PRETORIA – Despite its lacklustre growth over the past decade, South Africa remains a magnet for immigrants from elsewhere on the continent and beyond, for whom the towering buildings and sophisticated road networks in its cities represent economic and financial opportunities while a better human rights record relative to their home countries is an additional attraction.
Thousands make their way to Mzansi’s provinces with the hope of eking out an honest living through both formal and informal means. But in this pursuit, many foreign nationals return to their homelands in wooden coffins after succumbing to disease or crime in what is said to be one of the most violent countries in the world outside a war zone.
Increasingly, foreigners also face hostility from locals, including politicians and government officials, who accuse them of burdening South Africa’s public health system when they seek treatment in overcrowded state health facilities meant to serve citizens from low income households.
This has given rise to the term "health tourism", a reference to immigrants from poor countries whose health systems have all but collapsed.
Malawian mother of three, Eliza Buyanga, says she is forced to seek treatment at public hospitals in Pretoria as she cannot afford medical aid which would allow her to visit private clinics.
“Medical aid in South Africa is too expensive, particularly for us who are in the informal trade. The last time, years ago, when I got a quote for medical aid, they wanted to charge me thousands of rand per month," the hairdresser told the African News Agency (ANA).
"I have a family back in Mzuzu (Malawi) to look after. Besides the huge cost of medical aid, the providers demand many documents like proof of residences, work permits and others which I cannot provide. If my children are sick, I take them to Tshwane District Hospital for free,” added Buyana, who also runs a stall selling snacks and cigarettes in the capital’s bustling central business district.
Even bona fide South African citizens struggle with the high cost of healthcare.
Data released by Statistics South Africa in its General Household Survey report this week showed that the percentage of individuals covered by medical aid schemes declined from 17.1 percent in 2016 to 16.4 percent in 2018.
In other words, more than 47 million South Africans do not have medical aid, with just 9.4 million people enjoying the benefit of medical cover. Only about a fifth, or 22.6 percent, of South African households had at least one member who belonged to a medical aid scheme.
Johannesburg-based Zimbabwean investment banker Jerry Mashamba believes that with more empathy for immigrants’ circumstances, it would be possible for everyone to have adequate medical cover and for foreigners to pay repatriation costs from their income.
Mashamba has launched Mzansi Platinum Cover – a facility comprising medical insurance, a funeral plan and a tax free investment plan which pays out a lump sum when one quits employment.
“I ventured into this terrain after realising that our people are in need of help to solve these societal problems," he said.
"Most local companies in South Africa which offer these services are selective on who they cover. Some have a problems on covering the foreigners. Many people who are small business owners, say it is very expensive to go and get medical aid for their few employees.
"Think of, for example, small companies in the security business … many just want a payout when one of their staffers die. Suppose one of their staffers is shot at work, those companies need a proper hospital plan which makes their employees be attended at a proper (private) hospital,” Mashamba added.
Mzansi Platinum’s medical insurance starts from R291 per month which allows for four doctor’s visits per year and offers cover for 27 chronic diseases, a hospitalisation plan and a visit to a dentist.
The company also provides funeral cover for South Africa, Zimbabwe, Mozambique, Lesotho and Malawi.
"We are covering the migrants who are working even on farms. They have been having serious problems and often their bodies are denied dignity when they are taken across borders because of lack of funds," said Mashamba, who has held discussions with the embassies of Malawi, Zimbabwe and Mozambique in particular on how to raise awareness of his product.
With no private medical aid, foreign nationals struggle to get treatment at government hospitals, said Ngqabutho Mabhena, leader of a group which advocates for the interests of the Zimbabwean community in South Africa.
“Of late, our people are told at public hospitals that they cannot be treated unless they pay upfront," Mabhena told ANA.
"The fees can be as much as R5,000, money that they would not have in their possession. It is better for those who can, to make plans for private doctors. The majority of our people who are not documented are also not working and it is difficult for them to access healthcare in South Africa, particularly women who need regular checkups and so forth."
He said while older immigrants were often members of burial societies which offered assistance with funerals, younger people often did not bother to join, making it expensive — between R15,000 and R20,000 — for families to repatriate their bodies home when they die in South Africa.
"Surviving family members are forced to dig deep into their pockets. Remember, once parents across the borders hear that their offspring has passed on in South Africa, they want the body returned home for burial," Mabhena said.
"We have tried to get young people into burial societies but it is quite a challenge.”
African News Agency (ANA)