At least 94 mentally ill patients died after South African authorities moved them last year from hospital to unlicensed health facilities that were compared to "concentration camps", a government investigation revealed Wednesday.
Many of the deaths were due to pneumonia, dehydration and diarrhoea, as the patients were hurriedly shifted to 27 "poorly-prepared" facilities in an apparent cost-cutting measure that showed evidence of neglect.
The health ombudsman report, which sparked uproar in South Africa, detailed how some patients were collected from the Life Esidimeni hospital in the northern Gauteng province using open pick-up trucks.
Patients were then selected in a process like an "auction cattle market", before being taken away and then often shuttled between several of the new care centres.
As the scandal broke, provincial health minister Qedani Mahlangu resigned over the findings, which directly implicated her in the move.
According to the report, relatives were left in the dark over where the patients were – or even if they had died in the overcrowded, unheated centres that some witnesses said were like "concentration camps".
The centres also failed to provide seriously ill patients with enough food and water, leaving them severely malnourished, underweight and in some cases dying from dehydration.
Gauteng's provincial health department had terminated its long-standing contract with the Life Esidimeni hospital and moved more than 1 300 patients to an "unstructured, unpredictable, sub-standard caring environment", the report said. "One person has died from a mental health-related illness. None of the 93 (others) have died from a mental illness," health ombudsman Malegapuru Makgoba told local media as the report was released.
"The Gauteng Health Department took patients from a licensed institution and handed them over to unlicensed facilities," he added.
Makgoba said the death toll was likely to rise as investigations continued into the fiasco.
The report pointed towards the neglect that led to the deaths being caused by profit-seeking.
The 27 health care centres "were mysteriously and poorly selected" and were "unable to distinguish between the highly specialised non-stop professional care requirements… and a business opportunity," it said.
Gauteng Premier David Makhura vowed to hold accountable all the responsible officials.
The opposition Democratic Alliance party expressed outrage over the findings, and accused the government of lying about the death toll when reports of the tragedy began to emerge. "Criminal charges should also be laid against all implicated parties," said the party's provincial shadow health minister.