Technologies, Care and Repatriations: 1926–1966

Abstract Until 1950, there was no effective chemotherapy for tuberculosis. Treatment consisted of an enhanced diet, isolation, and skilled nursing—methods which were expensive and not greatly effective. The centrepiece of the mines’ management of tuberculosis was repatriation of sick miners, without notification of local authorities, isolation of those with infective disease, or education of those around them on how to avoid infection. This approach enhanced the mines’ profitability but confounded every principle of public health. In the 1950s, the development of mass miniature radiography and the discovery of new drugs for the treatment of tuberculosis radically changed the available technologies of care. In discussing international standards of compensation for occupational lung disease, ILO held that the worker’s history of dust exposure, a clinical examination and radiographic findings had to be considered. The Chamber of Mines used mass miniature radiography for a different purpose: those with dusted lungs were identified at entry medicals and then repatriated without compensation. Where chemotherapy was provided to sick miners, the treatment rarely lasted more than a month; as a result, most patients developed drug resistant tuberculosis. Today, South Africa and its labour-sending regions have one of the world’s highest rates of multi-drug-resistant TB.