Dutch East Indian Company

History of the VOC






AM van Rensburg

The hospital is left of the Church, 
and just left of the little stream

The Cape was established to serve as the sieckenhuis/hospital for the VOC ships. The primary objective of the VOC was to ensure the profitability of this trading company. Therefore the sieckenhuis was a vital part in the commercial cog of the VOC. Each sailing vessel carried an enormous crew, since the company counted on the inevitable wastage of manpower from sickness and disease. The crews faced the dreaded sea diseases of scurvy, fevers and dysentery. Any delay of the trading ships due to sickness meant less profit for the Company. The Company loss, literally amounted to much loss of lives. The Company's main concern was not the health of the sailors but the health and profits of the Company, which meant the ships and trade needed to proceed regardless. Thus a sieckenhuis at the Cape would help fulfill the mission of the Company.

The Portuguese had victualling stations at Mozambique and Madagascar which was on their sailing route to India, whereas the VOC was sailing further south to reach Batavia. They first had a station at St. Helena. A report from the ship Nieuw Haerlem reported, 1648, that St. Helena was losing its value as a refreshment station. It took up to a half a month to catch the pigs on the island and they recommended Table Bay to be the refreshment station instead.

As early as 1600 James Lancaster visited the Cape and Captain Hippon was looking for 'ningin' in 1611. The first temporary tent hospital was erected at Table bay in March 1627 by the crew of the ship, 'Het Wapen van Hoorn'. Over one hundred patients were brought to the land, "dank zij de vruchten en groenten genazen de zieken snel". Then in 1647 the shipwrecked 'Nieuw Haarlem' built a fort at Table Bay. The returning fleet who picked them up had on board a 32 year old barber surgeon by the name of Jan van Riebeeck.

Taking into account the need of the VOC it was no wonder that they sent the trained barber surgeon Jan van Riebeeck to head up the new settlement at the Cape. He arrived on 6 April 1652. The ships Walvisand Oliphant arrived on 15 May 1652 with their crew riddled with scurvy and dysentery. The men of the ship Oliphant pitched a tent for the sick, over 50 men were accommodated in the hospital tents.

On June 19, 1652 only 50 out of the 98 persons ashore could work, the rest were sick. The first task was to build a fort. For four years tents and rooms inside the fort served as a hospital. The sick first had to bring there own bedding. By Jan 1656 they build a shed inside the fort, the sick were sleeping on the floor. Van Riebeeck instructed that 100 matresses covers and 100 plillow slips out of old sail cloth for the sick. They then stuffed them with grass and dried seaweeds. The hospital was built inside the hornwork of the Fort. One wall butted into a stone wall, the other three walls were made out of timber. However within 10 months the timber walls were blown down. Over the gate way of the first hospital were written: "Dit huis, voor zieken opgericht verquist de swakken". This hospital was built against the fort and was able to care for 25 to 30 patients, Bruijns p 115. Beside the hospital was also the smith and wagonmakers shop.

The need for a hospital was directly related to sailors state of health. Searle gives the following factors for the bad health of the sailors and their high mortality:
1. The pre-enlistment state of the health of the men - Many a recruit were poorly nourished and scantily clad and would have been vulnerable to ill health. The zielverkopers were well known, however there were other methods of getting workers for the VOC. Some of these recruits were duped when they were intoxicated by alcohol and virtually press ganged into the company service.

2. Cramped and unhygienic living conditions of the crew - "In de kleine ruimte waren ze opgeborgen dicht op elkaar, waar gebrek was aan licht, zindelijkheid en frisse lucht, vooral als de magen het schommelen van het schip niet verdroegen. In de reisbeschrijvingen die dagen vinden we vermelden dat de meesten niets deden dan 'hoesten, spugen en huilen'" Searle on p 15 she was quoting EC Godee-Molsbergen work of Jan van Riebeeck en sy Tyd p 63

3. Lack of Fresh water and food - due to the duration of the voyage the ships had to rely on non perishable foods, thus their diet was very restricted with ill health being the result.

4. Harsh work and harsh discipline - they were exposed to the sun, wind and rain. Having to face the icy North Atlantic and then the oppressive heat of the tropics. Since many of them were the dregs of society they were likely to get involved in violent incidents, which in turn was confronted with harsh discipline on board the ships.

5. Lack of knowledge to prevent communicable diseases - it was believed that diseases were caused by bad vapours and not due bad hygiene. Their unhygienic living conditions led to diseases like typhus. The crew spent a lot of time and vinegar washing the ships but hardly washed themselves or their clothes and bedding.

6. Inadequate care of sick - even though there was a surgeon and two assistants on board each ship. The surgeon had to act as doctor, pharmacist, and nurse. It was his lot to carry out the treatment, administer the medicine and distribute the food.

No wonder the death rate at the sieckenhuis at the Cape was so high. This hospital was sometimes referred to as the cemetery rather than the hospital for obvious reasons.

One report of the work of a surgeon on as ship is given as follows:
Early in the morning they had to prepare the medicine and give dosages to specific needy individuals. Secondly they had to do the cleansing and dressing of wounds, ulcers, lancing and cleansing of foul wounds, then massaging of stiff and scorbutic joints. Thirdly at noon they had to fetch the food and serve between 40 and 60 patients. Fourthly they had to repeat the above in the evening. At night the surgeon was called out on demand. The surgeon also had to give a daily report to the captain of the ship on the patients. The surgeon had a medicijnenkist, this was often empty by the time they reached the Cape, Searle p 17

The first chief surgeon appointed at the Cape was Adriaen de Jager with a youth as his apprentice. The first sick comforter was Willem Barentsen Wijlants, whose wife gave birth to the first European child. One slave was appointed to serve as a sick attendant in 1658. Pieter van Meerhof was a surgeon at the Cape in 1661. In 1666 Chief surgeon Pieter van Clinckenbergh was made an administrator for keeping the Company books, his replacement as chief surgeon was Johan Jolijn. In 1666 there were 55 persons who died in the hospital. The same year four fifths of the Hottentots were wiped out by a typhus epidemic.

During the following years about 30 patients were landed per ship at the Cape, this makes 900 patients per year, the death rate of these patients in the hospital is supplied by Searle:
1655 ----- 45 ships called at Cape ------------ 11 died
1656 ----- 48 ships called at Cape ------------ 8 died
1657 ----- 27 ships called at Cape ------------ 6 died
1658 ----- 32 ships called at Cape ------------ 15 died
1659 ----- 25 ships called at Cape ------------ 19 died
1660 ----- 31 ships called at Cape ------------ 13 died
1661 ----- 33 ships called at Cape ------------ 13 died
Thus the hospital was rather succesful in limiting the deaths, ones they reached the Cape.

During 1669, 14 people died at the Cape:
8 patients from ships died
1 murder was recorded
2 died from accidental gun shot wounds
1 infant was strangled by her delirious mother who was suffering from small pox
The mother was executed by being placed in a bag with weights and dropped into the bay
1 died from natural causes

A Danish surgeon was keelhauled in 1673 for dangerously wonding a burgher.

The second hospital was built on the foreshore in 1676, they converted an old rice warehouse near the beach. It could cater for 100 patients Bruijns p 115, but by 1682 it was already too small. On 22 January 1696 van der Stel reports on eleven ships which arrived with 678 sick and very miserable persons. They thus also started to use the gardener's cottage and some other annexes for extra space.

Simon van der Stel started to build a hospital at the foot of the the vegetable garden and just opposite the church, where they were hoping to accommodate 700 patients. This hospital was build just beneath the compangie tuin. The first patients moved in on 24 October 1699. However some patients were still taken care of in the hold hospital until it was finally closed in 1709. The previous hospital was situated near the sea having to endure the westerly winter winds. There was a rotting stench, whereas the new hospital site had fresh air, and access to a fresh stream of water. (It was located on the corner of the present Adderley and Wale streets, right opposite the Church)

The church is in the middle
and hospital with gate to it on the right

A number of years after its inception Mentzel described the hospital: This hospital was build in the shape of a Greek cross. It was a single storey building but had a loft above which was used when there was an overflow of patients. The hospital was not divided into separate rooms. It consisted of one long passage way, with another cross passage dissecting it. Along the walls were wooden benches for less seriously ill patients. Bedsteads stood in the middle space and were occupied by the seriously ill. There were two doors, one in the hall and one in the front of the building. Above the front door was written in golden letters:

"Excipit hospition fractors morbisque viisque,
Haec domus et medicam larga ministrat opem,
Belga tuum nomen populis fatale domandis,
Horreat et leges Africa tuas

Translated as: This hospital offers shelter to those who are struck down with disease and ill health, and abundantly ministers medical aid. Your profound reputation is known. Oh Netherlands! to the people. Let also the African continent pay homage to your laws.

Laidler describes this hospital. Visiting hours were on Wednesday and Saturday afternoons from 1pm - 3pm. The entrance to the hospital was at the extremity of one of the short wings. This wing contained the rooms of the bookkeeper, a dark store between it and the stairway to the loft was a room serving as a mortuary. The other short arm contained the operating theatre, dispensary. At the end of of one of the long arms of the hospital was the sudatorium (hot air or a steam bath) where they treated the patients with mercury and they had to sweat it out. The chronic cases lay in the lower wing, whereas the upper wing was where the convalescents occupied wooden benches. If the hospital overflowed they would use the loft. The apothecary's dwelling and laboratory were on the outside wall of Berg st entrance (St George st). The floors were tiled and the slaves washed them down once a forthnight. The hospital had a bell that was rung at 9am and 3pm when breakfast and supper was served. Between 6 and 10 slaves formed nursing relays through the night. In the evening when the lights were lit the siekentrooster came and visited the patients. The lights were turned off at 9:30pm, if any matresses were found vacant in the evening, they were removed and the defaulter had nothing to sleep on. The next morning the defaulter also had to face a severe beating.

In the hospital they were not allowed to gamble or play games, nor was alcohol permissible. Swearing, blaspheming or scolding faced correction. Patients were not allowed to hurt anyone neither were they to pull one another's hair. For this the punishment was flogging. If a patient pulled a knife he was handed over to the justice system. No patient was allowed to leave the hospital without consent. If they tried to sneak out by means of the moat or broke a lock, door or window they were flogged and locked up and put on a diet of bread and water. Singing or making noise was not allowed. Any patient who did not attend morning or evening prayers was to be punished with 25 strokes.

In 1687 the Cape was hit by a typhus epidemic, half the Hottentots died and the Europeans were reduced from 612 persons to 309, refer to Laidler p 21. In 1713, 200 out of 570 slaves and a quarter of the Europeans in Cape Town died of Small Pox.

Jan Vettenman was the first chief surgeon who became a free burgher in 1657 and served the burghers. The sick comforter Pieter van der Stael was asked to be reader and teacher to the slaves on 17 April 1658. Another sick comforter who followed him was Ernestus Back.

In the early years about 30 ships visited the Cape each year and on the average 30 members of the crew were sick, thus the Cape had to cater for 900 patients per year.

When the French Protestants arrived a number of them were surgeons: Jean Durand, Jean Prieur du Plessis, Paul le Febre, Gideon le Grand. Paul Roux was a sick visitor.

Aletta Kaiser was the first midwife appointed at the hospital in 1685. Other midwives were Agatha Blom, Wilhelmina van Zijl, and Catharina Visagie.

On the flat area in the front of the 1st Fort there was a place for the sick, yet with the Castle they made no provision in it for a hospital, however they did provide with a hall in which they performed religious functions.

The Cape became a place the sailors could look forward to, a safe haven, a place of recovery. Van Mil p 81 quotes Nicolaus de Graaff with reference to the attitude on board ships seeing the Cape: " 't Is onuitsprekelijk te bescrijven, wat vreugde en blijdschap datter onder't scheepsvolk gehoord ende gesien wierd: die lam, kreupel en pas uit de koy konden komen, quamen boven om't land te sien"

Anna C Ras 'Die Kasteel en ander vroe?Kaapse vestingwerke 1652-1713' (Tafelberg, 1959)
PW Laidler and M Gelfand: South Africa Its Medical History 1652 - 1898: A Medical and Social History, Struik 1971
PW Laidler A Tavern of the Ocean
C Searle: The History of the Development of Nursing in South Africa 1652 - 1960: A Socio-Historical survey. Struik 1965
Bruijns Dutch Asiatic Shipping Vol 1
P van Mil: De VOC in de Kaart gekeken