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Medicine on the Rand: The Biko Doctors and South Africa’s Sharp Dissection

Myra Ann Houser

Myra Ann Houser, Assistant Professor of History, Ouachita Baptist University

The Johannesburg-based Rand Daily Mail’s September 15, 1977, edition contains a striking amalgamation of headlines on page 2: “Kruger Lays Down His Own Condition,” outlining South African Minister of Justice Jimmy Kruger’s attempt to convince anti-apartheid activists that white South Africans deserved most credit for the country’s economic and political development; “SA Faces UN Fury” and “Why UK Is Reluctant on Sanctions,” juxtaposing two divergent international opinions toward redressing the country’s infamous racial policies; “World Shocked at Biko Death;” and “Ex-Policeman Gets Twin Heart,” sharing the story of the world’s seventeenth heart-transplant recipient.  While these may, at first glance, seem a tad disjointed, they reveal the beginnings of a larger thematic story—that of a national medical profession grappling with a new spotlight and its own responsibilities within an oppressive state system.

On December 3, 1967, Louis Washansky received a new heart.  The world’s first successful transplant took place at Groote Schuur Hospital, adjacent to the University of Cape Town’s medical campus.  After a heated, multi-country race to perform such a procedure, news of the operation catapulted its chief of surgery, Christiaan Barnard, into international celebrity.  Media such as the Rand Daily Mail would report on Washansky’s progress (he died just eighteen days after receiving Denise Darvall’s heart) and future transplants, both in South Africa and abroad.

Just a decade later and three days before the aforementioned newspaper page, on September 12, 1977, Black Consciousness leader Stephen Bantu Biko had died what his lawyers would later call a “lonely and miserable death”—unattended and naked on a jail cell floor.  As public memory came to canonize the young and dynamic leader into a martyr, the country’s medical profession once again occupied newspaper front pages at home and abroad.  Ivor Lang, Colin Hersch, and Benjamin Tucker, physicians who attended the leader at various points between his arrest in early September and subsequent death, soon became known as the “Biko Doctors.” 


Less than one week after announcing that Biko had died as the result of a hunger strike, Kruger recanted and noted, according to the Rand Daily Mail, that “I didn’t say he starved to death.”  Naturally, this moved along a process of question raising, culminating with official autopsies and pathologies as well as, famously, private investigations of the body, such as the one performed by Biko’s companion Dr. Mamphela Ramphele.  After a professional consensus that the leader had died as the result of blunt-force head trauma suffered during a violent interrogation several days earlier, the Biko family requested a death inquest; advocates George Bizos and Sidney Kentridge represented the family.


These proceedings, beginning less than two months after Biko’s demise, provided a forum for interested citizens both in- and outside of South Africa to learn more about deaths in detention during an era where press freedom (including, often, that of Rand Daily Mail) came under fire.  While the verdict of “no one to blame” famously aroused ire toward abusive security police, it also brought the country’s medical profession under intense fire.  It is this particular fire that makes the digitized paper’s contrasting headlines so interesting.  According to inquest reports from November 17, police sought medical care for the prisoner when they discovered abnormal behavior; after a doctor told them that he might be “shamming” his injuries, they drove him—stripped naked and in the back of a Jeep—fifteen hours from Port Elizabeth to Pretoria for treatment.  There, he died.

In the wake of the failed inquest, the Bikos brought civil charges against security police.  The Medical Association of South Africa (MASA), meanwhile, launched its own investigation just two years later.  Resulting in part from the autopsy report that Ramphele produced and the pathology report that Dr. Jonathan Gluckman wrote, the group’s board attempted to ascertain whether Lang, Tucker, and—to some degree—Hersch, acted in their patient’s best interest.  Prevailing notions posited that they violated their profession’s code of ethics through kowtowing to official demands for an affidavit indicating that Biko had sustained no serious injury, and therefore been treated well, while in police custody and clearing him, despite his unstable physical and mental condition, for his fatal journey. 

During the inquest, journalists Melanie Yap, Bernadi Wessels, and Helen Zille of the Rand Daily Mail produced a damning expository report claiming that Biko’s medical team would have treated him differently had he been “any other prisoner.”  By 1979, when the inquest had long finished and the Medical Council began its own proceedings, the family settled its case with the state.

Reporting on the MASA investigation reveals tensions within the profession.  With the case re-examination set to proceed in 1980, Phillip Tobias, dean of the University of the Witwatersrand Medical School in Johannesburg expressed concerns on behalf of the school’s executive committee that MASA would not address the fundamental issues that led to Lange, Hersch, and Tucker’s poor and, perhaps, life-costing treatment.  They posited that the body perhaps feared malpractice litigation and, as a result, would not give the matter’s “irregularities” due credence.  Later, and with perhaps more public flair, physicians such as Barnard (who had himself faced Medical Council investigation related to his, um, flair for publicity) and Frances Ames, dean of the University of Cape Town Medical School, began denouncing—as always, for a variety of motivations—their profession’s response not only to Biko’s death but to deaths in detention generally. 

In 1983, after the investigation concluded and the doctors received in essence a slap on the wrist, Britain’s professional medical bodies famously urged a break with South Africa’s.  Rand Daily Mail reporting here demonstrates, as it did in 1977, public domestic awareness to international outcries.  This provides a stark contrast to notorious post-apartheid claims of political ignorance that some South Africans proffered as response to hearings on the nation’s “forty lost years.”

In context with its contemporaries, the Rand Daily Mail issues, particularly digitized as they are in full-page form, offering readers opportunity to contrast each day’s headlines, provide a useful source for understanding public discourse surrounding the Biko death inquest and subsequent medical profession fallout.  As a leading liberal white paper, the publication does not necessarily reflect majority opinion, but does provide a forum for reporting both domestic and international responses to apartheid—both in dramatic stories writ large and in more nuanced day-to-day reporting that aptly paints a holistic picture of the era.

Myra Ann Houser is assistant professor of history at Ouachita Baptist University in Arkadelphia, Arkansas. She teaches courses in African, southern African, Caribbean, and global history. She is most interested in legal and intellectual histories linking southern African liberation movements to their transnational allies and has published in African Studies Quarterly, South African Historical Journal, Atlantic Studies, in edited volumes, and on professional blogs. She is currently finishing a manuscript on the Southern Africa Project of the Lawyers Committee for Civil Rights Under Law, a group that helped fund and provide expert witnesses (included medical pathologists) to the Biko inquest and similar high-profile political cases.

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