South Africa’s Life Esidimeni Disaster and the Institutional Corruption That Opened the Door to It

In mid-2015, the Gauteng Department of Health in South Africa canceled a contract with Life Esidimeni, a subsidiary of a large hospital group that ran four facilities housing almost 2,000 people with mental illnesses. The termination of the contract and the chaotic transfers of people that followed resulted in enormous suffering and 144 deaths. Mental health care users died in conditions of neglect—emaciated, dehydrated, unmedicated, and with bedsores and gangrene. Their rights to health care services, to dignity, and to life were violated. The Life Esidimeni disaster occurred within the context of institutional corruption: a systemic and strategic influence that undermines an institution’s effectiveness by weakening both its ability to achieve its purpose and the public’s trust in it. Considering the institutional corruption that was the context for the Life Esidimeni disaster—including the overlap of political and administrative functions and the drive to save money, disguised as a desire for deinstitutionalization—this paper examines the public and legal processes undertaken to expose the disaster, to secure accountability, and to begin to deconstruct the conditions that allowed one of South Africa’s most shameful human rights violations of the democratic era.