Mining the Past in a Pandemic: Part I – The Great Smallpox Cover-up

As of writing,* the number of reported novel coronavirus (Covid-19) cases in South Africa is relatively low compared the hardest hit countries. However, that number has worryingly exceeded 400 as of 23 March. So far, none of these reported cases have occurred in the mining industry. However, coronavirus is an outbreak characterised by exponential spread in the absence of adequate measures to combat it at the same pace it spreads out. What has just been stated above may very well be incorrect before or shortly after this article is published.

The most noticeable impact of Covid-19 in South Africa at the moment is an economic one, which will likely be exacerbated by the impending lockdown to begin at midnight on 26 March. To that effect, one of the industries that stands to take the biggest hits is that of mining, an industry which has already had its fair share of problems over the past ten years.

However, it is not the primary purpose of this series of articles to provide an update on the situation concerning the coronavirus pandemic. Doing that would render this piece out-of-date in a matter of hours from its publication. Rather, it is to have a reflective gaze on the past to provide lessons for what to do, or perhaps what not to do, from now onward given the sordid history of the South African mining industry’s response to outbreaks of disease among its workers.

This is of particular urgency in the South African context. Among the most vulnerable to the wrath of Covid-19 are the immunocompromised, not just the elderly. Due to HIV and tuberculosis, it is an unfortunate reality that the immunocompromised are a significant proportion of the nation’s population. Furthermore, mineworkers in South Africa are a high-risk group for contracting immunocompromising conditions such as HIV due to the nature of the migrant-labour system.

The workforce of South Africa’s mines thus presents a uniquely vulnerable group, and in order to avoid the looming catastrophe, it is necessary for the mining industry not to repeat the past mistakes. In particular, the lives of workers must be put before profit, with the industry providing nothing short of complete transparency. However, the sacrifice of transparency in pursuit of profits provides the background of the first lesson from history, that being the outbreak of smallpox in Kimberly in 1883-4.[1]

Unlike Covid-19, the origins of which appear clearly linked to animals, smallpox’s origins remain a mystery. The earliest evidence of its existence was found on mummies in Egypt in the 3^rd century BC. Smallpox was caused by the variola virus. Fortunately, it is a disease of which we may speak in the past tense. Thanks to a successful vaccination campaign which defeated smallpox, its last naturally occurring case was in 1977. Incubation occurred over roughly 12 days in an infected individual.[2] Subsequent symptoms were marked by “a rising fever, a splitting headache and then its tell-tale symptoms, blisters in the throat and a rash that ripened into blisters on the skin, which turned into pus-filled pustules particularly on the face and limbs”.[3] The history of the disease was a devastating one, with a death rate of three in ten on average. However, surviving smallpox was not always a blessing, with severe scarring, blindness and infertility having been its common aftereffects among survivors.[4]

The disease was particularly deadly for South Africa’s Khoekhoen community in the century following the Dutch settlement in the Cape, the Khoekhoen having been a population with no pre-existing immunity to the disease when it was introduced into Southern Africa.[5] Outbreaks of smallpox continued to occur throughout South Africa in the 1800s, despite the existence of a vaccine, which had met with opposition and fear by certain segments of the population in Cape Town.[6] The most notorious of these outbreaks was that which occurred in Kimberley in 1883-4, when the presence of smallpox in that town was denied by those doctors connected to the mining industry.[7]

The two primary villains in this story are notorious in the history of South Africa. These are Dr Leander Star Jameson, a medical doctor, and Cecil John Rhodes, the most famous diamond capitalist in South African history.[8] These two men were close friends,[9] and while not the only culpable parties by any means, they were the most prominent.[10] The setting was Kimberley, a town which had, for a time, become the second largest settlement in Southern Africa thanks to its diamond industry.[11] Despite the prosperity one would assume would follow the rapid expansion of such an industry, the town fell horribly short in the context of public health, and was simply unequipped to deal with a serious epidemic.[12] Kimberley was simply not ready when Smallpox arrived in 1883.[13]

Jameson, who had initially diagnosed smallpox when examining those migrant labourers who are believed to have been the source of the outbreak, later retracted this diagnosis, instead claiming that it was little more than a skin disease.[14] He claimed that this disease was neither contagious nor lethal.[15] Despite the Medical Board reaching the conclusion that quarantine of the migrant workers was necessary, Jameson and some likeminded doctors proceeded to conduct a campaign of misinformation, distributing flyers which denied that those migrant workers who had been quarantined had smallpox.[16] Having close links with those in the diamond industry was a likely motive for Jameson to try quell any panic related to smallpox.[17] And as Viljoen has pointed out, the fact that many doctors were themselves claim owners in the diamond fields likely contributed to the lack of any significant challenge to Jameson by Kimberley’s medical establishment.[18] However, powerful elites such as Rhodes, wishing to avoid the closure of Kimberley’s diamond fields, were likely the real power in facilitating the cover-up of the outbreak of smallpox.[19] Rhodes himself insisted that the disease that was spreading in Kimberley be labelled “chickenpox”.[20]

It is not possible to go into the sordid details of the conspiracy between the diamond elite and compliant medical professionals.[21] Needless to say, the downplaying and outright denial of the existence of smallpox in Kimberley had catastrophic consequences.[22] Measures were finally taken to properly bring the outbreak under control (only following public pressure due to the increase of mortality among whites).[23] However, the mortality rate was high, with 700 people dying of smallpox in a town of over 20 000.[24]

What this contemptible episode in the history of South Africa’s mining industry demonstrates is the need for absolute transparency in a time of crisis. When the Covid-19 hits South Africa’s mining industry (not being a question of if), the well-being of workers and surrounding mine communities must take precedence. While a conspiracy such as that which occurred on Kimberley’s diamond fields is incredibly unlikely in an age in which information travels fast, the mining industry must be expected to act quickly and transparently in the event of any outbreak among its workers. It is hoped that mining companies heed President Cyril Ramaphosa’s call to take care of their workers during this period.

Written by Richard Cramer.

This work was carried out under the COVID-19 Africa Rapid Grant Fund supported under the auspices of the Science Granting Councils Initiative in Sub-Saharan Africa (SGCI) and administered by South Africa’s National Research Foundation (NRF) in collaboration with Canada’s International Development Research Centre (IDRC), the Swedish International Development Cooperation Agency (Sida), South Africa’s Department of Science and Innovation (DSI), the Fonds de Recherche du Québec (FRQ), the United Kingdom’s Department of International Development (DFID), United Kingdom Research and Innovation (UKRI) through the Newton Fund, and the SGCI participating councils across 15 countries in sub-Saharan Africa.