Healthcare workers, humanitarian organisations and migrants are warning that South Africa’s anti-migrant campaign is beginning to disrupt access to healthcare, raising concerns about interrupted chronic health treatment and broader public health.

The warnings follow the 30 June deadline set by anti-migrant groups for undocumented migrants to leave South Africa. 

Days before the 30 June deadline, public health workers warned that anti-migrant action could have serious consequences for healthcare access.

Humanitarian organisation Doctors Without Borders (MSF) says its teams are seeing nationwide patterns of patients being turned away from healthcare services or being too afraid to access them. 

Claire Waterhouse, MSF Southern Africa director of Advocacy and Analysis told Health-e News that their teams in Musina recently encountered two people with active TB who had been chased away from a clinic.

“Both of those patients have now developed drug-resistant TB, which is extremely concerning for our public health system as a whole.”

– Claire Waterhouse, MSF Southern Africa.

Waterhouse says they have launched an emergency humanitarian response in Gauteng, KwaZulu-Natal, the Western Cape and the Musina-Beitbridge border in recent weeks. 

Interrupted treatment

Earlier this week, Health-e News reported that Zimbabwean migrants living in Louis Trichardt in Limpopo were being turned away from clinics or warned that their latest collection of chronic medication would be their last. 

Several migrants with legal permits to live in South Africa, told Health-e News that they had been questioned about their documents and warned that future access to treatment was no longer guaranteed. 

“My concern is that I am legally in the country. If I am denied access to medication, where am I supposed to get treatment?” one woman living in Louis Trichardt told Health-e News.

MSF’s Waterhouse says they are receiving similar reports from their teams across South Africa. 

“Many people that we see now are afraid to access healthcare because of the threat of violence at clinics, and have been away from treatment and access for a while. This really has a detrimental effect on their healthcare as well as public healthcare as a whole,” she says. 

Waterhouse says they are particularly concerned about interruptions to healthcare for patients on chronic medication and vulnerable groups. 

“We are really concerned particularly about chronic patients, people who have HIV, TB, diabetes, high blood pressure, and not being on their medication when they really need that in their daily lives,” she says. 

“Diseases do not understand passports or borders. Diseases can affect anyone. It is not just individuals who are impacted by this.”

“We are also particularly concerned about pregnant women and young children who have not been accessing their immunisations or the care they need during pregnancy.” 

Waterhouse believes the consequences reach far beyond the people directly affected.

Fear keeps migrants from healthcare

Healthcare Workers Against Xenophobia (HCWAX), a coalition of doctors, nurses, researchers and public health practitioners, has urged healthcare workers to respond to the humanitarian needs of displaced migrants. 

The coalition says reports of migrants delaying or avoiding healthcare are becoming increasingly common as fear spreads through migrant communities.

The coalition warns that interruptions to HIV and TB treatment, antenatal care, childhood immunisations and chronic medication affect more than individual patients.

“When people are too afraid to visit clinics or continue treatment, the consequences extend beyond migrants,” says the coalition’s Dr Samah El-Boraei.

“Interruptions to care increase health risks for entire communities and place additional pressure on an already strained public health system,” she says. 

Government urges lawful migration management

In a statement earlier this week, an inter-ministerial government committee on migration condemned intimidation and warned that no individual or community group has the authority to enforce immigration laws or conduct searches of homes, businesses or public spaces. 

The statement says managing immigration, deportation and repatriation is the responsibility of the state.

The committee also says humanitarian support, including healthcare, food, water and sanitation, is being provided at temporary repatriation centres while law enforcement continues to address unlawful conduct linked to migration.

What the law says about immigrants’ access to healthcare in SA

Section27, a public interest law centre, says everyone in South Africa has the constitutional right to access healthcare services, regardless of nationality or immigration status. 

According to the organisation, this includes South African citizens, refugees, asylum seekers, documented and undocumented migrants. The organisation says decisions about a person’s immigration status rest with the Department of Home Affairs, not healthcare workers. 

It adds that public healthcare facilities should not refuse treatment based on nationality or documentation status.