The anti-migrant movement blocking foreigners from healthcare

A public clinic just north of Johannesburg has become the front line of a fight over whether foreigners can access public healthcare facilities in South Africa.

What started as a small local protest in one area in 2022 spread as activists from Operation Dudula, an openly anti-immigrant group, picketed some hospitals and clinics in Gauteng and KwaZulu-Natal provinces. They check ID cards and deny entry to anyone who is not South African.

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

Despite some arrests, authorities appear unable to prevent pickets.

The location of their latest campaign is in Dieplsoot, a poor district of more than 200,000 people near the country’s commercial centre.

On a cool spring Thursday morning, Sicelokuhle Moyo set off early for the clinic, wearing a blue-beige skirt, a thick windbreaker and a black headscarf.

The Zimbabwean, who has been living in South Africa since 2006, was going there as he often does to take medication for his chronic illness.

But this time, when he got to the door, everything was different.

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

“I said I have a passport. They said they don’t take a passport. They just want ID,” said Ms Moyo, hiding her disappointment behind a polite smile.

Despite this being a potential flashpoint, there was a strange calm and resignation as people knew that Operation Dudula activists had resorted to violence in the past.

Anyone who could not produce a South African identity document was turned away.

Walking slowly from the entrance, Ms Moyo joined a group of women on the roadside with young children strapped to their backs, waiting in uncertainty to see what would happen next.

Tendai Musvava, a woman in her 40s, also faced the same fate.

“I was standing in line and then they said, they [only] We need a few people with ID. I have no ID. I have a passport, I am from Mozambique. “I can’t take my medicine because I don’t have an ID,” he said.

Wearing a bright orange winter sweater and a white hat, Ms. Musvava looked despondent.

“I feel like they can do whatever they want because this is their country. I have no say. For now, I have to obey whatever they say. I have no choice.”

According to official figures, South Africa is home to approximately 2.4 million immigrants, who make up less than 4 percent of the population. Most come from neighboring countries such as Lesotho, Zimbabwe and Mozambique, which have a history of providing migrant workers to their wealthy neighbors.

Xenophobia has long been a problem in South Africa, occasionally accompanied by deadly outbreaks of violence, and anti-immigrant sentiment has become a major topic of political debate.

Operation Dudula, which started as a campaign and has at times been accused of using force to achieve its goal, has now become a political party with ambitions of participating in next year’s local government elections.

Party leader Zandile Dabula insists her organisation’s actions at public clinics in Johannesburg and other parts of the country are justified.

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

Faced with the reality that many immigrants are in the country legally, he turns to the argument that South Africans should be given priority because resources are minimal.

“Life comes first, we don’t deny that, but it can’t be a free-for-all. We can’t meet the needs of the whole world. We don’t have enough money.”

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

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

He says some people have to wake up at 4 a.m. to fight long lines at their local clinic because they know they’ll run out of medication if they don’t get there in time.

South Africa is a highly unequal society, with much of the country’s wealth in the hands of just a few people. Immigrants, who have high unemployment and poverty levels and often live in impoverished communities, are blamed by some for the problems people find themselves in.

The methods of Operation Dudula were met with sympathy among some Diepsloot residents.

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

“When I came here before, the queue was very long. But this time it only took me a few minutes to grab my belongings and get out,” he said.

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

“As South Africans, when we came to the clinic we found that the medicine we needed was not available. But there has been a difference since foreign nationals stopped using the clinic,” he said.

Ironically, some South Africans were not exempt from the anti-immigrant campaign.

They were also turned away from public health facilities because they could not produce identification; More than 10% of South Africans are thought to lack proper documentation proving their nationality.

But it is the disregard for the constitution in the actions of Operation Dudula that has angered activists on the other side of the debate.

“It is extremely problematic to have a group that is not sanctioned by the state to make decisions about who gets in and who gets out,” said Fatima Hassan, a human rights lawyer with the organization Health Justice Initiative.

“If the government does not deal with this situation very soon, it will lose the ability to impose law and order on its own.”

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

He told the BBC: “We don’t agree with that approach because health is a human right. As far as we understand the fact that the provision of services needs to be organized properly, you don’t organize it in bullying-style ways.”

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

However, a recent attempt by the South African Human Rights Commission to take the matter to court was technically unsuccessful, allowing the group to continue its campaign virtually.

In recent weeks, several Operation Dudula members have been arrested for blocking entrances to public health facilities. They were later released with a warning. But police action does not appear to have deterred the group.

Ms Hassan believes stronger action is needed, saying “the police and military should have been there from day one to prevent the incident”. [the picketing] because this is just lawlessness”.

Dr Phaahla said this measure was being investigated but police were “resourced limited in terms of monitoring and being able to respond in a timely manner when such incidents occur”.

While the state hesitates on what to do, Operation Dudula appears 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 rejected, is now looking for an alternative. Despite his limited resources, he is considering moving into the private sector.

“I think I’ll have to go to the doctor. I’ll pay the money. I’ll have to sacrifice to get it,” he said.

He had no idea how much this would cost him.

“I don’t have any money, but I’ll have to come up with a plan.”