South African vigilante group Operation Dudula has been organizing blockades at public hospitals, denying access to people they claim are migrants. Politicians use health care as a pretext for virulent anti-foreigner rhetoric. Former armed robber Gayton Mackenzie said he would eagerly “turn off the oxygen” of migrants on life support.

Foreigners are a convenient scapegoat for the catastrophic state of health. Chronic mismanagement, systematic corruption and a general contempt for the public are seen in the Life Esidimeni scandal, where 144 patients died from neglect. Operation Dudula and Mackenzie’s Patriotic Alliance have astutely tapped into a widespread sense of public anger at the government. But while post-apartheid South Africa has seen regular violence against African and Asian migrants, xenophobia is increasingly being organized into paramilitary and political formations.

The online accounts and public statements of Dudula members are saturated with, not only resentment toward migrants but domestic criminals and incompetent political leadership. In these spaces, legitimate news mixes freely with disinformation and conspiracy theories. But the veracity is not the point—together they convey a convincing emotional reality. That is the dreadful conclusion that South Africa is in a state of social collapse, a fear that has been escalated by the long-term fallout from the COVID-19 pandemic.

Throughout history, pandemics have acted like psychic depth charges on societies, dredging apocalyptic and extremist ideas from the depths. But rather than offering actual political and economic solutions to  this disturbing reality, xenophobic politics in South Africa rests on the implied promise of purging society of what they imagine as subhuman criminals and free-loading immigrants.

Anti-migrant groups are also connected to trucking and business ‘forums, which are effectively extortion rackets. Ironically, groups loudly espousing pro-law and order sentiments are actively involved in public violence and infrastructure sabotage.

A situation of economic misery, war, disease and the rise of extremist groups is a disturbing echo of the politics of a century ago when democratic governments across the world descended into right-wing authoritarianism.

Nazi Germany was especially obsessed with health, dominated by ideas of survival of the fittest and using eugenics to create perfect Aryan specimens. The reverse side of these pseudo-scientific fantasies was of using violence to purge “degeneracy.” While this was extended to groups ranging from the physically disabled to leftists, the main focus was on obsessive anti-Semitism, with Jewish people accused of spreading disease and compared to lice.

As JG Ballard observed, Hitler’s Mein Kampf amounted to 700 pages of biological paranoia. But while these ideas were the work of an obsessive crank, the crisis that propelled the Nazis into power allowed these deranged fantasies to become state policy, paving the way for extermination camps and the Holocaust.

As with Mackenzie, leaders like Hitler and Mussolini were at one point seen as grifters and failures, but in a climate of constant political and economic turmoil, they rebranded themselves as the forces of order. Twentieth-century fascists cultivated old human fears of contagion and death. Obsessive hatred of foreigners was not just an irrational outburst but became a cypher for the anxiety and shocks of modernity and capitalism. It created a powerful explanation for social strife and personal misery. Otto Fenichel, a Marxist psychologist forced to flee Nazi Germany, argued that this hatred became a band-aid to disguise the disturbing fact that “one’s own unconscious is also foreign.”

These parallels with contemporary South Africa are even more disturbing because xenophobic politics take place against a rising global tide of extreme nationalism and far-right culture war. But while contemporary movements share the hate-filled rhetoric and medical obsessions of historical fascism, there are key differences. Hitler and Mussolini wanted to replace parliamentary democracies with personal dictatorships, while many of today’s movements are prepared to work within the system, for now.

Operation Dudula has not articulated any vision of an alternative society, but rather wants the current and dysfunctional status quo exclusively reserved for South Africans. Their modus operandi parallels European parties like the Sweden Democrats. Once overtly Neo-Nazi, they have now recalibrated themselves as a parliamentary organization that protects public welfare, such as health, from immigrants.

Furthermore, the extra-parliamentary space of street politics claimed by Operation Dudula may also have the consequence of putting pressure on the ANC to adopt a more right-wing stance. In the wake of worsening social and economic conditions, anti-migrant policies, and other reactionary obsessions, may soon be one of the few things left for the party to campaign on.

Both organizations represent the contemporary politics of the “armed lifeboat.” In a world of increasing economic and ecological disaster, they push for countries to fortify themselves against outsiders. This takes place between the global North and poorer countries, as seen in Trump’s weaponization of anti-immigrant rhetoric. But, as recent events have shown, this can also take place within global South countries. Rather than offer any kind of principled stand, South African political leaders have accepted the expedient claims that the health-care system is swamped by foreigners as a convenient distraction from their own failings.

Empowered by their hospital demonstrations, Operation Dudula is now calling for the declaration of a national state of emergency around immigration. Behind this bluster is a dangerous political tactic. As Nazi political theorist Carl Schmitt argued, this state of exception is central to normalizing extremist ideas in the name of protecting the social “body.”

By calling on a pathological language of illness and domination, xenophobic groups are offering destructive solutions to social crises. In lieu of progressive and humanistic alternatives, there is a very real danger that tomorrow may, once again,  belong to them.