Medical Apartheid

Winner of several awards, Harriet A. Washington's "Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present" (2006) documents a history we tend only to know bits and pieces of. Those familiar with ethics will be aware of the Tuskegee Study, but likely not the bigger story. This is a troubling read, but one that should be read. The book is not published by a university or academic press, and certain quotes and references are not cited, which leaves some potential interesting trails to follow as dead ends. Nonetheless, it is recommended. A few quotes of note:

  • "Use of the term race to denote biologically different types of mankind evolved only in the eighteenth century, when the study of animal breeding gave rise to heightened awareness of animal subspecies and the possibility of breeding animals to encourage desired traits. Not coincidentally, this period coincided with the growth of the slave trade, when the biological distinctiveness of men became economically important. Those who studied the different groups of men were called ethnologists and were the forerunners of anthropologists. Ethnologists applied the classification and the categorization methods of the natural sciences, called taxonomy, to the study of man. Even after the meaning of race came to include subgroupings of man, it had several meanings. By races, some meant biological subspecies of man, analogous to the different breeds of dogs. For example, Swedish natural Carl von Linne - Carolus Linnaeus, the most famous of the taxonomists – categorized Africans (and, by extension, U.S. blacks) as Homo afer, theorizing that black men had different evolutionary forebears and had evolved along a separate evolutionary track from white men." (p. 33)
  • "Sim's silver sutures did help to end a real medical tragedy for many women, and some excuse the abuse of enslaved women on this basis. This essentially utilitarian argument presents an ethical balance sheet, with the savage medical abuse of captive women on one hand and countless women saved from painful invalidism on the other. However, such an argument ignores the ethical concept of social justice, and these experiments violated this essential value because the suffering and the benefits have been distributed in an unfair way, leading to distributive injustice. In this case, the most powerless group, which is also a racially distinct group and a captive group, is the group upon which doctors inflicted harm "for the greater good." Another, privileged group enjoys the benefits but shares neither the pain nor the risks. Thus the more unexpected acceptability is clear." (p. 69)
  • "the decision not to treat these sick men of the Tuskegee Study is a different crime, a crime of omission, and it illustrates several of the important patterns explored in this book. These include the selection of blacks for the riskiest studies; their disproportionate selection for nontherapeutic experimentation; the myth of medical distinctiveness (which held that syphilis was manifested differently in blacks); and the myth of hypersexed blacks as "incorrigible" vectors of sexual disease and dysfunction. The use of men as reservoirs of syphilis reinforce the familiar use of black bodies to generate the profitable wonders of new disease approaches (to which the subjects are rare the privy), and the clinical display of disease in the clinic and in medical journals." (p. 182)
  • "The United States also chose to seek Nazi expertise. In 1945, the U.S. State Department, army intelligence, and the OSS, the immediate forerunner of the CIA, recruited former Third Reich scientist, granting them immunity, jobs, and new identities in a resettlement program for Nazi scientists. It was named Operation Paperclip, for the mode of identifying potential recruits - a simple paper clip placed on each of their dossiers. In exchange, the State Department asked that the scientist resume their old habits - working on secret nonconsensual research projects, many of which exploded patients - but this time throughout the United States." (p. 229)
  • "research into sickle cell disorder, the first identified molecular disease, remains underfunded and the disease still awaits an effective treatment, but effective genetic therapies were mounted within just a few years after the gene for cystic fibrosis was discovered in 1989. Whites are at much higher risk than blacks for cystic fibrosis." (p. 315-316)
  • "This book uses the term race because it is accepted argot, it can be a convenient, commonly used way of designating ethnic groups that are perceived as distinct. We all know what we mean (or think we do) when we denote someone's race as "black" or "white." In our nation, race is inarguably important in discussions of health and disease. However, the Human Genome Project has erased any lingering doubts: Biological race does not exist, because all humans share the same genes. Although the proportions of genes differ, meaning that genetic differences exist, these variations map very poorly on to what we think of as races. This seems to introduce a logical contradiction: If race is not real, how can we speak of race-based therapeutics? The answer is that race is real, but it is not biological: It is social. What correlates very closely to most "racial" differences ns life expectancy, mortality, disease susceptibility, and survival is the race to which one is perceived as belonging." (p. 317)
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I Write What I Like – Steve Biko

Similar to other giants of the struggle against apartheid, we do not have a book written by Steve Biko that pens his ideas. For Robert Sobukwe, a biography was written, while for Steve Biko, we have a collection of his writings and transcripts, first published in 1978. The book contains powerful ideas, some of which are shared below, but also contains writings that are audience- and time-specific, making it a sometimes less than relevant read. I share some of Biko's ideas:

  • "Basically the South African white community is a homogenous community. It is a community of people who sit to enjoy a privileged position that they do not deserve, are aware of this, and therefore spend their time trying to justify why they are doing so. Where differences in political opinion exist, they are in the process of trying to justify their position of privilege and their usurpation of power." (p. 19)
  • "We are concerned with that curious bunch of nonconformists who explain their participation in negative terms: that bunch of do-gooders that goes under all sorts of names – liberals, leftists etc. These are the people who argue that they are not responsible for white racism and the country's "inhumanity to the black man". These are the people who claim that they too feel the oppression just as acutely as the blacks and therefore should be jointly involved in the black man's struggle for a place under the sun… It is rather like expecting the slave to work together with the slave-master's son to remove all the conditions leading to the former's enslavement." (p. 20-21)
  • "The myth of integration as propounded under the banner of liberal ideology must be cracked and killed because it makes people believe that something is being done when in actual fact the artificial integrated circles are a soporific on the blacks and provide a vague satisfaction because it is difficult to bring people from different races together in this country, therefore achievement of this is in itself a step forward towards the total liberation of the blacks. Nothing could be more irrelevant and therefore misleading. Those who believe in it are living in a fool's paradise." (p. 22)
  • "We must learn to accept that no group, however benevolent, can ever hand over power to the vanquished on a plate. We must accept that the limits of tyrants are prescribed by the endurance of those whom they oppress. As long as we go to Whitey begging cap in hand for emancipation, we are giving him further sanction to continue with his racist and oppressive system. We must realise that our situation is not a mistake on the part of whites but a deliberate act, and that no amount of moral lecturing will persuade the white man to "correct" the situation." (p. 90-91)
  • "I think there is no running away from the fact that now in South Africa there is such an ill distribution of wealth that any form of political freedom which does not touch on the proper distribution of wealth will be meaningless." (p. 149)
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New Publication: South Africa & the Group Areas Act

Cochrane, L. and Chellan, W. (2017) "The Group Areas Act affects us all": Apartheid and Socio-Religious Change in the Cape Town Muslims Community, South Africa. Oral History Forum.

Abstract: Oral history interviews with elders of the Cape Town Muslim community were conducted in order to record and explore the socio-religious changes that occurred over the last century. Our research explored experiences related to culture, society, language, religion, education, traditions, family life, dress, food and values. The primary event that was consistently identified by elders as a focal cause of change was the Group Areas Act (1950), which was a policy of the South African Apartheid government that resulted in the forced relocation of many members of the Muslim community in and around Cape Town, South Africa. This paper explores how individuals experienced the Group Areas Act at the time of its implementation and how elders understand this Act as contributing to long-lasting socio-religious change. Rather than draw conclusions, point to causes of change and outline specific outcomes of the Act, we end this article with diverse, inconclusive and debated experiences: a reflection of the oral histories of the Cape Town Muslim community. 

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Surplus People: Forced Removals in South Africa

The experts for this 'thought provoker' come from "The Surplus People: Forced Removals in South Africa" (1985) by Platzky and Walker, which is the summarized version of a five volume study on the topic. The book was published while apartheid was still forcing relocation and displacement, as one of its many policies for "separate development." In addition to its wealth of information, the book offers unique insight in that it is not a historical perspective, but one written at the time of the forced removals and was one of many important publications that drew greater levels of international attention to the atrocities being committed by the Apartheid government.

On apartheid:

  • "The South African government claims that the only way to secure a peaceful future for all is for the different racial groups to development in their own areas. The policy of separate development is thus enforced by the white-elected government in every sphere of political, economic and social life. In reality it furthers privilege in each of these spheres for most whites at the expense of most blacks. Whites have been given 87% of the land area, free education and every opportunity, while blacks are permitted to leave their areas only to sell their labour on the white market." (p. 27)
  • "After 1952 no African person was to be allowed to stay for longer than 72 hours in an urban area unless he or she had special permission to be there. This permission would be stamped in their passes for any policeman to inspect at any time, day or night. Those who did not have the correct stamps would be arrested. They could be imprisoned and fined." (p. 104)
  • "More stringent controls were also placed on the presence of African women in the urban areas. Because of the position of women as the focus of family life, officials regarded them as a key index of how stable and permanent the urban African population was becoming. For this reason, they were anxious to limit their numbers in the urban areas and confine them to the bantustans as much as possible." (p. 117)

Why relocate?

  • "Throughout the world people are moved to make way for infrastructural development such as building dams, highways or conservation areas, and for strategic purposes such as the clearing of border areas. South Africa is, however, exceptional in two respects. Firstly, the vast majority of people affected by these developments have no say in government – no vote and therefore no effective means of expressing their opinions in the matter. Secondly, because they are voteless they are not part of the interest group to benefit from developments such as improved water supply, transportation and national security. The removals are therefore forced and resented by the people." (p. 46)
  • "Almost all of those who are moved in terms of government policy are black, disenfranchised and dispossessed. They are moved because they are black, by a minority government which has made the maintenance of white supremacy the cornerstone of its programme. They are moved from white areas to those proclaimed for blacks. The bantustan policy of the national government – basic to the system of apartheid – has developed largely as an attempt to appease militant demands from blacks for some control over their own lives and for a share of the wealth of the country. In place of rights in a common South Africa, it gives them 'homelands' where they are supposed to exercise political rights and build their own economies. Historically, as will be shown, apartheid has been the foundation for economic growth in serving the labour needs of the mining, agricultural and industrial sectors of the white economy." (p. 16)
  • "As the years progressed, the function of the bantustans as enlarged relocation camps became more and more pronounced. As each new category of surplus people emerged or was called into being – labour tenants, unwanted farmworkers, the growing numbers of the urban unemployed – the dumping-ground function became progressively more important." (p. 123).
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