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Study Finds Old Attitudes Endanger Healthcare for Southern African Migrants


Zimbabwe Refugees in South Africa

Zimbabwe asylum seekers in South Africa encounter border violence, rape, crime, communicable diseases, and fears of deportation

According to a new study, healthcare professionals are jeopardizing South Africa’s population by denying treatment to asylum seekers, refugees, and migrants. The research, conducted by Human Rights Watch, outlines medical care rights that South African law guarantees to foreign-born residents. But it also describes how harassment, a lack of documentation, and threats of deportation discourage many newcomers from seeking treatment.

Zimbabwe mother and child with AIDS
Zimbabwe mother and child with AIDS

The report cites xenophobic tensions and systematic discrimination by medical professionals and in South African society and recommends reforms to improve the situation. Researcher Rebecca Shaeffer with the health and human rights division of Human Rights Watch helped compile data for the 89-page report. Speaking in Johannesburg, she explains that communicable diseases like tuberculosis and a lack of treatment for thousands of rape victims who routinely cross the border from Zimbabwe pose the greatest threats.

“South Africa has long suffered from a sort of denialism and a failure to adequately budget for its extremely high rate of communicable disease, especially HIV and TB. TB, which is generally a curable illness, is the leading cause of death in South Africa, and because the leading causes of death in South Africa are communicable and are usually treatable and yet largely untreated in South Africa, it literally cannot afford to be leaving out from prevention and treatment campaigns the most vulnerable members of its society,” she cautioned.

Airborne diseases like tuberculosis when not treated particularly jeopardize concentrated population centers where they are easily spread. Shaeffer points out that many migrants, especially those who are undocumented and those who have crossed the border from Zimbabwe, are fearful of coming forward to seek treatment because of concerns they might be deported.

“Some South African hospitals interpret the law in such a way that they require rape survivors to go and make a police report about the rape before they are able to get emergency health care that keeps them from getting HIV as a result of their rape. There’s only a 72-hour window in which this medication works to block transmission, and for many migrants, especially those who are undocumented, those who are from Zimbabwe, they are fearful of talking to police. They’re afraid they are going to be deported,” she notes.

Among the report’s recommended reforms, Shaeffer lists government implementation of a planned but postponed special dispensation permit for Zimbabweans to ease their fear of deportation.

“Since April, this program has not been implemented, and the majority of Zimbabweans are still crossing into the country in an illegal manner. Furthermore, South Africa has longstanding problems in its asylum seeking refugee systems. It doesn’t properly document asylum seekers and refugees, and there are serious and repeated reports that even documented asylum seekers and refugees are sometimes subject to arbitrary deportation and arrest. So it really needs to stop arresting and deporting people this year legally,” she points out.

Zimbabwe migrants gathered in South Africa near the border crossing.
Zimbabwe migrants gathered in South Africa near the border crossing.

Other recommendations include enhancement of police protection for migrants from criminals near the Zimbabwe border and from xenophobic violence throughout South Africa. Shaeffer suggests that opportunistic crimes committed near the South Africa-Zimbabwe border may be difficult to investigate.

“The perpetrators may be on both sides of the border, for example. And also, victims need to be assured that they won’t be deported if they cooperate with the investigation,” she said.

Musina at Zimbabwe's southern border with South Africa
Musina at Zimbabwe's southern border with South Africa

Another helpful measure would be the start of cross-border initiatives to help standardize medical records, prescriptions and dosages for medications, and regularize treatment regimes for people who are fighting off HIV.

“Doctors in different countries may be using slightly different drugs that can be confusing to doctors in the new country. They can also develop programs like treatment passports that allow doctors in one country to see what kind of treatment the person has been receiving on the other side of the border. They can also distribute maps of locations where people can pick up medications for chronic diseases like HIV and TB,” she noted.

Although some South African localities are working to promote these innovations, Rebecca Shaeffer says that international humanitarian organizations are providing the primary push to bring about a more regional approach to better health care in southern Africa.