Mental Illness, Psychiatry, and the South African State, 1800s to 2018, 2019
Definitions of and explanations for mental illness differ between societies and have changed over... more Definitions of and explanations for mental illness differ between societies and have changed over time. Current use of the term arises from secular and materialist episte mologies of the body and mind, influential from the 18th century, which rejected the spiri tual or supernatural as causes of illness. Since the 19th century, a specialist body of study, of law, practices, professionals, and institutions developed to investigate, define, di agnose, and treat disorders and illnesses of the mind. This was the emergence of psychia try and of a professional psychiatric sector. With origins in the West, at a time of capital ism and imperialism, psychiatry was brought to South Africa through colonialism, and its development has been strongly influenced by the country's economic, political, ideologi cal, and medico-scientific histories. There have been significant continuities: the sector has always been small, underfunded, and prioritized white men. Black patients were largely neglected. Discrimination and segregation were constant features, but it is helpful to identify three broad phases of the history of the psychiatric sector in South Africa. First, its most formative period was during colonial rule, notably from the mid-1800s to c. 1918, with an institutional base in asylums. The second broad phase lasted from the 1920s to the 1990s. A national network of mental hospitals was created and changes in the ways in which mental illnesses were classified occurred at the beginning of this peri od. Some new treatments were introduced in the 1930s and 1950s. Law and the profession's theoretical orientations also changed somewhat in the 1940s, 1960s, and 1970s. Institutional practice remained largely unchanged, however. A third phase began in the 1980s when there were gradual shifts toward democratic governance and the pro gressive Mental Health Act of 2002, yet continued human rights violations in the case of the state duty of care toward the mentally ill and vulnerable.
In South Africa, as elsewhere, museums, archives and other institutions often house large and gro... more In South Africa, as elsewhere, museums, archives and other institutions often house large and growing quantities of medically-related records. This paper draws attention to some of the complex issues concerning these materials such as the process of collecting and accessioning the material into public, museum or archive collections. The paper also explores the legal situation of their status within these collections, the lack of appropriate national protocols and guidelines for access to and the use of medical records for research purposes, as well as some of the problems encountered by researchers and historians in using such material. Moreover, the current guidelines used by biomedical professional bodies are seldom of assistance. Some specific problems which need to be considered are elucidated as researchers and historians try to find a balance between the right to privacy and confidentiality on the one hand, and the right of access to information on the other. This challenge is...
of health care policies and infrastructure occupied a far more central place than has yet been th... more of health care policies and infrastructure occupied a far more central place than has yet been the case in South African electioneering. While all parties agreed that the country’s public health system is still failing to meet citizens’ Constitutionally-affirmed right of access to health care, the forcing of this recognition into the political arena has in part had to come ‘from the ground up’, from those who work at state hospitals and clinics, including at South Africa’s ‘legendary ’ Chris Hani Baragwanath Hospital in Soweto. With just under 3,000 beds, the hospital is amongst the largest in the world, and has a far higher ratio of patients than WHO recommended standards. In October 2013, in a well-publicised media protest, eight Baragwanath doctors were photographed holding aloft posters stating, for example, ‘Patient in need of simple operation discharged (theatre lists too long). He died a few weeks later’, and ‘Tired Doctors (Shifts Longer than 16 Hours) = Compromise of Patien...
... Daniel Jordan Smith, for instance, writes of the ambiguities of modern, monogamous, marriage ... more ... Daniel Jordan Smith, for instance, writes of the ambiguities of modern, monogamous, marriage for Igbo women in south-eastern Nigeria, who now are ... in Africa does not tackle in sufficient depth, or at allfor instance, the influence and histories of Nigerian 'Nollywood' video films ...
In South Africa, as elsewhere, museums, archives and other institutions often house large and gro... more In South Africa, as elsewhere, museums, archives and other institutions often house large and growing quantities of medically-related records. This paper draws attention to some of the complex issues concerning these materials such as the process of collecting and accessioning the material into public, museum or archive collections. The paper also explores the legal situation of their status within these collections, the lack of appropriate national protocols and guidelines for access to and the use of medical records for research purposes, as well as some of the problems encountered by researchers and historians in using such material. Moreover, the current guidelines used by biomedical professional bodies are seldom of assistance. Some specific problems which need to be considered are elucidated as researchers and historians try to find a balance between the right to privacy and confidentiality on the one hand, and the right of access to information on the other. This challenge is...
Oxford Research Encyclopedia of African History, 2019
Definitions of and explanations for mental illness differ between societies and have changed over... more Definitions of and explanations for mental illness differ between societies and have changed over time. Current use of the term arises from secular and materialist epistemologies of the body and mind, influential from the 18th century, which rejected the spiritual or supernatural as causes of illness. Since the 19th century, a specialist body of study, of law, practices, professionals, and institutions developed to investigate, define, diagnose, and treat disorders and illnesses of the mind. This was the emergence of psychiatry and of a professional psychiatric sector. With origins in the West, at a time of capitalism and imperialism, psychiatry was brought to South Africa through colonialism, and its development has been strongly influenced by the country’s economic, political, ideological, and medico-scientific histories. There have been significant continuities: the sector has always been small, underfunded, and prioritized white men. Black patients were largely neglected. Discri...
This review begins with two confessions: firstly, asking me to review Plague, Pox and Pandemics w... more This review begins with two confessions: firstly, asking me to review Plague, Pox and Pandemics was something of an easy pick since, having taught a module "Epidemics and Social Change in Historical Perspective" for over a decade, I have long been a convert to the premise of and arguments put forward in this book. Secondly, reading it several times has not assuaged the chronic case of professional jealousy which it has induced in me, for Phillips has given us a powerful, punchy and poignant text that exposes some of the key forces shaping our region's history over the last several centuries. Indeed, taking a "holistic, social history of disease perspective ... this book ... places epidemics firmly within the country's past and treats them as something not extraneous to the mainstream of its history" (pp 9 10). It is therefore not only a history of epidemics in South Africa; it is a history of South Africa in the modern world.
dation upon which future research of post-WWII European immigrants builds. This review, however, ... more dation upon which future research of post-WWII European immigrants builds. This review, however, would be incomplete without pointing out some of the weaknesses of the analysis which affect the grounding of the overall argument. The book includes an enormous amount of visual images. While the author incorporates adequately the maps and graphs in the text, he does relatively little with the amazing array of photographs included. These photos seem to reveal profound changes in gender, ethnic, race, and class norms that are part of each city's history. Picturing shifts in identity on film say much about the photographer (whether an insider or outsider in these Italians enclaves) and the communities themselves. That Stanger-Ross missed the opportunity that might have bolstered his points about the longevity of Italian-ness is our loss as well as his. Staying Italian's second flaw comes in the shallow narrative of race and real estate. The linkage between the violent rage of white ethnic home owners and the realtors who exploited it for profit is one of the most dramatic and tragic stories of the 1950s and 1960s. Stanger-Ross rightly highlights how housing and demographic shifts in Philadelphia and Toronto explain the divergent paths of these cities' Italians. But, the power of racist agency and its implications, albeit complex, elude him. For example, the author's contention that “acts of loyalty” (p. 51) in which Italian Philadelphians kept houses within their families or social networks and “emphasized the social benefits of Italian neighborhood life” (p 57)—though they could not “easily reverse” patterns of racial exclusions —exemplifies the underplaying of racism's role in urban decay. Notwithstanding these critiques, Staying Italian adds crucial geographic and chronological breadth to scholarship on Italian immigration. Stanger-Ross' awareness of the importance of this as well as his ability to embed his research in scholarly dialogue are made well in the Conclusion chapter of the book (though less so throughout the narrative). Stanger-Ross' insights into how ethnicity survived in two major metropolitan “receiving” hubs alerts us to the interplay of economics, politics, and culture as well as the elasticity of Italian community life in the post WWII period.
... Murray and Sanders have navigated an empirical route through these problems based on the comp... more ... Murray and Sanders have navigated an empirical route through these problems based on the compilation from court archives of a near-definitive record of over 200 medicine murder cases in Basutoland from 1895 to 1966. ... Joint Editors. Rita Abrahamsen. Sara Rich Dorman. ...
Mental Illness, Psychiatry, and the South African State, 1800s to 2018, 2019
Definitions of and explanations for mental illness differ between societies and have changed over... more Definitions of and explanations for mental illness differ between societies and have changed over time. Current use of the term arises from secular and materialist episte mologies of the body and mind, influential from the 18th century, which rejected the spiri tual or supernatural as causes of illness. Since the 19th century, a specialist body of study, of law, practices, professionals, and institutions developed to investigate, define, di agnose, and treat disorders and illnesses of the mind. This was the emergence of psychia try and of a professional psychiatric sector. With origins in the West, at a time of capital ism and imperialism, psychiatry was brought to South Africa through colonialism, and its development has been strongly influenced by the country's economic, political, ideologi cal, and medico-scientific histories. There have been significant continuities: the sector has always been small, underfunded, and prioritized white men. Black patients were largely neglected. Discrimination and segregation were constant features, but it is helpful to identify three broad phases of the history of the psychiatric sector in South Africa. First, its most formative period was during colonial rule, notably from the mid-1800s to c. 1918, with an institutional base in asylums. The second broad phase lasted from the 1920s to the 1990s. A national network of mental hospitals was created and changes in the ways in which mental illnesses were classified occurred at the beginning of this peri od. Some new treatments were introduced in the 1930s and 1950s. Law and the profession's theoretical orientations also changed somewhat in the 1940s, 1960s, and 1970s. Institutional practice remained largely unchanged, however. A third phase began in the 1980s when there were gradual shifts toward democratic governance and the pro gressive Mental Health Act of 2002, yet continued human rights violations in the case of the state duty of care toward the mentally ill and vulnerable.
In South Africa, as elsewhere, museums, archives and other institutions often house large and gro... more In South Africa, as elsewhere, museums, archives and other institutions often house large and growing quantities of medically-related records. This paper draws attention to some of the complex issues concerning these materials such as the process of collecting and accessioning the material into public, museum or archive collections. The paper also explores the legal situation of their status within these collections, the lack of appropriate national protocols and guidelines for access to and the use of medical records for research purposes, as well as some of the problems encountered by researchers and historians in using such material. Moreover, the current guidelines used by biomedical professional bodies are seldom of assistance. Some specific problems which need to be considered are elucidated as researchers and historians try to find a balance between the right to privacy and confidentiality on the one hand, and the right of access to information on the other. This challenge is...
of health care policies and infrastructure occupied a far more central place than has yet been th... more of health care policies and infrastructure occupied a far more central place than has yet been the case in South African electioneering. While all parties agreed that the country’s public health system is still failing to meet citizens’ Constitutionally-affirmed right of access to health care, the forcing of this recognition into the political arena has in part had to come ‘from the ground up’, from those who work at state hospitals and clinics, including at South Africa’s ‘legendary ’ Chris Hani Baragwanath Hospital in Soweto. With just under 3,000 beds, the hospital is amongst the largest in the world, and has a far higher ratio of patients than WHO recommended standards. In October 2013, in a well-publicised media protest, eight Baragwanath doctors were photographed holding aloft posters stating, for example, ‘Patient in need of simple operation discharged (theatre lists too long). He died a few weeks later’, and ‘Tired Doctors (Shifts Longer than 16 Hours) = Compromise of Patien...
... Daniel Jordan Smith, for instance, writes of the ambiguities of modern, monogamous, marriage ... more ... Daniel Jordan Smith, for instance, writes of the ambiguities of modern, monogamous, marriage for Igbo women in south-eastern Nigeria, who now are ... in Africa does not tackle in sufficient depth, or at allfor instance, the influence and histories of Nigerian 'Nollywood' video films ...
In South Africa, as elsewhere, museums, archives and other institutions often house large and gro... more In South Africa, as elsewhere, museums, archives and other institutions often house large and growing quantities of medically-related records. This paper draws attention to some of the complex issues concerning these materials such as the process of collecting and accessioning the material into public, museum or archive collections. The paper also explores the legal situation of their status within these collections, the lack of appropriate national protocols and guidelines for access to and the use of medical records for research purposes, as well as some of the problems encountered by researchers and historians in using such material. Moreover, the current guidelines used by biomedical professional bodies are seldom of assistance. Some specific problems which need to be considered are elucidated as researchers and historians try to find a balance between the right to privacy and confidentiality on the one hand, and the right of access to information on the other. This challenge is...
Oxford Research Encyclopedia of African History, 2019
Definitions of and explanations for mental illness differ between societies and have changed over... more Definitions of and explanations for mental illness differ between societies and have changed over time. Current use of the term arises from secular and materialist epistemologies of the body and mind, influential from the 18th century, which rejected the spiritual or supernatural as causes of illness. Since the 19th century, a specialist body of study, of law, practices, professionals, and institutions developed to investigate, define, diagnose, and treat disorders and illnesses of the mind. This was the emergence of psychiatry and of a professional psychiatric sector. With origins in the West, at a time of capitalism and imperialism, psychiatry was brought to South Africa through colonialism, and its development has been strongly influenced by the country’s economic, political, ideological, and medico-scientific histories. There have been significant continuities: the sector has always been small, underfunded, and prioritized white men. Black patients were largely neglected. Discri...
This review begins with two confessions: firstly, asking me to review Plague, Pox and Pandemics w... more This review begins with two confessions: firstly, asking me to review Plague, Pox and Pandemics was something of an easy pick since, having taught a module "Epidemics and Social Change in Historical Perspective" for over a decade, I have long been a convert to the premise of and arguments put forward in this book. Secondly, reading it several times has not assuaged the chronic case of professional jealousy which it has induced in me, for Phillips has given us a powerful, punchy and poignant text that exposes some of the key forces shaping our region's history over the last several centuries. Indeed, taking a "holistic, social history of disease perspective ... this book ... places epidemics firmly within the country's past and treats them as something not extraneous to the mainstream of its history" (pp 9 10). It is therefore not only a history of epidemics in South Africa; it is a history of South Africa in the modern world.
dation upon which future research of post-WWII European immigrants builds. This review, however, ... more dation upon which future research of post-WWII European immigrants builds. This review, however, would be incomplete without pointing out some of the weaknesses of the analysis which affect the grounding of the overall argument. The book includes an enormous amount of visual images. While the author incorporates adequately the maps and graphs in the text, he does relatively little with the amazing array of photographs included. These photos seem to reveal profound changes in gender, ethnic, race, and class norms that are part of each city's history. Picturing shifts in identity on film say much about the photographer (whether an insider or outsider in these Italians enclaves) and the communities themselves. That Stanger-Ross missed the opportunity that might have bolstered his points about the longevity of Italian-ness is our loss as well as his. Staying Italian's second flaw comes in the shallow narrative of race and real estate. The linkage between the violent rage of white ethnic home owners and the realtors who exploited it for profit is one of the most dramatic and tragic stories of the 1950s and 1960s. Stanger-Ross rightly highlights how housing and demographic shifts in Philadelphia and Toronto explain the divergent paths of these cities' Italians. But, the power of racist agency and its implications, albeit complex, elude him. For example, the author's contention that “acts of loyalty” (p. 51) in which Italian Philadelphians kept houses within their families or social networks and “emphasized the social benefits of Italian neighborhood life” (p 57)—though they could not “easily reverse” patterns of racial exclusions —exemplifies the underplaying of racism's role in urban decay. Notwithstanding these critiques, Staying Italian adds crucial geographic and chronological breadth to scholarship on Italian immigration. Stanger-Ross' awareness of the importance of this as well as his ability to embed his research in scholarly dialogue are made well in the Conclusion chapter of the book (though less so throughout the narrative). Stanger-Ross' insights into how ethnicity survived in two major metropolitan “receiving” hubs alerts us to the interplay of economics, politics, and culture as well as the elasticity of Italian community life in the post WWII period.
... Murray and Sanders have navigated an empirical route through these problems based on the comp... more ... Murray and Sanders have navigated an empirical route through these problems based on the compilation from court archives of a near-definitive record of over 200 medicine murder cases in Basutoland from 1895 to 1966. ... Joint Editors. Rita Abrahamsen. Sara Rich Dorman. ...
From the book's back cover: Durban's McCord Hospital, this book argues, is one of the mos... more From the book's back cover: Durban's McCord Hospital, this book argues, is one of the most important hospitals of the twentieth century. Founded 'for the Zulu' in 1909 by American Christian missionaries, Dr James B. McCord and Margaret Mellen McCord, for more than a century it was a centre of affordable health care for the under privileged of many faiths, cultures and political persuasions. It also pioneered the training of black nurses, midwives and doctors and was supported by prominent figures such as John L. Dube and Chief Albert Luthuli. It initially faced, however, strong opposition from white factions in Durban and, by the 1960s was directly targeted for closure by South African Prime Minister Hendrik Verwoerd himself. McCords survived in part because apartheid forces did not understand that for several generations and for many communities, in had come to be a 'people's hospital'. This identity would help carry it through to the early twenty-first ...
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