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Exposing the Racially Biased Past of Medical Science: A Reckoning with Bioethics

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“The medical field and palaeoanthropology are built on a foundation of racist science. The history of physical anthropology, anatomy, and palaeoanthropology shines a light on the need for a reckoning with the past,” Christa Kuljian

 

Science does not exist in a vacuum. Scientists and their research are often shaped by their social and political content,” said Christa Kuljian, author, and research associate at the Wits Institute for Social and Economic Research (WiSER).

 

Speaking at the Annual Steve Biko Bioethics lecture, Kuljian explored how colonial thinking, the concept of ‘race typology,’ and apartheid had an impact on scientists’ assumptions, including Raymond Dart and Phillip Tobias, in their study of physical anthropology at Wits University and in their search for human origins in SA.

 

“When I started writing about the history of the search for human origins, I asked what impact did colonialism have on scientists studying human evolution in the early 20th century? What influence did apartheid have on that search? What I found in my years of research, in many archives is that for more than two centuries in this field, scientists viewed black people as specimens, not as human beings,” said Kuljian.

 

“The field of palaeoanthropology and I would argue the fields of anatomy and medical science are built on foundations of racist science and white supremacy. Which has bearing on bioethics today.

 

Kuljian explained that in the mid-1700s, it was Swedish botanist Linnaeus who first named humans as Homo sapiens. “He divided us into four variations, defined largely by geography and physical appearance. What a lot of people don't realise is that he created a fifth group called Homo Monstrosus, which included what he called monstrous, or abnormal people. He put the Khoi and the San people of Southern Africa in this category. This naming was powerful and dehumanising. Linnaeus sent a painful ripple effect across the centuries.

“Over 100 years later, when Charles Darwin published The Descent of Man Linnaeus's naming continued to have influence. At the same time, it had an impact on Robert Broome, a Scottish medical doctor and palaeontologist who arrived in SA in the late 1800s and declared the most interesting specimens were the natives.

 

“Many universities in Europe, as well as museums and universities in the US, had begun collecting human skeletons and the international skeleton trade was brisk. In a letter to Lawrence Wells, Broome described his work in 1897: I cut their heads off and boiled them in paraffin tins on the kitchen stove and sent them to Turner. William Turner was at the University of Edinburgh. White supremacy had taken hold in science around the world.

 

“What many people don't know about Raymond Dart is that when he arrived in SA, he started a human skeleton collection,” said Kuljian. The motivation for starting these collections was to understand comparative anatomy and race. “Scientists at the time thought that humans could be divided into separate and distinct, pure racial types. They thought these pure racial types, which we know now do not exist, would give them insight into human evolution.”

 

Dart believed in race typology that classified humans by their physical characteristics was an important aspect of physical anthropology and was particularly interested in the anatomy of the people of Southern Africa, especially the San and the Khoi. “He hoped that understanding their anatomy would give him a clue to understand race typology and human evolution,” explained Kuljian.

 

In 1936, Dart led a Wits expedition of scientists to the Kalahari. “The Wits scientists conducted their research in the stylised setting of a camp that had been created by Donald Bayne, a former farmer and hunter. Knowing that many local people were struggling to find food and water, he offered rations of both and brought them together from various places across the Kalahari to an area called Twee Rivieren.

 

“Dart gathered the names of the 77 people in the camp and issued each of them with a cardboard tag and a number. Dart and his assistant took cranial measurements and measured facial characteristics. They recorded eye colour and hair texture and wrote their findings on the cardboard tags. Darts publication in the Wits Journal Bantu Studies in 1937 makes disturbing reading as he gave special attention to the measurements of the external female genitalia. He believed that taking measurements and photographs of intimate body parts would contribute to the effort to confirm racial types,” Kuljian explained. In The Great Long National Insult Yvette Abrams writes about the sexual obsession that Europeans held with the Khoi and the San as long ago as the 1600s. Dart and his male colleagues brought these anthropological practises into the 20th century.

 

“After the measurements were completed, the scientists led each person to a second tent to have their face masks taken.” A technique to gather face masks by moulding plaster of Paris onto the faces of living people. Kuljian explained that seeing the completed face mask that looked eerily like him, the first man to undergo the process took the face mask, walked off, and could not be persuaded to give it back. “There were no standard procedures in place in 1936 for seeking a research subject’s consent. The Hippocratic Oath was originally written in 400 BC, and it was translated into English in the 1700s, but it wasn't adopted by the World Medical Association until 1948,” said Kuljian. “There were no required procedures in place at the University of the Witwatersrand in 1936 and there were very few established protocols at universities around the world. The ethics of taking these casts and measurements was never questioned by the scientists at the time.

 

“From then on through to the 1980s, almost every expedition from the Wits Department of Anatomy to study living people across Africa included taking face masks. Today at Wits there are over 1 000 masks in the Raymond Dart collection.

 

“After the Wits expedition, Raymond Dart brought members of this same San community to Johannesburg and placed them on display at the Empire Exhibition. The Empire Exhibition celebrated the 50th anniversary of Johannesburg,” said Kuljian. Speakers at the exhibition spoke about the San's physical characteristics and referred to them in demeaning ways. “In Bantu's studies, Dart wrote: Bushmen are, as it were, living fossils representative of the primitive state of all mankind. Mementos of our primaeval past.

 

“Dart wasn't the only person using this term ‘living fossil’,” explained Kuljian. “Jan Smuts, the Prime Minister of SA, was supportive of Dart and Robert Broome and called Khoi and San people living fossils, which is offensive and wrong. Living human beings are not fossils. “Dart and Smuts work together to develop a San reserve similar to the reservations for indigenous people in the US. The legislation did not pass, but it is one example of how the push for segregation existed in SA before apartheid,” Kuljian explained.

HISTORY OF COMPARATIVE ANATOMY & RACE TYPOLOGY – PHILLIP TOBIAS

 

“Philip Tobias was Raymond Dart’s student in the 1940s and 50s. Like Dart with the Taung child’s skull, Tobias is also widely known for his work in palaeoanthropology.

 

“Fifteen years after Dart’s expedition, in 1951, Tobias made his first of many trips to the Kalahari to study the San. Each of these trips involved measuring every part of a person's anatomy, as Dart did, including women's labia. “Tobias took over from Dart as the head of the Department of Anatomy in 1959. In over 35 years as head of the department, he continued to take face masks at each expedition across Southern Africa, and he added 2 000 human skeletons to the Dart collection, well into the 1980s.

 

“In many ways, Tobias differed from Dart,” Kuljian said. “As a young Jewish student, he was deeply affected by World War 2. Hitler's Holocaust raised scientific questions for him about race. In 1948, he was elected the President of the National Union of South African Students, Nusas, and he was supportive of Wits University remaining open to black students as the government-imposed apartheid.

 

“The paradox of Tobias's opposition to apartheid, on the one hand, and his scientific practises on the other, came through when he led another expedition, this time to Campbell in the Northern Cape. In 1961, Tobias exhumed the skeletons of Cornelius Kok II who had died 103 years earlier in 1858. Tobias exhumed the remains of several other family members as well. He wanted to collect other types of skeletons for the Dart collection,” explained Kuljian. “Scientific researchers did not include contextual information and biographies, but simply labelled them Griqua skeletons. According to a local newspaper article at the time, upon seeing a member of the Griqua community at the exhumation Tobias described him as ‘a wonderful link with the primitive’.

 

“By this time, apartheid laws were in full swing. The Population Registration Act initially classified Griqua people as African. They had to carry a reference book and pay a poll tax. If a person did not mention to a government official that they were Griqua, but instead said that they were coloured, they would be exempt from the tax. So, by the 1960s, most people who had previously described themselves as Griqua were classified as coloured.

 

“Tobias told the Kok family and the local newspaper reported that it would be two years before experiments and investigations could be completed and Cornelius Kok’s remains would be returned. However, the skeletons remained at Wits for decades. It was only after the end of apartheid that the Kok family approached Tobias, 35 years after the skeletons were taken, saying they wanted their ancestors remains back. The return ceremony at Wits was in 1996. It took another nine years of negotiations, and the remains were only reburied in Campbell in 2007. This is a story of institutional power, science, and race,” said Kuljian. After that initial trip to Campbell, Tobias led three further trips with students in 1963, 1967, and 1971 for excavations. “His trips interested other Wit’s professors, including Herta de Villiers and Trevor Jenkins. It's hard to believe that all three professors took measurements of women's labia in Campbell, which contributed to journal articles well into the 1960s.”

IMPACT OF STEVE BIKO’S DEATH ON MEDICAL ETHICS

Discussing the way Steve Biko’s life and death opened the way to address medical ethics, Kuljian said: “In 1966, Steve Biko began studying medicine at the University of Natal. At a young age, he understood colonial thinking, racism, and white supremacy, and he knew how destructive they were. In I write what I like, he wrote: The most potent weapon in the hands of the oppressor is the mind of the oppressed. His contributions to philosophy and black consciousness movement pushed back against the overwhelming influence of colonial and racism. “On September 12, 1977, Steve Biko died in detention. He was murdered,” said Kuljian. “Two days earlier, healthy and 30 years old, he had been arrested in Port Elizabeth. In prison the security police beat him badly and this is where the medical profession was implicated. Doctor Ivor Lang recorded that he found nothing wrong with Biko. Dr Benjamin Tucker examined him and recommended that Biko be taken to the hospital, but after the security police argued with him, he changed his mind and said it wasn't necessary. Security police drove Biko over 700 kilometres to Pretoria. Biko made the trip naked in the back of a van where he was injured further.
“Biko died the next night alone in hospital. It was the South African Medical and Dental Council's role to protect patients from improper medical conduct. They did not hold the doctors to account, and they attempted a cover up. This single death in detention amongst many under apartheid, led to an outcry and prompted many efforts related to human rights, medicine, and health,” explained Kuljian. “Professor Joe Variava, who is now professor emeritus at Wits, was one of the people to raise the alarm. Submissions to the Council were ignored, but Variava persisted. He was joined by other doctors, including Tim Wilson and Dumisani Nzimande. Tobias, who was dean of medicine at the time, joined, as well as Francis Ames and Trevor Jenkins.

 

“The group took their case to the Pretoria Supreme Court. Variava and others versus the South African Medical and Dental Council. To their surprise, on 30 January 1985, the judgement ordered the Council to hold a formal disciplinary hearing for the two doctors involved and to pay the costs for the case. Doctors Lang and Tucker were found guilty. Lang received only a caution and continued to practise for five more years until he retired. Tucker was struck off the role, but he issued a public apology and successfully applied to be reinstated.

 

“During this process, doctors at UCT and Wits saw the need to establish local medical ethics committees that would have status in the faculty and offer advice to doctors. Trevor Jenkins was involved in creating course material about medical ethics. Variava again played a role in 1997 when the Wits Faculty of Health Science was asked to make a submission to special hearings on the health sector in front of the Truth and Reconciliation Commission (TRC). Max Price, the dean, Trevor Jenkins, and Variava put together the material. “In his submission, Price said, we look specifically at the failure of the faculty to address human rights and ethics as a substantive and formal component of the curriculum prior to 1984. Price shared that in preparation for the TRC submission many white staff members believed that Wits had offered a liberal environment and an oasis of freedom for black staff and students during apartheid. However, in interviews this proved untrue. Many black staff and students felt angry and bitter because they experienced exclusion, humiliation, and hurt by discriminatory practises,” explained Kuljian. “As a result, Wits decided to conduct an internal reconciliation commission (IRC). If you don't look at everything from the past, they declared, the legacy will continue. Most of the submissions to the IRC related to the discrimination against black students in the 1960s and 70s under apartheid. For example, Variava remembers clearly that black students were not allowed in post-mortems if white bodies were being examined.

 

“The IRC did not review the history of the Dart Human skeleton collection, or the Dart Face mask collection.” There were several reviews of anthropological practises at Wits Medical School and the Department of Anatomy from the 1920s to the 1980s. However, no review of the trips to the Kalahari and other parts of the country and the continent. “The IRC focused on the impact of apartheid. It did not look more deeply at the influence of colonial thinking, white supremacy, and the hierarchy of race that had embedded even prior to the establishment of apartheid in 1948,” Kuljian said.

 

“Scientific racism was not only in people's minds, but also in the bodily remains in the basement of the building. “Earlier this year, reflecting on the IRC, professor emeritus Joe Variava said because the IRC did not review the faculties earlier pre apartheid history, the process was incomplete. Nevertheless, the IRC was an important process. “Thirty years after Steve Biko's death in 2007, Professor Ames Dhai became the founder director of the Steve Biko Centre for Bioethics at Wits. Professor Joe Variava served as board chair from its founding until his retirement.

POST APARTHEID SHIFTS

 

“No South African physical anthropologist was involved in providing the scientific underpinning for the government's race classification practises, wrote Tobias in 1985, when he was 60 years old,” said Kuljian. “Tobias was correct in the strict sense that no physical anthropologist submitted proposals to the government, wrote Tobias's student Alan Morris. Nor did they join in the legislative or administrative process, but Morris goes on to say that they were involved because they provided a fertile growth medium in which the apartheid ideology could flourish. The work of physical anthropologists did mirror the efforts of government racial classification. They were active at other universities and museums around the country, including the University of Cape Town and the University of Pretoria. At Stellenbosch physical anthropologists worked hard to distinguish the physical characteristics between white Afrikaners and people classified as coloured,” Kuljian said.

 

“But by the late 1980s, apartheid was under threat. At the same time, the scientific understanding of race and the theories of human evolution were changing. The field of genetics was proposing new ideas about human origins.
“In 1987, three researchers from the US published their research in Nature entitled Mitochondrial DNA and human evolution. The impact was dramatic,” Kuljian said. “For years there had been different interpretations of the fossil record. What the research showed was that all human beings on earth shared a common ancestor around 200 000 years ago in Africa.

 

“The new science made its way into the popular press and was starting to shape public opinion. Once again there was a negative reaction to the theory that humans had origins in Africa. It happened with Darwin, it happened with Dart and the Taung child’s skull, and it happened again in the 1980s and 90s with mitochondrial DNA.

 

“Just as a search for human origins was shifting, so too was the political environment in SA post-apartheid. Given his senior position at Wits, Tobias was asked by the SA government in 1996 to serve on a reference committee on the return of Sarah Baartmann's remains. As a result, Tobias was part of a lengthy and heated debate about whether a sample of Sarah Baartman's remains once they were returned to SA, should be retained for further DNA testing that would allow for scientific analysis.

But Dr Yvette Abrahams, who had conducted many years of research and written her PhD about Baartman, also
served on the reference committee. Abrahams, who is now the acting director of the Khoi and San Centre at UCT, took the opposite view. Using Baartmann's body for scientific research, she said, was wrong because she said it is exactly what we have spent the last decade saying was wrong for the French. Initially Himla Soodyall, who also served on the committee, agreed with Tobias, wanting to prove that Sarah Baartmann's soft tissue belonged to the same person as her skeleton. But after listening to the debates, Soodyall agreed and said healing is going to be a better antidote than the proof of evidence-based science,” explained Kuljian.

 

“Tobius continued to argue that it was a trifle naive to think that the two to three, or at most four English speaking physical anthropologists in SA helped create the climate or public opinion of apartheid. He continued to stand by his view that they had not provided prime ministers Malan (DF), Verwoerd (Hendrik), or Strijdom (JG) with the scientific underpinnings of their philosophy. In my view, Tobias never reconciled his opposition to apartheid with his anthropological practises,” said Kuljian.

“Tobias had the opportunity to work with the new post-apartheid government and reshape his reputation, but just as he wanted to reinvent himself, he wanted to protect Dart’s legacy as well. To the end of his life in 2012, Tobias continued to be loyal to Dart, and he downplayed the racism implicit in race typology, which he himself had earlier embraced.

 

“The lifting of apartheid provided an environment in which Tobias felt more comfortable embracing this new narrative of human origins. But in 1996, Saul Debeau published Scientific Racism in Modern South Africa. In 2000, Siraj Rasoul and Martin Legacy published Skeletons in the Cupboard. For the first time they chronicled the skeleton trade in SA at the turn of the 20th century and described in detail how human remains were collected unethically by numerous museums and university collections. And so began the slow process of working toward a national policy on human remains.

 

“For over 20 years, requests for reburial of remains have been dealt with on an ad hoc basis,” explained Kuljian. “Descendant communities and advocates, including Iziko Museum in Cape Town and others, have been pushing for government to develop a national policy on human remains that can guide all curators, museums, and universities.

 

“Finally in March 2021, the draught policy on Repatriation and Restitution of Human Remains was ratified by Parliament. The new legislation allows for the establishment of a national advisory committee and a dedicated office in the South African Heritage Resources Agency (Sahra), overseen by the Department of Sports, Arts, and Culture,” Kuljian said.

WHERE TO FROM HERE?

 

“This history is not over. The history of physical anthropology, anatomy, and palaeoanthropology shines a light on the need for a reckoning with the past. While some have argued that all collections of human remains should be reburied, the new national legislation says that they can be used for ethical research and educational purposes. But exactly how will that be implemented?” Kuljian asked. “There are two curators of the Dart collections at the Wits School of Anatomical Sciences today, Brandon Billings and Anya Meyer. They have inherited these collections just as curators of collections throughout the country and across the world. Over the past several years, they have implemented new internal policies and created ethics committees to oversee the collections. But these issues are not theirs alone. This reckoning is part of a broader faculty. It is institutional. And it's ours as a society. “Last year, Wits celebrated its 100th birthday. In 2025, we will mark the centenary of Raymond Dart having described the Taung child skull in Nature. It is time for us to reflect on what has changed in that century. This is a great opportunity for all of us. The medical field and palaeoanthropology are built on a foundation of racist science. So today in 2023, as we reflect on bioethics, we must be aware of these layers and this racist foundation. Only with that awareness and knowledge will doctors, medical professionals, geneticists, archaeologists, and anthropologists be able to build a more complete understanding of ethics that embraces everyone. Only then will we be able to build a new generation of anatomists, anthropologists, and scholars,” Kuljian concluded.

 

To watch the recording of this lecture, go to:
https://www.youtube.com/watch?v=yz-oEx0X6Ms

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