This article relates the legal status of Mozambicans in South Africa from 1985 onwards to key findings of a demographic census taken in 1992, an environmental health survey conducted in 1993, and in-depth fieldwork in some of the surveyed settlements in 1995. The case study area on the border with Mozambique is typical of South Africa's rural former homelands, with the exception that it has a large and long-standing refugee population. The environmental health indicators for refugees are considerably worse than for their hosts, and in-depth fieldwork suggests that this can be attributed to their legal and political vulnerability. This raises issues for South Africa's Reconstruction and Development Program, as well as conceptual challenges for promoters of human rights.