and enrolled nursing assistants to manage wards, jeopardising patient safety and in breach of SA Nursing Council regulations, said the ombud.
The ombud recommended the health department initiate a forensic investigation into the procurement processes for the Northern Cape Mental Health Hospital, and that the provincial head of health take appropriate action against several state employees, including the provincial office’s supply chain manager.
Motsoaledi said there were clearly extensive management failings at both hospitals. “If I was a physician and I was to make a diagnosis, I would diagnose multi-system organ failure,” he said.
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