Ethiopian asylum seeker denied life-saving dialysis in South Africa Published duration 6 November 2019

image copyright Alem Ereselo image caption Alem Ereselo's lawyer says she has been "very weak" since the dialysis was cut

An Ethiopian woman says she has been denied life-saving medical treatment in South Africa because she is an asylum seeker.

Alem Ereselo suffers from kidney failure but was taken off dialysis after a court ruling last month. Her lawyer said it was a "death sentence".

Doctors told Ms Alem earlier this year that they were terminating her treatment because of her asylum status.

But the high court ruled that it was "not only" for this reason.

How did it begin?

Ms Alem began suffering from kidney failure at the beginning of this year and now needs dialysis until a kidney transplant becomes available, her lawyer says.

The 36-year-old was receiving the treatment - which removes toxins and excess fluid from the blood - at the Helen Joseph Hospital in Johannesburg.

But she was notified in two letters in April that it would end.

In a list of possible reasons for the decision, the hospital highlighted an option saying: "You are not a South African citizen and do not possess verified documents pertaining to refugee status or permanent citizenship."

The letters, seen by the BBC, also referenced the limited number of slots for the procedure and the "increasing population in need of dialysis".

Why is asylum status linked to dialysis?

Ms Alem, an Ethiopian national, has been living in South Africa for more than nine years. Her application for asylum was rejected, but she is still awaiting final judgement on her appeal to get refugee status.

Her lawyer, Jessica Lawrence, told the BBC she was being denied the treatment based on a policy preventing asylum seekers in South Africa from receiving chronic dialysis, which is not considered emergency healthcare.

"They terminated the dialysis because the Department of Health policy is that asylum seekers are not entitled to chronic dialysis. She needs a kidney transplant but asylum seekers are not entitled to transplants" without ministerial approval, she said.

In the high court case last month, the hospital said it was not able to offer the treatment to non-South African citizens or permanent residents because of a shortage of resources, according to local media reports.

"We have limited numbers of... slots to accommodate transplant-eligible South African patients; and the treatment lasts on average for three to five years," one doctor said, adding that such treatment is "expensive to maintain".

The judge ruled that the case was not discriminatory against asylum seekers because "there are numerous South Africans who have been excluded from renal treatment of the same nature on the basis of scarcity of resources".

It was "not only because she was a foreign national that she was denied treatment," the judge said.

Doctors "were faced with limited resources and had tried to stabilise her condition. Further, they had a long list of other patients waiting for these expensive treatments".

But Ms Lawrence said it all came back to Ms Alem's asylum status. "They said they can't waste resources on someone who cannot receive a transplant but the only reason Alem can't is because of her immigration status," she argued.

The hospital said it could not provide further details on the case.

What now?

Ms Alem has been feeling "very weak" since the dialysis ended two weeks ago, her lawyer said.

Her friend, Hanna Abedo, told BBC Newsday that she was in "a bad way".

""The judge says it's because doesn't have the right documents… We begged the doctor to give her the treatment, but he refused and didn't want to talk to us. I used to go to the hospital with her many times. The doctor was telling her to go back home," she said.

Ms Alem's legal team is now raising money for private dialysis, as they prepare to launch a legal challenge and get ministerial permission for a kidney transplant.