Johannesburg Court Orders Action to End 'Xenophobic' Clinic Blockades and Protect Access to Healthcare

High Court orders state to act after "xenophobic" vigilantes block clinics

The Johannesburg High Court has ruled that South African authorities must take stronger, concrete steps to stop a spate of "xenophobic" protests that have blocked access to clinics and hospitals for undocumented foreign nationals. The court specifically named municipalities, the national health department and the police and ordered them to "take all reasonable measures to ensure safe and unhindered physical access... for all persons seeking health services."

For months, members of the vigilante group Operation Dudula — Zulu for "push back" — have staged pickets and checkpoints at public health facilities in Gauteng and KwaZulu-Natal, checking identity documents and denying entry to people they deem non-South African. Human rights organisations, including Doctors Without Borders (MSF) and the Treatment Action Campaign, told the court the authorities had not done enough to stop these actions.

"It is, in my view, a great pity that litigation was required... The weakness of the state's response to a direct and apparently well-organised attack on its efforts to secure basic healthcare for some of the most vulnerable people in our society is of grave concern." — Judge Stuart Wilson

MSF reported in August that the group's activities disrupted services at dozens of clinics and affected thousands of patients, including heavily pregnant women, children and people with chronic conditions such as diabetes and HIV. The NGO also documented incidents in which security guards and some hospital staff appeared to "collaborate" with vigilantes at two facilities.

The High Court had previously ordered Operation Dudula in November to stop unlawful blockages, but sporadic pickets and checkpoints have continued. The ruling reinforces the state's duty to protect access to public healthcare and to prevent non-state actors from denying essential services.

Context and implications

South Africa, the continent's most industrialised economy, remains a primary destination for people seeking work despite a high unemployment rate of around 32 percent. Official figures from 2022 estimate roughly 2.4 million immigrants — nearly 4% of the population — live in the country. Economic pressure and social grievances have at times fuelled anti-immigrant sentiment and episodic violence.

The court order places clear legal responsibility on municipal authorities, the health department and police to safeguard clinics and ensure that vulnerable patients can access care without fear or obstruction. Observers say the ruling could become a significant precedent in defending the right to healthcare and curbing vigilante action that targets migrants.