Vaccination in 19th century Natal met with acceptance, resistance

WHILE there is controversy concerning the Covid-19 vaccines and their efficacy, vaccination against smallpox in colonial Natal was largely well received.

Settler authorities were well aware of the efficacy of vaccination in suppressing the threat of smallpox in Britain where in 1853 vaccination had become mandatory.

When the port of Durban began receiving more shipping during the 1850s, it was realised that the harbour was potentially the gateway for the influx and transmission of smallpox.

As the secretary for native affairs, Theophilus Shepstone was aware of the vulnerability of the African population to smallpox and the need to act with both alacrity and caution. In a circular disseminated to all magistrates in Natal in October 1858, he stated: “The prevalence of smallpox in the Cape Colony … has induced the Lieutenant-Governor to attempt the introduction of vaccination among the Natives of this Colony as speedily and extensively as possible.

“Messengers have been sent to all the principal Chiefs ... informing them of the existence of this disease in the neighbouring Colony … explaining to them the efficacy of vaccination.

“To carry out this measure, His Excellency has not overlooked the possibility that at first the superstitious fears of the Natives may prevent them taking advantage of [what] is being offered … It is unnecessary to say that such a measure must not be introduced to them in the shape of an order ... ”

A significant aspect of Shepstone’s circular was his awareness of indigenous superstition and the challenge which Western medicine posed. Traditional healing had a distinct social context in terms of the healer’s authority and standing within his community.

Whereas in Western medicine, consultation is individual and private, diagnosis in the African context involved the community.

Significantly, what proved crucial to the success of vaccination campaigns was that variolation, a traditional form of inoculation, was practised in Africa long before the advent of colonial rule. The practice of inoculation – jova, in Zulu – had long been part of indigenous therapeutics.

In administering vaccination as jova, European doctors found Africans compliant and co-operative. Consequently, resistance to vaccination campaigns was very slight.

Facilitating the process of vaccination were Anglican missionaries like Bishop Colenso and Dr Henry Callaway. They recognised the need to work from within existing African views.

Callaway, who was a qualified medical doctor, respected traditional African medical practices. Like Colenso, he was culturally sensitive.

Implicit in Shepstone’s concern for African health was colonial dependence on African labour. It was the predominant economic issue of the colonial era because infrastructure development and the economy depended on it.

A further unstated concern of Shepstone’s was that of food security. Until Indian market gardeners became dominant, white colonists depended on African cultivators for much of their corn and vegetables.

The rapid increase in Indian immigration to Natal after 1876 and uncertainty as to their vaccinated status motivated the passage of legislation in August 1882 making vaccination compulsory. The response to the vaccination campaign was largely positive.

In a letter published in the Natal Witness on October 17, 1882, Anglican Bishop Colenso reported that over the previous four weekends his son, a medical doctor, had vaccinated between 1 400 and 1 500 Africans at Bishopstowe, near Pietermaritzburg. Reports from magistrates around the colony noted the compliance of Africans in being vaccinated. Of particular concern was the status of migrant labourers returning from the Kimberley Diamond Fields where an outbreak of smallpox had resulted in 600 deaths. In Durban smallpox-infected Amatonga labourers on a ship from Mozambique were isolated in a lazaretto on the Bluff headland.

There was no organised anti-vaccination movement in Natal. But there was resistance among some white colonists to having their children vaccinated. During the 1885 session of the Legislative Council, five separate petitions were tabled totalling 1 147 white objectors.

One of the petitions claimed that prosecutions amounted to “persecutions”.

There was an initial reluctance among Indians to have their children vaccinated. In his report for 1889, the Protector of Indian Immigrants wrote: “Many Indians disregard vaccination altogether.” However, that situation appeared to have improved based on subsequent reports.

In his 1893/94 report, the District Surgeon for Durban noted that most Indians had been vaccinated.

An extensive outbreak of smallpox occurred during the 1893-94 period. It originated on the Witwatersrand goldfields and spread across Natal as migrant labourers returned to their homes. Up to 500 Africans left each month for the goldfields with similar numbers returning.

A sense of urgency coloured Assistant Colonial Secretary Christopher Bird’s Circular Minute of October 12, 1893: “You will take steps to strictly enforce the penalties for breach of quarantine regulations … ”

Although infections were widely reported, there were very few deaths. Despite widespread vaccinations, in the last years of the century fresh outbreaks of smallpox claimed 90 lives.

By the latter Victorian period, it was apparent that Shepstone’s concerns regarding the African population on the issue of smallpox had been positively addressed. His fears of resistance by Africans to vaccination were not realised. The importance of safeguarding the health of the African population reflected the economic thread implicit in vaccination policy.

Railway development, the coal mines, the harbour and agriculture all relied heavily on African labour.

Ironically and unfortunately, the willingness of Africans to be vaccinated did not extend to having their cattle inoculated against the rinderpest scourge of 1896-98. Their refusal, despite the offer of government assistance, cost Africans an estimated 90% of their livestock.