Poverty, health and disease in the era of high apartheid: South Africa, 1948-1976

Abstract

A higher infant mortality rate and shorter life expectancy, coupled with a high prevalence of a variety of diseases commonly associated with malnutrition, are usually a reflection of the social conditions of poverty in a society. By arguing that apartheid formed the basis of inequality and therefore the main underlying cause of an unacceptable burden of the diseases of poverty among black South Africans, this thesis, Poverty, Health and Disease in the Era of High Apartheid: South Africa, 1948-1976, locates these health problems within their social, economic and political context. It further argues that if health and disease are measures of the effectiveness with which human beings, using the available biological and cultural resources, adapt to their environment, then this relationship underpins the convergence of medical and cultural interests. Under the impact of modern technology and society's dependence upon it, profound cultural changes have taken place and issues of health and the etiology of disease are among the areas most affected by these changes. This thesis explains why, in a pluralistic medical setting, where only modern (scientific) medicine was recognised as legitimate medicine by the apartheid government, for the majority of black South Africans the advent of modern medicine was viewed not so much as displacing indigenous (African) medicine but as increasing the medical options available to them. It is therefore contended here that for most black South Africans, indigenous medicine has played a critical role; it has mitigated the impact of apartheid medicine. Since differences that people perceive in these two medical systems are crucial to the medical choices that they make at the onset of illness, this thesis argues that knowing and understanding the reasons for making such choices would not only have practical value for health authorities in their efforts to improve local, regional and national health service delivery, but would also contribute to a general understanding of human therapy-seeking behaviour in this age of the HIV/AIDS pandemic.