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Sexually transmitted infection and public health in South Africa: Educational campaigns for prevention, 1935–1948 and 1999–2008

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Abstract

This contribution compares two educational campaigns for prevention of sexually transmitted infections (STIs) in South Africa: against syphilis in the decade before penicillin became widely available after World War II, and against HIV since 1999. The syphilis campaign was led by the South African Red Cross. The HIV/AIDS campaign is in the hands of loveLife, a well-financed health non-governmental organization. Widely separated in time, they nevertheless share basic characteristics that help to explain their limited effectiveness. Much public education for STI prevention assumes that accurate medical information, if delivered effectively, will promote necessary behaviour change to reduce risk of infection irrespective of the class, culture or education level of the target groups. Approaches based on that premise largely failed against syphilis in South Africa and have so far failed again against HIV/AIDS. The paper contends that the health propaganda generated in both campaigns took insufficient account of the socio-economic circumstances and beliefs that frequently constrain changes in behaviour even when self-preservation is at stake. As mass campaigns, they were unable to respond to regional and local differences that affected reception of their messages. Recipients of public funding and support, they each aligned themselves with prevailing political discourses in ways that also impacted on effectiveness. Despite these and other preventive efforts, syphilis in the 1940s, like HIV in the years since 1994, continued undiminished to take a heavy toll of people's lives and health.

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Notes

  1. Central Archives Depot, Pretoria, Department of Public Health Records (GES) 376, 4/5B,C,D contain extensive correspondence and reports documenting popular white fears of black workers and servants as carriers of contagion from 1938 into the 1950s.

  2. GES 2268 60/38 passim.

  3. GES 2264 60/38F, Minutes of 3rd meeting of Non-European Work Sub-Committee of the Social Services and Education Sub-Committee, South African Red Cross, 14 November 1938.

  4. For instance, see the transcripts of six ‘health specials’ published by the Natal Mercury, Rand Daily Mail, Cape Times, The Friend (Bloemfontein) and the East London Daily Dispatch in 1936, GES 2263 60/38D.

  5. Department of Public Health, Annual Report, Year Ended 30 June 1937 (Pretoria, Government Printer, 1937, U.G. 52–‘37); GES 2264 60/38F General Secretary, South African Red Cross Society to E.H. Cluver, Secretary for Public Health, 28 June 1938; E.H. Cluver to General Secretary, South African Red Cross Society, 20 July 1938; E.H. Cluver to Minister of Public Health, 16 November 1938; DPH Circular, 9 of 1938, 18 July 1938 to heads of government departments, provincial secretaries, and local authorities throughout the Union.

  6. GES 2264 60/38F E.H. Cluver to General Secretary, South African Red Cross Society, 20 July 1938.

  7. GES 2264 60/38F Minutes of 3rd Meeting of the Film Sub-committee of the Medical and Propaganda Sub-committee of the Red Cross's National Committee for Health Education, 16 September 1938.

  8. GES 2264 60/38G Scenario for Two Brothers by Joseph Albrecht for African Film Productions (1940). See Jeeves, 2003.

  9. GES 2264 60/38G.

  10. GES 2264 60/38G Scenario for Two Brothers (1940).

  11. GES 2268 60/38L.

  12. Department of Public Health, Annual Report, Year Ended 30 June 1937. Pretoria, Government Printer, 1937, UG 52–‘37, 20; GES 1979 34/33F Minutes of the 18th meeting of the Council of Public Health, 9–10 February 1938; GES 1902 11/32E Report of the Interdepartmental Committee on Vital Statistics of the Non-European Population, 1937.

  13. Report of the National Health Service Commission, 1942–1944, U.G. 30–‘44. Government Printer: Pretoria, pp. 24–26.

  14. Both have arguably worsened since 1994, but inequality is now certainly less racial than it was under apartheid.

  15. ‘Address delivered by the Deputy President, Ms Phumzile Mlambo-Ngcuka, at the National Imbizo on Ubuntu … ,’ 17 November 2006, quoting from a widely known African proverb (www.thepresidency.gov.za). A discussion of the clash of communal values and democratic liberal individualism is in Rosemary Jolly and Alan Jeeves, ‘Gender Equity, HIV/AIDS, and Democracy in Rural South Africa since 1994’ (forthcoming).

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Acknowledgements

The authors acknowledge the support of the Social Sciences and Humanities Research Council of Canada that financed the initial stages of the research. The Canadian Institutes of Health Research funded the project entitled ‘Transforming Violent Gender Relations to Reduce Risk of HIV/AIDS Infection among Young Women and Girls.’ In addition to the authors of this paper, the investigators in 2004–2006 were Will Boyce and Nomusa Mngoma, Queen's University; Sarita Verma, University of Toronto; Steve Reid, Centre for Rural Health, University of KwaZulu-Natal (critical review of the proposal, instruments, procedures and data collection); Eleanor Preston Whyte, HIVAN, University of KwaZulu-Natal; Tracy Vienings, Centre for the Study of Violence and Reconciliation, Johannesburg; Claudia Mitchell, McGill University (critical review of the proposal and procedures); and Belinda Dodson, University of Western Ontario (critical review of the proposal and data collection). The following gave valuable support to the project as research assistants: Diane Davies, Ncedile Mankahle, Vuyelwa Mkhize, Tobias Mngadi, S’thembile Ngidi, Cyril Nkabinde, Hana Saab, Sid Sahay and Siduduziwe Zulu. The authors also wish to thank the editors of this special issue and their readers for their helpful suggestions for revision.

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  1. Department of English and Institute for Population and Public Health, Queen's University, 49 Bader Lane, Kingston, K7L 3N6, Ontario, Canada

    Alan Jeeves & Rosemary J Jolly

  2. Southern Africa Research Centre, Queen's University K7L 3N6, Canada and Department of History, University of South Africa, 0003, UNISA, South Africa

    Alan Jeeves

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Jeeves, A., Jolly, R. Sexually transmitted infection and public health in South Africa: Educational campaigns for prevention, 1935–1948 and 1999–2008. Soc Theory Health 7, 264–283 (2009). https://doi.org/10.1057/sth.2009.3

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