South Africa: Challenges on accessing healthcare for refugees and asylum seekers
01 April 2019

The JRS's health team attends a chronically ill patient at her home in Johannesburg / Image: Irene Galera (JRS)
The ongoing abuse of refugees and asylum seekers can be affronted at a political level but it won’t be resolved until it is tackled on a human level

Gugu Angela Mngadi brings her personal impressions regarding the access to healthcare facilities in SA for refugees and asylum seekers. A testimony based on her experience while volunteering for advocacy at the Jesuit Refugee Service South Africa (JRS) as a paralegal.

This article aims to highlight how refugees and asylum seekers living in South Africa encounter challenges when accessing healthcare facilities, which is a basic human right.

The legal status for refugees, asylum seekers and migrants is unclear, according to documents received from JRS’s beneficiaries. This fuzzy distinction is due to the general lack of knowledge within the South African society regarding the status of these individuals, which leads to an increasing rate of intolerance of our fellow neighbors and xenophobia.

It is important to precisely define that what is meant by healthcare is a basic human right. The human right to healthcare entitles every individual to the highest standard that is attainable with regards to physical and mental health. This includes access to all medical services, sanitation, adequate food, decent housing, healthy working environment and respectable working conditions. In addition, the South African Constitution enshrines the obligation to respect every person’s rights and prevents the state from denying or limiting access to healthcare services, which should be available to every person on a non-discriminatory basis. (Republic of South Africa 6 Section 27 (2) Act 108 of 1996).

The South African Bill of rights is the cornerstone of the South African Democracy. It affirms the most important values regarding human dignity, equality and freedom. Nevertheless, refugees and asylum seeker are regularly deprived of these rights, especially in relation to healthcare. An adequate healthcare service is consistently denied to refugees and asylum seekers, both at a grassroots level and at a systemic level, despite the fact that the South African law requires that they are treated in the same manner as South African nationals.

Refugees and asylum seekers are forced to pay high fees or cash up front to access to healthcare services, which in most cases are pocketed by the corrupt healthcare administrators. These fees include both administrative fees and cost of medication, which increases the level of abuse, harassment and exploitation. Those who are not up to date with documents, or who lack of them completely, face additional challenges and are at risk of no receiving healthcare. Others, with treatable life-threatening diseases and disorders, such as kidney dialysis, become so frustrated with attempting to access their treatments that they resign themselves to an inhumane death. However, there are those who keep on trying, hoping to get assistance one day. This is usually accompanied by no consistency from one hospital to the next. The chance to be treated depends on the individual who assists you.

The South African Constitution, legislature, government and, generally speaking, the state as a whole, do not consider these challenges faced by refugees and asylum seekers at healthcare facilities -which also frames how South Africa welcomes refugees and asylum seekers.

I believe there is a considerable role played by xenophobia when reviewing these challenges. Xenophobia can be defined as a deep dislike of non-nationals by nationals of a recipient state. During the short period of time that I have been volunteering, I have witnessed several of these violations to our Constitution and legal framework. These transgressions against refugees and asylum seekers in most cases are carried out by fellow South Africans. Xenophobia is characterized by a prejudiced discourse, usually operating on the basis of profiling people and making negative assumptions based on nationality. South Africa as an industrialized country has attracted many foreign nationals who seek refuge from poverty, economic crisis, war and governmental persecution in their home countries.

As a result, South Africans find it hard to accept that refugees and asylum seekers are also human beings and have become angry and frustrated at the increasing rate of migration of people from the neighboring countries into South Africa. These frustrations come to a boiling point due to the belief that refugees and asylum seekers are dominating the already limited employment and housing opportunities in the country, leaving locals citizens believing they have no opportunities to better themselves.

These frustrations of the South African populace do not take into consideration the many hardships faced by refugees and asylum seekers when leaving their home countries in pursuit of a better life. There appears to be no recognition of the fact that many of these people leave behind families, loved ones and ancestral homes in pursuit of a better life with many of them walking for days, crossing multiples borders while evading armed conflicts.

In conclusion, one can clearly see that there is a dire situation within South Africa that needs to be addressed. The ongoing abuse of refugees and asylum seekers can be affronted at a political level but it won’t be resolved until it is tackled on a human level. Like many things in South Africa, the policies, laws and procedures are both correct and in place to adequately address the problems experienced by refugees and asylum seekers. Yet, until these people are recognized for what they are, human beings, one will not see the proper actions being taken when delivering the required services.

Read our article South Africa: Human rights through the lenses of asylum seekers and refugees to learn more about JRS’s beneficiaries struggling to access healthcare facilities in SA.

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Mr. Tim Smith
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