Full-length version of the piece that appeared in The Times, 7 April 2014

Ruth Maclean in Cape Town

Psychiatric patients lined up for plastic plates of grey food, supervised by stressed nurses. Shouting men banged their cutlery on plastic tables, some with half an eye on the fuzzy television screen behind its steel mesh housing. In the kitchen, the cooks shouted instructions at patients energetically washing up.

Outside the barred windows, stern-faced men in uniform guarded the gates to this, one of Valkenberg Hospital’s medium-secure wards, pacing up and down its concrete, caged walkway.

After three years in British psychiatric institutions, Shrien Dewani will get his first taste of the South African equivalent this week. He returns to South Africa a murder suspect and hate figure, rather than the pitied, grieving husband who left in 2010.

After a £200,000 wedding in Mumbai, he and his new bride Anni flew to South Africa for a fairytale honeymoon. Soon after they arrived in Cape Town, however, Anni Dewani was shot dead in one of the country’s most notorious townships, Khayelitsha. The taxi driver who took them there and two alleged hitmen are all serving long prison sentences for her murder. However, they all claim they had been hired by Mr Dewani to kill his wife.

Three years and a long extradition battle later, Mr Dewani arrives in Cape Town tomorrow (Tuesday) morning, expected at last to give his account of what happened that night.

Before any trial, however, psychiatrists must decide whether Mr Dewani is fit for one. The millionaire from Bristol who once ran care homes across southern England will now be cared for – and guarded – at Valkenberg, Cape Town’s oldest state psychiatric hospital.

It will not be “luxurious or comparable to the best in the UK, [but] habitable,” London’s High Court heard, before it made the decision to send him back.

Mr Dewani will take his place on the washing up rota with everyone else, and will rarely be allowed out of his medium-secure ward.

“Some of them are allowed a ground pass,” a nurse said, indicating the quieter patients. “But they do all this nonsense outside, so we have to take it away.” For some patients that means they are locked up in their block, with its small, worn patch of grass, for 24 hours a day.

Books and gadgets are usually confiscated – but he will be allowed to keep cigarettes. If they choose to move to Cape Town with him, his family will be restricted to visiting him for two hours a day. The rest of the time, he will have to adhere to a strict daily routine, with his last meal at 4.30pm.

Mr Dewani suffers from severe post-traumatic stress disorder (PTSD) and depression, and has spent many of his days sitting in a camper van parked in the grounds of a mental health unit in Bristol, playing computer games.

There will be no such peace at Valkenberg.

Many South Africans think he should be taken straight to prison. Despite its mature gardens, picturesque old Dutch-style buildings and magnificent views of Table Mountain, Valkenberg feels like one.

Four fences cut most inmates off from the outside world: two around its perimeter and two, topped with barbed wire, surrounding individual wards. If someone in desperation managed to get past all this, they would emerge into the outside world in blue overalls with faded badges proclaiming them property of a Valkenberg ward. In the UK, that would be like declaring that you belong to Bedlam.

Flanked by security guards and a mental health nurse who will greet him at the foot of the plane, Mr Dewani will travel to Cape Town tonight. On arrival he will be taken straight to the Western Cape High Court.

There he will be formally charged and will make an application for bail. Bail is often granted in South Africa: Oscar Pistorius, for one, spent a year on bail before beginning his ongoing trial for the murder of his girlfriend Reeva Steenkamp.</p><p>Even if he is granted bail, however, Mr Dewani will need to be evaluated for his fitness to stand trial. This would mean at least a month under forensic observation in Valkenberg.

Although there is a long waiting list for this ward, the authorities have pledged to accommodate him. “We have our pressures and challenges to deal with but there will certainly be a bed for him and we will be able to evaluate and observe him according to all international standards and protocols,” the provincial Minister of Health, Theuns Botha, said.

Those under forensic observation – as well as the acutely disturbed – are not normally allowed the same freedoms as most of Valkenberg’s residents. However, Mr Dewani has been promised a cell of his own in the general ward, and will not have to mix with others awaiting trial for rape or murder. He is probably the first person ever to be granted this concession. The South African authorities, keen to show their country and its systems in the best possible light, are treating this particular patient with great caution. Yoga lessons and ping pong further sweeten the deal.

Valkenberg has a long and chequered past. It was built in 1891 to house 36 mental health patients from Robben Island – the latter became a military outpost, and then the prison which held Nelson Mandela for 27 years. Ingrid Jonker, one of South Africa’s most famous poets, drowned herself after spending long periods at Valkenberg.

In still segregated Cape Town, often described as a last outpost of colonialism, Valkenberg used to comprise two racially segregated hospitals, straddling the Black and Liesbeeck rivers. Such segregation here is a thing of the past and Valkenberg is much more mixed than the city around it.

It has been no stranger to controversy over the years: it was once almost shut down; there have been “massive escapes” by patients who overpowered staff; neighbours of Ward 20, the forensic observation ward, reported seeing patients being taken from building to building in steel cages.

It has been overcrowded and under-resourced, and the conditions in which patients live were until recently considered abysmal. According to Dr Sean Baumann, a senior psychiatrist at the hospital, as recently as 2006 conditions in Ward 20 were a “gross infringement on human rights, never mind the abysmal working environment of people caring for them.”

Had Mr Dewani been a normal patient awaiting trial then, he could have been locked in a ward with no light, ventilation or toilets, sharing a bedpan with his cellmates.

Since then Valkenberg has undergone major renovations. Part of a one billion rand (£57m) revamp, due for completion in 2016, has gone towards making Ward 20 habitable.

If Mr Dewani is found unfit to stand trial after 30 days at Valkenberg, he will either wait there until he he is deemed ready to be tried, or the charges will be withdrawn and he will become a state patient. Unless the hospital authorities, the Attorney-General, and a judge agree to his discharge, he will then stay on at Valkenberg.

The hospital’s motto is: “Sometimes to cure. Often to relieve. Always to comfort.”

It is hard to imagine what comfort Shrien Dewani could draw from living among the deeply psychotic, constantly reminded of his wife’s murder by the shadow of Table Mountain.

Times version http://www.thetimes.co.uk/tto/news/uk/article4056309.ece