Fight over foreigner access to public healthcare in South Africa

The South African Human Rights Commission (SAHRC) has lodged an urgent application in the Durban High Court against groups such as Operation Dudula and March & March.

These groups have been blocking non-nationals and undocumented individuals from accessing public healthcare facilities.

Operation Dudula and other groups argue that non-nationals and undocumented individuals overburden South Africa’s strained healthcare system, advocating for South Africans to be prioritised.

Meanwhile, the SAHRC insists that the South African Constitution guarantees universal access to healthcare regardless of nationality or immigration status.

This has escalated into protests, blockades at clinics and hospitals, public condemnations, and legal action by the SAHRC.

In its 2 July 2025 statement, the SAHRC reaffirmed that healthcare is a constitutional right for everyone in South Africa and called on:

• Health departments to ensure non-discriminatory access to services;
• Healthcare professionals to treat all patients ethically and impartially; and
• Law enforcement to prevent rights violations and related violence.

The SAHRC said it had engaged the Department of Health and the National Police Commissioner after reports that groups such as Operation Dudula and March & March were blocking non-nationals from public healthcare facilities.

Despite assurances from authorities, the Commission said the harassment continued unchecked.

“The SAHRC continues to observe and receive complaints relating to the denial of non-nationals and undocumented persons access to public healthcare facilities.”

Invoking its powers under the Human Rights Commission Act, the SAHRC has filed an urgent application in the Durban High Court, set to be heard today, 10 October 2025.

The Commission urged the public to respect the rule of law, condemning any private attempts to enforce immigration controls or deny healthcare access. It said that such actions violate human rights and the Constitution.

The Economic Freedom Fighters (EFF) filed a criminal police case against Operation Dudula in September 2025, for the group’s campaign blocking access to public healthcare facilities for foreign nationals and undocumented migrants.

Operation Dudula has responded defiantly, framing the case as an attack on South African citizens’ rights.

“We will not be bullied by the likes of the SAHRC because they are advocating for people who are in this country illegally,” spokesperson Zandile Dabula said.

Dabula reiterated demands for prioritising citizens amid healthcare strain.

The big healthcare debate

Parliament’s Portfolio Committee on Health has acknowledged growing public and political concern over access to healthcare for undocumented foreign nationals.

Committee chairperson Dr Sibongiseni Dhlomo reaffirmed that, under both international law and Section 27 of the Constitution, all individuals, including undocumented migrants, are entitled to emergency medical care.

However, he said the issue requires urgent policy review to prevent prejudice against South Africans without identity documents.

Health Minister Dr Aaron Motsoaledi is expected to meet civil society leaders to discuss the matter.

ActionSA’s Dr Kgosi Letlape called the situation a “blind spot” in the health system, saying undocumented migrants without insurance strain already overburdened hospitals.

Within government, similar frustrations have surfaced, Limpopo Premier Phophi Ramathuba faced disciplinary proceedings in 2024 for comments on treating Zimbabwean nationals in provincial hospitals.

Dhlomo suggested that amendments to the Immigration, Citizenship, and Refugees Acts are needed to clarify eligibility for healthcare, arguing that South Africa’s limited resources must be allocated more clearly.

The committee also called on Home Affairs to expedite these legislative reviews.

Operation Dudula hailed Dhlomo’s remarks as vindication of its stance that only emergency care should be provided to non-citizens.

The group has stationed members outside Gauteng hospitals, demanding proof of ID and turning away foreign patients, actions condemned by Doctors Without Borders as unlawful and inhumane.

The NGO said such conduct violates basic human rights and distracts from the real cause of healthcare strain: underfunded and poorly managed public health institutions.

Meanwhile, ActionSA has proposed amending Section 27 of the Constitution, arguing that South Africa cannot sustain open access to public healthcare for all.