Cape Town, South Africa – The gates of the Town Two Clinic in Khayelitsha are chained shut, a stark and silent testament to the brazen power of extortion gangs who have forced a vital public health facility to cease operations. The closure has left thousands of residents, including the elderly and chronically ill, without access to essential medical care, and shines a harsh spotlight on the escalating crisis of "protection rackets" holding Cape Town's townships hostage.
The breaking point came in the early hours of Monday morning, when armed men stormed the clinic, not to seek medical help, but to demand money. They seized two security guards, holding them against their will while they contacted the guards' employer with a chilling ultimatum: pay a "protection fee," or face the consequences.
The security company, which has not been named out of concern for its safety, refused to pay the ransom. In response, the gangsters threatened to return and "cause havoc," a promise of violence that could endanger staff and patients alike. Faced with such a direct and credible threat, the City of Cape Town, which runs the facility, made the difficult decision to close the clinic indefinitely as a precautionary measure.
"The men, in turn, threatened the guards, saying if the money was not paid, they would come back to the clinic and cause havoc," confirmed Ward 93 councillor Thando Pimpi.
For the community, the impact is immediate and devastating. Signage placed at the closed clinic now directs patients to the nearest alternative facilities—Matthew Goniwe, Luvuyo, and Mayenzeke clinics—forcing sick and vulnerable people to travel long distances for care. A temporary mobile clinic has been set up at the Metro Police offices in Mandela Park, but it can only offer limited services.
"It is sad that sick people, including old people, must walk long distances to other clinics to collect their medication," said Mzanywa Ndibongo, chairperson of the Khayelitsha Health Forum. "We cannot allow the hooligans to dictate to us."
A Climate of Fear
The fear is palpable. When journalists visited the deserted clinic, a lone security guard was on duty, but pointedly not in uniform. Speaking on condition of anonymity, he laid bare the terror these gangs inspire.
"I don't want people to identify me as a guard. It's for my own safety," he said. "I'm scared of the thugs in a big way, and I am putting my life at risk by coming to work."
His fear is a reflection of a much larger scourge. The incident at Town Two Clinic is not an isolated one, but a symptom of a rampant and organised extortion economy spreading like a cancer through Cape Town's townships. From Khayelitsha to Philippi and Nyanga, criminal syndicates are preying on businesses, construction sites, and now, essential public services.
The model is brutally simple. Gangs demand monthly "protection fees," typically ranging from R500 to R1,000, from businesses as small as roadside vegetable stalls and hair salons. Those who refuse to pay are threatened, assaulted, or have their property vandalised. For many small business owners, whose monthly profits are often less than R2,000, the choice is between paying the gangs or closing down and losing their livelihood entirely.
"These protection fee guys are taking food out of our mouths, because we have to pay money we don't have," one fruit seller in Philippi told reporters. "Many businesses around here have closed because they cannot afford the exorbitant fees. They have guns and wear face masks. We are helpless and hopeless."
Another resident who used to rent out rooms explained the impossible situation: "It is either you pay, or you, your family or clients are hurt."
A Failing System?
The crisis has grown so severe that it is crippling not only the township economy but also the delivery of basic municipal services. Refuse collection, infrastructure projects, and even ambulance services have been suspended in various areas after staff and contractors were threatened. The City of Cape Town reports that the cost of protecting its projects from these "construction mafias" is unsustainable, diverting millions of rands from service delivery to private security.
"Instead of delivering 1,000 houses you're going to deliver 900 houses because a chunk of your money is being wasted on security that shouldn't be needed," stated Mayoral Committee Member for Safety and Security, JP Smith.
While the South African Police Service (SAPS) insists that fighting extortion is a "very high on the priority list" and has established a dedicated task team, residents and community leaders see little progress on the ground. Many victims are too terrified to report the crimes, having received death threats for even considering it. This creates a vicious cycle of silence and impunity.
"We are concerned about the growth of the protection fee syndicate because people must now pay a protection fee before they get services," said Nokuthula Dyantyi, a resident living next to the closed clinic.
The City has launched its own "Enough is Enough" campaign, urging residents to use an anonymous tip-off line, but acknowledges that without effective arrests and convictions, the problem will persist. The closure of the Town Two Clinic is a painful illustration of this reality. It shows that these criminal networks have become so emboldened that they are willing to deprive an entire community of its right to healthcare to enforce their demands.
As provincial detectives from the serious violent crime unit investigate the incident, a community waits in hope and fear. They hope for the swift reopening of their clinic and for justice to be served. But they fear that this is just the beginning, and that the services they depend on for their very survival remain at the mercy of gunmen in the shadows.
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