19/08/2025
Dr Simon N Spoor wrote:
On DEDULA and POLITICAL COWARDICE — in response to a lost post on the topic and others like it on this forum.
Colleague, you are right to name the unbearable strain that has been placed on us as clinicians in this collapsing system. You are also right to feel torn when faced with the reality of resource shortages, multiple deaths, and the question of how we uphold our oath when the state abandons its duty.
Let us be clear: we do not betray our ethics when we treat the sick, regardless of whether they carry a South African ID or a foreign passport. We betray our ethics if we participate in scapegoating the poor, the migrant, the powerless, and thereby excuse the very politicians who created this disaster.
The state is cynically diverting anger away from its own failures. Operation Dudula, and the poisonous xenophobia it promotes, is not a grassroots “solution.” It is a smokescreen encouraged by a political class that has stolen billions through tenders, looted hospital budgets, and left us with collapsing infrastructure, unemployed doctors, and crumbling services.
The National Health Insurance Bill itself already restricts access for “illegal foreigners” to little more than emergencies and communicable diseases. The ruling elite then turns around and blames migrants for the overcrowding and medicine shortages which are, in truth, the direct product of their corruption, austerity, and mismanagement.
Look at Gauteng today: doctors are being forced to fight for basic commuted overtime pay, compelled to submit rosters and “portfolios of evidence” just to be remunerated for work already done. Contracts are being arbitrarily downgraded.
At the same time, hospitals stand half-staffed while thousands of qualified doctors remain unemployed. These shortages are not accidental—they are policy. The government manufactures scarcity to justify austerity, while funds are siphoned into the pockets of tenderpreneurs.
The question, then, is not whether “South Africa has bitten off more than it can chew.” Our country is immensely rich in resources, skilled workers, and human talent. The question is who has been chewing, and on whose behalf.
The truth is bitter: it is the politicians and their business cronies who have swallowed the wealth meant for the people, and now they ask us to police borders in the ward, to turn the clinic into Home Affairs, to act as enforcers of their cowardice.
As doctors, our ethics are not naïve. They are radical. To heal the sick without fear or favour is the sharpest political act we can commit in a time when the government seeks to divide us. We must stand firm: we treat all in need, we reject xenophobic scapegoating, and we hold the state fully accountable for the shortages, the deaths, the collapse. And more than that, we must organize ourselves as patriotic clinicians of all nationalities—South African and foreign-born alike—to take matters into our own hands.
The politicians have proven themselves unfit to run this health system. It falls to us to defend it, democratize it, and fight for a healthcare system that serves the people, not the corrupt.
If we bow to Operation Dudula, we become accomplices in barbarism. If we stand together against it, we embody the true spirit of medicine: solidarity, humanity, and resistance.