Identifying Risk and Compensating Tuberculosis: 1916–1957

Abstract Driven by concerns of the white Mine Workers Union, South Africa was the first state to compensate for silicosis and tuberculosis as occupational diseases. The Acts were woven around the binary pairing of miners (whites) and native labourers (blacks). That device enabled legislators to racialise the labour laws without mentioning race. This chapter traces the development of thorough medical examinations, comprehensive health care and a generous compensation system for whites, alongside a system designed to prevent the employment of men who already developed lung disease and to minimise compensation for the (black) majority of the workforce. Having reluctantly agreed to compensate tuberculosis, the Chamber of Mines was relentless in opposing the many critics who argued that the mines were a source of infection. As the critics reiterated, dust exposure created a pool of infected men who were repatriated to rural areas where little or no biomedical care was available. The low wages offered by the mines impoverished labour-sending communities, and this in turn created the ideal social setting for infection to take hold and to spread. Finally, because most infected miners did not receive compensation, their home communities were further impoverished by having to care for men who were no longer able to work.