The ANC's Medical Trial Run: the anti-apartheid medical service in exile, 1964 to 1990 by Melissa

339 Pages·2017·3.75 MB·English

by  Melissa Armstrong

The ANC’s Medical Trial Run: the anti-apartheid medical service in
exile, 1964 to 1990

by

Melissa Diane Armstrong

A thesis submitted to the Faculty of Graduate and Postdoctoral Affairs
in partial fulfillment of the requirements for the degree of

Doctor of Philosophy

in

History with Specialization in Political Economy

Carleton University
Ottawa, Ontario

© 2017, Melissa Diane Armstrong
ABSTRACT

South Africa’s current ruling African National Congress (ANC) government inherited a
relatively well-developed healthcare system that was steeped in institutionalised racism.
The apartheid era created the conditions for poor health and provided poor healthcare for
black South Africans. However, little research has been done on the history of health and
healthcare provision for the South Africans who were exiled by the National Party in
1960 and more specifically on the medical sector developed by the ANC for exiles in
civilian settlements and military camps based in newly independent, sympathetic nation-
states in southern Africa. The exiled South Africans were affected by the legacy of
colonialism, exposed to the repression of apartheid and were subject to the first efforts of
the ANC’s medical sector and (eventual) Health Department while they were in exile.
Indeed, many health professionals who filled leadership positions in the post-apartheid
Department of Health were trained in exile and had been a part of the medical sector in
the liberation struggle during some portion of the thirty-year period that the ANC was in
exile. This medical sector formed in exile is the subject of this dissertation.
The history of the ANC’s medical sector in exile sheds new light on the
importance of health to the international legitimacy of the ANC but also to the
individuals whose lives were at risk in exile. Moreover, it begins to show that the
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Department of Health was also a product of apartheid in the sense that it emerged as a
political response to the inequalities in South Africa and was forced to contend with
exiles that had been damaged by the South African system. Attempts to understand the
post-apartheid National Department of Health in South Africa must first contend with this
history of health and healthcare in exile.

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ACKNOWLEDGMENTS

Throughout the research and writing of this thesis, I was met with generosity,
graciousness, and support from close friends and complete strangers; both were essential
to the success of this project.
The Department of History and Institute of African Studies at Carleton University
have been supportive and encouraging from day one. Over the last four years, the
Department of History’s faculty and staff have offered moral and financial support and
carved out opportunities for me to succeed and for that, I am grateful. Special thanks to
Joan White for her attention to detail and genuine desire to help me to meet deadlines and
June Payne at the IAS for her sense of humor, love of sushi and interest in tabata.
Many thanks to my Carleton University student cohort in the History Department.
Will Tait and his partner Jennifer Gosslin were incredibly hospitable and supportive. I
will forever be indebted to them for all of those Sunday dinners. I was fortunate to have
been in the same PhD student intake as Stuart Mackay and Meghan Lundrigan. They
have been good officemates, excellent sounding boards and more importantly, great
friends. I am also grateful to Matthew Moore. I benefited from his resolve to hit the gym
and his down-to-earth outlook on life. Additionally, I was lucky to share the same
supervisor as Christine Chisholm, Dahay Daniel and Candide (Nyondo) Mawoko. All
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three of these ladies have definitely shaped my academic and non-academic experience in
Ottawa for the better.
Outside of Carleton University, this thesis benefited from the assistance of three
important individuals. Special thanks goes to my Auntie Sharon Westberg, for her
meticulous work with her red pen. These acknowledgements will have suffered
grammatically because she did not get a chance to edit them. Perhaps one day, I will learn
the definition of a “hanging gerund” and be able to place commas appropriately on my
own. Additionally, thanks must go to Kelly Humphrey for her support through the whole
four-year process and for slogging through an early draft of this thesis and providing
much needed feedback. I also appreciate Becky Hartley for her willingness to block off
hours to work or study amidst our busy baseball schedule in the summers. I am grateful
that we both strive to have our cake and eat it too.
I gratefully acknowledge the Vanier Canada Graduate Scholarship for their
financial support. This scholarship gave me the opportunity to complete multiple research
trips to South Africa and have ample time to search the archive in a thorough manner.
With the scholarship, I was able to devote my time undividedly to the research and
writing stages of this thesis.
This research benefited from the expertise of many scholars. I am especially
grateful to Colin Bundy for his guidance during the early stages of my research on the
ANC in exile while I was a Masters student in 2012/13. His enthusiasm for and interest in
the topic was very encouraging. Additionally, I want to thank Hugh Macmillan, Jonny
Steinberg, Jocelyn Alexander, Michael Panzer, Carla Tsampiras, Theresa Eldmann, and
Robert Shell for either commenting directly on aspects of this work or generously sharing
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their own research with me. Thanks also must go to my thesis defense committee Thula
Simpson, Jim Opp, James Milner, Candace Sobers and Susanne Klausen for their
generous engagement with this work and thoughtful suggestions for revisions leading up
to the final submission.
I am particularly grateful to the staff at the ANC archive at the University of Fort
Hare for making me feel comfortable and at home in the archive. I am especially thankful
for the assistance of archivists Ike Maamoe and Vuyo Feni-Fete. Not only were they able
to offer their assistance to find needed files, they were also considerate enough to keep
me informed about the level of safety on campus during the university student strikes in
2015. I also appreciated Ike’s willingness to keep the archive open late so that I could
continue working as needed after business hours.
South Africans are among the most warm, open and welcoming people that I have
ever met. When I first arrived in Johannesburg to start this research in 2013, I was picked
up by Tristan Gevers, a friend of a friend from Oxford University; we had never
previously met. Tristan brought me back to his home where I met his parents Ron and
Rozanne and three sisters, Stephanie, Melissa and Caitlyn. Since then, the Gevers have
become like family; I came and went from their house often enough in the past four years
to have been given a key to the front door. They have included me in their family outings;
painstakingly explained the finer points of cricket and rugby to me; taken me to the
doctor; helped me to buy, register and license a car; and most importantly been open,
honest and completely without pretense. Without the reassurance of their love and
hospitality, I may not have had the nerve to continue the project.
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I was greeted with a second outpouring of kindness in the Eastern Cape. After
contacting a local church in 2013 and asking if someone in the congregation had the gift
of hospitality, I was pointed, without hesitation, straight up the hill in Grahamstown to
the Robertson’s house. There, I was greeted by Sue and Ian Robertson and their
daughters Laura and Emily. I have stayed with the Robertson’s for many months between
May 2013 and February 2017 while commuting from Grahamstown to Alice to visit the
archive. Everyday I returned to their home to enjoy an already-prepared hot meal, warm
fire and great conversation. Once again, I was welcomed in like family and have been
treated as such ever since. I have learned so much from Sue and Ian and appreciate them
more than they will ever know. Without their love and support, the months of archival
research in the Eastern Cape would have been unbearably lonely.
There are no words to express how grateful I am for the patient and insightful
supervision of Susanne Klausen. I have had ample opportunity to be made aware of how
lucky I am to have worked with her. I could not have had a better supervisor for this
project. Over the course of four years, she has written me nearly eight hundred emails in
order to provide references, administrative updates, research advice, thesis corrections,
encouragement/much-needed moral support, and details for hiking Table Mountain in
South Africa together. Needless to say, I have not been a neglected student and I am
thankful for that. She has challenged me to be a better researcher and writer. But most of
all, I am grateful to her for reminding me that writing history is not an academic exercise
but an act of social justice. And… no matter where I end up, we will always have
Bloemfontein’s Emoya and the charging rhino experience.
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Thanks goes to my three sisters Krista Friesen, Kerri Korol and Andrea Gonzalez
and cousin Jenn Doerkson along with their families for unflinching support and
unconditional love. I could not have done this without them. I am also grateful to my
Grandma Wilkinson for her twice-daily prayers and passion for debate; I am confident
that even now, after she has passed away, she is celebrating this thesis submission with
me.
Finally, I am especially thankful for my parents, Chuck and Holly Armstrong,
who have done nothing but stand behind all of my academic exploits. Dad, I have
appreciated your consistent encouragement, willingness to enthusiastically read and
comment on my work and your many words of wisdom. Mom, thank you for always
listening and for your daily commitment to my productivity; I hope that you fully know
that your constant behind-the-scenes acts of service have made all the difference. Without
you both, I would not have been able to complete this thesis. It is, therefore, to the two of
you that I dedicate this work.

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TABLE OF CONTENTS

Abstract ii
Acknowledgements iv
Table of Contents ix
List of Maps x
List of Illustrations xi
List of Acronyms xii

Introduction 1

1. “Some Kind of Government-in-Exile”: From medical sector to Department of Health,
1962 to 1990 36

2. “We Shall Continue to Treat ANC Patients at All Our Hospitals”: Cooperation
between the Health Department and its southern African hosts 81

3. Exposing “Policies of Genocide”: The Health Department’s role in the anti-apartheid
movement, 1977-1990 129

4. “The Ambulance is on a Safari…”: Implementing primary healthcare policy
in southern Africa, 1977-1990 170

5. “It Was a World of Paranoia”: The mental health crisis in exile 218

Conclusion 283

Bibliography 292

Appendix A – Ethics Clearance Form 325

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LIST OF MAPS

1. Geographical Location of Kongwa camp 46
2. Medical facilities available to the ANC in southern Africa 87
3. The ANC in Tanzania 89

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