Questions regarding the legal right of migrants to receive medical assistance have resurfaced amid the humanitarian consequences of recent violence against migrants and the mass processing of foreign nationals at the Musina Temporary Repatriation Centre in South Africa.
Although some argue that state healthcare should only be accessible to South African citizens, the country's Constitution, legislation, and court rulings present a broader picture. Article 27 of the Constitution states that 'everyone has the right to access health care services,' and this right extends beyond citizens. Furthermore, it is guaranteed that no one can be denied emergency medical care, regardless of nationality or immigration status.
By common understanding, the word 'everyone' implies that constitutional guarantees cover foreign nationals, including refugees, asylum seekers, and, in special circumstances, undocumented migrants.
Regardless of a person's immigration status, state medical facilities are not entitled to refuse emergency medical care. This applies to treating life-threatening illnesses or injuries requiring immediate attention. Consequently, hospitals and clinics cannot legally deny care to an individual solely due to the lack of South African identification documents or valid migration papers.
The organization Healthcare Workers Against Xenophobia (HCWAX) confirmed this legal position, stating that 'the Constitutional Court's decision of July 5, 2026, clearly shows that key provisions of immigration law relied upon by the government are unconstitutional.' HCWAX emphasized that South Africans fought against such exclusionary and dehumanizing practices at great cost.
The organization also noted that 'the government's failure to uphold this legacy is an indictment of its commitment to the Constitution. Its willingness to rapidly process people through the immigration system while failing to protect their rights contradicts its claims of upholding the Bill of Rights.' HCWAX added that healthcare workers will always assist those in need, but this does not absolve the government of its constitutional duties, and it should not rely on non-governmental organizations and frontline workers to fill gaps created by its own actions while allowing the ongoing demonization of migrants as convenient scapegoats.
South Africa's state health policy also provides for the treatment of infectious diseases such as HIV and tuberculosis, as interrupting treatment poses significant public health risks. State programs for combating HIV and tuberculosis are designed to ensure continuity of care, especially for patients already receiving antiretroviral therapy (ART) or tuberculosis medication.
Additionally, pregnant women have the right to maternal health services under national health policy, and children are protected by Article 28 of the Constitution, which guarantees every child access to basic health services.
Recognized refugees generally have the same access to basic state health services as South African citizens, according to the Refugee Act. Asylum seekers whose applications are still pending also have the right to medical care while legally in the country.
The situation for undocumented migrants is more complex. While immigration law regulates a person's legal status in South Africa, this does not automatically override constitutional rights. The Ministry of Health previously instructed state medical facilities not to refuse life-saving care solely because the patient lacks documentation. Nevertheless, human rights organizations have repeatedly reported cases where migrants were allegedly denied treatment or required to produce documents before receiving care.
This issue has regained attention following warnings from public health organizations that people displaced during recent anti-migrant operations risk interrupting medication for HIV, tuberculosis, and chronic diseases. HCWAX argued that treatment interruptions can have long-term consequences for both individual patients and public health, especially with infectious diseases like tuberculosis.
Humanitarian organizations, including Médecins Sans Frontières (MSF), have also expressed concern about the continuity of care for patients with HIV, tuberculosis, diabetes, and hypertension during the recent displacement of migrants.
The Department of Home Affairs asserts that repatriation operations are conducted lawfully and that humanitarian obligations are being met. At the same time, health organizations insist that immigration control must not interfere with constitutional rights or the provision of essential medical care. As the government continues to process migrants in repatriation centers, access to healthcare is likely to remain a key legal and public health issue, especially given that the South African Constitution continues to guarantee the right to health for 'everyone' while prohibiting the denial of emergency medical care.
The decision to stay in South Africa has become extremely risky for many migrants due to growing political hostility and a changing legal landscape, creating an atmosphere of intense fear and uncertainty.
Pressure has reached a critical point with the emergence of the 'March and March' movement—a nationwide campaign against immigrants that has set an unofficial deadline of June 30, 2026, for all undocumented foreigners to leave.
One anonymous 28-year-old citizen from Zambia spoke about the support she received during recent unrest. When the June 30th closure occurred, her South African neighbor hid her children in her home while protesters marched through their neighborhood. For her, this act represents the 'real South Africa,' which strongly contrasts with the aggressive images of protesters often shown on television.
She also noted that while politicians may blame migrants for economic problems, such as job shortages, the people they interact with in daily life truly understand their character. A 34-year-old citizen from Zimbabwe, who wished to remain anonymous, explained that returning home is impossible for him because there are no employment opportunities there, and he came here seeking a better life.
He emphasized that his attempts to legalize his status did not receive proper assistance from the Department of Home Affairs (DHA). He also stated that crime should not be attributed to any specific nationality.
For those who have decided to stay, the situation is not just a fight against bureaucracy, but a struggle for survival against coordinated efforts aimed at making their existence impossible. However, the current climate has allowed some employers to exploit xenophobic sentiments, leading to reports of unfair dismissals and illegal 'pseudo-layoffs' among migrant workers.
A 30-year-old citizen from Mozambique, who preferred to remain anonymous, stated: 'I am not a criminal, and I am not depriving anyone of a livelihood.' She clarified that her only 'crime' is selling vegetables to support her family back home. She vowed to stay at all costs until her status is legalized, claiming that assistance from the Department of Home Affairs is unavailable.
She also dispelled the common misconception that they arrived without any documents, which is untrue. An anonymous 40-year-old citizen from Zimbabwe noted that people perceive them as criminals but ignore the thousands of rands they spend maintaining legal documentation in a fundamentally flawed system. He added that the Department of Home Affairs suffers from terrible queues and even more serious corruption, and that being undocumented is not a choice, but a consequence of the system itself. Nevertheless, his life has taken root here, and he intends to stay, even if it means living in the shadows.
Ultimately, belonging is not a piece of paper issued by the government; it is an act of sheer will. Migrants who have chosen to stay are redefining the very fabric of the communities in which they live, proving that home is built not where you started, but where you stand your ground.
While political discussions and border debates continue within echo chambers, these people quietly continue their lives, embodying their beliefs in the schools, workplaces, and streets of the country they have come to call home.
As tensions surrounding illegal immigration in KwaZulu-Natal (KZN) and across South Africa escalate, lawyer Susan Abro of Susan Abro Attorney cautions that while legislation provides clear mechanisms to combat illegal migration, private citizens are not entitled to assume the role of law enforcement officers.
Recent civil society actions by March and March have intensified discussions on immigration, leading to the closure of many businesses, intimidation of foreigners, eviction notices issued by landlords, and demands for identification documents from people suspected of not being South African citizens. These events have fueled growing concerns about xenophobia, vigilantism, and the undermining of the rule of law.
Susan Abro emphasizes a crucial distinction: if a person is illegally in South Africa, there are established legal procedures, including detention and deportation, governed by immigration law. She asserts that the responsibility for upholding these laws rests solely with the relevant state authorities, not with private individuals.
Abro clarifies that immigration control falls under the jurisdiction of the Department of Home Affairs, the South African Police Service, and other authorized officials. Citizens do not have the legal right to stop people on the street, demand identification, or force them to prove their citizenship.
When individual groups or organizations begin conducting their own immigration checks, it shifts away from the principle of the rule of law towards vigilantism, which, in Abro's view, represents a dangerous path for any constitutional democracy.
Reports from Durban are particularly alarming: some foreign-owned businesses are being forced to close due to intimidation. Furthermore, some landlords and agents are allegedly demanding that legally registered foreign tenants vacate premises or provide immigration documents within days, despite no breach of the lease agreement.
Abro insists that a landlord cannot simply evict a tenant under public pressure or fear. South African law establishes very strict legal procedures for eviction, which apply regardless of a person's nationality. Similarly, an agent cannot arbitrarily lock up tenants or impose unreasonable deadlines if there is no legal basis for doing so.
The expert notes that many small businesses owned by foreigners play a significant role in local communities, providing space to local landlords, creating jobs, offering informal credit to clients, and supplying affordable goods where large retail chains might not offer such accessibility.
Abro believes that the current situation highlights broader issues within state systems. If the problem of illegal immigration exists, the government is obligated to manage borders, combat corruption, strengthen immigration control, and investigate criminal activity through proper police channels. The state cannot abdicate these duties by allowing citizens to self-regulate immigration.
She warns that permitting private groups to decide who has the right to be in South Africa creates uncertainty for everyone. Today it may be foreigners, and tomorrow it could be another vulnerable group. Once society accepts the idea that private individuals can determine who has rights and who does not, the protections guaranteed by the Constitution will begin to erode.
Abro concludes that South Africa's constitutional democracy is founded on the principle of equal protection under the law for every person, and disputes must be resolved through judicial processes, not coercion or intimidation. The Constitution does not prohibit the government from applying immigration law; rather, it requires that it be done lawfully and fairly, but it does not permit people to take the law into their own hands.
She also points out that the humanitarian consequences in certain areas of KZN should prompt reflection among South Africans, as many displaced foreigners now depend on support from religious organizations and civil society after losing housing, business, and livelihoods. In conclusion, Abro stresses that the principles of constitutional democracy and the rule of law require the government to strictly enforce immigration legislation, but they also demand that every person be treated lawfully and with dignity. By allowing intimidation and vigilantism to replace proper legal procedure, we undermine the very Constitution that protects us.
