The three gunmen showed up just 10 minutes after the security guards had arrived for the early morning shift. Tshiamo Nere* admits he was \u201cfrozen\u201d with shock and could only stare as the men aimed their weapons at him and two colleagues at Khayelitsha\u2019s Town Two clinic in Cape Town, as screaming nurses and patients fled.<\/p>\n
They had a message, the men told the unarmed guards. \u201cThey demanded a protection fee from the security company that employs us to guard the clinic,\u201d Nere says. \u201cThe patients, frightened, scattered; and nurses ran for their lives.\u201d<\/p>\n
The men promised to return and cause \u201chavoc\u201d if their demands were not met. It was the first time the health clinic had been targeted, but Nere says the security company that employs him has still not paid the fee and he fears the men will be back soon.<\/p>\n
double quotation markCape Town \u2026 is not an isolated incident. It happens in Johannesburg; it happens in Port ElizabethThapelo Mohapi<\/p>\n
Town Two is not the first public health clinic in South Africa\u2019s townships to experience such an incident. A rash of extortions and robberies targeting medical staff and people using health centres in impoverished areas has been reported over the past few years.<\/p>\n
People in Khayelitsha say muggings outside the township\u2019s clinics and hospitals are becoming more commonplace as thieves demand \u201csomething for safe passage\u201d, says Nere. He no longer walks to work in uniform, instead wearing civilian clothes in the hope of being less noticeable.<\/p>\n
\u201cThe Cape Town incident was in the spotlight last month when it happened, but it is not an isolated incident,\u201d says Thapelo Mohapi, secretary general of Abahlali baseMjondol<\/a>, a grassroots union movement for people living in slums across South Africa. \u201cIt happens in Johannesburg; it happens in Port Elizabeth city.\u201d<\/p>\n Thapelo Mohapi, of the Abahlali baseMjondolo movement, says many attacks go unreported<\/p>\n This time last year, two healthcare workers <\/a>were shot and killed in Lusikisiki, in Eastern Cape. In November, two nurses were shot at while guarding a clinic in the same province. But most violence, extortions and muggings go unreported, says Mohapi.<\/p>\n South Africa\u2019s police do not keep specific data on violent crime targeting healthcare centres or personnel, but anecdotal reports<\/a> from members of the Democratic Nursing Organisation of South Africa (Denosa) and other healthcare organisations show that the problem has been growing in the past few years.<\/p>\n The most recent analysis, from the South African Medical Association (SAMA)<\/a>, published in 2023, called the problem \u201can epidemic of workplace violence in the healthcare sector\u201d \u2013 and it is the poorest who suffer most.<\/p>\n Unathi Sula, 32, a patient from Khayelitsha, says: \u201cI came to Town Two clinic early to be the first in line for medication, but the clinic was shuttered for three days.\u201d Sula is pregnant with her fourth child and needs anti-retroviral medications<\/a> to keep her HIV in check.<\/p>\n Sula cannot afford the taxi fare to visit more secure hospitals in other parts of Cape Town. Also, her medical files, like those of many patients at Town Two clinic, are on paper and so cannot be accessed from other hospitals.<\/p>\n double quotation markThe reason mafias haven\u2019t been suppressed is because this crime doesn\u2019t affect the upper classes, who use private hospitalsThapelo Mohapi<\/p>\n Mohapi says attacks like that at Town Two clinic could create medical deserts in the poorest parts of town if doctors and nurses stop working in high-risk areas.<\/p>\n \u201cThe reason mafias haven\u2019t been suppressed and eradicated is because this crime doesn\u2019t affect the middle and upper classes, who use private, highly secured hospitals,\u201d he says, adding that he believes criminal gangs have infiltrated the police.<\/p>\n Denosa first sounded the alarm over security problems at health centres and \u201ccorrupt arrangements\u201d around the issue in 2023, after three nurses were shot dead and a spate of violent muggings took place at clinics in the Eastern Cape region. Denosa\u2019s spokesperson, Simphiwe Gada, said at the time that nurses were too afraid to go to work.<\/p>\n Col Andr\u00e8 Traut, commander of the South African police service in Western Cape province, says the force takes the Town Two clinic incident and other disruption to health services very seriously.<\/p>\n \u201cThe investigation has identified an extortion group operating in the area and is at an advanced stage,\u201d Traut says. \u201cWhile specific figures cannot be disclosed due to ongoing investigations, targeted operations, high-visibility deployments and intelligence-driven actions are yielding positive results.\u201d<\/p>\n Patients queue at Khayelitsha\u2019s Town Two clinic. When clinics close, many patients at the centre of the HIV and TB infection crisis cannot get vital medication. Photograph: Handout<\/p>\n \u201cExtortion is now a priority focus in the Western Cape, as it undermines community safety and disrupts essential healthcare,\u201d he says. The police have appealed to people to come forward to report attacks.<\/p>\n However, Mohapi questioned the call for communities to report gangs to police, saying whistleblowing is deadly in South Africa and people have been killed or forced into hiding for speaking up.<\/p>\n \u201cWe are under siege,\u201d says Dr Owami Dube* in Johannesburg, who adds that impoverished people on chronic medications are becoming collateral damage of organised crime.<\/p>\n Two of Dube\u2019s colleagues have been killed: Dr George Koboka was shot dead in his surgery in Soweto, Johannesburg\u2019s largest township, in March 2022; and in February 2024, his friend Dr Michael Isabelle was killed during an apparent robbery at his Soweto practice.<\/p>\n After his friend\u2019s death, Dube shut his practice in Soweto and relocated to an affluent district of Johannesburg. A further 23,400 health professionals have left the country<\/a> to work abroad.<\/p>\n