Lawyers for Human Rights (LHR) has warned that the government can be taken to court if it fails to intervene in the public health crisis of vigilantes stopping foreigners, and some South Africans, from entering state hospitals and clinics.
The Independent on Saturday reports that it said the government was obliged to treat everyone, citizens or not, and if the police and other state institutions do not urgently intervene, a court of law can be approached for an order to restrain and interdict whoever is turning people away from facilities.
Militant groups Operation Dudula and March and March have been blocking the entrance to hospitals for the past two months, demanding people show their South African IDs before deciding whether they can get medical help.
Refugee leaders in Durban say that at least two people have died because they failed to get the treatment they needed.
“Everyone has the right to healthcare services. The law does not allow us to watch people die of medical conditions, or see them get infected with communicable diseases,” the LHR said.
Many of the foreigners in Durban have turned to the clinic at the Dennis Hurley Centre (DHC) for help. However, director Raymond Perrier said it’s not just foreigners, but South Africans – especially the homeless – who are turned away.
“We’re dealing with people who have appointed themselves as gatekeepers to the hospitals, and have no legal basis for doing so. There is no reason legally why foreign nationals can’t access a government clinic. The police and the hospital authorities may not be complicit, but they are passive in the face of this. So the solution is simple: you enact the law. That’s why we have a law.”
Perrier said some of their overseas donors have been “horrified” and questioned why the police and the Department of Health have not resolved the matter.
He said this could have an impact on future funding.
“When other overseas donors are looking at whether and how they support healthcare in South Africa, and they hear these kinds of stories, they’re going to shrug their shoulders and say, we don’t help organisations that tolerate this kind of behaviour. And … the people will suffer even more; it’s always the poorest people who are most affected,” he said.
Meanwhile, Health Minister Aaron Motsoaledi has admitted the government does not know how many foreigners are using public health facilities because the data is not being measured, reports BusinessLIVE.
In written responses to questions posed separately by MPs from the EFF, Action SA and the IFP, the Minister told Parliament that neither public health facilities nor provincial Health Departments recorded information about patients’ citizenship or immigration status.
Action SA MP Kgosi Letlape said the Minister’s admission validated his party’s long-standing concern that the public healthcare system was burdened by “an unquantified and unmanaged demand”.
“In the absence of tracking, verification or appropriate data collection, the department is unable to account for the full scope of its service delivery liabilities,” Letlape said in a statement.
“This is particularly concerning given that millions of foreign nationals, many of whom are undocumented or lack any form of medical insurance, reasonably make use of taxpayer-funded public healthcare services. In a public health system already buckling under pressure, with overcrowded hospitals, long queues, understaffing and medicine shortages, this lack of oversight is reckless and unsustainable,” said Letlape.
There were about 2.4m international migrants living in SA in 2022, equivalent to 3.9% of the population, according to Stats SA’s last census.
Under SA law, foreign nationals are largely entitled to the same health benefits as citizens. Foreign nationals do not have to pay for HIV or tuberculosis treatment, and face the same means-tested fees as citizens for services obtained at clinics, community health centres and public hospitals. This applies to people with an asylum permit, refugee status or a temporary resident permit, and to undocumented migrants from the SADC region. Undocumented migrants from outside the SADC region may be charged the highest fees, but this is not always enforced.
ActionSA said it wanted to amend the Constitution “to address the untenable reality in which SA is expected to provide unlimited public healthcare to undocumented immigrants”.
Responding to IFP MP Nompumelelo Mhlongo’s questions, Motsoaledi said there was no mechanism in place for provincial Health Departments to recover costs from immigrants’ countries of origin if they failed to pay their accounts.
It was not the Health Department’s duty to check the immigration status of patients, he told EFF MP Chumani Matiwane. Neither the department nor public health facilities had ever stopped anyone from entering public health facilities and accessing healthcare services, he said.
It was up to law enforcement agencies to deal with people who prevented patients from obtaining the care sought, he said.
Writing in GroundUp, an asylum seeker with valid papers shares her experience at a Johannesburg clinic, where health workers appear to be complicit in Dudula’s bidding.
She writes:
My recent trips to the local clinic for my daughter’s immunisations have left me full of fear, anxiety and hopelessness.
Is this the new reality for immigrants in South Africa? It feels as if it is just a matter of time before we witness another surge in violence and death.
It appears that all foreigners, whether documented or undocumented, have now been lumped together and deemed unwanted by Operation Dudula. Its members have been protesting at government clinics across Johannesburg, preventing foreigners from getting services at health facilities.
I am an asylum seeker with a valid permit. My daughter was born 15 weeks ago in a public hospital in Johannesburg, and her birth was registered there. I was told to go to the Esselen Street Clinic on specific dates for her to get vaccinated.
Both times that I took her to the clinic, in June and July, the clinic staff were monitoring the number of immigrants and South Africans served. The immigrants were told to wait until all the South Africans in line were served, before we could be helped.
I felt ashamed to be in this situation. I was not treated with dignity and respect.
I was 16-years-old when, in 2006, my siblings and I left Zimbabwe to come to South Africa. We did not do it “for the fun of it”. I was a minor, and the move was traumatic. I left behind everything I knew to come here. It was a massive culture shock. I had to quickly adapt to a new school, a new syllabus, a new language.
In 2008, I was in grade 11 when massive xenophobic attacks took place across the country. It was a scary period, seeing it on the news, staying cooped up indoors out of fear.
I’ve been here for 19 years, but it doesn’t feel like home. Zimbabwe doesn’t feel like home. It is only a distant memory. I feel like someone who has no roots. I feel for my children because I wonder what the future holds for them.
I am self-employed, baking and selling special occasion cakes while also helping my husband manage his event equipment company.
But at the end of the day, I don’t blame the South Africans. They have every right to be angry because of the narrative that is pushed on social media and by leaders who claim “foreigners are taking all the jobs”, to gain votes.
At the end of the day, it’s people higher up the food chain who are pitting us against each other – using us as a scapegoat for unemployment. It’s a sad situation.
The asylum seeker, who asked to be anonymous, contacted GroundUp via email. GroundUp staff have fact-checked her story.
Response from Foster Mohale, spokesperson for the National Department of Health
There is no policy of prioritising healthcare users based on their nationality or immigration status in South Africa. Thus, we are not aware of any incidents in which healthcare users have been discriminated against based on their immigration status.
Our health professionals are duty-bound to assist any patients, regardless of nationality or migrant status, because they took a Hippocratic oath, and any action that goes against such oath will be dealt with according to relevant professional council – the SA National Council for Nurses, HPCSA for doctors and other categories of health professionals.
We call upon anyone who is denied healthcare service from any public health facility to report to the nearest Department of Health, so we can investigate.
Response from Zandile Dabula, spokesperson for Operation Dudula
When people come to the country, they need to have a valid reason why they are here.
When you have a proper visa, you will have medical insurance. This means you will have funds to pay for medical bills.
We are sitting with undocumented people, or people who are just here in the country, claiming to be here legally, yet they are not here to do anything, that’s why they will not even have medical insurance. [Ed: asylum seekers are not required to have medical insurance.]
We are not saying they shouldn’t be attended to. What we are saying that if they are attended to, they must pay for the service.
If they’re undocumented they must be treated and handed over to law enforcers.
BusinessLIVE – State does not know how many foreigners use SA’s public health
Independent on Saturday article – State is failing foreign nationals (Open access)
GroundUp – Joburg clinic staff make me ashamed to be an immigrant
See more from MedicalBrief archives:
Anti-foreigner group ups ante at healthcare facilities
Activists deny migrants access to hospitals and clinics
Operation Dudula protesters force migrants to pay for healthcare