By Tswelopele Makoe
IN what can only be described as a perfect storm of political and social upheaval, explosive events keep on unfolding nationwide.
Among them is the commencement of the formal inquiry into the conduct of Limpopo Premier Phophi Ramathuba by the Health Professions Council of SA (HPCSA).
This investigation stems from a trending video of the Premier’s remarks to a foreign national, who was a patient back in 2022, when Ramathuba was the Health MEC of Limpopo.
The HPCSA, together with a number of complainants, have since launched what appears like a witchhunt against the Premier, citing Ramathuba for unprofessional conduct, a “breach of fundamental ethics, and fostering a discriminatory environment”, among others.
The Premier has fervently rejected these allegations against her, stating that they are unfounded and baseless. Ramathuba has further argued that the conversation between her and the patient did not constitute any form of unprofessional conduct and was relevant to her work as a political head of the provincial Department of Health.
The fact of the matter is that the perspective that was conveyed by Ramathuba was a frequently occurring one in our current national climate – encompassed in the prevalent slogan, “put South Africans first”.
This precept is not only occurring in discourses around healthcare, but also service delivery, food safety, institutional constraints, anti-corruption, insufficient infrastructure, and so many more. All of these challenges are interconnected to and derive from one critical issue: the failure of our government to ensure proper border security.
The government’s ineptitude in grappling with the mounting border control crisis has only proliferated. The nation is facing an unprecedented surge in illegal immigration, porous borders, and overwhelmed immigration systems. Naturally, this issue has compounded into widespread tensions over security, resource allocation, and national sovereignty.
The simple reality is that the government’s inability to meaningfully tackle border control has resulted in a steady increase of undocumented immigrants. Simply put, undocumented migrants cannot be tracked and are essentially ghosts in our society.
Not only are they endangered, vulnerable to arbitrary detentions, lack of access to resources and more, but they can also easily evade prosecution for crimes they may commit, elude proper billing for municipal services, healthcare, housing, and so much more.
In 2019, the SA Local Government Association (Salga), the mayors of Johannesburg and Ekurhuleni, and the Department of Home Affairs briefed parliament on the impact of illegal migration on South African cities.
What was highlighted here was that the proliferation of illegal immigration ultimately worsens the challenges faced in the provision of basic services and temporary emergency accommodation to citizens.
They further re-emphasised those foreign nationals who arrive lawfully and hold immeasurable skills that are essential to bolstering our economy, while those who are illegal simply overburden the system and exacerbate issues of overcrowding and effective law enforcement.
Similarly to Premier Ramathuba, the Minister of Health Dr Aaron Motsoaledi was lambasted back in 2018 for restating this very sentiment – that illegal and undocumented immigrants are putting an impossible burden on South Africa’s health system.
He explained: “The weight that foreign nationals are bringing to the country has got nothing to do with xenophobia … it’s a reality. Our hospitals are full.
“When more and more come, you can’t say, 'the hospital is full now. Go away.' They have to be admitted … and when they get admitted in large numbers, they cause overcrowding; infection control starts failing.”
In a nation where over half of the entire population still lives below the poverty line, controlling migration is of the utmost importance. Service delivery and law enforcement is based on fundamental information that is collected in our national census.
The government uses this information primarily in their designation of resources, budgets, and quotas. If a body of the treasury accounts for 3 million citizens in a particular region, it will allocate resources according to that figure.
If there are even 5 000 undocumented persons sharing in those resources, this impact will be adversely detected. There will be a lack of medication, hospital beds, and other critical tools that are needed by healthcare institutions.
These result in instances where is babies are birthed on the floors of hospitals, when healthcare workers are forced to reuse old, unsanitary equipment, and when critical resources simply run out.
South Africa is home to an estimated 4 to 5 million undocumented immigrants. According to recent reports, over 70% of the country's undocumented migrants are concentrated in major urban centres like Johannesburg and Cape Town. This means that healthcare, housing, education, job competition, public services, law enforcement, and more, are immeasurably strained.
The government’s apathetic approach to the dire issue of border control is ultimately detrimental. The nation is already drowning in long-standing social, economic, institutional and political challenges, and the uninhibited influx of illegal migrants only seeks to magnify these issues.
Across our contemporary society, we are contending with challenges that stem directly from untraceable citizenry, and this is a dire issue that cannot be overlooked. This issue is so pervasive in our society that there is a television show that brings focus to it: “Fake Marriages” on Moja Love 157.
Here, illegal migrants pay desperate citizens for marriage contracts. In the past week alone, we can recite a number of societal bombs that can commonly be traced back to our porous borders. From illegal mining by Zama Zama’s, to the theft of cable wires, to violent upheavals over municipal service delivery, to hordes of children dying from food poisoning by nefarious local spaza shop owners, it is critical that we mitigate these issues, directly from the root.
As far as Ramathuba’s case is concerned, I believe the HPCSA are very evidently barking up the wrong tree. They should be focusing their efforts towards addressing the widespread immigration issue, and the government’s inaction in this regard.
The government’s failure to enforce border security is not only eroding our already fractured system but also severely igniting widespread dissent, resentment, and intensifying crime.
As the flow of illegal migrants continues unabated, the ripple effect is being felt across the nation—undermining public trust and putting already fragile infrastructure under severe pressure. It is vital that the government pulls itself up by the bootstraps and address this challenge with the seriousness that it deserves.
As Former President Nelson Mandela once valiantly said: “Safety and security don't just happen; they are the result of collective consensus and public investment.”
* Tswelopele Makoe is a Gender & Social Justice Activist and the Editor at Global South Media Network. She is a Researcher and Columnist, published weekly in the Sunday Independent, Independent Online (IOL), Global South Media Network (GSMN.co.za), Sunday Tribune and Eswatini Daily News. She is also an Andrew W. Mellon scholar, pursuing an MA Ethics at the Desmond Tutu Centre for Religion and Social Justice, UWC. The views expressed are her own.