What can I do as an immigrant with a chronic condition? I am being denied access to health care by Operation Dudula.

The long answer

As you must know, Operation Dudula, which was started in 2021, started blocking foreign nationals from hospitals and clinics in Gauteng from late 2022 to the present, turning away foreign nationals if they didn’t have ID documents. 

IOL News reported in an article on 18 September 2022 that Section27 brought a court case in 2023 against the Gauteng Department of Health (DoH) because of a circular issued by the Gauteng DoH:  “Circular 27 of 2020”, contained ambiguous wording around the “scheduling of fees for hospital services”. IOL News said that some senior hospital managers viewed this circular as an instruction from the Gauteng DoH to deny means testing and free (or lower-fee) services to pregnant and lactating women and children if they were asylum seekers, undocumented persons or stateless – unless they needed emergency services. This contradicts the National Health Act.

In 2023, the Gauteng High Court ruled in favour of Section27 and the patients, confirming the right to free healthcare for pregnant, lactating women and children under six. But, despite the court order, some Gauteng health facilities continued to demand payment from pregnant migrant women and turned them away.

GroundUp reported in October 2023 that the DoH was ordered to put notices up in hospitals and clinics stating that children under six and pregnant and breastfeeding women were eligible for free health care irrespective of nationality.

Now, public health institutions can only turn away women and children if they are insured by a medical aid scheme or came to South Africa specifically seeking free health care. 

The government took its time to condemn the xenophobic protests, and to emphasise that “the right to access basic health services is a basic human right that is guaranteed by the Constitution … which makes provision for every person in the country, regardless of their nationality or documentation status to access health care”.

This was an important victory, but Dudula has not stopped its campaign to illegally force foreigners out of the country, its incitement to hate and its violent xenophobic demonstrations. 

And the problem is that while Dale McKinley of the Kopanang Africa against Xenophobia (KAAX), a group established in opposition to Operation Dudula, says that Dudula is a small vocal minority which stood for 2024 elections and got very few votes, it seems to be supported by many South Africans, who are told that it is foreigners that cause hardship in the country, not the huge ongoing inequality in our society. 

But now in June 2025 there is a crucial legal challenge against xenophobia ongoing in the Gauteng High Court in Johannesburg, brought by civil society organisations against Operation Dudula, the Department of Home Affairs (DHA) and the SA Police Service (SAPS).

KAAX, the South African Informal Traders Forum, the Inner City Federation and Abahlali baseMjondolo, represented by the Socio-Economic Rights Institute, filed the legal challenge in 2023 to ask the court to prevent Operation Dudula from assaulting or harassing foreign nationals and to stop Operation Dudula from impeding access to healthcare services and schools for the children of international migrants.

The Daily Maverick reported that DHA and SAPS were added for failing to protect vulnerable communities from Operation Dudula’s xenophobic conduct and, in some instances, for allegedly colluding with or supporting the group’s activities. Apparently, police were present but failed to act, during attacks in Jabavu, and the Jeppe Police Station refused to assist victims of the Msibi House eviction.

Operation Dudula failed to file an opposing court motion so the court case proceeded without them on 10 and 11 June.  

The applicants’ attorney, Jason Brickhill, described Operation Dudula’s ongoing unlawful activities as:

• Hate speech and incitement 

• Unlawful demands for documents 

• Wearing military-style uniforms: Brickhill said that Dudula’s military apparel at gatherings was intended to convey threats, and to convey that they were exercising the authority of military forces.

• Targeting businesses and traders: this included forcibly shutting down businesses and informal trading stalls operated by migrants and demanding the dismissal of migrant employees. In one incident, there was an arson attack on the Yeoville market after threats from the group.

• Illegal evictions: this included threatening and violently and unlawfully evicting migrants and South Africans from their homes without court orders, notably at Msibi House in New Doornfontein.

• Interfering with access to services: This involved the anti-migrant group obstructing access to healthcare facilities and schools by threatening and removing migrants. The affidavit mentions incidents at Jeppe Clinic and the forced closure of the Streetlight Schools: Jeppe Park Primary School.

Brickhill argued that the SAPS failed to investigate complaints and protect victims, and colluded with or acquiesced to Operation Dudula’s actions. He said the DHA was accused of supporting Operation Dudula by conducting raids at the group’s instigation.

The court was asked for orders stopping Dudula’s alleged unlawful activities and to compel government action against it. The applicants also asked for interdicts to restrain Operation Dudula from harassing individuals, demanding identity documents, making hate speech, interfering with access to healthcare and schools, and conducting illegal evictions.

The applicants want the government to implement its national plan against xenophobia, and are also asking for a constitutional challenge to declare Section 41 of the Immigration Act invalid, because it allows for warrantless searches without reasonable suspicion.

The court has not yet delivered its verdict and this is a very important case to keep our eyes on. 

In the meantime, it seems that the Gauteng Department of Health is taking action against Operation Dudula's disruptions of healthcare services, and you should report any harassment to the police. You could also approach organisations like the Consortium for Refugees and Migrants in South Africa (CoRMSA) or Doctors Without Borders (MSF) South Africa, for assistance to access the medical care you need. These are their contact details: 

• CoRMSA

• Address: 5th Floor, 87 De Korte St, Heerengracht Building Braamfontein, Johannesburg.

• Tel: Office: 011 403 7560/0032/0033

• Email: communications@cormsa.org.za

• MSF Doctors without borders 

• Address: 9th floor, 70 Fox Street, Marshalltown, Johannesburg

• Email: office-joburg@joburg.msf.org

• Tel: 011 403 4443

Wishing you the best,
Athalie