A community clinic just north of Johannesburg has become the frontline of a battle in South Africa over whether foreigners can access public health facilities.
What started as a small local action in one area in 2022 has spread, with activists from the avowedly anti-migrant group, Operation Dudula, picketing some hospitals and clinics in Gauteng and KwaZulu-Natal provinces. They check identity cards and stop anyone who is not South African from entering.
Despite some arrests, the authorities seem unable to prevent the pickets. The site of their latest campaign is in Diepsloot – a poor township of more than 200,000 people near the country's commercial hub.
On a cool, spring Thursday morning, Sicelokuhle Moyo, dressed in a blue-and-beige skirt, thick windbreaker and a black headwrap, set out early for the clinic.
The Zimbabwean, who has lived in South Africa since 2006, was going there, as she often did, to collect her medication for a chronic condition. But this time, when she reached the gate, things were different.
Two men wearing white T-shirts emblazoned with the slogan Operation Dudula – Mass Deportation were stationed at the entrance. They demanded that everyone produce their documents before being allowed inside.
I said that I had a passport. They said, they don't take passports. They want IDs only, Ms Moyo said, hiding her frustration behind a polite smile.
Despite this being a potential flashpoint, there was a strange calmness and resignation as people knew that Operation Dudula activists had been violent in the past. Anyone unable to produce a South African ID book was turned away.
South Africa is home to about 2.4 million migrants, just less than 4% of the population, according to official figures. Most come from neighbouring countries such as Lesotho, Zimbabwe and Mozambique, which have a history of providing migrant labour to their wealthy neighbour. Xenophobia has long been an issue in South Africa which has been accompanied by occasional outbursts of deadly violence. Anti-migrant sentiment has become a key political talking-point.
Operation Dudula, at times accused of using force to make its point, has transformed into a political party with ambitions to contest upcoming local government elections.
Party leader Zandile Dabula insists that the prioritisation of South Africans in healthcare is justified. The public health system, which caters for almost 85% of the population, is overburdened, leading her to argue that South Africans must come first.
However, the methods employed by Operation Dudula have drawn criticism. Activists argue that a group not sanctioned by the state should not control access to healthcare, which is guaranteed by the South African constitution for everyone, regardless of nationality.
As Operation Dudula escalates its campaign against migrants, many vulnerable individuals, both foreign and some South African citizens, find themselves deprived of necessary medical care, highlighting a complex intersection of healthcare rights and nationalism in South Africa today.