White Plague, Black Labor: Tuberculosis and the Political Economy of Health and Disease in South Africa

414 Pages·1989·21.67 MB·English

by  Randall M. Packard

WHITE PLAGUE, BLACK LABOR
COMPARATIVE STUDIES OF
HEALTH SYSTEMS AND MEDICAL CARE
General Editor
John M. Janzen
Founding Editor
Charles Leslie
Editorial Board
Don Bates, M.D.,
McGill University
Frederick L. Dunn, M.D.,
University of California, San Francisco
Kris Heggenhougen,
University of London
Brigitte Jordan,
Michigan State University
Patricia L. Rosenfield,
World Health Organization
Magdalena Sokolowska,
Polish Academy of Sciences
Paul U. Unschuld,
University of Munich
Francis Zimmermann,
Ecole des Hautes Etudes en Sciences Sociales, Paris
For a list of titles in this series, see back of book.
WHITE PLAGUE,
BLACK LABOR
Tuberculosis and the Political
Economy of Health and Disease
in South Africa
Randall M. Packard
UNIVERSITY OF CALIFORNIA PRESS
Berkeley Los Angeles
University of California Press
Berkeley and Los Angeles, California
Copyright © 1989 by The Regents of the University of California
Library of Congress Cataloging-in-Publication Data
Packard, Randall M, 1945—
White plague, black labor : tuberculosis and the political economy
of health and disease in South Africa / Randall M. Packard.
p. cm.—(Comparative studies of health systems and medical
care ; 23)
Bibliography: p.
includes index.
ISBN 0-520-06574-3 (alk. paper).—ISBN 0-520-06575-1 (pbk. :
alk. paper)
1. Tuberculosis—South Africa—History. I. Title. II. Series.
RA644.T7P28 1989
614.5'42'0968—dc!9 89-4802
CIP
Printed in the United States of America
123456789
For Carolyn, Kendra, and Matthew
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Contents
List of Tables and Graphs ix
Abbreviations xii
Preface
XV
Introduction: Industrialization and the
Political Economy of Tuberculosis 1
1.
Preindustrial South Africa: A Virgin Soil for
Tuberculosis? 22
2. Urban Growth, "Consumption," and the
"Dressed Native," 1870–1914 33
3. Black Mineworkers and the Production of
Tuberculosis, 1870–1914 67
4. Migrant Labor and the Rural Expansion of
Tuberculosis, 1870–1938 92
5. Slumyards and the Rising Tide of
Tuberculosis, 1914–1938 126
6. Labor Supplies and Tuberculosis on the
Witwatersrand, 1913–1938 159
VII
viii Contents

7. Segregation and Racial Susceptibility: The
Ideological Foundation of Tuberculosis
Control, 1913–1938 194
8. Industrial Expansion, Squatters, and the
Second Tuberculosis Epidemic, 1938–1948 211
9. Tuberculosis and Apartheid: The Great
Disappearing Act, 1948–1980 249
Epilogue: The Present and Future of
Tuberculosis in South Africa 299
Notes 321
Select Bibliography 367
Index 379
List of Tables and Graphs
TABLES
1. Municipal Revenues and Expenditures, 1912—1913 57
2. African TB Mortality within First Month after Diagnosis,
Johannesburg, 1906-1914 66
3. TB Infection Rates and Exposure to Mine Work, 1910—
1912 74
4. Effect of Overtime on TB Incidence, Transvaal Collieries,
1909-1911 84
5. Comparison of Deaths and Repatriations (per 1,000 work-
ers) in Deep and Outcrop Gold Mines, 1910-1912 89
6. Percentage of Mozambique and Tropical Miners in Out-
crop and Deep Mines, 1910—1912 90
7. African Food Consumption and Per Capita Income, Johan-
nesburg, 1935 149
8. Scurvy Cases and Length of Service, Randfontein Mines,
1926 169
9. Scurvy Cases and Length of Service, Rand Mines Ltd.,
1923–1930 169
10. Impact of Reduction of Workers with Less than One Year
Service on Incidence of TB among BSA Mineworkers 189
11. Increases in Urban TB Mortality Rates, 1938–1945 212
12. Prevalence of TB among Africans Living in Selected Rural
Areas in the 1950s 213