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This is the second and concluding part of a personal history of social medicine in South Africa in the early years after the second world war.
As described in part 1 of this account, upon entry to the Witwatersrand University Medical School (“Wits”) in 1945, Zena Stein and I were mutually committed to a kind of practice that might alleviate the lives of needy communities. In South Africa, that arena was necessarily among “non-whites”. On learning of the work and theories of Sidney and Emily Kark, it was at once evident that we could hope for no better exemplars. Their example had to do not with their comfortable personal relationship, but with their practice of a form of medicine that could be socially meaningful.
To our dismay, in 1948 the Nationalist party led by D F Malan, its totalitarian sympathies undisguised, won a majority in the first post-war election.1 A name change to the National Party conveyed the false assumption of national representativeness. Yet for the next 45 years apartheid (“apartness”), was the governing doctrine. The revised name masked planned inequality sustained by outright racism. Necessary to that system was a repressive political apparatus and almost undiluted power. As a medical student at Wits in the mid-1930s Sidney Kark, a leading figure in student politics both at Wits and nationally, had expressed a strong social bent. In this lamentable post-1948 era the Karks, pressed by an unsympathetic new regime, had perforce to balance their proclivities against sustaining a government funded mission. The sensible course was to abjure overt political action.
For our own part—students free of such constraints—we felt compelled to espouse the political cause of equal rights for all races. In the aftermath of the second world war, the promise of political reform had sparked the enthusiasm of …
↵* The most distinguished among them was probably the cardiologist Maurice McGregor, subsequently dean of medicine at McGill University in Montreal.
↵† In an odd quirk of memory, it occurred to me recently that I never did receive any formal written notice of dismissal. I have searched both my memory and such files as I retain and find no trace of such a document. I can only conclude that I never did receive such notice.
↵‡ The name derived from an intriguing metaphor based on the Chisa boy: deep underground in the gold mines of the Witwatesrand, he was the black miner responsible for lighting the dynamite sticks placed in holes drilled into the rock face to blast out of the rock the gold veins embedded in it.
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