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Healthcare without borders — the importance of eradicating medical Afrophobia


Dr Cresencia Nyathi is a human rights coordinator at Africa Unite. Lelethu Nogwavu is a human rights project development officer at Africa Unite and a PhD Candidate in public law at the University of Cape Town.

Afrophobia has become deeply institutionalised in post-apartheid South Africa as hostility towards migrants and refugees persists, particularly in the aftermath of the Covid-19 pandemic.

About two million immigrants live in South Africa, many of whom have difficulty accessing public services like healthcare. Medical Afrophobia in the context of South Africa refers to the fear or hatred of people from other African countries who seek medical treatment or services in South Africa.

This phenomenon is often fuelled by prejudice and misinformation and has led to discrimination, violence, and other forms of mistreatment against foreign nationals seeking medical care.

Many South Africans have expressed concerns about the burden that foreign nationals may place on the country’s healthcare system, and there have been instances of violence and harassment against African foreign nationals seeking medical care.

Read more in Daily Maverick:Operation Dudula calls off protests at Kalafong hospital after ‘fruitful’ meeting with health minister

Sadly, African foreign nations have been constantly made scapegoats for the public health systems in crisis due to government failure. Such a blame game is done to divert attention from severe challenges facing the governance of public health.

In addition, our society needs to understand that healthcare is a basic human right, and every individual deserves to be treated with dignity and respect, regardless of their cultural or national background. Discrimination in healthcare is a breeding ground for medical Afrophobia and undermines the principles of healthcare.

It is misplaced to ask whether or not migrants put undue strain on the healthcare system. The reality is that South Africa’s health system has been plagued by problems and it functions poorly as a result of poor governance. There are general shortages of nurses and doctors, high workloads, and low morale among staff.

Additionally, there has been massive government corruption, mismanagement, State Capture and apathy over many years and these also play a role. People move into and across South Africa, which is a reality that needs to be planned for.

Groups like Operation Dudula have pushed an anti-immigrant sentiment which is closely linked to the country’s dire economic situation, partly caused by increased poverty, scarcity of resources and high unemployment rates.

In September 2022, hostility against foreign nationals was exhibited by members of Operation Dudula outside Kalafong Provincial Tertiary Hospital in Pretoria. One of the most recent incidents was in January 2023 when members of Operation Dudula chased away African migrants from the Jeppe Clinic in central Johannesburg. 

Consequently, the Collective Voices, a collective of 30 organisations, released a statement condemning Operation Dudula’s attack on patients at Jeppe Clinic in Johannesburg that not only jeopardised individual health, but also public health.

There is rising fear amid the intensification of public remarks advocating health Afrophobia that has been met with little denunciation or government action.

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For instance, Limpopo Health MEC Dr Phophi Ramathuba in 2022 openly castigated a migrant patient for killing the healthcare system, and then Minister of Health and now Minister of Home Affairs Aaron Motsoaledi asserted in 2018 that when foreign nationals get admitted in large numbers, “they cause overcrowding, infection control starts failing”.

However, New24 reported that audit reports and formal statistics revealed “no indications of any significant adverse impact of foreign nationals on the healthcare system in the province (Limpopo), but enough evidence of poor management and weak financial controls contributing to a system in distress”.

Doctors Without Borders has also stated that resentment towards migrants in health services has been driven by inflammatory and political statements from government officials, including the Limpopo Health MEC.

These examples reveal the hostile attitudes towards migrants of public healthcare and state officials who have the most face-to-face contact with African migrants and refugees.

Medical xenophobia can take many forms, including language barriers, cultural misunderstandings, and discriminatory practices by healthcare providers. It can also result from a lack of cultural competence or sensitivity training for healthcare providers, leading to biased attitudes and actions towards patients from different backgrounds.

Some healthcare staff tend to be guards who have tasked themselves to hinder migrants’ access to healthcare services. On the other hand, many are not averse to enriching themselves at the expense of vulnerable migrants and refugees.

Chasing people away from healthcare based on their nationality is completely inhumane, unfair and illegal. The right to have access to healthcare services is a basic human right guaranteed by the Constitution of the Republic of South Africa.

Section 27 of the Constitution provides that everyone has the right to have access to healthcare services, including reproductive healthcare services, and no one may be refused emergency medical treatment. The law is clear that everyone has the right to healthcare regardless of their status. It is repulsive for anyone to deny other people (who are already vulnerable) access to healthcare.

Combatting medical Afrophobia in South Africa requires a multi-faceted approach that addresses the underlying causes and spreads awareness and understanding.

It is a long-term process that requires the efforts of all members of society. By working together, it’s possible to create a more inclusive and tolerant society.

People need to be made aware of the root causes of Afrophobia and the negative impact it has on both individuals and entire communities. Community programmes, workshops, and community projects can accomplish this. Designing and implementing capacity-building initiatives that concentrate on outreach, education, and training programmes for healthcare professionals as well as public awareness campaigns that draw attention to the harmful effects of medical Afrophobia are urgently needed to promote cultural competence in healthcare.

Moreover, we need to open platforms that encourage honest, open dialogue between different groups of our society as this can help break down stereotypes and increase understanding and empathy. The dialogues can also include conversations about the challenges faced by the healthcare system and work towards finding solutions that are fair, equitable, and respectful of the rights and dignity of all individuals, regardless of their nationality or background.

Because Afrophobia often stems from unaddressed socioeconomic challenges like poverty, unemployment, and competition for limited resources, addressing these root causes can help reduce tensions and prevent Afrophobic violence.

The government needs to ensure that the healthcare system is equipped to handle the needs of all patients, regardless of their background. This can help reduce tensions and ensure that everyone has access to quality medical care.

The media also plays an important role in shaping public opinion and combating Afrophobia. Capacity building on peace journalism equips journalists to report on the issue responsibly and promotes understanding and respect for all individuals, regardless of their background. DM


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