Medical records seen by the Mail & Guardian indicate that Schabir Shaik never met the formal requirements for medical parole, but a combination of pressure from his private physicians and an erroneous claim from a correctional services doctor that his condition was "terminal" tipped the balance in his favour.

Key to his successful application was an astonishing report compiled by Dr Ngenisile Mbanjwa, a former nurse who had reportedly graduated as a doctor at Medunsa only in 2005. In her letter Mbanjwa summarised her understanding of Shaik's medical condition for the parole board.

In fractured English she wrote: "Based on all the medical reports from my colleagues/Independent Medical Practitioners concerning the inmate-patient's medical condition, all the investigations and medications the inmate-patient is on, the prognostic features and concurrently with end (final) stage multiple organ failure (terminal illness) due to uncontrolled or refactory hypertension despite multiple medications including psychiatric medications."

As far as can be established from documents seen by the M&G, Mbanjwa never examined Shaik herself. She based her assessment on medical reports, mainly from Shaik's private doctors, which, while sympathetic to Shaik, nowhere claimed that Shaik was suffering multiple organ failure or had entered the final stages of a terminal illness.

A May 2008 letter from Shaik's private psychiatrist, Dr Abubaker Gangat, warned only that his persistent high blood pressure had "potentially dire consequences for the eyes, kidneys, heart and brain" and that "organ damage to the eyes and kidneys is already present".

Gangat noted: "In summary, Mr Shaik has Severe Emotional�Disorder combined with life-threatening physical disorders, as enumerated."

And a June 2008 letter from Shaik's private physician, Dr Salim Gaffoor, stated that Shaik had "severe resistant hypertension with end organ damage". He noted that despite multiple drug therapy his blood pressure "remains constantly high and his complications are progressive. In my view I feel that we will not achieve blood pressure control while he is incarcerated.

"In view of his deteriorating health I feel that Mr Shaik should be given correctional supervision as this may give us a chance to improve his blood pressure and prevent fatal complications."

Both letters were part of a bundle received by correctional services on January 2 2009 and were apparently annexed to Mbanjwa's report.

Medical parole may be granted only in terms of section 79 of the Correctional Services Act if a person "is diagnosed as being in the final phase of any terminal disease" for them "to die a consolatory and dignified death".

A medical consultant approached by the M&G, who asked not to be identified, said that while Shaik was clearly not well, from the information available he was not terminally ill.

The consultant said there did not appear to be any evidence of renal damage and Shaik's cardiac abnormalities were not severe.

He said that if Shaik's retinal damage from his high blood pressure had indeed reached "stage four", as stated in some of the reports, one would expect "significant visual acuity problems" that would normally be inconsistent with Shaik driving a car -- as he was seen doing a few months after his release.

He also questioned whether blood tests were conducted to see if Shaik was taking or absorbing the medication to control his blood pressure.

Nevertheless, Mbanjwa's report, which she copied to former prisons minister Ngconde Balfour, interpreted Shaik's "potentially dire" problems as falling within the terms of the Act.

She wrote: "I concur with their recommendations to be palored [paroled] on medical grounds, and the case may be, to die a consolatory death, as stipulated in terms of Section 79."

It appears unlikely that the parole board that approved Shaik's release would have been in a position to question Mbanjwa's assessment.

The board did not include a doctor and it appears that the only doctor treating Shaik who was formally interviewed was Shaik's psychiatrist, Gangat. It is understood the board asked him if releasing Shaik was likely to lead to an improvement in Shaik's medical condition, which he affirmed.

Contacted this week, Mbanjwa referred all queries to correctional services spokesperson Manelisi Wolela, but revealed that she had left the department and was now in private practice. It appears she was with the department for only about two years. Questions to correctional services about the circumstances of her departure were unanswered at the time of going to press. Wolela said the issue of Shaik's medical parole was regarded as "closed".

A report of the Health Professions Council on the medical advice that informed Shaik's parole cleared two doctors who were treating him at the Nkosi Albert Luthuli academic hospital, Datshana Naidoo and Sajidah Khan.

However, according to a copy of the report seen by the M&G, the inquiry did not address the conduct of Mbanjwa.

A source familiar with medical aspects of the case said he doubted that Shaik had been the beneficiary of a conspiracy, but just "got lucky" *1.

Against that assessment must be considered: