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22 August 2025 | Story Dr Nombulelo Shange | Photo Supplied
Dr Nombulelo Shange
Dr Nombulelo Shange is a sociology lecturer at the University of the Free State (UFS).

Opinion article by Dr Nombulelo Shange, Lecturer in the Department of Sociology, University of the Free State 


 

The rising xenophobic violence and exclusion towards African nationals from outside of South Africa is increasingly becoming an emotive issue that is impossible to engage and unpack. In the social-media, “Trumpification” age we live in today, truth-telling and evidence are secondary or even completely irrelevant against the loud, “smart-sounding opinions” rooted in lies and misinformation spread online. Some have used statistics to show that foreigners only make up roughly 4% of our population, which is significant, but not enough to account for our rising unemployment and South Africans’ difficulty in accessing social services and goods such as education and healthcare. There are bigger challenges rooted in our incomplete revolution, rooted in coloniality, where resources and land were left at the hands of the white oppressor, in exchange for “peace”. There are bigger challenges rooted in corruption and poor governance. But even with these realities, many bury their heads in the sand and opt to believe the incomplete story that foreigners are our single greatest problem. 

 

Self-inflicted harm 

Many others have turned to history as a reminder of how African countries in different ways, aided our armed struggle and apartheid resistance, warning that we might need the continent soon and we would have alienated all of our neighbours if we continue down this path. Others have turned to politics and economics, which show us the importance of having strong economic ties with neighbouring countries to ensure growth and development. We saw this in part historically with the European Union and we see it today with the rise of Asian markets like China, Japan, South Korea, Singapore and others. Some of the pluralistic approaches to the rapid growth of many of these Asian markets is in relaxing borders to enable the flow of people, ideas, technology, money and resources. But South Africans continue to respond by fighting for the isolating barriers put up by colonialism and later apartheid in order to strengthen their cruel inhumane policies and stronghold against black people. 

We often do this to our own detriment as black people and people of colour, structures such as Operation Dudula and March on March, seldom march to white schools in the suburbs to demand that white people prove their citizenship and belonging. They do this in predominantly black or mixed areas, applying a self-imposed apartheid dompas system, that limits our movements. They ignore the fact that many South Africans themselves are undocumented because of a variety of historical and contemporary issues and struggles related to accessing important services like Home Affairs. They base many of their strategies on hateful intangible stereotypes like the belief that foreigners are dark, cannot speak South African languages or pronounce specific words. The ideas around what it means to be South African are usually very linear and often prioritise namely Nguni culture and languages. So, if you are not a light skinned, Zulu/Nguni person, without your ID, you find yourself at risk of being harmed or being denied important services like healthcare in an emergency for example. We are too quick to forget the lessons of the COVID-19 pandemic; illness does not care who you are, what race or nationality you are, it spreads and places all of us at risk. Denying foreigners access to healthcare, while many of them live in overcrowded black townships, places black South Africans in harm’s way and can lead to a public health crisis in areas where people were struggling to access healthcare long before the influx of foreigners in the country. 

 

Silence and inaction of our leaders

Noticeable in this whole mess and scary new norm, is the silence and inaction of our leaders. The violent and harmful actions of South Africans can in part be explained by their desperate state stemming from poverty, unemployment, and violent crimes experienced today. The tensions can in part be explained by a lack of adequate awareness of the diverse historical and contemporary importance of the continent and our immediate neighbours for our own growth and development. The overwhelming silence of our leaders is hard to make sense of. The Economic Freedom Fighters (EFF) leaders remain some of the few leaders that condemn this violence and call for a united Africa. It is believed this stance even cost EFF supporters in the 2024 elections, but they still continue to hold onto this important ethical stance, while more prominent leaders shy away from the issue. Many of these leaders were themselves either born or raised in exile or started their own families outside of the country and were the direct beneficiaries of the kindness and sacrifice that many African countries showed us during apartheid. In this new climate of having to prove “South Africanness” and therefore belonging gymnastics, many of them would have their belonging questioned. But rather than call out the violence and put protections in place, while creating awareness on diverse complexities that create “South Africanness”, our leaders are silent. And perhaps more startling, is that our government is partly made up of a political party that campaigned on the hate of foreigners. Including political parties like the Patriotic Alliance in governance has helped formalise fringe ideas like the “abahambe” slogan, which was a chant directed at African foreigners, threatening and instructing them to leave. The threats have materialised, and foreigners are having different kinds of violence enacted on them.  

 

Afrophobia protects colonial borders

Many social commentors warned that the xenophobic utterances embedded in slogans such as “abahambe” coming from Patriotic Alliance leader, Minister Gayton McKenzie, are deeply rooted in anti-black hate. The TikTok accounts of creators such as: Nikita Lexi, Tara Roos, Samantha Jansen, Kaapie in Korea, Romantha Botha, and many others, have provided interesting and important context and caution with their historically rooted, evidence-based truth-telling that speaks to a plethora of contemporary South African issues, including race. Minister of Sports, Arts and Culture, McKenzie has now recently come under fire for posting old racist and sexist tweets, where the biggest frustration is over his repeated use of the “k-word”. The minister’s actions raise a lot of questions about the intersecting links between Afrophobia, tribalism, hate towards blackness and self-hate as a psychosocial condition plaguing many black people and people of colour, especially in South Africa. What we learn from the minister’s tweets is that Afrophobia is often used to mask racism. It is concerning for a government minister to hold such views, while they are responsible for providing services to the predominately black masses, and artists, in the case of McKenzie. 

What might be perhaps the most damaging and harmful to us as black South Africans, is that our Afrophobia disconnects us to valuable, self-affirming spiritual, social, historical, ecological and economic ties we have with the African continent. We protect the colonial borders that tore our families and cultural groups apart. Our hate is a worship of the colonial shackles that dismembered our ancestors, histories and experiences and that still stifle us today. 

News Archive

Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

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