'-.:1:.~~.1;,
22
Society in transition,
200 I, 32( I )
The problem of syphilis in South Africa is so closely related to the development of
the country that a study of the social factors responsible for its spread is likely to
assist in its control. Few countries can have a higher incidence of the disease than
has South Africa. ...
[Evidence from a scatter of sample studies of men, women, children and babies is
then assembled indicating prevalence rates of c23% amongst both rural and urban
dwellers and rates of new cases increasing at about 3% p.a.]
Our present review indicates that not only are we
dealing with a large mass of latent syphilis in the
African populations, but also with a very high
incidence of new infections each year. The process is taking place in highly urbanised areas, as
well as in the more remote rural di'su.icts.A study
of the social pathology of the diseasemust, therefore, include an historical analysis, as well as an
assessmentof presenttrends which are maintaining the spread of syphilis.
Before Europeanscame to South Africa syphilis was unknown among the Africans. The Zulu
have no specific name for the disease,other than
isifo sabelul1gu (dise~se of white men) or isifo
sedolopi (disease of the town).
[Kark's historical review covers early race contact, especiallyon the diamondfields of Kimberley
and the gold fields of the Witswatersrand,and the
effects of the compound'system. He also analyses 1936 censusdata to indicate the geographical
demography of the African population.]
The living conditions of the Africans in the
Kimberley area were conducive to the spread of
syphilis. Drunkennesswas common; compounds
were filthy and there was a rapid movement of
men to and from the diggings. ...The striking feature was that a large group of men were living
under abnormal social conditions,
because very; .
few, if any, had their wives and families with them,:'
This resulted in promiscuity, prostitution and the; ,
sure spread of syphilis. ...i
In the towns the number of unattached men is~,
I
four
times greater
greaterthan
thanthat
thatofofunattache.d
attached men
a1~ !,.
six times
women.~
I
Over and above this a large number of these unat.;
tached men are not permanent residents in th~ ;
towns. Where there is such a high proportion °\ '
virile adult men as compared with women, the r~
suIts are likely to be undesirable. The men will
seek their social and sexual life in shebeens an~r
brothels. Prostitution and alcoholism are well-es!
tablished immediate causes of syphilis
Furth ~r1
more the temporary nature of the sojourn of thl:S~
men is not conducive to the development of\
moral social code, which might influence behavioui~
as it would be in the case of a stable community{
The additional factor to be dealt with in Soud:"
r
Africa is the movement of men so infected in tbie
l
towns, to tbeir homes in the rural areas. In thi.j$
way venereal disease has been brought to the mo~ t'
remote comers of the country.
!
A limited study carried out in the Polela dist1-j~t;
indicates that this is the main source of infectlq '"
of the rural population. The Polela study indicat~5
~
:;::.:;;:i'~~~;~~::;~:,
.32(1)
Society in transition, 2001, 32(1)
23
tllat the majority of married women (29 out of 32)
at work
from
the
rural
areas,
comprise
a group
alpatients were infected at home by their husbands,whoready used to sexual intercourse.
In the old
days
a
had recently returned from work in a town.No-fewer
widow
would
become
the
'wife'
of
her
late
toan 23 6ftfie contacts who had infected
husband's
brother
and
have
children
with
him.
these 32 women had been infected in town. The
This
still
happens
today
(but
not
as often
as beposition of married men is somewhat different.
fore)
and
it is probable
that
this
group
of women
Few (2 out of 20 partners.) were infected by their
will
present
an ever-increasing
problem
in the
wives. The majority were infected during an extraspread
of syphilis.
The
other
group,
whose
husmarital union. A number (10) were infected in their
bands
leave
them,
will
often
also
indulge
in extrahome area. Like the marred men, single men are
marital
intercourse,
more
especially
if their
husfrequently infected while away from their homes
bands
Thus remain
we
haveaway on for
the long
one periods.
hand
a set of condi(6 out of 10 cases).The majority ofgirl~ and single
women (13 out of 14 patients) were"'infected in
tions
in urban
areas
ideal
for th.e spread
of syphihome districts by contacts who had contracted
lis, and
on the
other
hand
a migrant
labour
force
the disease in the area, as well as while away from
which
successfully
spreads
this
disease
to the.
the area. Not infrequently these contacts were
rural
areas
where
social
conditions
are also
suitmarried men.
able
for
its reception.
All
General discussion:
The industrial revolution in South Africa, commf:ncing with the discovery of diamonds and continued with the large-scale mining of gold, led to
the development of an urban life which has profoundly disturbed the family stability and sexual
mores of several million Africa!} people.
Urbanisation as a process is bound to disturb
patterns of living which have been developed in a
rural society, but urbanisation in South Africa has
taken a partictllarly disturbing directiqn as far as
the African is concerned, as it has developed
mairily on the basis of migratory labour. This system of migratory labour of adult men has led to
instability and pathology in fal11ily relationships.
The code of morals of the men VI'ho have been
to town appears to have arisen though the
realisation of a new, free, sexual life, one that does
not regard sexual intercourse in a serious light,
but as a cheap commodity for temporary pleasure.
This results in adultery and intercourse with single
girl ~ at rural homes ~ a state of affairs which the
work at Polela indicated to be not uncommon. despite the fact that the tribe as a group frowned on
such activities.,
In addition, the very large number of wido\\'s
'. .and the many women whose husbands are a\vay
rate
this
has
since
the
great
a
the
ing
relations
ing
with
an
last
a
re-orientation
individual
70
life
The
destroycheapen-
women
and
bring-
as
leaving
their
South
process
is
at
the
of
on
opment
of
emerge,
among
the
gradually
life
benefits,
control
urbanisation
the
socia!
in
the
to
few
remhave
of
men
pathological
relathe
rural
communi-
life.
With
the
our
urban
areas
spread
pathology
a
social
a set
lies
be
requires
and
family
but
masses
This
disturbed
urban
family
other
of
in-
sexual
\vhich
therapy
a stable
such
any
must
year.
to
healthy
relationships
result
the
of
attempts
n"eatment
of
African
ordered
of
root
of
in
every
save
Treatment
succeed
succ~ssful
tablishment
Africa.
the
abo\,lt
will
a
inevitable
and
based
of
facts
of
brought
towards
social
homes
economic
treatment
disorder
line
the
the
development
no
cannot
first
tionships
breaking
wrong,
changes
in
unhealthy
emerged
and
of
years,
personality
family
problem
men
pathological
syphilis
the
and
historical
of
...will
right
understanding
spread
such
customs,
standards,
of
the
ties
social
moral
the
social
edy
producing
rigid
between
and
cases.
ever-increasing
days,
Bantu
of
during
and
at an
syphilis.
Without
culcate
on
digging
concepts
it
involved
vast
in
system
old
going
diamond
changes
down
ing
been
of mores
of
the
of
develwill
which
syphilis.
ans\ver
syphilis.
es-
In
to
the