© 2004 by Society for the Social History of Medicine
Disease and Death in the South African War: Changing Disease Patterns from Soldiers to Refugees
1 Department of Geography, Downing Site, Cambridge University, Cambridge CB2 3HU, UKE-mail: daniel{at}low-beer.com and andy.cliff{at}geog.cam.ac.uk 2 Department of Geography, University of Nottingham, Nottingham NG7 2RD, UKE-mail: matthew.smallman-raynor{at}nottingham.ac.uk
The involvement of civilians, Boer women, children, and blacks is increasingly integrated within the military history of the South African War. This article assesses the disease history of the war in this context, collating data on mortality from various sources for the first time. Over 60 per cent of total deaths during the war were among civilians, shared among all ethnic groups (Boer, black, and white), and measles was probably the largest killer. Disaggregation by individual refugee camp shows: the rapidity of the epidemics; the early mortality peaks by July 1901; the varied timing and severity of disease by camp; and the importance of measles in explaining the very high mortality rates. At first sight, the decline in overall mortality appears to coincide with the ‘magical effects’ of the British commissions so often cited by historians. However, individual camp mortality curves do not support this historical explanation. We emphasize the epidemiological dynamics of measles, as well as the effects of local camp conditions of overcrowding and malnutrition. Providing a less dashing picture, the South African War is best characterized by measles as well as typhoid. The war shows the crossing in importance of a nineteenth-century military disease history represented by typhoid, and a refugee–civilian disease history that extends to the end of the twentieth century.
Keywords: South African War, disease, mortality, refugee camps, measles, epidemiology, civilian