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Health care system not equipped to deal with migrants

Zimbabwe asylum seekers queue outsdie the home affairs for pre-registration with the UNHCR at the Musina showground Guy Oliver/IRIN
South Africa's adoption of a "liberal immigration policy" for Zimbabweans is placing greater burdens on the already stretched health care system, the international relief NGO, Médecins Sans Frontières (MSF), said on 2 June in Johannesburg.

At the launch of its report, No Refuge, Access Denied: Medical and Humanitarian Needs of Zimbabweans in South Africa, MSF's medical coordinator in South Africa, Eric Goemaere, told a press briefing there was a misconception that the crisis in neighbouring Zimbabwe had been resolved by the formation of the unity government on 11 February.

"The political and economic situation in Zimbabwe today is far from stable, and the health system continues to exist in a state of near collapse," the report said. "As a result, Zimbabweans will continue to flee to South Africa in desperation, and will require both guaranteed protection and proper assistance to address their medical and humanitarian needs."

In April, South Africa announced the introduction of a special permit for Zimbabweans that would also make a range of social services available to migrants.

"The permit confers on them the right to stay in South Africa for a period of six months, it confers on them the right to schooling or education, it confers on them the right to work and access to basic health care," Jackie MacKay, director-general of immigration services at the department of Home Affairs, told local media at the time of the announcement.

In May, Home Affairs announced a new 90-day visa, but it would only apply to people with travel documents; a Zimbabwean passport costs about US$820, a price few can afford.

Goemaere conceded that few, if any, countries would have adopted such a liberal entry policy, especially as the volume of Zimbabwean migration to South Africa has been estimated at three million to four million people, most of whom were poor and desperate. Giving migrants legal status was better than not, as it would prevent alleged abuse by the police, he added.  

"We will wait for the policies to see what it [the special permit] means ... [in terms of] rights. Everyone in South Africa has access to health care, but will they [Zimbabwean migrants] have access to free health care? That is important. Will they have access to shelter if they have no where else to go? And who will pay for a roof over their heads?"

Although issuing the special permits and stopping deportations were welcome developments, two months after the announcement the special permits had not been enacted. "We're scared it might just be a promise and not come into reality, and is just a delaying tactic," Goemaere told IRIN.

Poor migrant health

The MSF report said their mobile clinics in the South African border town of Musina and central Johannesburg were treating between 4,000 and 5,000 Zimbabweans monthly, "mainly for respiratory-tract infections, including a substantial proportion of tuberculosis, sexually transmitted infections, gastro-intestinal and diarrhoeal conditions." About 30 percent to 40 percent of those treated tested HIV positive.

But xenophobia remains a problem and the report highlighted incidents of severely injured Zimbabweans being turned away by hospital staff, a six-year-old Zimbabwean rape victim being denied follow-up medical treatment, and nurses leaving a pregnant woman on the gurney after realizing she was "a foreigner".

Bianca Tolboom, an MSF nurse and Johannesburg project coordinator, told IRIN: "It is absolutely true the South African health system is overburdened and understaffed, and is triggering this problem [of healthcare] for Zimbabweans."

South African health care workers, including doctors, have been protesting poor pay, working conditions and  interruptions in essential medical supplies.

Goemaere said that should the South African government call for assistance in providing health care, the international community should respond.


This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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