South Africa: Human rights through the lenses of asylum seekers and refugees
21 March 2019

(L-R) Ivette Mbayo, an asylum seeker from the Democratic Republic of Congo, talks with Marceline Sangara, head of JRS's Home Based Care, at her home in Malvern during one of JRS's home based care visits / Image: Irene Galera (JRS)
“South Africa should look at human beings, and life should be a priority,” Patience Matsi Maleni

Human Rights open the door to both dignity and equality, but they are the result of centuries of social effort. In fact, they are a vulnerable human construction and large groups of people see their rights violated on an ongoing basis.

This International Human Rights Day, we direct our attention towards a right considered to be one of the most crucial worldwide: access to adequate healthcare. Specifically, what that means for asylum seekers and refugees living in South Africa.

“Is there anyone who has rights?”

Ivette Mbayo, an asylum seeker from the Democratic Republic of Congo (DRC) established in Johannesburg, only buys one tablet of her daily medication at a time as she was told they were unavailable at the government hospital or clinic, and she can’t afford to buy them all at once. She is 58 years old and suffers from kidney failure and associated illnesses like hypertension and diabetes.

Mbayo has been denied a kidney transplant as she is not a South African citizen. Even though the South African Bill of Rights, section 27, states “Everyone has the right to access to health care services,” and, “No one may be refused emergency medical treatment.” Nevertheless, the South African National Health Act has banned non-South African citizens or permanent residents from human organ transplants since 2012.

Mbayo should be able to receive a palliative treatment, such as dialysis. Although public clinics and hospitals give her appointment after appointment, they do not treat her. “That is just a way to refuse to treat me in a polite way,” states Mbayo. As an asylum seeker, she is not always able to pay the R 50 (3 EUR) hospital fee either.

Currently, the Jesuit Refugee Service (JRS) provides Mbayo with home based care services from the health team, as well as consultation fees and money for transportation to  government hospitals. For her kidney dialysis at the private hospital, she is sponsored by a church member. Unfortunately, dependence on private funds is not a long-term solution.

 “If I can’t get money tomorrow, I will not take [the medication],” affirms Mbayo. As her illness does not allow her to work, sometimes a coconut (R 10 / 0,65 EUR) is the only affordable alleviation for her renal problem.

Mbayo escaped to South Africa with her three kids in 2007 after facing torture and sexual assault at the hands of armed groups. Her husband was murdered the night of their escape. “I was ten years old and I just remember being at my mother’s back. It was terrible, gunshots, people fleeing the country…” explains Victoire, Mbayo’s middle daughter.

Despite living in the country for more than a decade, she has not received a residence permit or a refugee status. Every six months, Mbayo has to travel to Pretoria to renew her asylum seeker documents –getting fined if she misses the appointment due to her health. There is a big difference between her previous life as a lawyer in the DRC and the days she and her children spend sleeping on the streets in South Africa. Her oldest daughter was kidnapped once at the age of 14 and got pregnant. “My heart is broken because my life was good,” Mbayo laments.

“Back home there is nothing, and here neither,” mentions Victoire. She saw her studies interrupted last year as her mother could not pay for the schools fees anymore. Mbayo used to sell cosmetics, cakes, and other small items on the streets until her kidney condition worsened. Her youngest son (currently in grade twelve) is the only one receiving an education at the moment. The family struggles with xenophobia at school too. “They used to call us black mambas,” expands Victorie, “and elephant legs to my mother,” referring to the physical consequences of Mbayo’s illness. “I mostly accompany my mother to the hospital. The treatment is terrible. [The doctors] do not care. And it is somebody’s health,” she states.

Not far from Mbayo, Assumani Matondo Nibizi, age 33, waits in a room provided by JRS at Nazareth House, a care facility in Yeoville. He is also from the DRC, and chronically ill from kidney failure. Charlotte Maxeke Hospital, formerly known as Johannesburg General Hospital, did not consider his request for a kidney transplant or dialysis as he is “a foreigner” in the eyes of the health system.

He avoided recruitment from armed groups heading to South Africa as a teenager. He hoped to find a safe place, but he is undocumented after losing his papers while working as a car guard in Johannesburg. Nowadays he is too ill to work, and his friends abandoned him after his illness developed. “This discrimination can happen to everybody in my situation. When you are ill you are supposed to be taken care [of],” explains Nibizi, “I feel death walking towards me but I can’t do anything.” In his opinion, it might be time to return to the DRC. “So at least I have my mother to bury me.”

“How can you say we have a Human Rights Day when people are dying? Is there anyone who has rights?” asks Marceline Sangara, head of JRS’s Home Based Care programme. She considers it crucial to tell the stories of asylum seekers and refugees in South Africa to raise social empathy and combat xenophobia. 

Sehorane Lehlomela, the JRS South Africa Country director criticizes the discrimination towards migrants in the health system. “We are losing patients who are denied major operations.”

Life, a priority

Lokanda Ngwe was a camera man from the DRC who passed away in October at the age of 38. He was one of JRS’s beneficiaries last year. His kidney started to fail after coming to South Africa in 2017 with his wife, Patience Matsi Maleni, a nurse.

“Mr. Ngwe has been diagnosed with end stage renal failure and unfortunately as per guidelines of exclusion criteria, does not qualify for renal transplantation and chronic renal dialysis,” reads Helen Joseph’s refusal of treatment document from the hospital. The exclusion criteria guidelines are simple, he was holding section 22 of Refugee Act No 130 of 1998. In other words, he was an asylum seeker. Due to the lack of resources, as well as a social administration that does not address the needs of refugees and asylum seekers, migrants are the last to receive access to healthcare in South Africa.

After the refusal announcement, Ngwe attended private treatment – with an average cost between R 2000 and R 4000 (between 123 and 247 EUR) per session. Eventually, they could not afford the expense. “I then started to knock at the doors of several NGOs to save the life of my husband,” explains Maleni. JRS provided them with home based care services and transport solutions to the healthcare facilities. Currently, Maleni herself volunteers for JRS’s health team. “Helping others helps me a lot to release my stress.”

She also attends English classes while she waits to be granted refugee status, to get a job and bring her three children (nine, six, and five years old respectively) to South Africa.

“South Africa should look at human beings, and life should be a priority,” Maleni feels. Neither nationality, nor documents, should interfere with a person’s right to access a healthy state of wellbeing, a Human Right.

Press Contact Information
Mr. Tim Smith
+27 11 618 3404