In 2020, Grace Kasongo*, originally from the Democratic Republic of Congo, gave birth at Steve Biko Academic Hospital.

Following a stay of four days, she was billed R110 028, an amount she could not afford to pay. After informing the hospital that both she and her husband were unemployed, Kasongo was told to pay R300 to be discharged.

“I was ordered to never seek any form of health services, either for me or my son at any public health facility anywhere in Gauteng until the outstanding amount has been settled”, Kasongo tells Health-e.

“I was told that the services are free, hence I went and gave birth at that hospital.”

Three years later, she has not accessed any health services for her child, and lives in a constant state of worry. “He is always sick and he is not receiving any form of medical attention. I can’t afford to pay for private doctors and I just have to rely on some home made remedies when he is not well.”

Her son has missed almost all his childhood immunisations. She’s afraid she’ll be arrested if she visits any public health facility in Gauteng.

Violation of court order

The National Health Act decrees that all pregnant or breastfeeding women and children under the age of six are entitled to healthcare services at any level. Kasongo is not alone in being denied this right.

In April 2023, the Gauteng High Court upheld the right of all pregnant and lactating women and children under 6 years, irrespective of nationality and documentation status, to access free health services at all public health facilities, including hospitals.

Since the ruling was handed down, civil society organisations say they continue to receive reports of pregnant migrant women being ordered to pay in order to access services.

Some of the reported facilities are Charlotte Maxeke Hospital, Tambo Memorial Hospital, South Hills, Germiston City Municipal Clinic, Heidelberg Clinic and Edenvale Clinic.

Speaking to Health-e News, human rights lawyer at SECTION27, Sibusisiwe Ndlela says they are concerned that they have received a handful of cases since the court order was handed down in April. 

How many women have been denied healthcare?

Ndlela says they are currently collecting statistics of cases which are being reported, which they will present before the court in the next three months.

“If you look at that court order there is a return date for October of 2023. That is when we will properly be in a position to put forward all of the evidence that we have gathered,” says Ndlela.

He says that they are not going to release the exact number of migrant women who have been denied access to medical services until October.

“At the moment we are writing a letter to the Gauteng Department of Health, to give then an opportunity to rectify the situation as we do not just want to go to court and surprise them, but I am sure that they are aware of the report because this has widely been reported,” says Ndlela.

Gauteng Department of Health is silent

Kasongo says she continues to receive calls from the Steve Biko Academic Hospital, demanding she settle the bill.

“They know very well that I am unemployed and there is no way I will be able to raise that money. I am even struggling to buy essentials for my son, so where am I going to raise the money? My only crime was to give birth and now my child is not able to access medical health services because of that,” says Kasongo.

Kayan Leung, an attorney at Lawyers for Human Rights says that they are deeply concerned by the recent reports that the Gauteng Health Deartment continues to demand payment balances from migrant women.

“Mothers and newborns have been detained after discharge from the postnatal ward at Tambo Memorial Hospital until they have been able to bribe the unit to let them go home. This extortion is a shame to O.R Tambo’s legacy,” says Leung.

Kasongo has pleaded with the Gauteng Department of Health to address her issue.

“I feel like I have done almost everything within my power to have the hospital reverse the bill, but all I do always falls on deaf ears”, says Kasongo*.

Attempt to get comments from the Gauteng Department of Health failed.-Health-e News.

*Name has been changed.


  • Ndivhuwo Mukwevho

    Ndivhuwo Mukwevho is citizen journalist who is based in the Vhembe District of Limpopo province. He joined OurHealth in 2015 and his interests lie in investigative journalism and reporting the untold stories of disadvantaged rural communities. Ndivhuwo holds a Bachelor of Arts degree in Media Studies from the University of Venda and he is currently a registered student with UNISA.