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ARTICLES

Health, Surveillance and Community: South Africa's Experiment with Medical Reform in the 1940s and 1950s

Pages 244-266 | Published online: 14 Jan 2009

  • Marks , S. , Harrison , D. , Phillips , H. T. , Susser , M. , Yach , D. , Tollman , S. M. , Tollman , S. M. , Marks , S. , Andersson , N. , Feierman , S. and Janzen , J. 1997 . American Journal of Public Health , 87 : 452 – 59 . eds, The Social Basis of Health and Healing in Africa (Berkeley, 1992), 131–61 South African Medical Journal, 83 (1993), 679–84; American Journal of Public Health, 83 (1993), 1037–39; American Journal of Public Health, 83 (1993), 1039–42; Era’, American Journal of Public Health, 83 (1993), 1043–50; Social Science and Medicine, 32 (1991), 633–42;
  • Marks , S. and Andersson , N. 1917–50 . Disease, Medicine, and Empire: Perspective on Western Medicine and the Experience of European Expansion Edited by: MacLeod , R. and Lewis , M. 257 – 83 . London and New York ‘Typhus and Social Control: South Africa,’, in, eds, (1988,;R.M. Packard, ‘Agricultural Development, Migrant Labour and the Resurgence of Malaria in Swaziland’, Social Science and Medicine, 22 (1986), 861–7;R.M. Packard, ‘Tuberculosis and the Development of Industrial Health Policies on the Witwatersrand 1902–32’, Journal of Southern African Studies, 13 (1987), 187–209;R.M. Packard, ‘Industrial Production, Health and Disease in Sub-Saharan Africa’, Social Science and Medicine, 28 (1989), 475–96;R.M. Packard, White Plague, Black Labour: Tuberculosis and the Political Economy of Health and Disease in South Africa (Berkeley, 1989);R.M. Packard, ‘Industrialisation, Rural Poverty and Tuberculosis in South Africa, 1850–1950’, in Feierman and Janzen, Social Basis of Health and Healing, 104–30;R.M. Packard, ‘The Invention of the “Tropical Worker”: Medical Research and the Quest for Central African Labor in the South African Gold Mines’, Journal of African History, 34 (1993), 271–92. From a somewhat different perspective, related works include: E.N. Katz, ‘The White Death: Silicosis (Miners’ Phthisis) on the Witwatersrand Gold Mines, 1886–1910’ (PhD thesis, University of the Witwatersrand, 1990);E. Katz, The White Death: Silicosis on the Witwatersrand Gold Mines 1886–1910 (Johannesburg, 1994);H. Phillips, ‘“Black October”: The Impact of the Spanish Influenza Epidemic of 1918 on South Africa’ (PhD thesis, University of Cape Town, 1984), published in Archives Year Book for South African History (Pretoria, 1989);H. Phillips, ‘The Local State and Public Health Reform in South Africa: Bloemfontein and the Consequences of the Spanish ‘Flu Epidemic of 1918’, Journal of Southern African Studies, 13 (1987), 210–253;D. Wylie, ‘The Changing Face of Hunger in Southern African History, 1800–1980’, Past and Present, 122 (1989), 159–99
  • Marks . ‘South Africa's Early Experiment’; A. Jeeves, ‘Migrant Workers and Epidemic Malaria on the South African Sugar Estates, 1906–48’, in A. Jeeves and J. Crush, eds, White Farms, Black Labor: The State and Agrarian Change in Southern Africa, 1910–1950 (Portsmouth and Pietermaritzburg, 1997), 114–36
  • Marks . ‘South Africa's Early Experiment’, 453
  • 1945 . The DPH became the Department of Health in
  • Kark , S. L. 1951 . Social Medicine Edited by: Cluver , E. H. 661 – 700 . [Johannesburg] On the health centre concept and the work of the Pholela Clinic see the following:, ‘Health Centre Service: A South African Experiment in Family Health and Medical Care’, in et al, eds, (Z. Jacobson, ‘Case Note-Book of the “Riversend” Community’, in S.L. Kark and G.W. Steuart, A Practice of Social Medicine: A South African Team's Experiences in Different African Communities (Edinburgh, 1962), 256–66;S.L. Kark, ‘The Social Pathology of Syphilis in Africans’, South African Medical Journal, 23 (1949), 77–84;S.L. Kark and J. Cassel, ‘The Polela Health Centre: A Progress Report’, South African Medical Journal, 26 (1952), 101–4, 131–36;S. Marks and N. Andersson, ‘Industrialisation, Rural Health and the 1944 National Health Services Commission in South Africa’, in Feierman and Janzen, The Social Basis of Health and Healing, 131–61
  • Tollman , Yach and . ‘Public Health Initiatives in South Africa’, 1044
  • 1939 . Annual Report of the Department of Public Health, Year Ended 30/6/39 Pretoria (U.G. 57–‘39, 71–2
  • 1939 . Annual Report of the Department of Public Health, Year Ended 30/6/38 Pretoria (U.G. 49–‘38, 29
  • 1939 . Union Government, House of Assembly Debates (Hansard), vol. 35 (A.O.B. Payn, cols 6371–2;V.L. Shearer, cols 6384–7;C. Bain-Marais, col. 6382;R. Stuttaford, cols 6391–4
  • Hansard . 1939 . vol. 35, col. 4613, Dr. Karl Bremer, 12 May
  • 1941 . Annual Report of the Department of Public Health, Year Ended 30/6/41 Pretoria (U.G. 46–‘41, 58, emphasis original
  • Central Archives Depot . 1917 . Department of Public Health Archive (GES), 46/32, Pholela Health Unit, Annual Report for the Year Ending 30 June 1950
  • 1951 . GES, 2704 1/62, Medical and Health Services for the Union, ‘Social Medicine in South Africa’ prepared by Department of Information and revised by Secretary of Health, Dr. George Gale, in—he said he made little change to the text but updated the figures
  • Marks . ‘South Africa's Early Experiment’, 453
  • Kark , S. L. ‘Health Centre Service: A South African Experiment in Family Health and Medical Care’, in A Practice of Social Medicine, 661–700
  • Ibid., 668
  • On the malaria assistants, see Jeeves, ‘Migrant Workers and Epidemic Malaria’
  • The Karks recount the episode in Promoting Community Health, 80
  • 1940–53 . GES, 2704 2/62, Polela Health Unit General Matters, DPH memo (4 Nov. 1940) of a visit of Dr. F.W.P. Cluver, DCHO, Durban, and Mr. Stuart to the Native Unit at Bulwer on 24 Oct. 1940;Kark to DCHO, Durban, 5 Dec. 1940;Kark's monthly report, 5 Feb. 1941, and Summary of Main Activities at Polela, Feb.-Mar. 1941, n.d.;DCHO, Durban to SPH, 2 June 1942;GES, 1917 46/32, Polela Health Unit, Annual Report for the Year Ending 30 June 1945
  • 1947 . GES, 2727 1/70A, W. Harding le Riche, Medical Officer (MO)-in-charge, Knysna to Secretary of Health, 30 Jan. and 17 Feb. 1947, and David Landau's report on his tour of inspection of the health-centre service, 20 May 1947;Marks, ‘South Africa's Early Experiment’
  • Leff , S. 1953 . Social Medicine London (D. Porter, ‘Changing Disciplines: John Ryle and the Making of Social Medicine in Britain in the 1940s’. History of Science, 30 (1992), 137–63
  • 1948 . GES, 2958 PN6, 2, George Gale to DCHOs Cape Town, East London, Bloemfontein, Durban, Pretoria, 24 Dec.
  • Department of Public Heaith . 1948 . Report for the Year Ended 30/6/47 Pretoria (U.G.58–‘48, 18;GES, 2775 PL1, Memorandum on Health Centres prepared by the department for the Central Health Services and Hospitals Coordinating Council [1945]
  • Ryle , A. GES, 2958, PN6, 2, John, ‘A Report on the Health Centres Service of the Union Department of Health’
  • Ibid.
  • In a later article, I plan to develop a full assessment of Ryle's report and its impact on the Department of Health's project
  • Ibid.
  • Gale , George . 1949 . ‘Government Health Centres in the Union of South Africa’ . South African Medical Journal , 23 : 630 – 6 .
  • Sidney and Kark , Emily . ‘A Comparative Study of Two Rural African Families’, in A Practice of Social Medicine, 245–55
  • Ibid., 255
  • Promoting Community Health, 75
  • GES, 2958, PN6, 1, George Gale, ‘Annexure to Dr. Gear's Comments upon the Training Scheme for Health Personnel: Durban’
  • 1947 . GES, 2727 1/70 D, Landau's report, 20 May
  • 1947 . GES, 2727 1/70A, W. Harding le Riche, MO-in-charge, Knysna to Secretary of Health, 30 Jan and 17 Feb. 1947
  • GES, 2958, PN6, 2, John A. Ryle, ‘A Report on the Health Centres Service of the Union Department of Health’
  • As reported in ibid. and the documents already cited by Landau and le Riche
  • GES, 2958, PN6, 1, George Gale, ‘Annexure to Dr. Gear's Comments upon the Training Scheme for Health Personnel: Durban’
  • Promoting Community Health, 8, 65
  • 1944 . On the department's awareness and appreciation of Ryle's work, see, for instance, GES, 2727 1/70, Union Government statement on health centres []
  • Promoting Community Health, 8, 10–13, 21, 86–7
  • The Karks discuss their view of the National Party government's destructive policies in ibid., 193–5
  • 1945 . See, for example, Hansard, House of Assembly Debates, vol. 51 (cols 795–820, speech by Henry Gluckman on his motion calling on the government to implement the recommendations of the NHSC
  • Ibid.
  • 1944 . Rand Daily Mail, 10 Oct., clipping in GES, 2369 195/38 [vol. III], National Health Services Scheme
  • GES, 2958. PN6, 2, John A. Ryle, ‘A Report on the Health Centres Service of the Union Department of Health’
  • Anatomy of Power, 139
  • Ibid., 146
  • Ibid., 142
  • Ibid., 145–6
  • Ibid., 147–8
  • Ibid., 1
  • Ibid., 5
  • Ibid., 7
  • 1991 . Curing Their Ills: Colonial Power and African Illness Stanford For that sort of measured approach applied in a different context, see Megan Vaughan
  • 1940–53 . GES, 2704 2/62, Polela Health Unit General Matters,: Kark to DCHO, Durban 5 Dec. 1940, first monthly report
  • Anatomy of Power, 7–8
  • Ibid., 146
  • For an assessment of Halley Stott's project at the Valley Trust, see D. Wylie's forthcoming ‘Starving on a Full Stomach’
  • Kark , Sidney L. ‘The Social Pathology of Syphilis’ and his ‘Migrant Labour and Family Health’, A Practice of Social Medicine, 194–209
  • Promoting Community Health, 72–5

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