MSF, Doctors Without Borders, South Africa, xenophobic attacks blocking healthcare in Pretoria
South Africa

Intensifying xenophobic climate and politicisation of healthcare blocks patients from hospitals in Pretoria

Ongoing xenophobic protests outside Kalafong Provincial Tertiary Hospital are preventing patients, including migrants, from accessing the facility. These actions must be rejected and should trigger urgent action by health authorities and leaders to protect access to healthcare for all, says Doctors Without Borders (MSF) in South Africa
 
Operation Dudula supporters have been protesting outside the hospital for three weeks, chanting threatening statements through loud hailers and preventing many from entering the facility. 
 

Just this morning, several people were turned away by the protestors based on their appearance and accent. Sibusiso Ndlovu, health promotion supervisor for MSF in Tshwane

“Just this morning, several people were turned away by the protestors based on their appearance and accent,” says Sibusiso Ndlovu, health promotion supervisor for MSF in Tshwane, adding that the protestors are putting the hospital staff under immense pressure with demands that all foreigners be removed. 
 
“They have even demanded that critically ill patients who are migrants must be ‘unplugged’ and taken out,” she says. 
Hostility to serving migrants in South Africa’s health facilities has been intensifying, fueled by inflammatory and political statements from government officials, including Limpopo Health MEC, Dr Phophi Ramathuba, who was recently recorded berating a Zimbabwean patient in a health facility, claiming that migrants are overburdening the health system. 
 

If migrants are fearful for their safety in entering or leaving health facilities, and if health workers are placed under pressure to behave as immigration officers, the consequences will be felt across the population. 
 
“One major concern as the politicisation of healthcare expands is that serious notifiable diseases could go unrecorded and untreated, which will inhibit the public healthcare system’s overall capacity and ability to contain infectious disease outbreaks,” says Dr Tasanya Chinsamy, medical activity manager for MSF in Tshwane.  
 
One of the patients denied care in Kalafong Hospital today was a 37-weeks pregnant migrant woman with high blood pressure, who instead had to seek help from a local clinic.  “Clinics are not equipped to provide tertiary care for complex cases such as these which require access to a specialist  and certain medications that are only available at hospital level,” Chinsamy says.  
 

When patients are denied the appropriate level of care initially their conditions often worsen and they return as emergency patients. Their risk of becoming more ill or dying is thus greatly increased, as is the cost to the government. Dr Tasanya Chinsamy, medical activity manager for MSF in Tshwane.

“When patients are denied the appropriate level of care initially, their conditions often worsen, and they return as emergency patients. Their risk of becoming more ill or dying is thus greatly increased, as is the cost to the government. Nobody benefits, and the most vulnerable suffer disproportionately regardless of their nationality or legal status,” says Chinsamy. 
 
Denial of healthcare at Kalafong Hospital is being caused by protestors, but there is an increasing trend in Gauteng Province whereby migrants are denied access to services by facility staff.  
 
MSF, through its operations in Tshwane, has recorded several cases where migrants with a legitimate right of access to health have been denied care. Many of these instances involve access to maternal and child health, which is guaranteed under South Africa’s constitution and through various laws and healthcare policies.  

MSF urges national and provincial health authorities to ensure that gatherings and threatening groups are immediately removed from hospital entrances and that all people in South Africa requiring health services are properly assisted with impartial medical care and treated with dignity.  

Since 2019, MSF has run the ‘Tshwane Migrant Project’, located at the Sediba Hope Medical Centre in Tshwane Central Business District (CBD), alongside local partners to provide supportive services for vulnerable people, including vulnerable migrants, such as linkage to care for psychosocial and medical needs. This included a specialised hub for those who are often unable to access appropriate health care and/or social services.

In 2021, MSF teams working in Tshwane and Johannesburg ran migrant health projects which supported COVID-19 vaccination activities for undocumented people at a time when there was no other access available.