STUDENT SUCCESS: Celebrating at Nelson Mandela University’s April graduation ceremony are Master of Philosophy in IT Governance student Unarine Jerritha Manari (left) and her supervisor, lecturer Rofhiwa Rodney Ramaru.
That is the warning from Nelson Mandela University researcher Unarine Jerritha Manari, whose Master of Philosophy in IT Governance study explored the cybersecurity risks facing the country’s increasingly digital healthcare sector.
Her research examined the growing risks linked to the Internet of Medical Things (IoMT) — connected devices and healthcare systems that collect, monitor and share patient data online. These include wearable health monitors, patient monitoring systems and smart medical devices increasingly used in hospitals and clinics.
“Cybersecurity in healthcare should be treated as a core patient safety priority, not just an IT concern,” says Manari, who was supervised by Rofhiwa Rodney Ramaru from the University’s IT Management and Governance Department and graduated in April.
Born and raised in a village outside Thohoyandou in Limpopo, Manari completed a BCom in Accounting at the University of Venda before moving into IT governance and cybersecurity after securing an IT Audit internship at an international telecommunications company in 2014.
That experience sparked what would become a career in cybersecurity.
“My interest in information technology and cybersecurity began during my IT Audit internship,” says Manari. “Through that experience, I was exposed to the intersection of technology, risk, and governance, which sparked a genuine passion for IT.”
Now a senior cybersecurity specialist and researcher in the scientific research, development and innovation sector, Manari also served as technical lead for the cybersecurity workstream on a national health project at the Council for Scientific and Industrial Research (CSIR).
When cyberattacks become life-threatening
Manari says the urgency of healthcare cybersecurity became especially clear during her work on the national health project.
“That experience highlighted the critical importance of securing healthcare systems and protecting sensitive patient information,” she says.
Her research found that attacks on healthcare systems can have consequences far beyond stolen information.
“Risks go far beyond just data theft,” says Manari. “A compromise can lead to disruption of critical medical services, delayed or incorrect treatment, manipulation of patient data, and even threats to patient safety and life.”
According to Ramaru, South Africa is currently the most targeted country on the African continent for cyberattacks, with healthcare institutions increasingly under pressure.
“In 2025, healthcare organisations across Africa faced an average of 3 575 weekly attacks — a 38% surge from the previous year. Cyber threats against healthcare systems are becoming increasingly severe as hospitals and medical services grow more digitally connected.”
South Africa’s digital healthcare gaps
Manari’s research identified several major weaknesses affecting healthcare cybersecurity systems in South Africa, including outdated systems, weak governance structures, limited funding and a shortage of cybersecurity skills.
She says the public healthcare sector remains especially vulnerable because many facilities are under-resourced and still rely on outdated technology.
“The private sector is in a better position as compared to the public sector,” she says. “Outdated systems and lack of cybersecurity skills remain a major concern.”
One of the findings that concerned her most was the lack of African research focusing specifically on cybersecurity risks linked to connected healthcare technologies.
Another major concern, she says, is the shortage of specialised skills needed to manage increasingly complex digital healthcare systems safely.
Her research proposes several mitigation strategies, including stronger cybersecurity governance, improved access controls, better encryption, regular vulnerability management and greater awareness training across the healthcare sector.
She says cybersecurity failures are often driven as much by human behaviour as by technology itself.
“Many of the biggest risks come from human behaviour and decision-making,” says Manari. “Healthcare professionals or even patients may unintentionally expose devices through weak passwords, phishing attacks, misconfigurations, or lack of awareness.”
Building trust in digital healthcare
As healthcare systems become increasingly digital, Manari believes strong cybersecurity will play a critical role in building public trust in healthcare technologies and services.
“Without strong cybersecurity, users and organisations are less willing to adopt digital technologies due to risks like data breaches, fraud, and system disruptions,” she says.
Ramaru says secure digital healthcare systems are also essential for South Africa’s broader digital economy.
“Patients will not adopt telemedicine platforms they do not trust,” he says. “Research that strengthens cybersecurity governance directly underpins the trust that digital markets depend on.”
Manari hopes her research will help strengthen governance practices, influence future cybersecurity policy and support the development of secure healthcare systems that can improve access to medical services, particularly in rural communities.
She also plans to pursue a PhD next year while continuing her work in building secure and resilient health systems.
For Manari, the message behind the research is ultimately a practical one.
“Healthcare providers and policymakers must proactively invest in strong governance, resilient systems and continuous education, training and awareness to protect patient data, ensure service continuity, and safeguard lives in this increasingly connected digital environment,” she says.
South Africa’s healthcare sector already under cyberattack
Several recent cyber incidents have highlighted the growing risks facing South Africa’s healthcare sector as hospitals and laboratories become increasingly dependent on digital systems, says Mandela University’s Rofhiwa Ramaru.
Mediclinic Southern Africa was hit by a cyber extortion attack in May 2025, while the National Health Laboratory Service suffered a ransomware attack that disrupted blood test processing nationwide. Lancet Laboratories also faced regulatory penalties linked to data breach notification failures under the Protection of Personal Information Act (POPIA).
According to Ramaru, healthcare institutions remain attractive targets because they cannot afford prolonged downtime.
“The most serious risk is direct patient harm,” says Ramaru. “When ransomware hits a hospital network, patient monitors freeze, surgical robots stop, and access to electronic health records is lost.”
Ramaru also warns that patient health information remains one of the most valuable forms of data targeted by cybercriminals because of its long-term personal and financial value.
As healthcare systems become more digitally connected, he says stronger cybersecurity protections are essential for safeguarding both patient safety and public trust.
ABOUT NELSON MANDELA UNIVERSITY
Nelson Mandela University is in the coastal city of Gqeberha, in the Eastern Cape, South Africa, with a campus in George.
The largest university in the southern and eastern Cape, its existence is a result of a merger of the University of Port Elizabeth, Port Elizabeth Technikon and the Port Elizabeth campus of Vista University. It was initially named Nelson Mandela Metropolitan University in 2004, in line with the restructuring of the higher education sector. However, in 2017, it was renamed Nelson Mandela University, the only higher education institution in the world to carry the name of South Africa’s former president, Nelson Rolihlahla Mandela. Its values are based on respect for diversity, excellence, Ubuntu, social justice and equality, integrity and sustainable stewardship.
This comprehensive University offers degree, diploma and certificate courses. Spread over seven campuses, it is home to over 30 000 students. More than 500 study programmes are offered in seven faculties: Business and Economic Sciences; Education; Engineering, the Built Environment and Technology; Health Sciences; Humanities; Law and Science.
Nelson Mandela University is reputed for its excellence in, among others, art and design, building, chartered accounting, engineering, health and environmental sciences and information technology. Its state-of-the-art Ocean Sciences campus is one of its kind in the country. This campus’s range of marine and maritime education and training, research, innovation and engagement programmes is aimed at supporting the continent’s blue (ocean) economy.
The University is home to the country’s 10th Medical School, unique in South Africa as its comprehensive primary healthcare approach focuses on the four pillars of medicine: disease prevention, health promotion, treatment and rehabilitative medicine.