President of the Nigerian Union South Africa, Mr. Smart Nwobi, speaks with CHUKWUDI AKASIKE about the restriction placed on Nigerians and other foreigners from accessing healthcare in South Africa’s public hospitals by an anti-migrant group, and the steps being taken to tackle the issue.
What does your group represent?
The Nigerian Union South Africa (NUSA) is the umbrella body that protects the interests of Nigerians in South Africa. It was founded in 2008 and has been active for 17 years.
What is the situation like at the moment? Are Nigerians really being denied healthcare in public hospitals?
Yes, the situation is very disturbing and unfortunate. Those preventing foreigners, including Nigerians, from receiving medical care are not government or health department officials. South Africa’s Constitution (Section 27 of the 1996 Constitution) guarantees everyone the right to access public healthcare. However, a group known as Operation Dudula has taken the law into its own hands, barring Nigerians and other migrants from hospitals. This act is xenophobic, unlawful, and unconstitutional.
What has the South African government said about this?
The Minister of Health, Dr. Aaron Motsoaledi, has condemned the group’s actions. He said if they want foreigners excluded from healthcare, they must seek to change the law through parliament, not by harassing doctors or patients. He stressed that denying foreigners medical care is illegal, and doctors have a professional oath not to refuse treatment to anyone.
What are the consequences of this action?
Besides foreigners being denied treatment, some South Africans without proper citizenship documents are also affected. Members of Operation Dudula harass patients, demanding identity cards, and expel anyone without a South African green card. Their actions are not based on facts or research, but purely xenophobic.
Why are South Africans not resisting this?
Some citizens have complained, but many still lack official documents. Even naturalised citizens, especially those who don’t speak local languages, are targeted despite paying taxes. This makes the whole act illegal and discriminatory.
How has your union responded?
NUSA has strongly condemned the development. We are working with progressive South African groups, the Human Rights Office for Refugee Affairs, and the African Diaspora Forum to challenge this in court. Legal action is being prepared.
The group claims foreigners are overstretching the public health system. How do you respond?
That argument lacks evidence. They have not provided statistics showing that foreigners overwhelm the system. It’s just xenophobia. Initially, they targeted foreign traders, accusing them of taking over informal markets. Now they have shifted their focus to healthcare, and they have even threatened to stop foreign children from attending public schools, despite the fact that such schools charge fees. Their actions are clearly coordinated.
When did this ban begin?
It started early this year and became more aggressive around July and August.
How badly are Nigerians affected?
The impact is severe. I receive multiple distress calls daily. Nigerians are resorting to self-medication out of fear of being attacked or denied care in hospitals. Many are dying unnecessarily as a result.
What steps are you taking with the Nigerian government?
We have written to the Nigerian Consulate and will follow up again. We are urging Nigerian diplomats to engage South African authorities and also appeal to President Bola Tinubu and the Senate to intervene diplomatically. Locally, NUSA is also working with other African migrant unions to mount legal challenges.
Has the Nigerian government intervened?
So far, no. The embassy and consulate have not taken any concrete action. We are calling on President Tinubu to urgently step in, especially with the G-20 meeting coming up in South Africa.
What alternatives are Nigerians using?
Those who can afford it go to private hospitals, but most cannot. Many depend on self-medication, which is risky. NUSA has organized medical outreach in some provinces, hiring African doctors to provide free tests and treatments, though our resources are limited.
Operation Dudula argues foreigners should return home and fix their economies. What lessons should African leaders draw from this?
The truth is, if African governments developed their countries, fewer people would migrate. That would reduce xenophobia and afro-phobia—Africans attacking fellow Africans. South African blacks targeting other black Africans is a sad reality.
How long have you lived in South Africa?
I have been here since 2008, for 17 years. I studied and completed my master’s degree here.
Are you practising law there?
Yes. I run Nwobi (Smart) Attorneys Inc., a leading law firm in South Africa, employing others as well.
What has your personal experience been?
Most South Africans are good people, especially those who are educated and widely travelled. The problem is with a small fraction of unexposed individuals fueling anti-migrant campaigns. Africa’s borders are artificial, and unfortunately, some don’t see beyond them.
What facilities exist in South Africa that Nigeria lacks?
Public healthcare here is far superior—even better than many private hospitals. Around 20% of doctors are foreigners, and about 40% of those are Nigerians. Social grants also exist for the poor, unemployed, and elderly.
How are health workers treated?
Doctors and healthcare staff are well-paid—three times more than what their peers earn in Nigeria. This ensures strong retention of talent.
What about electricity?
Power supply is relatively stable. While there have been challenges with load shedding under ESKOM, they were managed quickly. Reliable power supports hospitals, businesses, and investments. Nigeria has much to learn from this.
How many Nigerians currently live in South Africa?
A 2023 survey estimated 500,000, but today, Nigerians are about 800,000 in South Africa.
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