Apartheid, the system of racial and ethnic separation introduced in South Africa in 1948, was a gendered project. The immediate goal of the white Afrikaner men who led the apartheid state was to control black men: to turn black men from perceived political and criminal threats into compliant workers. Under apartheid, African men would travel to work for whites in towns and on mines, but their homes would be in rural ethnic “reserves,” known as “homelands” or “Bantustans.” This vision depended on the labors of African women: while their men migrated to work, women were to maintain their families in the increasingly overcrowded and desolate countryside, reproducing the workforce cheaply while instilling a sense of ethnic difference in their children. “Coloured” (mixed-race) and Indian women were similarly charged with social reproduction on a shoestring, in segregated rural and urban areas. White women uniquely had the franchise and freedom of movement, but they were also constrained by sexually repressive laws. Apartheid’s gendered vision of production and social reproduction faced continual resistance, and it ultimately failed. First, it failed because African women increasingly moved from rural areas to urban centers, despite laws limiting their mobility. Second, it failed because some women organized across ethnic and racial lines. They often organized as mothers, demanding a better world for a new generation. Both their nationally and internationally resonant campaigns—against pass laws, educational and health care inequities, police brutality, and military conscription—and the fact of their collective organization gradually undermined apartheid. Officials generally underestimated the power of women, and their contributions have continued to be under-appreciated since apartheid ended in 1994, because women’s political style emphasized personal and familial concerns. But because apartheid was premised on transforming how families lived, actions of women in fact undermined the system from its core.
Definitions of and explanations for mental illness differ between societies and have changed over time. Current use of the term arises from secular and materialist epistemologies of the body and mind, influential from the 18th century, which rejected the spiritual or supernatural as causes of illness. Since the 19th century, a specialist body of study, of law, practices, professionals, and institutions developed to investigate, define, diagnose, and treat disorders and illnesses of the mind. This was the emergence of psychiatry and of a professional psychiatric sector. With origins in the West, at a time of capitalism and imperialism, psychiatry was brought to South Africa through colonialism, and its development has been strongly influenced by the country’s economic, political, ideological, and medico-scientific histories. There have been significant continuities: the sector has always been small, underfunded, and prioritized white men. Black patients were largely neglected. Discrimination and segregation were constant features, but it is helpful to identify three broad phases of the history of the psychiatric sector in South Africa. First, its most formative period was during colonial rule, notably from the mid-1800s to c. 1918, with an institutional base in asylums. The second broad phase lasted from the 1920s to the 1990s. A national network of mental hospitals was created and changes in the ways in which mental illnesses were classified occurred at the beginning of this period. Some new treatments were introduced in the 1930s and 1950s. Law and the profession’s theoretical orientations also changed somewhat in the 1940s, 1960s, and 1970s. Institutional practice remained largely unchanged, however. A third phase began in the 1980s when there were gradual shifts toward democratic governance and the progressive Mental Health Act of 2002, yet continued human rights violations in the case of the state duty of care toward the mentally ill and vulnerable.