A disturbing pattern has emerged in the past weeks at public clinics across Gauteng. Groups of protestors have blockaded clinics, denying access to foreign nationals, many of them refugees and asylum seekers. Their justification? That undocumented immigrants are “stealing” South African resources, crowding healthcare facilities, and straining already limited medical supplies. One slogan echoed outside Roseville Clinic says it all: “This is not the foreigners’ clinic.”

But beneath the noise of protest chants and inflammatory accusations lies a more complex, dangerous truth: these actions are rooted in xenophobia, not facts. And vulnerable people, especially migrant women, people living with HIV, pregnant asylum seekers, and those with chronic conditions, are paying the price.

Eric Butoki, Chair of the Southern Africa Refugee Organization Forum, has been documenting the fallout. “More than 50 people have been chased away from health facilities just in the past few days,” he told journalists. These include individuals with appointments, prescriptions in hand, and many cases, legal documents proving they are in the country under refugee or asylum status.

Butoki describes the actions as “administrative xenophobia,” a targeted campaign, fuelled by misinformation and political scapegoating. “Most people blocked at the gates are not undocumented. Some have lived here legally for decades, with South African IDs or refugee status.”

One Zambian woman, who has been collecting life-saving medication from her local clinic since 2010, was turned away and told flatly, “This is not your clinic.” She left empty-handed, unwell, and unsure if she’d survive without her medicine.

South Africa’s Constitution is clear. Section 27(1)(a) affirms that “everyone has the right to have access to health care services, including reproductive health care.” It does not say “citizens only.” It does not say “only those with IDs.” It says everyone. The Constitutional Court has further ruled in Soobramoney v Minister of Health (KwaZulu-Natal) and other cases that this right must be progressively realised, but that certain basic services, especially emergency and essential care, cannot be arbitrarily denied.

Moreover, South Africa is a signatory to the 1951 Geneva Convention on Refugees. Under international law, refugees and asylum seekers cannot be denied access to essential services, including health care. SRHR services, including contraception, maternal care, and HIV treatment, are not luxuries. They are human rights.

One of the most repeated falsehoods is that foreign nationals “steal” medical supplies meant for South Africans. But there is no evidence that foreigners disproportionately burden the public health system. In fact, many migrants contribute to it as workers, taxpayers, and caregivers. Those employed in the informal sector still pay VAT on every purchase. Many undocumented workers pay income tax through employers using false IDs, another symptom of a broken immigration system, not a reflection of their intent.

The truth is, South Africa’s health system is strained because of decades of underinvestment, corruption, and mismanagement, not because of the Zimbabwean woman seeking prenatal care or the Congolese man refilling his ARVs.

The current wave of hostility is not accidental. Batoka and other observers note that recent remarks by provincial officials have directly stoked this backlash. When senior leaders publicly suggest that “only those with transactional IDs” should be allowed into hospitals, it legitimises vigilante-style policing of clinic doors.

South Africans and non-South Africans alike deserve healthcare workers who are not overburdened, properly staffed facilities, and policies based on evidence, not fear.

Yes, health systems need regulation and documentation. But that must happen through law, not through intimidation. And it must distinguish between migrants, refugees, asylum seekers, and undocumented persons, not treat all foreign-born people as criminals.

If the goal is to reduce pressure on facilities, we must invest in community-based care, improve the referral system, and create authentic dialogue between communities, not empower xenophobic mobs.

Let’s be clear, turning away a pregnant woman, an HIV-positive man, or a child with a fever at the clinic gate is not policy. It’s cruel. And it is unconstitutional.

Written by Makhosemvelo Mthembu of the Southern Africa Litigation Centre