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South Africa Hospitals Accused of Mistreating Pregnant Migrants

Asylum seeker Francine Kalala is suing South Africa’s government, claiming that two hospitals turned her away while in labor – forcing her to give birth in a train station. Activists say the neglect and abuse she suffered are rife in the country’s healthcare system.

Written by Mxolisi Ncube Published on Read time Approx. 5 minutes
In June, Francine Kalala gave birth to her baby daughter in Johannesburg's Park Station, after she says two hospitals refused to admit her while she was in labor because she is an asylum seeker. Hoberman Collection/UIG via Getty Images

JOHANNESBURG, South Africa – In June this year, Francine Ngalula Kalala, an asylum seeker from the Democratic Republic of Congo (DRC), delivered her baby girl at a Johannesburg railroad station, assisted by security guards and watched by hundreds of onlookers.

Kalala, 31, was forced to give birth at Park Station because she had nowhere else to go. The delivery had followed a five-hour ordeal during which she traveled a total of about 60 miles, including a 45-minute train ride from Pretoria while she was in labor – vomiting the whole way.

Kalala says she had no other choice. She says she had been turned away by two government-run hospitals because she was carrying an asylum seeker’s permit. After the birth, Kalala and her husband say things got worse: Even though their baby was turning blue, they were sent away from another hospital until they finally found one that would take them in.

Now, they are suing the government for unfair treatment and discrimination, shining a light on what rights activists say is the systematic abuse and neglect of pregnant asylum seekers by South Africa’s hospitals.

The South African constitution entitles migrants and asylum seekers to the same free basic health services as citizens, including maternity care. But rights campaigners and migrants themselves say many are mistreated at the hands of hospital staff, with stories of verbal abuse, neglect and assault. Some say they have been forced to pay up to R2,000 (about $149) for their treatment.

Kalala’s story has been met with a confusing back-and-forth in the press. Gwen Ramokgopa, the deputy health minister and member of the Executive Council for Gauteng province, which contains Johannesburg, apologized to the family and launched an investigation. But Health Minister Aaron Motsoaledi announced that Kalala had never been turned away from the hospitals – he says she voluntarily left one and the other she never even went to.

But Kalala and Serge stand by their version of events and say the day news of their ordeal broke, the health minister called to warn them against speaking to the press.

With the help of the African Diaspora Forum, a migrants’ rights organization headquartered in Johannesburg, Kalala and Serge are taking the government to court in a case set to launch soon at the Equality Court. As part of the lawsuit, the couple want the hospitals to pay damages and Motsoaledi to publicly apologize for contradicting their story.

‘The Wrong Place’

Kalala and her husband fled the strife-torn DRC in 2016 and briefly stayed in Cape Town, where she became pregnant and received early prenatal treatment before they moved to Pretoria in May.

At 2 a.m. on June 1, she went into labor and her husband Serge drove her to Tshwane District Hospital, where she says she was refused treatment. “The nurses told me I was not allowed to be admitted to the hospital because I have an asylum seeker’s permit,” Kalala says. “I waited there for hours while those who came after me were all attended to.”

The couple say they then tried Steve Biko Hospital, but they were turned away immediately. In desperation, they caught a train to Johannesburg, in the hopes of traveling on to a hospital in Edenvale, where Serge’s sister-in-law had given birth. But they never made it.

At around 7 a.m. at Park Station in Johannesburg, Kalala gave birth to a baby girl.

Soon after she was born, the baby started to turn blue. Kalala and Serge went to Johannesburg’s Charlotte Maxeke Academic Hospital, where they were told it was “the wrong place” for them, says Kalala. Serge begged a doctor to at least wash the baby in the hopes that they would realize how desperate the situation was and admit her, but he was ignored.

Eight hours after she gave birth, Kalala and her baby were eventually taken in at Hillbrow Hospital, where both got the medical attention they needed.

“It was worse than anything that happened to me in the DRC. I felt I was not welcome in South Africa and even thought I needed to leave this country,” says Kalala.

The Ministry of Health did not respond to questions from News Deeply about the allegations of mistreatment. Requests for comment from the hospitals were directed to the ministry.

A Huge, Silent Problem

“[Francine] Kalala’s ordeal was widely publicized and treated as an exceptional case, but we know that migrant women accessing maternal care routinely face discrimination and abuse within the public healthcare system,” says Dr. Rebecca Walker, a postdoctoral researcher with the African Centre for Migration and Society at Wits University.

Despite Kalala’s experience, to some migrant women, she’s considered lucky – at least she and her baby are healthy. Activists and reporters often hear stories of children dying or being left disabled as a result of ill treatment or neglect by hospital staff.

“Many women who are fearful of being charged [money] and mistreated choose not to book their place at a hospital for delivery – and thus wait until the last minute to go,” says Walker. “This means they have to be treated as an emergency. But it also means that fear of abuse and being charged is forcing them to risk their own and their baby’s health.”

Rights groups say the problem partly stems from misconceptions about the impact of migrants on South Africa’s healthcare system, with the public and even many government authorities believing that foreign women are burdening the system by coming to the country specifically to give birth.

“Data and research challenges these myths, showing that not only is the number of non-nationals in South Africa generally much lower than assumed – it’s around 3 percent of the overall population, reflecting a global norm – but that there are not large numbers of pregnant migrant women accessing services,” Walker says.

Dewa Mavhinga, Southern Africa director for Human Rights Watch, says the government’s failure to monitor and punish the perpetrators is fueling the abuse.

“At present, there is yet to be comprehensive research to determine the extent of the problem of access to healthcare for migrants, especially pregnant women, but what is clear is that this is a huge, silent problem that has so far been neglected by the authorities,” he says.

For his part, Serge wants to make sure this never happens to another couple.

“We hope that after this, the next foreigner who goes to hospital to deliver will not receive similar treatment,” he says.

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