Johannesburg/Brussels - Violence, sexual abuse, harassment, appalling living conditions and a serious lack of access to essential healthcare define the desperate lives of thousands of Zimbabweans in South Africa today, warns the medical humanitarian aid agency, Medecins Sans Frontieres (MSF), at the launch of its new report, “No Refuge, Access Denied: Medical and Humanitarian Needs of Zimbabweans in South Africa” .

Recent developments in both Zimbabwe and South Africa have done little to alter the fact that scores of Zimbabweans continue to flee to South Africa as a matter of survival, nor to adequately improve the daily living conditions of Zimbabweans once they cross the border. MSF is calling on the government of South Africa and United Nations (UN) agencies to urgently address the specific humanitarian needs of vulnerable Zimbabweans falling through the cracks of South African society.

“Every day, despite claims that Zimbabwe is ‘normalising’, thousands of Zimbabweans continue to cross the border into South Africa, fleeing economic meltdown, food insecurity, political turmoil, and the total collapse of their health system,” said Rachel Cohen, Head of Mission for MSF in South Africa. “Instead of finding the refuge they so desperately need, they endure intolerable suffering on their journey to and within South Africa.”

Since 2007, MSF has been providing basic primary health care, referral to secondary and specialised care, emergency medical treatment for victims of violence and epidemic outbreaks, and specific services for survivors of sexual violence, as well as unaccompanied minors. Each month, MSF medical teams perform between 4,000-5,000 consultations for Zimbabweans along the border in Musina and at a clinic in inner-city Johannesburg at the Central Methodist Church, a ‘safe haven’ for thousands of Zimbabweans.

“We see thousands of sick, wounded, psychologically scarred, and marginalised Zimbabweans in both Johannesburg and Musina every month. They come to us because they have nowhere else to turn,” said Dr Eric Goemaere, Medical Coordinator for MSF in South Africa.

“Many of those who reach us have chronic diseases, such as HIV and TB, and severe violence-related injuries, most often from rape and sexual assault experienced while crossing the border from Zimbabwe, but also in South Africa itself. Consultations in our Johannesburg clinic have almost tripled in the last year, a telling sign of the extent to which Zimbabweans are consistently denied access to even the most basic health care services necessary for their survival.”

The South African Constitution guarantees access to health care and other essential services to all who live in the country – including refugees, asylum-seekers, and migrants – regardless of legal status. But, in reality, Zimbabwean patients are rejected outright, or often charged exorbitant fees, subjected to long delays or inappropriate treatment, or prematurely discharged, placing health care out of reach for many.

“The stories of our patients are truly shocking,” said Bianca Tolboom, MSF Nurse and Project Coordinator in Johannesburg. “I’m talking about pregnant women, unconscious or critically ill patients, even a six-year-old girl who had been raped, who were all refused the medical care they urgently required. Ã? It’s deplorable, it’s a breach of medical ethics and it’s a violation of their rights under the South African Constitution. This nightmare of neglect must end.”

MSF has been treating an increasing number of victims of sexual violence in Musina. Ã? In April, more than half of those treated had survived gang rape and 70% had been raped under armed threat of a gun, knife or other weapon. Ã? Another worrying trend is the number of unaccompanied children crossing the border alone. They then make their way to the Central Methodist Church, a journey of more than 500km, where as many as 4,000 Zimbabweans seek shelter each night - either dangerously packed into all available space inside the building, or sleeping on the pavement outside the church.

Currently, there are more than 150 unaccompanied children, between the ages of seven and 18 years, crammed into the Central Methodist Church. These children are extremely vulnerable and exposed to many forms of abuse in South Africa, yet no viable solution has been found to ensure they are properly assisted or protected.

“Each day, MSF teams witness the failure of the South African government primarily, but also of UN agencies, to meet the basic medical and humanitarian needs of vulnerable Zimbabweans,” continued Cohen. “The recent announcement by the South African Department of Home Affairs that a new system will be put in place to regularise the legal status of Zimbabweans in South Africa, and to stop their systematic deportation, is a welcome departure from the government’s previous policy of aggressive harassment, arrest, and deportation. However, these measures have yet to translate into tangible improvements in the lives of most Zimbabweans. Their only places of safety are under attack and they remain relegated to the shadows of society, forced to live in squalor and denied access to adequate assistance and protection.”