Anti-migrant movement blocks foreigners from healthcare

A community clinic just north of Johannesburg has become the frontline of a battle in South Africa over whether foreigners can access public health facilities.

What started as a small local action in one region in 2022 has expanded, with activists from the openly anti-migrant group, Operation Dudula, protesting at some hospitals and clinics in Gauteng and KwaZulu-Natal provinces. They check ID cards and prevent anyone who is not a South African from entering.

“Dudula” means to remove something by force in the Zulu language.

Despite some arrests, the authorities seem unable to prevent the pickets.

The site of their latest campaign is in Dieplsoot – a poor town of more than 200,000 inhabitants located near the commercial center of the country.

On a cool spring Thursday morning, Sicelokuhle Moyo, dressed in a blue and beige skirt, thick windbreaker and black headband, left early for the clinic.

The Zimbabwean, who has lived in South Africa since 2006, went there, as she often did, to collect her medication for a chronic illness.

But this time, when she reached the portal, things were different.

Two men wearing white T-shirts emblazoned with the slogan “Operation Dudula – Mass Deportation” were stationed at the entrance. They demanded that everyone present their documents before being allowed entry.

“I said I have a passport. They said they don’t accept passports. They only want IDs,” Ms Moyo said, hiding her frustration behind a polite smile.

Although it was a potential flashpoint, there was a strange calm and resignation as people knew that Operation Dudula activists had been violent in the past.

Anyone unable to present a South African identity book was turned away.

Walking slowly from the entrance, Ms Moyo joined a group of women at the side of the road, young children strapped to their backs, waiting in uncertainty for what would happen next.

Tendai Musvava, a woman in her forties, suffered the same fate.

“I was in the queue and then they said, they [only] I need people with IDs. I don’t have an identity document. I have a passport, I come from Mozambique. So, I can’t get my medicine because I don’t have ID,” she said.

Ms. Musvava, dressed in a bright orange winter sweater and white hat, looked dejected.

“I just feel like they do what they want because it’s their country. I don’t have a say. For now, I have to follow what they say. I don’t have a choice.”

South Africa is home to around 2.4 million migrants, or just under 4% of the population, according to official figures. Most come from neighboring countries like Lesotho, Zimbabwe and Mozambique, which have a history of supplying migrant labor to their wealthy neighbor.

Xenophobia has long been a problem in South Africa, accompanied by occasional outbreaks of deadly violence, and anti-migrant sentiment has become a key political talking point.

Initially a campaign, Operation Dudula, which has sometimes been accused of using force to assert its point of view, is now a political party which aims to run in next year’s local elections.

Party leader Zandile Dabula insists what his organization is doing in public clinics in Johannesburg and other parts of the country is justified.

“We want priority to be given to South Africans. Emergency care – we understand you need to be treated – but if you are illegal you need to be handed over to law enforcement,” she told the BBC.

When confronted with the fact that many migrants are in the country legally, she returns to the argument that South Africans should be given priority because resources are minimal.

“Life comes first, we do not deny that, but it cannot be a gift for everyone. We cannot meet the needs of the entire planet. We do not have enough.”

The constitution guarantees the right to access health care for everyone in the country, regardless of their nationality or immigration status.

But Ms Dabula says the public health system, which serves almost 85% of the population, is overburdened.

She says some people have to get up at 4 a.m. to join long queues at their local clinic because they know if they don’t get there in time there will be no more medicine.

South Africa is a deeply unequal society, in which much of the country’s wealth is held in just a few hands. Levels of unemployment and poverty are high and migrants, who often live in poor communities, are blamed by some for the problems people find themselves in.

Operation Dudula’s methods found a sympathetic audience among some Diepsloot residents.

One of them, South African Sipho Mohale, described the Operation Dudula campaign as “positive change”.

“The last time I was here, the queue was very long. But this time it only took me a few minutes to collect my things and get out,” he said.

Another resident, Jennifer Shingange, also welcomed the presence of activists in Diepsloot.

“As South Africans, we would come to the clinic to find that the medicines we need are not available. But since foreign nationals stopped using the clinic, there has been a difference,” she said.

Ironically, some South Africans have not been spared from the anti-migrant campaign.

They too were turned away from public health facilities because they could not produce an identity book – it is estimated that more than 10% of South Africans do not have documents proving their nationality.

But it is the disregard for the constitution in Operation Dudula’s actions that angers activists on the other side of the debate.

“Having a group that is not state-sanctioned decide who comes in and who goes out is deeply problematic,” said Fatima Hassan, a human rights lawyer at the Health Justice Initiative.

“If the government fails to bring this situation under control very quickly, it will lose the ability to enforce law and order itself.”

Deputy Health Minister Joe Phaahla told the BBC his government opposed targeting foreign nationals or anyone else trying to use local clinics and hospitals.

“We do not agree with this approach because health is a human right. While we understand the fact that service delivery needs to be properly organized, it is not organized through intimidation-type methods,” he told the BBC.

Several major political parties, including the Economic Freedom Fighters and the Democratic Alliance, have also condemned Operation Dudula.

But a recent attempt to take it to court by the South African Human Rights Commission failed on technical grounds, allowing the group to continue its campaign.

Several members of Operation Dudula have been arrested in recent weeks for blocking entrances to public health facilities. They were later released with a warning. However, the police action does not seem to have deterred the group.

Ms Hassan believes stronger action is needed, saying “the police and army should have been there from day one to prevent [the picketing] because it’s simply anarchy.”

Dr Phaahla said the measure was being considered, but police said resources were “limited in terms of their ability to monitor and respond in time when such incidents occur”.

As the state hesitates on what to do next, Operation Dudula appears to be emboldened and is turning its attention to public schools, saying it is part of a campaign to combat illegal immigration.

But in Diepsloot, the group’s action is leaving people without the medical help they need.

Ms. Musvava, who was turned away, is now looking for alternatives. Despite her meager resources, she plans to turn to the private sector.

“I think I’m going to have to go to the doctor. I’m going to pay the money. I’m going to have to make sacrifices to get it,” she said.

She had no idea how much it would cost her.

“I don’t have any money, but I’m going to have to make a plan.”

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