Fear and confusion rife among foreign nationals about accessing Covid jab in South Africa

Refugees at the Diakonia Centre on March 08, 2021 in Durban, South Africa. (Photo: Gallo Images/Darren Stewart)

Foreign nationals living in SA who have some form of identification are eligible for vaccination against Covid-19. But confusion is rife, even among healthcare workers — and some migrants say they won’t get vaccinated for fear of deportation. Meanwhile, the question of how to register those without identity documents lingers.

Simon*, 42, is a Malawian national who works as a caretaker in Sea Point in Cape Town. At his age, he has been eligible for a Covid-19 vaccine for some time. He told Daily Maverick, however, that he won’t be queuing for his jab in the foreseeable future — for one very specific reason.

“I don’t have papers,” Simon said. “If they see this, maybe I can be sent back to Malawi.”

By “papers”, Simon meant that he lacks the legal right to live and work in South Africa. But he does have a passport — a Malawian one — which is all he technically requires to be vaccinated.

Although confusion is widespread on this point, Dr Nicholas Crisp — the head of the government’s vaccine programme — clarified the situation to Daily Maverick on Monday: all foreign nationals over 18 are eligible for free vaccination in South Africa as long as they have some form of identification. This could be a passport from any country, an ID book, refugee or asylum-seeker papers, and so on.

The requirement of a form of registration, Department of Health spokesperson Popo Maja has previously said, is to be able to track anyone who experiences adverse effects from any of the vaccines.

But Simon’s fears appear to be widespread.

Vinayak Bhardwaj, the regional migrant referent for Doctors Without Borders (MSF), told Daily Maverick that fear of deportation is a barrier to seeking vaccination.

“Speaking to migrants themselves, we have heard some express fear of getting vaccinated as they have expired passports which they’ve been unable to renew due to Covid,” Bhardwaj said.

In reality, any information gathered during Covid-19 testing or vaccination cannot lawfully be used to police immigration.

“Healthcare workers should not be expected to be immigration enforcement officers,” Sally Gandar, the Scalabrini Centre’s head of advocacy, told Daily Maverick.

“The information provided is for health-related reasons, and should not be shared with other departments.”

Gandar says that the information gathered is supposed to be kept confidential and password-protected. Sharing the information with the Department of Home Affairs for immigration enforcement purposes would violate the privacy of the patient, which would be unlawful.

She adds that the Scalabrini Centre, which supports migrants in South Africa, is fielding constant queries from non-citizens expressing confusion about whether they are entitled to register for vaccinations.

“We have also received reports where people have been refused the vaccine based on their documentation type. This indicates that there is also a need to provide communication targeting healthcare workers, so that they too know that non-citizens are eligible for the vaccine, and should be assisted to receive it,” Gandar says.

It is also possible that some non-citizens are being denied vaccination for xenophobic reasons. In June, NGOs including the Jesuit Refugee Service released a statement drawing attention to the fact that at certain healthcare facilities in Gauteng, migrants were being charged for basic healthcare services they are entitled to receive free in terms of the Constitution.

The University of the Witwatersrand’s Professor Francois Venter told Daily Maverick that in inner-city Johannesburg, “Everyday experience of xenophobia — especially at the hospitals — is routine to the point of being institutionalised. Foreigners are turned away by security guards and clerks, illegally, long before they see a health worker.”

Venter added that given the police’s reputation for clampdowns and extortion, “any ‘come and get vaccinated, foreigner’ message may well get met with justifiable nervousness”.

With an estimated three million foreign nationals in South Africa, and many more South Africans lacking any form of identification, some are asking whether enforcing the vaccination ID requirements is worth it in the vital quest to achieve herd immunity.

MSF’s Bhardwaj says only the Department of Health, which has a full view of the vaccine programme, can determine whether “the marginal benefit of recording accurately who got what [vaccine]” would outweigh “the urgent need to avoid a fourth wave of Covid-19 which would devastate our significantly depleted human resources for health”.     

Crisp told Daily Maverick that vaccine authorities are “busy with a solution” for registering undocumented individuals, which should be available by 10 October.

In the meantime, it appears that many vaccine sites are finding workarounds to the problem of registering those without any identity documents. The Western Cape government has already made provision for vaccinating undocumented people using a paper-based registration form. In Gauteng, some sites have permitted people to register using a police affidavit.

Health experts contacted by Daily Maverick were in unanimous agreement that vaccine-related communication from the government had not been clear enough.

“We don’t think any of the Covid-19 vaccine-related communication has been adequate, even for South Africans,” Bhardwaj said.

“What we are seeing in [MSF’s] support for the Covid-19 vaccine roll-out here in Khayelitsha, Western Cape is that there are not even the most basic information and education materials available to counter the deluge of disinformation out there. 

“What we also see, though — encouragingly — is that with some engagement and willingness to engage concerns, vaccine registrations effectively double.” DM

*Simon is a pseudonym used to protect identity. The individual’s full name is known to Daily Maverick.


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