Silent screams find a voice

2017-12-17 06:12
Family members of patients who died after being moved from Life Esidimeni to inadequate facilities attend the arbitration hearing into the matter. PHOTO: Gallo Images / The Times / Alaister Russell

Family members of patients who died after being moved from Life Esidimeni to inadequate facilities attend the arbitration hearing into the matter. PHOTO: Gallo Images / The Times / Alaister Russell

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The Marikana and Life Esidimeni tragedies betray an appalling truth: officious politicians and their political officials, with the connivance of private parties inured to human debasement, contrived to end the lives of many people through a rogue and perverse act of state violence, military grade in the former case and, chillingly, as health policy in the latter.

A hapless president established the highly politicised Farlam commission of inquiry to investigate the slaughter in Marikana. A frantic minister of health set the health ombudsman to the task in the case of Life Esidemeni.

Both enquiries reveal that differences in the proximate circumstances do nothing to obscure the fact that the victims died, in both instances, in and at the hands of the state.

The similarities, however, end there. The outcomes of the Farlam commission are as clear as mud and about as meaningful. The outcomes, so far, of the Life Esidimeni enquiry are anything but.

The reasons for this are uncomfortably clear.

While the Farlam inquiry was predictable in its tentative apportioning of guilt, the health ombudsman’s report dispassionately dissects the human details of the disaster, in which guilt and recompense are evoked by the deed laid bare in all its many harms.

Most tellingly, the cause of the victims of the state’s mental health policy implementation was taken up by seasoned civil society activists and experts, not teams of lawyers in corporate posture. This is not to impugn the professional remit of Judge Ian Farlam and the various senior legal minds at the commission. Indeed, the commission was waylaid into navigating a familiar political maze of cynical twists and evasive turns and, in truth, could not have arrived at different outcomes.

In the Esidimeni case, an experienced medical scientist, with scarce resources but equipped with a reflexive rigour and, more importantly, steeped in the classical medical training that frames scientific thought in empiricism and invests scientific endeavour with ethics, swiftly and unsensationally produced a compelling account of the disaster, with each spot-lit character in the “dramatis personae” displaying the full array of ignorance, arrogance and rank neglect.

There is no scurrying obfuscation, no evading culpability and no respite from the truth in the health ombudsman’s findings. This is unprecedented in the annals of pre- and, depressingly, post-democracy government. In particular, proposing a thorough extra-prosecutorial airing of the anatomy of the disaster evinces a clarity of purpose lacking in the Farlam report.

Beyond this, things take a different turn in the fates of the survivors, perpetrators, authorities and observers alike.

It is likely that even the health ombudsman could not have foreseen that his recommended course of action would provide for a penetrating and excoriating discovery of a state that is in thrall to crass power, a public service that is beyond caring and ghouls who let people starve to death under their roofs.

The good judge’s entreaties to the parade of dramatis personae to explain their actions are tinged with incredulity, which intensifies with each engagement. Exasperated, he was moved to ask: “But where was the empathy?”

If I may proffer an answer, my lord, it is that it was missing in action, absented without leave, outsourced to another level in a self-regarding hierarchy or to dodgy accomplices.

Empathy, like nature and life, has been commodified. The economics of this empathy produces only grisly models and grim accounting, nowhere more so than in the instance of mass deaths.

Yet it is empathy that, when set to a discipline, becomes the duty of care. The duty of care is axiomatic for the state that dispenses services to the people; for those who hold the treasure of others in trust; for professionals and public servants; and for those charged with political office. It is axiomatic, too, for those who vote for and appoint them.

The duty of care does not end so long as the wellbeing of people is in the custodial embrace of the physician, nurse, lawyer, teacher, company director, municipal manager or politician with the power to affect people’s lives. For those obliged to a duty of care, there is no alternative to its fastidious exercise.

Through some bizarre transmogrification, the state has wilfully ­elided its sovereign purpose. The manifest contradiction that ensues is the stuff of civic nightmares.

A baleful, unresponsive and incapable public service is a mortal danger to society. Defensive and imperious, in mindless supplication to political power, in mute obeisance of a dissembling hierarchy, in wilful erasure of the first precepts of service, it becomes, in George Orwell’s take on political language, “… like a garrison in an occupied town”.

Marikana, Life Esidimeni and state capture draw a laser-like bead on those in office and those they direct who fail in this most fundamental of duties, the duty of care. For as long as that continues, awful tragedies will play out in a relentless procession of disasters.

So, if you happen to attend some political conference rumoured to be convening this week, a word to the wise – do not be too certain of your certainties.

When you decide upon an action that has a remote impact on human wellbeing, it is better not done if it is done without the obligatory duty of care.

By all means, cast your vote, but first exercise your duty of care. You may surprise yourself. You might just make the right choice.

And, to the eminent jurist moved to tears at the litany of human-induced and state-abetted horrors, you, sir, share in an ancient grief as written in Measure for Measure by William Shakespeare:

“But man, proud man,

Dres’t in a little brief authority,

Most ignorant of what he’s most assur’d;

His glassy essence, like an angry ape,

Plays such fantastic tricks before high heaven,

As make the angels weep.”

Dasoo is chief executive officer of Health Equity Partners

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