Many refugees flee their country of origin in fear of persecution, and they come to South Africa to seek refuge and protection. The rights of non-nationals to access the health care system is a complex matter and has been a major topical point in the country. This conversation on health xenophobia in South Africa was sparked by Limpopo Health MEC Dr Phophi Ramathuba’s remarks about immigrants. In a video, Dr Ramathuba was seen lambasting a Zimbabwean woman who was in a hospital bed seeking medical treatment. She told the woman that foreign nationals are killing her health system and they must go
back to their countries of origin for medical treatment. Health or medical xenophobia is a term used to describe negative
attitudes and practices of healthcare providers towards foreign nationals based on their national origin. This results in the medical maltreatment of the person seeking health care services.

There have been many instances of health xenophobia in clinics and community health centres. Members of Operation Dudula have been turning away immigrant patients from the Jeppe Clinic in Johannesburg and harassed immigrants outside several clinics last year, including Hillbrow and Kalafong in Tshwane. It was reported that members of Operation Dudula demanded that all foreigners leave the clinics and that only South Africans could receive treatment, with some people being assaulted by members of the group. Immigrants suffering from chronic illnesses such as HIV, diabetes and high blood pressure are unable to access medication crucial to their well-being since Dudula started gatekeeping at the clinics. It is important to note that Dudula’s actions are tantamount to criminal and illegal conduct.

The health care crisis in South Africa is not caused by foreign nationals; they are scapegoated for the failures of the state to address the health care crisis by the people who fail to hold the relevant parties – ministers and directors general – accountable. Denying immigrants access to clinics and hospitals will not solve the health care crisis in South Africa. Groups like Operation Dudula should focus on the root causes of the health crisis – corruption, irregular expenditure (such as in the case of Babita Deokaran, former Chief Director: Financial Accounting at the Gauteng Health Department, turned whistle-blower who was murdered for exposing R1 billion worth of irregular tenders issued at the Tembisa Hospital) – and stop the misconception that it is caused by foreign nationals. Chasing people away from health care facilities based on their nationality is inhuman, illegal and unfair. It diminishes their human dignity. What is the position of the law on this matter? The right to access health care services is a basic human right guaranteed by the Constitution. Section 27 of the Constitution states that all people in South Africa, regardless of status or nationality, have the right to have access to health care services and that no one may be refused emergency medical treatment.

The National Health Act confirms that all people in South Africa can access primary health care at clinics and community health centres. Pregnant or breastfeeding women, and children under the age of six, are entitled to free health care services at any level. According to the Refugees Act of 1998, refugees in South Africa have the same right to access health care as South African citizens, as set out in the Constitution. This right is also considered to include asylumseekers. The Department of Health Circular confirmed that refugees and asylum seekers, with or without permits, can access the same basic health care services as South African citizens, including treatment for HIV. Universal access to health care without discrimination is a human right enshrined in the United Nations Declaration of Human Rights, 1948. The Minister of Health is urged to publicly condemn the actions of operation Dudula and uphold the Constitution and the domestic and international legal obligations which ensure the right to health for all.

The South African Police Service must condemn and act quickly to prevent vigilante groups such as Operation Dudula from violating people’s rights to health and fuelling xenophobia. All health care facilities (clinics, community health centres and hospitals) should ensure that all staff, medical and nonmedical, recognise the right to health for all, as well as that all migrants, refugees and asylum seekers regardless of their documentation status have the same access to health care services as South Africans.

All South Africans are urged to denounce vigilantism and xenophobia, to stand in solidarity with non-nationals, asylum seekers and refugees. It is important to remember that united we stand, divided we fall, in the true spirit of Pan-Africanism. Organisations to contact for Advice (Collective Voices against Health Xenophobia Coalition):

  • Socio-Economic Rights Institute
    (SERI) – 011 356 5860
  • Kopanang Africa Against
    Xenophobia (KAAX) –
  • Lawyers for Human rights (LHR) –
    011 339 1960/ 066 076 8845
  • SECTION27 – 011 356 4100
  • Amnesty International South Africa
    – 011 283 6000
  • Centre for Applied Legal Studies
    (CALS) – 011 717 8600
  • ProBono.Org – 011 339 6080
  • Doctors Without Borders (MSF) – 011
    403 4440/1/2
  • African Centre for Migration and
    Society (ACMS) – 0800 029 99 /
    0600 123456
  • Consortium for Refugees and
    Migrants in South Africa (CoRMSA) –
    011 403 7560/0032

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