THE
VOC CAEP SIEKENHUIJS
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"
BIBLIOGRAPHY
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
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