Doctors Without Borders (MSF) has raised concern about the growing number of documented foreigners fleeing South Africa, saying the “self- repatriation” process cannot always be described as voluntary.
The humanitarian organisation says many Malawians, Mozambicans and Zimbabweans with valid documentation have been left with little choice but to return to their home countries after facing intimidation, violence and threats linked to anti-illegal migrant sentiment in parts of South Africa.
“The narrative that the so-called ’self-repatriation’ process is always voluntary is questionable, as many fearful Malawians, Mozambicans and Zimbabweans insist that they are documented but have little choice other than to flee for their safety,” the humanitarian organisation said.
MSF has expressed concern about interruptions in health care among people living with HIV, TB, diabetes, hypertension and mental health conditions, as defaulting on treatment can have serious and, in some cases, life-threatening consequences.
The government established a Temporary Repatriation Processing Centre (TRPC) in Musina on July 1 after consolidating operations from several sites around the country. The interministerial committee on migration said they have seen a tremendous increase in the number of foreigners who have been deported or repatriated.
Its medical tent is located some distance from where people queue daily to board buses back to their home countries, making it difficult for health care workers to reach those in need of medical assistance.
MSF said while the system appears efficient, it warned that vulnerable people may be missed because they are reluctant to leave queues to seek medical care or because they move on before receiving assistance.
Further, the organisation said many migrants continue travelling through informal routes.
“More than 100,000 people fleeing or being displaced are the sort of numbers MSF sees in hot conflict areas, not relatively stable democracies such as South Africa,” said MSF emergency medical team member Caroline Masunda in Musina. “With so many displaced people, we call on governments in the region to step up collaborative efforts to ensure continuity of care for patients.”
MSF counsellors across the border in Beitbridge are concerned about the trauma their patients are experiencing.
*Nobuhle, who had been living in Soweto, Johannesburg, and working as a chef, was devastated to return home from work on July 17 to find her house had been burnt down. Her three children were away at the time.
“I lost my passport and permit, all my clothes and furniture, my children’s birth records and birth certificates. I have nothing with me. All I have is this small handbag. I do not even have a change of clothes,” she said.
Nobuhle said she has lost hope.
“I thought having a passport and permit would save me, but no, I was wrong. I wanted to kill myself. I have lost hope, and I do not know what I will do,” she said.
Passing through Musina, *Joseph, a 49-year-old Malawian from Pietermaritzburg who has been working as a tailor in South Africa since 1995, had to leave his antiretroviral (ARV) medication as he fled his home.
He said people came to his house telling him to go.
“I ran away and went to hide with my friends. Then I went to Durban. I [was] staying there at the bus station; it was raining, but we were outside. I left my [HIV] medication there in the house. I don’t worry about that or the clothes; if I am still alive, I can get it. I haven’t taken the medication in a few weeks. It is a relief; I got my medication from MSF,” he said.
*Freedom Moyo, a 46-year-old Zimbabwean, moved to South Africa in 2009, where he has been working as an electrician and plumber.
Treated at Beitbridge, he said he was forced to leave South Africa after his health deteriorated because he had been unable to access his ARV medication.
“I defaulted on my medication for three months because of the xenophobic attacks in South Africa. I could no longer access the clinic as I used to, and my condition worsened. Before all this, the nurses in South Africa would not take it lightly if we missed the day for collection of our ARVs. Now everything has changed; they no longer want us.”
He said he had to be admitted to hospital in Zimbabwe.
“When I arrived on the Zimbabwean side, I was admitted for four days because I had lost a lot of weight, my leg was swollen, and I was feeling very weak. I am happy because I received a one-month supply of ARVs and was referred to a local clinic in Gweru for continued treatment.”
MSF said their teams are also treating many patients who do not have access to their chronic hypertension medication.
The organisation noted that, left untreated, high blood pressure can lead to serious complications, including strokes, heart failure, blood clots and even death.
*Joyce, a Malawian from Boksburg North near Johannesburg, was also treated by the MSF team in Musina.
Joyce said her blood pressure reading was 214/95, and she was not going to the clinic, as she was afraid.
When she fled her home, Joyce travelled to Musina after sleeping outside for two days.
“We are seeing a trend in Musina of patients who have been unable to access life-saving HIV and TB treatment for months after being turned away from South African health care facilities because they are migrants, increasing their risk of treatment failure and, in some cases, developing drug resistance,” Masunda said.
MSF cited the example of *Munyaradzi, who was exposed to a toxic chemical while working in a Zimbabwean gold mine six years ago and still struggles with debilitating pain.
He had not had access to his chronic pain medication for seven weeks while he travelled from Dennilton, a rural town straddling the Limpopo-Mpumalanga border, to the repatriation centre.
“That chemical affected me in 2020, and I started taking tablets from that year until now. I know they don’t like us here in South Africa, so I got my mind to go back home, but the police caught me before I went. They took me to the police station. I told them about my situation, that I am taking tablets. They didn’t take me to a clinic until now,” he told MSF. “My body has got so much pain.”
