April 21, 2015

For the past week, a medical team from Doctors Without Borders/Médecins Sans Frontières (MSF) has been responding to the health needs of people displaced by violent xenophobic attacks in South Africa’s KwaZulu Natal (KZN) province.

The team began its work on April 14. After conducting assessments at the Isipingo, Chatsworth and Phoenix displacement camps, which collectively house more than 5,000 people near the coastal city of Durban, the team began providing basic medical care. A second team will soon conduct similar assessments in the Ekurhuleni region near Johannesburg.

The team in KZN is focused on providing for the unmet medical and humanitarian needs of fearful migrants and refugees—predominantly people from Mozambique, Malawi, Zimbabwe, and the Democratic Republic of Congo—who have been driven from homes by the violence. MSF is providing medical and water and sanitation services in the three camps and working in conjunction with the provincial Department of Health (DoH) to ensure regular mobile clinics, referrals to hospitals, assistance to survivors of sexual and gender-based violence, and medication for chronic conditions like HIV and TB.

Significant Needs

The needs are indeed significant. “We have seen children with diarrhea, fever, skin diseases, and a case of pneumonia,” says Dr. Gemma Arellano, MSF emergency team leader in KZN. “We have also treated men who had been badly injured in the violence but had not tried to get care because they were too scared to go hospital or leave the camps with assistance.”

“In Chatsworth Camp,” Arellano continued, “one man suffered fractured ribs in an attack 14 days ago, but he was too scared to seek help. Despite the pain, even today, he does not want to go a hospital for fear of being targeted again. In Phoenix Camp, we treated a man who had multiple arm fractures. Only three hours earlier, he had been severely beaten by a mob of 15 men. They threw him into the river after the attack, but he managed to survive. We have seen pockets of violence targeting individuals.”

Camps Not the Answer

The number of displaced people in each camp is based on estimates by our team since camp managers were not able to do routine population registrations. The MSF team reports that buses have started to arrive to repatriate people back to Malawi, Mozambique, and Zimbabwe.

Nevertheless, Phoenix Camp, which is about 26 kilometers [just under 17 miles] north of Durban, currently hosts an estimated 2,500 people and is growing rapidly. MSF installed a 1,500-liter water tank and is measuring the medical needs of camp residents based on medical profiling when people are registered. The focus is on countering the risk of waterborne diseases by supplying soap and water, as well as buckets for washing, along with attending to the needs of pregnant women and children under five years old.  Medical needs for people with HIV and TB are also being monitored and the DoH will be reestablishing access to ARV medication inside the camp.

There are currently an estimated 3,500 people in Chatsworth camp, about 20 kilometers [12 miles] north of Durban, which is filled to capacity. Around 20 percent of the camp population consists of children under five years old. MSF will supply mobile clinic services in the camp, coordinate nutritional screenings, and run a measles immunization campaign for children.

Isipingo Camp, situated about 21 kilometers [less than 13 miles] south of Durban, was the first camp established and is home to approximately 400 people. The primary problems identified in the initial assessment were related to access to primary health care and psychosocial needs.

Though MSF is providing care in the camps, it does see protracted residence in them as a solution to the ongoing crisis. “MSF urges that community reconciliation between the displaced and South Africans should commence immediately to de-escalate the tensions and reduce fears,” says Andrew Mews, MSF head of mission for South Africa and Lesotho. “This could allow displaced people to safely return to their homes, if they wish, and ensure that reintegration back into South African society can begin. The South African authorities have the capacity to respond to the current emergency but reconciliation and reintegration efforts must not fall by wayside.”

Additional Concerns

MSF remains concerned about rising tensions elsewhere in the country, and our teams in other Johannesburg, Rustenburg, and Cape Town are monitoring the situation and collaborating with civil society groups and communities to denounce the violence and promote reconciliation activities.

In Johannesburg MSF is assembling a second team tasked with conducting medical assessments in the coming days in Ekurhuleni and elsewhere where displaced people have sought safety.

MSF commends the courage with which the majority of South Africans are standing up against xenophobia through the actions of civil society groups, faith-based organizations, and individuals mobilizing support to stop the violence and show solidarity with displaced foreign nationals.

In Malawi, Mozambique, and Zimbabwe, three of the six southern African countries where MSF currently runs routine HIV and TB projects, our teams are on stand-by in case local governments express a need for support as some of their nationals start arriving after repatriation actions.

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