Xenophobia and Intergroup Conflict: An Inquiry Through The Concept of Health A qualitative field study on the perceptions of health among refugees and asylum seekers in Cape Town, South Africa

Abstract: Motivated by the ongoing and widespread xenophobia in South Africa, this study explores the experiences of health access and the health sector by refugees and asylum seekers so as to understand intergroup relations, and more specifically the tensions between nationals and non-nationals. In achieving this, an ethnographic fieldwork was conducted in Cape Town, South Africa during Spring 2017; semi-structured interviews with refugees and asylum seekers provide the material for analysis to identify key perceptions on health and xenophobia to shed light on what possible peacebuilding initiatives should address. Key themes uncovered that intergroup violence based on nationality is prevailing in the areas and townships where refugees and asylum seekers live side by side with (black) South Africans. The presence of violence and the fear of risk of violence appear to fuel intergroup resentment and hostility. The lack of social well-being of the refugee became apparent in their frustrations in attaining safety in their everyday life. Moreover, it positions them so that they are unable to improve their own situation and attain health, health access, and health rights. Additionally, it found that a major obstacle to the realisation of health is connected to legal documentation as well as perceived competition for scarce health service. Specifically, it uncovered the perception of assumed hostile attitude (or fear hereof) by nationals among refugees and asylum seekers constitute both visible and invisible access barriers to the public health system and social integration. The application of the instrumental group conflict theory to the ethnographic interview material thus showed that to end what I term ‘norms of protracted social conflict rooted in xenophobia’, refugees and asylum seekers access to and treatment in the health sector is integral for their inclusion into society. It can simultaneously foster relations with the locals and, at the same time, allow for an everyday life wherein the individual can participate in and contribute to the South African society.