South Africa clinic staff extorting immigrants

South Africa's Gauteng High Court has ordered the government and police to take decisive action against xenophobic vigilantes who have been blocking immigrants from accessing public healthcare services, following months of reports of intimidation and unlawful screening at clinics in Johannesburg.

The ruling comes amid growing allegations that immigrants are being denied treatment at public health facilities and, in some cases, are being extorted by clinic staff and security personnel allegedly acting in collusion with members of the vigilante group Operation Dudula.

In November, the High Court interdicted Operation Dudula from demanding identity documents from members of the public, ruling that such actions were unlawful. Despite the order, immigrants and advocacy groups say abuses have continued, with some clinic workers allegedly exploiting the situation by charging desperate patients for access to services and medication that should be provided free of charge.

Investigations by GroundUp at several Gauteng clinics found consistent reports of extortion in areas where Operation Dudula has previously blocked immigrants from healthcare access.

At Spartan Clinic, immigrants reported that some staff members were allegedly sharing their personal WhatsApp numbers with patients who had been turned away. Through these channels, patients were reportedly offered antiretroviral treatment, chronic medication, child immunisations and prenatal services for a fee. Those who agreed to pay were allegedly given special appointments and allowed into the clinic without interference.

One immigrant patient, who has been collecting antiretroviral medication at Spartan Clinic for several years, said she was turned away from the gate in October. She later obtained a clinic staff member's contact details and was allegedly asked to pay for her medication.

"I was desperate and feeling sick after weeks without my medication," she said, adding that she paid R200 for a month's supply after being ushered into the clinic by a nurse.

Another patient shared screenshots of conversations in which prices were quoted for medication, including R200 for a month's supply of antiretrovirals and R300 for three months.

At Jeppe Clinic, immigrants said they were sometimes allowed inside but then not attended to, leaving them vulnerable to informal networks selling medication obtained through clinic staff. One woman told GroundUp she bought antiretroviral medication for R300 from a middlewoman with alleged connections to clinic workers.

The woman selling the medication said she was asked by a clinic staff member to help identify other immigrants in need of chronic treatment, receiving a small kickback for each transaction.

Similar concerns were raised at Yeoville Clinic, where immigrants said those with valid permits were sometimes admitted, while undocumented patients were turned away. Some alleged that payments to staff enabled access to services such as child immunisations.

Civil society groups say the situation has had serious consequences for public health. Ethel Musonza of Zimbabwe Isolated Women in South Africa said her organisation had received multiple reports of immigrants being forced to buy chronic medication from clinic staff.

"Many people have defaulted on their HIV treatment, and some who were on preventive medication can no longer access it," she said, calling for urgent intervention by law enforcement and health authorities.

The Gauteng Department of Health did not respond to requests for comment. However, national Department of Health spokesperson Foster Mohale said the department was not aware of any extortion at clinics.

"If this is true, it is unlawful, and we condemn it in the strongest terms," Mohale said. He urged anyone with evidence to report it to the department or the police so that investigations could be conducted.

Mohale also said none of the clinics mentioned had reported shortages of medication.

The High Court ruling has renewed pressure on authorities to enforce the law, protect vulnerable communities and ensure that public healthcare services remain accessible to all, regardless of nationality or documentation status.