Brian Altonen, MPH, MS

Aside from the many expected risks of work as a slave, certain injuries, diseases and medical conditions are also some of the unfortunate consequences of slavery. Problems related to injuries and the unsafe work environment are pretty much common sense. Add to this the normal problems related to human behavior and emotions in the workplace, and perhaps the best we can do to bring home the notion that slave workers are always going to have it worse. It is not always as easy to do the same for true occupational diseases and how they relate to the jobs most often related to slavery. Slaves often engage in those forms of work that white-workers or “Masters” and their families try very hard to avoid. What today we might call the grungiest of work responsibilities, such as sweeping guano, tending to latrines, cleaning horse stalls, or shoveling slop into pig pens, we often think very little about, even though these responsibilities have high risk for disease attached to them. To best understand those diseases that slaves expose themselves to due to their occupations, it helps to first classify these diseases as either traditional to African American people due to their heritage and places of origin (now thought of as genetic), or as diseases introduced to these people due to their new lifestyle and occupations as servants.

Due to the behavior of merchants and Western European people and culture overseeing the slave trade industry, we more often learn about the diseases brought over from Africa and African culture as a result of the African people and their way of living. Rarely do we pay much attention to the experiences they suffer as a result of becoming a part of our culture. Examples of diseases that we blame the African climate and topography for, and their people for naturally bearing this contagion due to some sort of Erasmus Darwinian line of thinking, include yaws and betel, leprosy and various skin discolorations, rashes and animalcule-based infections like the African worm (Taenia solis, aka T. africana), tapeworms and ringworms. We hear about their adaptations to their various tropical fevers, which often become epidemic to more distant, non-tropical settings. On a select very few occasions we might even learn about their culturally-bound problems like the belief in Obi-ah (early voodoo).

As for the occupational diseases related to slavery, we hear about very few of these experiences except in passing as part of any diaries or journals written about these experiences during the earliest years. We also on occasionally find limited coverage on this topic in the medical journals. This may in part be due to the types of jobs these individuals often have. It is not the commonplace domestic and barnyard work that results in these unusual medical problems, but more the backstage work required by plantation owners residing in extremely large houses. It is these tasks that often result in unheard or or unimagined medical problems and consequences. The illnesses that develop due to the jobs they assign their slaves to, jobs which members of their immediate family would never agree to engage in willingly, are a unique kind of stress placed on local health care systems.

Slaves often fill the important gaps in the society we are trying to form. Imagine for a moment a workplace set up during the Middle Ages, where the consequences of being a washperson could be losing your life due to a fall into a vat of boiling water filled with dyes or soap. As a slave of the sugar, molasses and rum industry your took your chances working alongside similar pieces of equipment. As a slave working in a mercantile setting, you risked your life to a loosely secured merchant vessel with its wares still on board. As a miner, there was the poorly dug shaft to worry about. As a mill worker, the overworked water wheel or poorly secured millstone could be the reason for the next demise. Each of these occupational health risks existed fifty years before the new cotton gin was operated in the fields, or the next baler, shucker or root puller. The occupational health related to slavery is a topic that deserves better coverage than it has been given over the years. This section provides some examples of this important history of public health issue.

Examples:

The following are important examples of this important piece of early American public health history.

James River Ringworm. The James River ringworm epidemic of the famous James River of Jamestown area in Virginia is appropriately the first to be covered in this part of my historical medical geography review. James River was the first part of this country laid claim to by the British explorers, in particular by the famous Captain John Smith. The first Anglican town to be formed on this shoreline setting, ca. 1597, was also the first to become extinct for unknown reasons. A century later, as the slave trade was being established, and the first large plantations totally devoted to tobacco growing formed in this part of the country, the need for slaves was imminent and by 1706/7 resulted in the import of the first African slaves. For another century, this region made use of the slave trade, and like most other parts of the country where slave immigration was now an important business commodity, probably suffered from the typical disease related events related to these migration patterns and local population changes. Slaves were favored for having a history of measles and small pox, meaning they were naturally immune to these deadly diseases and therefore could not become lost investments due to catching these diseases following a purchase.

The possibility that these individual could bring with them previously unrecognized diseases was unlikely due to the well documented appearances of diseases like yaws, leprosy, elephantiasis, etc. Even some of the less obtrusively appearing skin diseases were usually documented before any sales could be made, such as impetigo or the alopecia that developed due to long term exposure to vermin. The massive ringworms, appearing much like deliberate forms of skin change due to its concentric patterns, were avoided for the most part. The James River ringworm epidemic of Virginia however was apparently a very unexpected disease to erupt, and due to its very specific localization, we have to conclude that it was either a disease of an endemic nature native to this region, or it was a newly introduced disease that was brought into this region. For this reason, a number of disease research techniques I like to employ were applied to this mysterious epidemic, relatively short lived in early American medical history. Sequent occupancy, population versus environmental dependency of a disease, and the combined impacts of socioeconomic and quality if life on disease migration behaviors are discussed.

A Unique Miasmic Dysentery. A latrine-generated dysentery was probably very common to slave populations. Diseases that are overly common are perhaps those which are missing the most from the medical literature during its early years. In New York, a very unique epidemic involving just a few negro slaves cleaning the latrines was given slightly more than a page worth of coverage in the Medical Repository in 1805. The reason for this coverage of a possibly very common epidemic involves its relationship to the other diseases and theories for their causes abound in the medical journals. Climate and season weather were the major areas focused upon by New York physicians trying to define the causes for their recurring endemic disease patterns. This latrine-related problem appears to offer proof for a miasma-based theory focused on putrid environmental settings. Septon was a common name assigned to certain causes for disease. One of the most unusual outcomes of this philosophy for disease was the development of food inspectors, trying to prevent the sales of bad, decaying meat suspected as causes for local diarrheal epidemics. The first food inspection laws were written and passed due to these kinds of observations. The unique miasma released by latrines and poor septic systems gave reason for canals to be better built and managed, clean water sources in the form of reservoirs developed in countryside and aqueducts moving mountain stream and river water into urban settings became popular requirements before defining a new town setting as a healthy place to live.