By: Nthompho Tovhakale
Beyond any person’s citizenship status lies humanity.
For Elonga Mabiala*, this sentiment literally meant protecting the life of her 12-year-old nephew, Makasi Kasanda*, who has had chronic diabetes since a young age. Elonga is a recognised refugee from the Democratic Republic of Congo with valid documentation residing in South Africa. She is also the primary guardian to her nephew, Makasi, following his mother’s passing.
Since his diagnosis, Makasi requires insulin to regulate his blood sugar levels. He has always received medical care from a regional hospital in Gauteng and paid a minimum fee for treatment.
However, this allegedly changed around the 12 June 2026, when he was refused treatment at the facility due to an arrears amount of R7,500.
Elonga is unemployed and receives financial support from family members. Without payment, the hospital refused to treat her nephew.
Following the facility’s alleged refusal to assist Makasi, Elonga approached the Alexandra and Hillbrow clinics to seek assistance for the boy. Despite her persistent efforts, Makasi remained without medication for several days, which caused his health to deteriorate rapidly. The Constitution of South Africa guarantees that everyone has the right to access health care services, including emergency medical services. This right applies to both citizens and non-citizens, including refugees. In addition, the National Health Act states that healthcare providers and facilities may not refuse emergency medical treatment to any person. This means that the preservation of life should not be impeded by a person’s refugee status.
Furthermore, the Patient Administration and Revenue Policy recognises that refugees are eligible for means testing and may be classified for subsidised care.
This was Elonga’s motivation when she reached out via social media to SECTION27’s Advice Office and consulted with paralegal, Thembi Mahlathi, together with health rights attorneys, Khanyisa Mapipa and Asiphe Funda, who assisted to expedite the matter. Due to the urgency of Makasi’s case, Ms Mapipa reached out to Rahima Moosa Hospital, where the dedicated doctors in their paediatric unit were more than willing to assist. Makasi was admitted at the urgent care unit of Rahima Moosa due to his critical condition and provided with the medication he needed.
Following this traumatic ordeal, Ms. Mahlathi emailed the Regional Hospital in August 2026, requesting that Elonga be means tested and charged according to her affordability.
Makasi’s story highlights the potentially deadly discrimination that can arise in the South African healthcare system based on a person’s citizenship status and class. An inability to afford healthcare services should never result in exclusion from care. Even though the Constitution protects refugees, they continue to face barriers when trying to exercise their right to healthcare.
Through its intervention, SECTION27 was able to help secure Makasi’s right to access to healthcare services and ensure that the Hospital continued providing him with diabetic medication.
As a public interest litigation organisation in South Africa focused on the right to access healthcare services, SECTION27 and its partners play a critical role in holding public health facilities accountable in fulfilling their constitutional obligations.
Access to healthcare should not be withheld by anyone regardless of ethnic group, race, nationality or birth status. The constitutional provision to the right to healthcare for everyone should not solely be theoretical but must be practically enforced by the government.
*Not their real names.
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