Dostin Lakika’s research while affiliated with University of the Witwatersrand and other places

The COVID-19 pandemic was an unprecedented crisis characterised by widespread disruption and significant loss of life. Governments worldwide responded with a myriad of containment measures aimed at curbing the spread of this deadly virus. In South Africa, a nation accommodating migrants from diverse backgrounds, COVID-19 mitigation protocols were authorised but met with criticism not limited to local citizens. Cross-border migrants decried these measures as manifestations of medical xenophobia and 'migrantcide', engendering reluctance among many, particularly migrants, to seek medical treatment from public healthcare facilities. This article delves into the perspectives and beliefs of Congolese and Somali asylum seekers and refugees living in South Africa, with a particular emphasis on their perceptions of COVID-19 within an immigration landscape often fraught with hostility. The central argument posits that animosity and state negligence in a time of socioeconomic difficulty exacerbated migrants' misconceptions regarding COVID-19, contributing to their hesitancy in using South African public healthcare facilities during the pandemic. The profound deficit in trust between refugees and healthcare practitioners, stemming from inadequate communication channels, further exacerbates existing tensions and mistrust. Based on extensive fieldwork conducted in 2021 among Congolese and Somali communities in Yeoville and Mayfair—two suburbs of Johannesburg, South Africa populated by migrants—this paper explores the various meanings, perceptions and beliefs surrounding the COVID-19 pandemic. It examines how these factors contributed to rising anxiety and fear, as well as the diverse responses adopted to address the deadly disease. The hesitancy of migrant groups to seek medical assistance from public healthcare facilities led them to explore alternative means of managing COVID-19 symptoms. While some of these approaches occasionally yielded positive outcomes, they often fell short of achieving the desired results, potentially resulting in an increased number of infections and fatalities that remained untested and unreported.

The health of refugees has been widely documented, as has the impact of a range of factors throughout the migration journey from being exposed to violence to the impacts of immigration detention. This study adds to our understanding of health-related quality of life amongst refugees and asylum seekers by evaluating health-related quality of life as measured by the Short-Form 36 (SF-36) Health Survey using meta-analysis. The aims of this study were to (1) provide a summary and overview of health-related quality of life (as measured by the SF-36), including the extent to which this varies and (2) explore the factors that influence health-related quality of life (as measured by the SF-36) amongst refugees and asylum seekers. A search was undertaken of MEDLINE, CINAHL, PSYCINFO and SCOPUS, returning 3965 results. Papers were included if they sampled refugees (or asylum seeker or those with refugee-like experiences) and used the SF-36 (or its variants) as an outcome measure. Mean scores and standard deviations were pooled using a random effects model. The pooled sample size was 18,418. The pooled mean scores for the SF-36 physical summary measures was 54.99 (95% CI 46.01–63.99), while the mental health summary measure was 52.39 (95% CI 43.35–61.43). The pooled mean scores for each of the sub-scales ranged from 49.6 (vitality) to 65.54 (physical functioning). High heterogeneity was found between both summary measures and all sub-scales. In comparison to SF-36 results from general populations in high and middle income countries, these results suggest that refugee quality of life is generally poorer. However, this varied substantially between studies. One issue that is not well clarified by this review are the factors that contributed to health-related quality of life.

Drawing on interviews with Congolese in Johannesburg, this research explains some of the impact of the discriminatory immigration laws in South Africa that expose refugees to various forms of precarity. I show that precarity becomes a driving force for these people to engage in illegal or unauthorized activities, and I analyze how Congolese refugees attempt to obtain legal status and adapt to intensified discriminatory immigration policies and practices. I argue that the criminalization of migration creates a paradox: it subjects migrants to increased vulnerability due to restrictive policies, but it also empowers them to assert their agency in response. Yet due to the generally illegal nature of their chosen activities, migrants are exposed to more exploitation, perpetuating their criminalization and vulnerability. I demonstrate the adverse outcomes of government antimigrant policies that push people into precarity without necessarily endorsing the illegal activities migrants may employ.

This article explores the link between migration and alienation and its impact on the mental health and wellbeing of Congolese and Somali asylum seekers and refugees—two of the largest populations of displaced migrants in South Africa. Drawing on ethnographic research in Johannesburg, we highlight the various ways alienation is both imposed upon and experienced by migrants and argue that systemic dis integration, or acts of alienation, can be seen as deliberate and active policies and practices that are instrumental in excluding asylum seekers and refugees from everyday life. The experiences of marginalization and othering narrated by Congolese and Somali migrants highlight ways in which alienation and dis integration from critical social connections including family, community, and familiar contexts fundamentally impact wellbeing and mental health as well as strategies of care-seeking, and other forms of relational resilience. While conceptualizations and metrics of integration may in some ways capture the fallout of disintegration, such as access to livelihoods, housing, education, and healthcare, we suggest that this does not adequately assess the profound damage by acts of alienation on crucial relationships. The alienated psyche of innumerable migrants in South Africa results in the feeling that “when a bad thing happens…you are better only when you are home.” This pain, or feelings of alienation, we argue, are a crucial aspect to our understanding of alienation and in turn, highlight the importance of alienation as an apt analytical tool through which experiences of asylum-seeking in South Africa can be understood.

Background: Strike action carried out by healthcare workers raises a range of ethical issues. Most fundamentally, as a strike is designed to disrupt, it has the potential to impact patient outcomes and healthcare delivery. This paper synthesises and analyses the empirical literature that details the impact of strike action on healthcare delivery. Methods: A systematic scoping review was utilised to examine the extent, range and nature of research activity. Embase, Medline, CINAHL, Bioethicsline, EconLit and Web of Science were searched, yielding 5644 results. Papers were included if they examined the impact that strike action had on healthcare delivery (i.e., admissions, presentations, waiting time). After screening, 43 papers met inclusion criteria. Results: Nineteen studies explored presentations to emergency or admissions to hospital. Both dropped dramatically when comparing non-strike to strike periods. Ten studies examined length of stay in hospital and waiting times. No clear relationship was found with strike action, with some studies showing that wait times decreased. Nine studies examined the impact of strike action in facilities that were not on strike, but were impacted by nearby strike action along with the impact that strike action had on treatment seeking. Hospitals dealing with these upstream impacts often saw increase in presentations at hospitals, but results relates to treatment seeking during strike action were mixed. Conclusion: Strike action can have a substantial impact on the delivery of healthcare, but this impact is not felt uniformly across services. While many services are disrupted, a number are not, with several studies reporting increased efficiency.

This article explores the conceptualization of the body among former Congolese soldiers living as refugees in Johannesburg. The article draws on extensive fieldwork in Johannesburg, South Africa and employs the concept of deterritorialization and reterritorialization to explain the bodies of those who have decided to join the Congolese Army. The article reveals the complex ways in which the army manipulates soldiers’ bodies to generate diverse lines of connection, coalition, and removal (or disconnection). We support that the soldiers’ bodies are not necessarily owned by the country, but that soldiers’ bodies become owned by military institutions, who employ nationalist rhetoric to justify their existence and actions. The act of joining the army could be considered a way of cutting ties with civilian life and joining a new world in which the individual is socialized into military culture. Through initiation, the soldier’s body is reterritorialized; it becomes a national asset. While this study focuses on former Congolese soldiers, it has broader relevance, giving insight into how soldiers perceive their body shifting from individual possession to be reterritorialized as the body of the nation.