In the departure lounge of OR Tambo (taking a break from complaining about the missing TV remote and milk) Helen Zille, the former leader of South Africa’s opposition party, the Democratic Alliance (DA), and premier of the Western Cape, casually invoked, in a series of tweets, one of the continued liberal myths of colonisation – that Europeans brought advanced and widespread medical care to the colonies.
Zille later apologised and attempted to clarify the tweets saying that she was not defending colonialism but had “merely said that although it [colonialism] had been an oppressive and evil system, not every consequence had been negative.” She remains the subject of a disciplinary investigation by the DA.
However, rather than leaving her apology and clarification as it stood, she then went on to accuse those who had criticised her of trying to shrink her mind to “fit the contours of political correctness”, “especially if you’re white” and of threatening to infiltrate her beloved DA with “every tenet, myth and shibboleth of African racial-nationalist propaganda”.
It was as a begrudging apology as you’re likely to find.
Zille further tried to justify her position with a misleading take on Singapore’s rapid post-colonial development which she says was based on union bashing, foreign investment and colonial amnesia and a result of “uncompromising meritocracy, zero tolerance for corruption, and a determination to build on the institutional foundations the colonists had left behind.”
As Cambridge University economist Ha-Joon Chang has pointed out Singapore’s success also involved massive state housing investment, total state ownership of land and 22 percent state ownership of the economy – strategies I don’t recall Zille ever getting behind.
But let’s stick to the issue of healthcare and medicine.
Zille implies that colonialism left behind a wealth of medical technology and infrastructure which newly independent states could build upon in the march towards development and progress, and that in spite of the injustices of colonialism, colonised people should be grateful for this.
The only problem is that that, for the most part, this is not what happened.
When it comes to medical affairs in the first few centuries of colonisation, what colonists primarily brought to Africa, Asia, and Latin America – in addition to land-theft, slavery and violence – were diseases which killed indigenous populations on a genocidal scale due to a lack of local immunity.
Indigenous populations in swathes of the Americas were almost wiped out by diseases brought by colonialism. Although there are no firm statistics an estimated 90% of Khoisan died from a smallpox epidemic the Dutch brought to the Cape in 1714.
This is aside from the fact that the slave compounds of the Western Cape, whose inhabitants built Cape Town and planted the region’s wine farms, were dire places where slave women could be freely raped with no legal barrier.
In addition, as elsewhere in the colonies, colonists also helped themselves to indigenous therapies. In the late 18th century a Swedish syphilis physician and early bio-prospector Karl Thunberg, working for the Dutch East India Company, learned of the medicinal properties of a local bush used by the Khoisan for a variety of treatments. He began marketing the bush for medicinal reasons in Europe calling it “Rooibos.” Recent studies have shown the anti-oxidant, anti-inflammatory and potentially anti-carcinogenic benefits of Rooibos tea.
Aside from bio-prospecting (which has become big business in places like the Amazon), traditional healing and remedies were widely treated with scorn across the colonies.
Furthermore, the myth that colonialism brought medical enlightenment, at least in its early centuries, is obviously false precisely because Europe itself did not have modern biomedicine until the late 19th and early twentieth century.
Up until the late 19th century European medicine primarily consisted of, to put it bluntly, drugs – opiates which made pain and dying easier, and which were harvested themselves from the colonies (Singapore was a centre of the trade).
A short anecdote is a case in point. In 1846 Hungarian doctor Ignaz Semmelweis discovered that washing hands could reduce maternal mortality. He was universally disbelieved, fired from his job and stigmatised to the point that he ended up in asylum.
This was basically the level of European medical knowledge a good few centuries into the colonial project. European medical knowledge in the late 19th century was dominated by miasma theory, in which invisible polluting mists were viewed as the cause of illness.
What Zille is presumably referring to is 20th century biomedicine, public health and epidemiology.
Twentieth century medical advances in colonised nations proceeded in a scattered and haphazard way, primarily with the aim of maintaining armies in the “white man’s grave” firstly, and, after World War I, a colonised labour force which, if not healthy, was at least alive.
Fundamentally though, these interventions were not brought by colonists to the colonies, but were developed through colonisation.
Malaria is an interesting case. Quinine, used during the colonial era as a treatment for malaria, was first widely used by indigenous Peruvians in its natural form. The discovery that malaria was caused by parasites carried by mosquitoes was made by a Scottish physician working in the colonial office in China.
Patrick Manson initially developed the theory that mosquitoes carried parasites through experiments he conducted on his Chinese gardener Hin-Lo, whom he forced to sleep with the windows open to be banqueted upon by mosquitoes which Mason later dissected.
Mason later founded the London School of Tropical Hygiene and Medicine in 1899, the world’s pre-eminent institution for the study of tropical diseases, which was directly funded by the Colonial Office as was Britain’s The Royal Society, one of its most important scientific research academies.
And Britain was not unique. Germ theory, the theory that disease transmission is caused by micro-organisms, which formed the foundations of modern medicine and epidemiology, was only accepted in the late 19thcentury through the work of the Frenchman Louis Pasteur, among others.
However, the theory was not widely accepted and its implications for public health unclear well into the 20th century – the colonies provided the perfect setting for brutally testing these theories on unwilling colonial populations.
For instance, in 1926 the French Pasteurians responded to a sleeping sickness epidemic in Cameroon by forcibly lining up local populations, palpitating their necks for lymph swelling, branding those who had the parasite by marking their heads and then giving them treatment which widely caused blindness and death.
This, along with interventions like it, served an important role in justifying the control of colonised populations while at the same time attending to epidemic diseases which forced labour migration worsened in the first place.
The point is that the foundations of modern medicine and public health were developed by colonial expropriations of resources and through coercive experiments on colonized populations, as much as they were discovered in the laboratories of London and Paris.
Zille’s question should be inverted – “would Europe have transitioned into specialised health care and medication without colonisation?”
The answer is very likely no, at least not in its present form.
Finally, this “colonial influence” (a euphemism if ever there was) did not simply translate directly into “specialised health care and medication” for most colonised people. It had to be fought for by anti-colonial movements, post-colonial governments, and civil society, and this struggle is ongoing. Many post-colonies are also now also centres of medical research and pharmaceutical production.
Yes, there were some beneficial medical interventions aimed at colonised people which saved lives, but as often these interventions were offset by related attempts to control and regulate colonised populations.
In South Africa as elsewhere in Africa, modern medicine and epidemiology was entirely complicit in both the exploitation of black labour, and laying the foundations for apartheid-era geography.
Enforced labour to mines and urban areas resulted directly in high rates of epidemic disease like tuberculosis on the one hand; on the other, epidemic diseases and health conditions were used to legitimate the eviction of black populations from urban areas into townships on urban peripheries throughout the twentieth century.
Furthermore, as Frantz Fanon, himself a French-trained medical doctor, documented, medics in the colonies were complicit in the torture and confinement of opposition in anti-colonial wars like those in Algeria. In South Africa we know that while there were progressive white doctors, there were also the likes of Wouter Basson, South Africa’s own “Dr Death” who headed the apartheid state’s chemical and biological warfare programme.
Let me be clear though: mine is a scientifically orthodox position, and I do not doubt the efficacy of biomedical methods or technologies.
Saying this I do not preclude that they can co-exist with other healing systems nor that indigenous forms of knowledge and therapies can be beneficial.
But as we know these histories matter. Former South African president Thabo Mbeki, in his fatally misguided suspicion towards HIV treatment, also drew on the the bitter experiences of the colonial past, but used these as a justification for rejecting available and well-researched therapeutic advances in AIDS treatment while promoting untested nutritional supplements as an alternative.
In doing so he allowed hundreds of thousands to die unnecessarily and tragically.
But Zille’s perspective, and those like hers, is also pernicious.
It casually erases centuries of mass death by focusing on developments that took place in the final decades of colonialism, which drew directly from the brutal extraction of colonised peoples’ land and labour, and experimentation on their bodies, but which rarely benefitted them.
Zille’s views go directly against the idea that the world’s medical knowledge should be more equally distributed – and not as some type of humanitarian gift, or through a free market or “meritocracy”– precisely because its foundations were made through colonial exploitation.
The present global divide between who lives and who dies unnecessarily is also a continuation of the colonial legacy and a new form of global apartheid.
Both Mbeki and Zille’s views are opposite in their views of the past, but both are contaminated by history’s miasma.
* This piece draws on research from, aside from those hyperlinked, the following sources: John Chasteen’s “Born in Blood and Fire”; Frantz Fanon’s “A Dying Colonialism”, Pumla Dineo Gqola’s “Rape: A South African Nightmare”, Douglas Haynes’ “Imperial Medicine”, Margaret Lock and Vinh-Kim Nguyen’s “An Anthropology of Biomedicine”, Randall Packard’s “White Plague, Black Labour”, and Richard Pithouse’s “That the tool never possess the man.”
Main Photo: Helen Zille continues to lecture the nation via Twitter. But her oblivious and ahistorical approach to colonialism and medicine is in need of a check-up – Courtesy of the Democratic Alliance
Matthew Wilhelm-Solomon is a Writing Fellow on the Migration and Health Project Southern Africa, based at the African Centre for Migration & Society, University of the Witwatersrand. The views expressed are his own