"Making useful men and women of our children": Investigating the Medical Inspection of Schools in the Cape Province, 1918-1938

2023-03, 2023-03
Journal Title
Journal ISSN
Volume Title
The history of school medical services is an underrepresented area in the South African historiography, either of education, childhood, or medicine. Little is known about the ideological or legislative origins of inspections, nor how these programmes operated, and what effect they had on social meanings of childhood and the state of child health. The thesis addresses this gap by examining the pioneering years of the Cape school medical service, (1918-1938). The Cape Province in the interwar, segregation era offers a unique case given its size and history of liberalism. In the twentieth century, the state claimed greater responsibility for the welfare of some of its citizens; ameliorating white poverty while entrenching systems to segregate those who were black, coloured, or Indian. Beginning in the nineteenth century and continuing through the twentieth, childhood was progressively regulated through state intervention, compulsory education, and child welfare work. Nevertheless, one’s class, gender, and especially race mediated the extent to which this idealised (western, middle-class) vision of childhood was a possibility for all children. The thesis applies traditional qualitative techniques and quantitative analysis to a range of sources, chief among them being the annual reports of the school medical inspectors. It is found that those promoting school medical inspections touted the service as a best means for alleviating white poverty and securing a healthy, productive white population. The thesis thus uncovers the political origins of school medical inspections and contributes to understanding how child health was leveraged in discussions of the “poor white problem”. When inspections began in 1918, inspectors were restricted to visiting school board schools which were predominantly (but not exclusively) white. In examining the operation of school medical inspections, it is found that, while the service’s value was widely perceived, financial insufficiency limited what the inspectors were ultimately able to achieve. A failure to provide medical treatment for indigent children also restricted the service’s impact. The thesis argues that demands for state involvement in the provision of free treatment offer a window on this early period in South Africa’s social welfare history and societal notions about the state's responsibility to its youngest citizens. By applying a mixed-methods approach to the annual school medical inspection reports, the thesis explores the impact of the Cape school medical service. To do this, the statistical returns of the inspection reports were transcribed which (recognising bias and subjectivity inherent in the data) constitutes a new dataset for examining historical child health outcomes in the Cape. The thesis finds, through their annual reports, the inspectors constructed an image of child health. This image comprised subjective meanings of healthiness and the contemporaneous state of child health. By measuring public and parental compliance with inspections, the thesis finds that school medical inspections contributed to the medicalisation of childhood, education, and parenting. Through their everyday interaction with children, lectures to teachers, meetings with parents and publication of official reports, the Cape school medical service altered societal perceptions of the ideal childhood.