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(Title of the Thesis)* 1 A 'new experiment in local government' The Local Health Commission: A Study of Public Health and Local Governance in Black Urban Areas in Natal, South Africa, 1930 - 1959 by Mary Susan Caesar A thesis submitted to the Department of History In conformity with the requirements for the degree of Doctor of Philosophy Queen’s University Kingston, Ontario, Canada (May, 2015) Copyright ©Mary S. Caesar, 2015 1 NHSC interview with the LHC, 9 August 1943, LHC Minutes, Vol. 1, 1 November 1941-31 March 1943 i Abstract The Local Health Commission (LHC) was established in 1940. Its significance lies in the fact that it adopted a public health-based approach to local governance and that it delivered health and welfare services to residents of the neglected black and multi-racial urban areas. Even though its mandate was the antithesis of the goals of urban apartheid, the LHC expanded its scope after the National Party came into power in 1948. This dissertation is firstly, an institutional history of the LHC. Secondly, it examines the ways in which black urban residents practiced in municipal institutions by demanding that the LHC not only fulfill its mandate but, that it also amend its programs in order to meet their needs. A third and final theme of this dissertation is the role of Advisory Boards in addressing the public health crises specifically, ways in which the ABs held the LHC accountable. By exploring the LHC through these three themes, this dissertation addressed larger historical questions: firstly, the role of white liberal bureaucrats in the development of public health and urban governance in South Africa and secondly, the nature of black people’s participation in state institutions before 1994. ii Acknowledgements I would like to thank Prof. Marc Epprecht, my supervisor. His generosity, support, encouragement and above all, his belief in me enabled me to conduct the research and work through the various research questions and countless drafts. His vast knowledge of South African history was an invaluable resource to me. He also provided me with financial support and introduced me to his contacts in the academy in South Africa. I would also like to express my appreciation to my dissertation committee members: Professors Gary Kynoch, Sandra den Otter, Ishita Pande and Elaine Power. They gave generously of their time and their expertise to help me improve this dissertation. I especially appreciated Professor Kynoch who served as my external examiner and challenged me to think beyond the limitations that I imposed on my analysis. Professor den Otter was a constant source of support during my time at Queen’s and in Kingston. I’m sure that I am only one of many graduate students who benefitted from her assistance to students in her position as Associate Dean of the School of Graduate Studies. Professor Ishita Pande was and will remain an inspiring historian. A number of Librarians and Archivists gave generously of their time. I thank especially the staff of the Pietermaritzburg Provincial Archives especially Thabani Mdladla; the National Archives and South African National Library, both in Pretoria. In Canada, the Librarians at Stauffer Library were very helpful in finding all the South African resources. Drafts of this dissertation were presented in Canada and South Africa. I thank the organizers of the Canadian Association of African Studies (CAAS), a welcoming environment for young scholars; the 'New Directions in the Histories of Health, Healing and Medicine in African Contexts' Workshop, Durban, South Africa in 2012; and the Studies in National and International and Development (SNID) seminar series at Queen's University. I would like to thank Dr. Scott Rutherford and Prof. Susanne Klausen who helped me talk through my confusion as I developed the arguments in this dissertation. iii Over the years, I received financial support from different sources: Queen's University Graduate Award, Queen's International Tuition Award, the Ban Righ Centre, Prof. Marc Epprecht, Prof. Crush and the Southern African Research Centre, The Dean's Travel Grant and family and friends who generously supported and hosted me in Kingston and in South Africa. There are a number of institutions and people in Kingston, Canada who assisted me during the research for this dissertation. Prof. Jonathan Crush and the staff at the Southern African Research Centre provided me with a nurturing academic environment. They have also become friends over the years. The staff of the Ban Righ Centre provided friendship and a welcome space to reflect and write but most of all, the nourishing bowl of soup and a cup of tea. At the Queen's University International Centre (QUIC) I received not only valuable advice but an international family. In South Africa I received assistance from family and friends in South Africa: my parents, Joseph and Catherine Caesar; Mercy Katsenga who traveled from Zimbabwe to South Africa in order to take care of Fadzai; Sally and Tommy Hudsonberg; Chandré Caesar, who came to Kingston from South Africa to see us through yet another dreary Canadian winter; and Gerald Katsenga. Gerald not only visited us in Canada but provided us with a home in South Africa. In Canada, I owe so much to my friends especially those who also became the child's co-parents: Karen Dubinsky, Susan Belyea, Susan Lord, Paul Kelley, Sayyida Jaffar and Scott Rutherford. Ken McPhail and Susanne Klausen are my dear friends whose home is our home and sanctuary. Susanne is also my inspiration to do important South African history. Finally, to Fadzai Katsenga, still the “brightest star in the sky”. iv Table of Contents Abstract ......................................................................................................................................................... ii Acknowledgements ...................................................................................................................................... iii List of Tables ............................................................................................................................................... vii List of Images ............................................................................................................................................. viii List of Maps ................................................................................................................................................. ix List of Abbreviations ..................................................................................................................................... x Alphabetical List of Public Health Areas, Natal, c.1941 - c.1959 ............................................................... xii Alphabetical List of Types of Local Authorities in Natal, c.1938 and c.1960 ............................................ xiv Chapter 1: Introduction ................................................................................................................................. 1 The "poo revolt" ............................................................................................................................................ 5 Public Health Defined ................................................................................................................................. 14 Public Health and Black Urban Areas Before 1930 .................................................................................... 18 Administration of Black Urban Areas ......................................................................................................... 23 Research questions, Significance and Chapter Outlines .............................................................................. 28 Chapter 2: A History of Public Health and Governance of Black Urban Areas .......................................... 32 Public Health ............................................................................................................................................... 32 Governance of Black and Multi-Racial Urban Areas .................................................................................. 61 Conclusion .................................................................................................................................................. 65 Chapter 3: "A Menace or Potential Menace to Public Health", Black Urban Areas and The Public Health Crisis in Natal, 1930 to 1940 ....................................................................................................................... 66 Irregular Urbanization and The Public Health Crises in Natal .................................................................... 69 Official Narratives of Urban and Public Health Crises in Natal .................................................................. 74 The Thornton Committee: A Novel Approach to Health and Urban Governance ....................................... 78 Making Sense of The Thornton Committee's Recommendations ................................................................ 84 Conclusion ................................................................................................................................................ 100 Chapter 4: "A New Experiment in Local Government": The Local Health Commission in Natal, 1940 - 1959........................................................................................................................................................... 101 A New Public Health-Based Local Authority ..........................................................................................
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