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A group of wellwishers carrying get-well placards arrive at the Mediclinic Heart Hospital where former South African President Nelson Mandela is being treated in Pretoria, June 16, 2013.Ben Curtis/The Associated Press

It's the most exclusive prize in town: access to Nelson Mandela's hospital room. And what should be primarily a medical issue has, inevitably, become intertwined with sensitive questions of politics, power and celebrity.

South African police are tightening their control of the Pretoria hospital where the frail 94-year-old liberation hero has spent the past 10 days for treatment of a recurring lung infection. But in an intensely partisan climate, with an election looming next year, there are mounting questions about who can visit Mr. Mandela – and why.

Mr. Mandela himself has been retired from politics since the end of his presidential term in 1999, but he remains one of the most iconic personalities in the world, and the battle for access to him has sparked disputes among politicians, doctors, bodyguards and the media. The gatekeepers to Mr. Mandela often have their own agendas and interests, critics say.

At the hospital where Mr. Mandela is being treated, there is an increasingly heavy police presence. Cars are searched at the entrance, elevators and stairwells are watched, and relatives of other patients at the hospital have complained that they are being stopped and harassed.

South Africa's ruling party, the African National Congress, announced last week that only "relevant people" should have access to the former president. It cited the "pressure" and "restrictions" of his hospital admission, and it said it had "deferred this responsibility" to President Jacob Zuma.

But when Mr. Zuma visited Mr. Mandela in hospital last Thursday night, he brought with him a senior ANC leader: the treasurer-general, Zweli Mkhize. The President did not explain why he was accompanied by a top politician who had no official duties at the hospital.

"There could be no reason for this other than a political one," said a commentary in a leading South African newspaper, the Sunday Times, on the weekend.

It said the ANC was clearly using its association with Mr. Mandela "to win votes" in the upcoming election. "Instead of Zuma's visit being used to demonstrate unity, he turned it into a party-political affair," the newspaper said.

Mr. Zuma also acknowledged that he had the flu last week. Normally anyone with a contagious illness would not be permitted into the hospital room of a weak and vulnerable patient, but Mr. Zuma's spokesman insisted to journalists that the visit was medically approved.

Mr. Zuma was widely criticized in late April for bringing a group of ANC officials to Mr. Mandela's home to pose for television pictures with the obviously feeble and frozen-faced former president, who seemed unresponsive to his visitors.

Since his latest hospital admission, Mr. Mandela has been getting a stream of daily visits from his family members, including children and grandchildren, along with his wife, Graca Machel, and his ex-wife, Winnie Madikizela-Mandela (herself an ANC member of Parliament). But some of his closest and oldest friends have been conspicuous by their absence – apparently because Mr. Mandela's medical team has discouraged them from visiting.

Now one of Mr. Mandela's police bodyguards has made a series of sensational allegations against the medical staff, accusing them of controlling access to Mr. Mandela and using that control for their own photo opportunities.

The bodyguard, Warrant Officer Shaun van Heerden, said the former president is "very lonely" because his doctors have "put him right back in prison again" by preventing his friends from visiting him.

"For these medical people, it's all about photo opportunities with Madiba and him signing autographs," the bodyguard told a South African newspaper, the Saturday Star, using the affectionate clan name for Mr. Mandela.

"Sometimes they would come to his room late at night and put copies of his book under his hands to be signed," said WO van Heerden, who has been a member of Mr. Mandela's special protection unit for nearly 10 years.

"Whenever a special guest comes to see Madiba, they want to be in the picture with him," he said, citing the example of former U.S. secretary of state Hillary Clinton, who visited Mr. Mandela last year.

The Mandela medical team is headed by the military surgeon-general, Vejay Ramlakan, a long-time ANC member who was imprisoned with Mr. Mandela and other political prisoners at Robben Island in the apartheid era. He has not commented publicly on the bodyguard's accusations.