Human Rights Violations and Mistrust among Refugees in South Africa: Implications for Public Health during the COVID Pandemic
Round 1
Reviewer 1 Report
Very well written and researched.
Some suggestions for stronger clarity: End the introduction with “the aim of this study…” and say how this is accomplished - through interviews, etc. A simple nod to tell the reader what to expect.
The method section needs expanding a bit to set up the methodological approach - the method used (interviews) needs theoretical justification. Why not ethnography or observation or surveys? Meaning, guide the reader from the lit review to justify the choice to do interviews, and rely on the methodological approaches of others. For example, Paula Saukko’s “Doing Research in Cultural Studies” would be useful to help boost this section (before identifying participants). Likewise, rely on the literature to justify snowball sampling in the context of this particular research.
Finally, and minor - it’s not always clear if italics are added for emphasis or if it’s a stylistic choice to identify a quote. There are quotes not in italics (or at least attributed in parentheses as if they are quotes). This needs to be clearer.
I look forward to seeing this published.
Author Response
Please see the attached.
Author Response File: 
Author Response.docx
Reviewer 2 Report
The paper is an interesting case study on the perception of discrimination in refugee communities with respect to access to health services in South Africa. However it misses a) a broader embedding into an international theoretic literature on structural discrimination of vulnerable groups (and in particular within public health systems(; b) a more structured framework for identifying factors of discrimination. Is discrimination arising from refugees being treated differently to other groups of the population (which amounts to a deliberate and targeted discrimination), or are they differently affected by rules which are the same for everyone, because they have different needs (e.g. access denied to accompanying persons might be the same for everyone, but for refugees it is a particular problem, because they then have no interpreter); c) a clearer argumentative linkage between "discrimination in access to health services" and distrust. Conspiracy theories arise for a number of reasons in different communities and if we could get rid of conspiracies just by sufficient information in an accessible language and non-discrimination, we would not have any conspiracies about COVID within the male, white, native population in the US or Western Europe - but we have. Is there data on "trust" in Covid-19 policies in other South African communities? Is the refugee community here standing out compared to other vulnerable groups? Are the effects different? This would allow to position the results in the broader field of factors leading to distrust.
Until the end the question to be answered by this research is not fully clear: is it about the systematic discrimination of refugess in the health sector and how this further deteriorated during COVID19 or is it about the response of the refugee community to the pandemic? By clarifying the focus the argument can be sharpened and clearer causal linkages can be provided.
Author Response
Please see the attached.
Author Response File: Author Response.docx
