The doctors' dilemma: The health care of workers on the Witwatersrand gold mines, 1892-1910

Katz, Elaine N.

The doctors' dilemma: The health care of workers on the Witwatersrand gold mines, 1892-1910

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ISS-217.pdf (1.87 MB)

Date

1994-08-08

Authors

Katz, Elaine N.

Abstract

An issue as topical and controversial today as it was as the beginning of the 20th centurv is who does the doctor serve? Does he (or she) practise medicine to heal his patients, make a livelihood and attain status in society, or does he have a wider social function involving a duty to society and its restructuring with an accompanying responsibility for preventive health care? George Bernard Shaw, social reformer as well as dramatist, tackled this question in 1906 in 'The Doctors' Dilemma', which he described as a tragedy. In his preface to the play, written in 1911, he urged that medical services be reformed, because, as he argued, the object of the profession was 'not the health of the patient and of the community at large, but the protection of the doctor's livelihood and the concealment of his errors'. South African doctors also faced this dilemma during the same period. In the middle of 1901, shortly after the Witwatersrand gold mines had restarted operations, and while the Anglo-Boer War was still in progress, major health problems surfaced in the industry. By the time that peace was declared (in May 1902), the mortality from disease among white miners and African mineworkers had assumed such serious dimensions that Lord Milner, Governor of the Transvaal and High Commissioner of South Africa, was forced to intervene. Remedial measures were essential, the more especially as Milner's financial plans for the reconstruction of the Transvaal under British rule hinged largely on the 'overspill' from the gold mines. This paper examines the responses of the Witwatersrand medical profession to the working and living conditions of white and African mineworkers both of which had a detrimental effect on their health. It also specifically analyses the reactions of these doctors to the excessive disease death rate among African mineworkers, chiefly from pneumonia, and to the high mortality from silicosis (miners' phthisis) which predominated among white miners, especially machine operators. It argues that the doctors, who were in a conflictual position, subordinated the needs of their patients (both black and white) for their own economic gain and to further the financial priorities of the mineowners, the so-called Randlords.