South Africa 2020 Crime & Safety Report

This is an annual report produced in conjunction with the Regional Security Offices at the U.S. Embassy in Pretoria and Consulates in Cape Town, Durban, and Johannesburg. OSAC encourages travelers to use this report to gain baseline knowledge of security conditions in South Africa. For more in-depth information, review OSAC’s South Africa-specific page for original OSAC reporting, consular messages, and contact information, some of which may be available only to private-sector representatives with an OSAC password.

Travel Advisory

The current U.S. Department of State Travel Advisory at the date of this report’s publication assesses South Africa at Level 2, indicating travelers should exercise increased caution due to crime, civil unrest, and drought. Review OSAC’s report, Understanding the Consular Travel Advisory System.

Overall Crime and Safety Situation

The U.S. Department of State has assessed Pretoria, Johannesburg, Cape Town, and Durban as being CRITICAL-threat locations for crime directed at or affecting official U.S. government interests.

Crime Threats

Violent crime remains an ever-present threat in South Africa; however, criminals do not single out U.S. citizens for criminal activity, as most crimes are opportunistic in nature. Common crimes include murder, rape, armed robbery, carjacking, home invasion, property theft, smash and grab, and ATM robbery. Armed robbery is the most prevalent major crime in South Africa, most often involving organized gangs armed with handguns and/or knives. The South African Police Service (SAPS) recently released April 2018 – March 2019 crime statistics for all major crimes.

In December 2018, U.S. Embassy employees reported criminals had pepper sprayed a group of people departing the Global Citizen concert in Johannesburg in an attempt to partially incapacitate victims and steal phones and other valuable personal property.

Of concern are home invasion robbery and carjacking. These crimes are often violent and can occur at any time of day. In many cases, criminals prefer to attack when the occupants are home or arriving/leaving the premises, because the residential alarm is inactive and the occupants can identify the location of valuables. In August 2019, someone attempted to gain forcible entry to the home of an Embassy employee through a pedestrian gate. Embassy security personnel responded to the residence, inspected the gate, and noticed significant pry marks on the steel frame of the gate near the lock. Although the pry tool slightly damaged the gate frame, the suspects were unable to gain access to the property.

In September 2019, an Embassy employee reported a burglary of the attached garage of their residence. It appears that the suspects reached the electric fence using rubber tubing to prevent activating the alarm and forced the garage door open by unknown means.

Most carjackings occur when the victim arrives at home and pulls into the driveway or entrance gate; the carjackers pull up behind the victim to block an escape path. Carjackers may kill or seriously injure victims who resist or fail to comply with demands. In many scenarios, robbers force the victim into the house, rob them of their valuables, and take the vehicle.

South Africa has one of the highest rates of rape in the world. While rapists do not specifically taret foreigners, foreigners have been victims.

Financial and identity theft crimes, including debit/credit card and advance-fee scams, are common. Most businesses have portable credit card machines they bring to the customer to allow them to swipe their card themselves. Despite these safeguards, scammers frequently clone cards, resulting in fraudulent charges. ATM fraud includes the placement of a skimming device on the ATM itself or the ruse of a “helpful citizen” who offers to assist. Review OSAC’s reports, The Overseas Traveler’s Guide to ATM Skimmers & Fraud and Taking Credit.

Review OSAC’s reports, All That You Should Leave Behind, Hotels: The Inns and Outs, and Considerations for Hotel Security.

Cybersecurity Issues

South Africa has seen a significant rise in cybercrime, and SAPS lacks the resources and technical capability to combat the crimes effectively. Organizations with the financial resources continue to invest heavily in cybersecurity to protect their assets. Much of the country, to include critical infrastructure, remains vulnerable to cyberattack.

Avoid connecting to public Wi-Fi hotspots, as it is difficult to ascertain if the connection is secure. If you must connect to a public Wi-Fi hotspot, use a virtual private network (VPN).

Identity theft remains a significant concern due to several contributing factors: SIM swap fraud, a strong infrastructure of money wiring services, readily available internet, prepaid cell phones, high levels of corruption in many companies and government agencies, and a lack of police resources/expertise to combat this type of crime.

Review OSAC’s reports, Cybersecurity Basics, Best Practices for Maximizing Security on Public Wi-Fi, Traveling with Mobile Devices: Trends & Best Practices, and Satellite Phones: Critical or Contraband?

Other Areas of Concern

Avoid township neighborhoods and Central Business Districts (CBDs), particularly after dark, unless traveling with an organized tour group or someone who knows the area. (Soweto, for example, is a known and heavily visited township enjoyable during the day or when traveling with a tour group.) Increase awareness in CBD areas during daylight, due to high crime rates and spontaneous protests often involving roadblocks and demonstrators burning tires/throwing rocks and other projectiles.

Occasionally, the U.S. Diplomatic Mission to South Africa may declare specific locations off-limits to employees because of risk of violence or other physical danger. When these same dangers apply to private citizens, the Mission will alert the public to the fact. Check the Mission website to review Security Alerts.

The U.S. Consulate General in Cape Town requires all employees use fully armored vehicles for official travel into townships in the Cape Peninsula and other areas prone to high levels of crime. Townships are less developed but heavily populated areas, generally located on but not limited to the edges of urban centers.

Transportation-Safety Situation

Road Safety and Road Conditions

Traffic moves on the left, and steering wheels are on the right side of the vehicle. Vehicles pass on either side or travel at varying speeds (some very fast, others very slow) in all lanes. It is common to see older, poorly maintained vehicles breaking down and creating road hazards. Be vigilant when driving on the highway, particularly at night. The Mission prohibits employees traveling after dark outside of most major metropolitan areas.

Texting/talking on a cell phone without a hands-free device while driving is a violation of the law and can result in heavy fines, the impoundment of your cell phone, or the solicitation of a bribe by an errant police officer.

While the highway system and toll roads are generally in good condition, automobile accidents are the highest single risk to drivers and pedestrians. This is due to dangerous driving practices, speeding, alcohol use, slow and un-roadworthy vehicles, the condition of the road surfaces, and the frequent presence of pedestrians/animals in the road outside of large cities. South Africa has a high rate of fatal traffic accidents, according to the Road Traffic Management Corporation (RTMC).

Toll roads have emergency call boxes similar to those in the U.S. Secondary roads are often in poor condition and frequently marked by potholes. Highway signage can be inconsistent; this is more evident when driving on secondary and tertiary roads. Highway lighting is limited outside major cities and towns. Road construction is often poorly marked. Many construction zones outside metropolitan areas use a “stop-and-go” approach where one lane completely closes and the adjacent lane becomes one-way, alternating between directions.

Roadway policing mainly consists of speed traps and checkpoints where officers check for mechanical malfunctions, operator compliance with license restrictions, and alcohol consumption. The legal blood alcohol limit is .05% and is strictly enforced. When stopped at a checkpoint, police may be require to see a valid driver's license. Police have stopped some foreign drivers and informed that their foreign driver’s license is not valid in South Africa, in an attempt to secure a bribe. Foreign driver’s licenses, in English or with an attached translation, are normally valid for three months. International driver’s licenses are valid and accepted for the duration of the license.

Other common road-related crimes include smash-and-grab robberies, where a robber smashes a vehicle window to grab what is easily accessible (e.g. purse, briefcase) when a motorist is stopped in traffic or at a stop light. After snatching the item, the robber flees (often into nearby townships where it is dangerous to pursue). These crimes can occur anywhere, but most are at major intersections and at highway off-ramps.

Criminals may target vehicles on the highways, but seldom do so during daylight hours. Gangs will place debris in the road and wait for a vehicle to stop after hitting the object. In another frequent scenario, an individual (or several working together) may park a vehicle on the side of the road feigning a mechanical problem in an attempt to flag down passing traffic for help. When a passerby stops to assist or to inspect damage, the criminal robs the driver of valuables and sometimes steals the car and/or assaults them. If a vehicle is on the side of the road, do not stop to render assistance. Instead, call 10-111 (nationwide emergency police number) to report the vehicle’s location so authorities can respond.

Motorists should be aware of their general geographic location and travel with a South African road atlas or a GPS navigation system. Some GPS systems may route motorists through dangerous neighborhoods/townships and/or on remote/unsafe rural roads. Always travel with a fully charged cell phone and a mobile charger. Save emergency telephone numbers for the South African Automobile Association (AA), which recognizes American Automobile Association (AAA) membership, or other roadside assistance companies. AA and other roadside assistance companies can provide armed response units that will wait with motorists until the vehicle can be repaired or towed to a service center.

As a pedestrian or cyclist, take extreme care when crossing streets or traveling on South African roads. Collisions involving vehicles and pedestrians and cyclists are common. Drivers are often aggressive toward pedestrians and cyclists and fail to yield the right-of-way, even in marked crosswalks.

Lock doors, leave no valuables in plain view, and roll up windows. Remain a safe distance behind the vehicle ahead of you to allow space for avoidance maneuvers. Wait inside your vehicle on the street until the vehicle gate is open before pulling into a residence; this will provide you an escape route if confronted. Stay on main roads and keep to well-illuminated public areas. If you think someone is following you, drive to the nearest safe area (any area that is populated or normally covered by security cameras). Use caution when traveling and be prepared with a full tank of fuel, spare tire, cell phone, water, and other supplies when traveling in rural areas.

Review OSAC’s reports, Road Safety Abroad, Driving Overseas: Best Practices, and Evasive Driving Techniques; and read the State Department’s webpage on driving and road safety abroad.

Public Transportation Conditions

U.S. Mission personnel do not use minibus taxis, hail taxis from the street, or hire taxis from taxi stands. Public transportation accidents involving trains, buses, minibus taxis, and private cars are a regular occurrence. Minibus taxi drivers are often unlicensed and may drive erratically. In addition, criminals have targeted minibus taxis and buses for hijacking and robbery. Often, the safety and security standards on public transportation systems, especially in urban areas and townships, are not on par with U.S. standards. Use individual metered taxis dispatched from established taxi companies or hotels. Rideshare is a good alternative to taxis as you can pre-confirm price, vehicle, and driver. When using Uber or other rideshare companies, use only those with a dispatch application that provides vehicle description, license plate number, and the driver’s name, picture, user rating, and the ability to share trip information. Verify the information provided, such as the vehicle make/model, license plate number, and driver’s name/picture, prior to entering the vehicle. Taxi drivers may confront rideshare drivers that pick up passengers near taxi stands. Find an alternate, well-lighted public location to meet rideshare vehicles. Do not use rideshare to travel outside major metropolitan areas or to previously disadvantaged areas.

U.S. Mission personnel do not use Metrorail service. Despite a 2004 Constitutional Court order stating that Metrorail has an obligation to ensure reasonable measures for the security of rail commuters, violent crime, accidents, and disgruntled passengers acting out are not uncommon. Shosholoza Meyl long-distance rail service; Gautrain suburban rapid rail service; and luxury rail services, such as Shosholoza Meyl Premier Classe, Blue Train and Rovos Rail are generally safe and reliable, though mechanical problems and criminal incidents do sometimes occur.

Review OSAC’s report, Security In Transit: Airplanes, Public Transport, and Overnights.

Aviation/Airport Conditions

Pilferage of luggage at OR Tambo International Airport (JNB) in Johannesburg occurs, particularly at the passenger pick-up area outside the arrivals terminal, where criminals may pose as Good Samaritans offering to assist with luggage. Do not place valuables in checked luggage.

Criminal syndicates have followed passengers from JNB and robbed them at their destination (hotel or residence) or while en route to their destination. SAPS has seen the following methods used to commit follow-from-airport robberies:

· Robbery upon arrival at a residence or hotel;

· Assailants pretend to be police, using fake badges and blue lights;

· Assailants using two vehicles block in a victim at a traffic light;

· Assailants will slightly bump a victim’s vehicle to create an accident scene.

In May 2019, an unmarked vehicle containing four individuals claiming to be police officers stopped a commercial contractor truck transporting packages from JNB to the U.S. Embassy on the R21 motorway. The fake police officers armed with AK-47 rifles forced the contractors from the vehicle before driving away with the truck.

There have been numerous incidents in which fake police officers pull over vehicles to rob passengers at gunpoint – so-called “Blue Light” robberies. Many victims report they had just withdrawn large sums of money from ATMs or exchanged money at a foreign exchange booth. If the vehicle stops for these police imposters, the criminals rob occupants at gunpoint of their valuables. These fake police officers often use unmarked vehicles with a police light in the dashboard and flash what appears to be a “badge” to pull over vehicles. In some incidents, the criminals have used modified fake, “marked police vehicles” and wear a police uniform. If a police vehicle (marked or unmarked) wants you to pull over by, turn on your emergency blinkers and drive slowly to a secure, well-illuminated area.

Terrorism Threat

The U.S. Department of State has assessed Pretoria, Cape Town, Durban, and Johannesburg, as being MEDIUM-threat locations for terrorism directed at or affecting official U.S. government interests.

Traditionally, South Africa’s nexus to international terrorism has been through recruiting, funding, and as a safe haven for international terrorists. There has been increased activity by ISIS sympathizers and supporters locally.

Anti-U.S./Anti-Western Sentiment

Anti-U.S./Anti-Western sentiment has not changed since 2017. In a Pew Research Center study released in June 2017, 53% of South African respondents had a favorable view of the U.S. Occasionally anti-capitalism groups remark that the U.S. is to blame for unemployment and other inequalities.

Political, Economic, Religious, and Ethnic Violence

The U.S. Department of State has assessed Pretoria, Cape Town, Durban, and Johannesburg, as being MEDIUM-threat locations for political violence directed at or affecting official U.S. government interests.

After more than 20 years of democratic rule since the end of apartheid, the government maintains a vibrant free society and a market-based economy. Despite inequality in income and educational opportunity, persistent poverty, a severe HIV/AIDS pandemic and violent crime, South Africa remains a successful multiparty democratic society and boasts a robust civil society.

KwaZulu-Natal, a coastal South African province, suffers from a long history of political violence. The province has been plagued with politically motivated killings of ANC, Inkatha Freedom Party (IFP), and National Freedom Party (NFP) members in contest for power and economic gain. In recent years, intra-party killings have risen significantly, with ANC members reportedly ordering the killings of rival party members, either in run up to elections, or in connection to a potential tender award or other economic benefit. The violence targets local politicians, not U.S. citizens.

Civil Unrest

Labor strikes and protests occur frequently and can be violent and disruptive; avoid them, given the frequency at which they turn violent. Gauteng Province hosts the political and economic capitals (Pretoria [Tshwane] and Johannesburg, respectively) and typically experiences more labor unrest than other provinces. Labor unions carry substantial political influence, and can mobilize thousands of people. Typical protest activities include blocking major thoroughfares between Johannesburg and Pretoria (termed “go slow”) by vehicles, or gridlocking Johannesburg’s Central Business District (CBD) with large numbers of protestors. Labor unrest affects mining, farming, retail, civil service, public transportation, private trucking, and manufacturing sectors.

Unlicensed protests have led to property destruction and assaults. Unannounced large-scale wildcat strikes have occurred in the mining sector and in agricultural areas in the Western Cape in recent years. These wildcat strikes involved thousands of workers and led to numerous deaths, injuries, and extensive property damage.

Although not connected to industrial action, another form of protest is “service delivery protests,” which often flare up in neighborhoods when water, electricity, or other public utilities are cut off. These protests often result in burning tires, stoning vehicles, and blocking roads.

Review OSAC’s report, Surviving a Protest.

Religious/Ethnic Violence

Migrants, refugees, and asylum seekers from other African countries perceived to be competing for jobs with South Africans are sometimes the target of attacks. These attacks are often violent and mainly occur in the largest townships and in CBDs. The government attributes the attacks to high unemployment (the official unemployment rate is 26.7%), and has challenges in addressing the root causes. Bystanders have captured local law enforcement officers on video standing idly as vandals loot shops. As a result, those living in urban areas are prone to resolve matters on their own, leading to further conflict and violence. In recent years, several well-publicized fatal incidents have involved mob attacks on citizens of other African and South Asian countries. Authorities seldom prosecute perpetrators successfully.

Post-specific Concerns

Environmental Hazards

Beginning in 2015, South Africa has been in the midst of its worst drought since 1982, with water shortages across the country. Although the severity of the drought is episodic, many areas of South Africa are still experiencing severe drought and tight water restrictions. Funding for long-term water projects is limited due mainly to a lagging economy, inefficient management of water infrastructure, and non-payment for services rendered.

In March 2017, the city of Cape Town declared a state of disaster due to drought, and the Western Cape government declared a state of disaster throughout the province in May 2017. The Government has implemented restrictions on water usage and urges all residents and visitors to minimize their consumption of water. Restrictions and rationing of water may become more stringent as the available supply dwindles. The City of Cape Town website contains current information on reservoir levels and water restrictions

During the rainy season, thunderstorms, lightning strikes, or water damage often disrupt power to alarm systems, traffic lights, and other electronic equipment. Use adequate surge protectors to protect computers and other electric equipment.

While visiting game parks and reserves, it is dangerous to leave your vehicle or be on foot, even in the presence of a guide. Observe all local/park regulations and exercise appropriate caution in unfamiliar surroundings. Wild animals have seriously injured and killed visitors. Even in the most serene settings, wild animals present a threat to life and safety. Be mindful of the possible presence of sharks when swimming or engaging in water sports. Accidents can occur when swimming in the ocean or walking/climbing on shore areas not designated as lifeguard-patrolled beaches. Do not swim alone in isolated beach areas and do not dive into unknown bodies of water, as hidden rocks, fast-moving currents, or shallow depths can cause serious injury or death. Rip tides are common and unpredictable. On public and private beaches alike, be sure to swim in marked and guarded areas.

Critical Infrastructure

Although the infrastructure is relatively stable, it is not without challenges. Consumer demands, insufficient power generation, and the theft of electrical wire and other equipment often interfere with the government-owned utilities’ ability to supply power. South Africa’s primary electricity supplier, Eskom, periodically conducts load shedding (rolling blackouts) to safeguard the electrical grid. Electricity outages have increased even though Eskom has brought new generation capacity online. Eskom continues to address overdue maintenance issues and upgrades infrastructure, but these fixes have not eased load shedding.

Landline telephones are becoming more unreliable and difficult to maintain or replace. Copper wire is a target of theft and, therefore, is scarce. Telephone systems are saturated, making it increasingly difficult to get new phone numbers and to have landlines installed or replaced.

Economic Espionage/Intellectual Property Theft

National, provincial, and local governments remain committed to combating the production and importation of counterfeit products and to enforcing intellectual property rights per World Trade Organization (WTO) commitments. However, the demand for name brand items at all socio-economic levels sustains the demand for counterfeit products (e.g. music, clothing, accessories). South Africa has made progress against counterfeit digital media through close cooperation between authorities and industry.

Importation of manufactured counterfeit products has been more difficult to stem. One manufacturer of a U.S. clothing brand in Durban is working with local authorities to remove Chinese-made imitations from the streets and to halt importation of these items. The inability to find the source of the counterfeit products has hampered local investigations. The U.S. Mission is in close contact with the South Africa Companies and Intellectual Property Commission (CIPC) in combating counterfeiting and protecting intellectual property rights.

Personal Identity Concerns

South Africa is one of the most progressive countries in the world in the protection of LGBTI rights, but it still faces several challenges. The Constitution outlaws discrimination based on sexual orientation and same-sex marriage has been legal since 2006. Although the legal system protects LGBTI individuals, public attitudes are divergent. Human rights groups report that the local LGBTI community, particularly in the townships, is subject to hate crimes, gender violence, and targeted killings. There have been no reports of violence against U.S. citizens or tourists because of their sexual orientation. LGBTI travelers outside of major cities should exercise caution when visiting traditional communities, as they may be less accepting of public displays of affection or LGBTI culture than in major cities and tourist destinations. Review the State Department’s webpage on security for LGBTI+ travelers and female travelers.

Review OSAC’s report, Freedom to Practice, and the State Department’s webpage on security for faith-based travelers.

South Africa law mandates access to buildings for persons with disabilities, but these laws are rarely enforced. However, many tourist attractions, and restaurants near tourist attractions, have with ramps and other options to facilitate access. Review the State Department’s webpage on security for travelers with disabilities.

Drug-related Crime

South Africa is the largest market for illicit drugs in sub-Saharan Africa, and serves as a transshipment point for cocaine and heroin primarily destined for Europe. South American cocaine enters South Africa primarily via air to Johannesburg’s O.R. Tambo International Airport. A portion diverts for local consumption and the remainder continues internationally, often in the hands of Nigerian criminal organizations. Heroin, primarily of Afghan origin, typically arrives in ports in Tanzania, Kenya, and Mozambique from southwest Asia before being subsequently smuggled overland into South Africa, often transiting Zambia and Botswana. Heroin not consumed within South Africa then continues via air to Europe, although a small percentage ships to the United States. Drug producers synthesize methamphetamine (known locally as “tik”), methcathinone (“cat”), and methaqualone in South Africa from precursor chemicals imported primarily from India and China.

Cannabis is legal in South Africa. However, a dangerous mixture called “Nyaope” has emerged in poorer communities, combining heroin and marijuana, often mixed with other toxic substances. Quantifying domestic drug use is difficult. The stated goals of South Africa’s National Drug Master Plan are to “reduce illicit drug supply, demand, and harm,” but insufficient resources and limited capacity challenge implementation. An ongoing nationwide anti-crime operation, Operation Fiela, focuses enforcement efforts on geographic areas identified as havens of illegal drugs, weapons, and other illegal activities. However, Operation Fiela has attracted controversy for its alleged targeting of foreign nationals. The nationwide operation involves police and military raids, and has resulted in the arrest of an estimated 10,000 suspects and the seizure of large quantities of weapons and drugs.

South Africa cooperates with international counterparts to increase the impact of its efforts against transnational drug trafficking and other forms of crime. U.S. law enforcement agencies effectively coordinate with South African counterparts on investigations and operations and provide training to build capacity.

Kidnapping Threat

Kidnap-for-ransom (KFR) has occurred on few occasions, sometimes involving ISIS sympathizers. U.S. citizens have not been the target of kidnap for political gain. There have been a few cases of criminals misrepresenting themselves as legitimate businesspersons and abducting U.S. citizens seeking business opportunities. In August 2019, a U.S. Embassy local-hire employee reported that he and his family were the victims of an armed robbery and kidnapping while visiting family graves at the Odi Cemetery in the Mabopane Township of North Pretoria. Three male suspects, all armed with handguns, ordered the victims to lay on the ground; they then proceeded to take the Embassy employee’s shoes, car keys, wallet, work and personal cell phones, money, and a couple of personal items from the car. The criminals secured the employee in the trunk of his own car and relocated his wife and son into the passenger compartment of the vehicle. The three suspects got inside employee’s car and drove for approximately five kilometers from the scene before getting out of the car and throwing the car keys in the bushes. All three suspects departed without further incident. Review OSAC’s report, Kidnapping: The Basics.

Other Issues

Review OSAC’s report, Picture This: Dos and Don’ts for Photography.

Read the State Department’s webpage on customs and import restrictions for information on what you cannot take into or out of other countries.

Police Response

SAPS has made a strong effort to decrease its response time in recent years. While active crimes will take precedence over crimes that have happened in the past, SAPS tries to respond to incidents within a reasonable time. SAPS patrol vehicles will typically be the first responding unit and can open a case docket and take statements at the scene, or can advise the complainant to report the crime at the nearest police station. There are effective detective programs at all SAPS stations, and a detective is on duty 24/7. Once the detective receives a case and they are ready to continue the investigation, they will generally contact the complainant.

The formation and use of community watch groups is increasing slowly. They complement SAPS efforts to detect/deter crime and provide improved response to calls of a serious nature. Though there has been an improvement in community policing, the public mistrusts police and sees them as corrupt. Corruption does occur in South Africa. Complaints of street level shakedowns for money or similar forms of harassment are not common among the U.S. expatriate community, but can happen. According to the Ethics Institute’s 2017 South Africa Citizen’s Bribery Survey, 37% of respondents knew someone who had been asked to pay a bribe in the past year. On occasion, police officers have informed motorists that they can pay a fine directly to the officer in a speed trap or at a road-worthy checkpoint. If this occurs, the best course of action is to advise the officer to provide a citation and that you will pay the fine at a police station.

The emergency line in South Africa is 10-111 from any phone or 112 from a mobile phone. Download the State Department’s Crime Victims Assistance brochure.

Police/Security Agencies

SAPS has nationwide policing responsibilities broken down into national, provincial and municipal levels. In addition to SAPS, there are various traffic and metropolitan police departments throughout South Africa. The National Traffic Police has authority to enforce traffic laws throughout South Africa, especially on all major highways. In addition, there are traffic police departments at the provincial level in each of South Africa’s nine provinces. The metropolitan police departments enforce traffic and criminal offensives in their areas of operation.

For residential/commercial properties in affluent neighborhoods, the use of private security companies is normal for first response to a crime in progress. These private companies generally have 1-2 armed officers in response vehicles and patrol neighborhoods throughout the day. While more affluent areas employ roving security reaction units with the responsibility of responding to violent crimes, these patrols have done little to decrease the prevalence of these crimes.

Medical Emergencies

The private health care sector in South Africa ranks among the best in the world. Counterfeit medication is not a significant problem in South Africa, but the lack of effective border controls, well-organized criminal syndicates controlling these illicit practices, and the tremendous amount of proceeds they generate means counterfeit medications may become a challenge. These illicit practices affect all levels of society, although the poor are the primary targets. If you believe your medication might be counterfeit, immediately return it and/or report to SAPS or local authorities.

Three private health corporations, NetCare, Mediclinic, and Life Hospitals, dominate the private health care system in South Africa. Each corporation runs approximately 60 hospitals throughout the country. Nearly every medium-sized city, including those near remote game parks, has at least one private hospital operated by one of these corporations. The more remote hospitals provide less specialized care; it is best to transfer to a corporate hospital if you are significantly ill or injured. The three corporate websites have excellent search tools to find a hospital, clinic, or doctor anywhere in South Africa. You may also find contact information for available medical services and available air ambulance services on the U.S. Consulate Johannesburg website.

U.S. government employees in Africa often evacuate to South Africa for medical treatment. Travelers should purchase traveler/medical evacuation insurance policies. Medical facilities in South Africa generally do not accept U.S. health insurance. A foreigner without local health insurance may have to pay for medical services in advance with cash or a major credit card. Hospitals may refer those unable to pay a deposit to the closest public health facility for treatment. Review the State Department’s webpage on insurance overseas.

HIV/AIDS remains a major public health concern. Due to South Africa’s high HIV infection rate, seek immediate medical assistance in the event of a sexual assault, high-risk sexual encounter, or blood-borne injury.

Travelers entering South Africa from World Health Organization (WHO) yellow fever-designated countries must present their current and valid International Certificate of Vaccination record (commonly called a “yellow card”) as approved by the WHO or a statement of medical exemption (also located on the same “yellow card”). Yellow fever vaccination must have been administered at least ten days prior to arrival, in accordance with WHO regulations. Immigration inspectors do not generally accept letters, scans, copies, or faxes regarding prior yellow fever vaccination. Authorities enforce this requirement on travelers flying to South Africa via any WHO-designated yellow fever country, even if the plane makes an unscheduled landing in a yellow fever country; passengers in transit from the United States through Senegal and Ghana, and who do not leave the aircraft, do not require a yellow fever certificate. While authorities may not apply this requirement consistently, those who cannot present an original, valid yellow card risk refusal of entry. South Africa does not administer yellow fever vaccination at ports of entry. According to the WHO, a yellow fever vaccination is now valid for life and does not require renewal after a period of time; however, not all countries honor this new guideline.

Malaria does exist in low-elevation areas in the northeast, including Kruger National Park; the border with Mozambique; in Gauteng province. Individuals traveling to these areas should consult their medical provider or a travel medical clinic regarding prophylactic malaria medications, and take precautions to avoid mosquito bites.

South Africa has the world’s third-highest rate of tuberculosis (TB), behind India and China, with statistics estimating 322,000 cases of active TB in 2017. TB continues to be the leading cause of death in South Africa. WHO gives a figure of 22,000 deaths from TB in South Africa in 2017, but this excludes those people who had both TB and HIV infection when they died.

The CDC offers additional information on vaccines and health guidance for South Africa.

Water is potable from most city taps, and food bought from grocery chains does not require decontamination.

Review OSAC’s reports, The Healthy Way, Traveling with Medication, I’m Drinking What in My Water?, Shaken: The Don’ts of Alcohol Abroad, Health 101: How to Prepare for Travel, and Fire Safety Abroad.