Sot. Sci. Med. Vol. 31, No. 2, pp. 213-232, 1993 0277-9536/93 $6.00 + 0.

00
Printed in Great Britain Pergamon Press Ltd

DISEASE AND MORTALITY AMONG GOLD MINERS OF

GHANA: COLONIAL GOVERNMENT AND MINING
COMPANY ATTITUDES AND POLICIES, 1900-l 938

RAYMOND DUMETT
Department of History, Purdue University, West Lafayette, IN 47907, U.S.A.

Abstract-This article traces the causes of high mortality rates among African gold miners in the former
British colonial territories of the Gold Coast and Ashanti, 19OlS-1938. No previous studies exist for the
early decades owing to the neglect by both mining companies and government officials to keep adequate
statistics on African miner death rates, a flaw which reinforced the lackadaisical response of the
government to problems of prevention and treatment. A milestone report issued in 1924, demonstrating
that sanitary precautions, housing conditions and medical treatment for most African miners were
wretched, forced the colonial state to gather regular data on Africans and make long overdue
improvements, so that mortality rates for underground miners slowly declined by the time of the Second
World War. But the published statistics concealed from view the far greater incidence of general deaths
from pulmonary and respiratory tract disease among short-term migrant labourers, who lived in the
mining towns, but returned to die in their home villages.

Key words-miners, shanty towns, tropical disease, industrial disease, pneumonia and tuberculosis,
colonial administration, West Africa

In approaching questions of sickness and mortality about publicizing European sickness and mortality
among indigenous miners in the major gold mining rates on the Coast [3]. As a consequence of the
towns of the Gold Coast and Ashanti in the early colonial regimes laissez-faire attitude, it was easier
twentieth century one encounters a double barrier to for the mining companies also to drag their feet in
clear understanding. The first was that the colonial providing up-to-date information on African miners
state was overwhelmingly concerned with the health health and hospitalization. The present paper is part
of the European population, and especially with the of a larger study on the history of the goldmining
protection of government officials, against the rav- industry in Ghana in the late nineteenth and early
ages of malaria and other tropical fevers. Thus, a twentieth centuries. The investigation attempts to
substantial portion of the descriptive evidence in stretch the boundaries of historical writing about
health reports and memoranda of the time focussed patterns of indigenous disease and mortality in a
on this issue alone [l]. A second barrier for the poorly staffed European tropical colony where only
historian attempting to reconstruct those times, was limited statistical data on the general African popu-
the governments inability, ascribed to shortage of lation was made available.
staff and revenue and to local resistance, to gather
The mining towns of Tarkwa and Obuasi
accurate data on patterns of African sickness and
mortality. Under these circumstances the statistical There were two main mining complexes in the Gold
bases for determining patterns of illness and mor- Coast and Ashanti prior to the First World War. The
tality among specialized occupational groups such as first center included the twin towns of Tarkwa and
miners, are less complete than those series available Aboso in Wassa State which lay about 40 miles
for Kimberley and the Rand in South Africa and for inland by railway from the port terminus of Sekondi
the copper mining areas of Zaire and Zambia [2]. Not in the southwestern part of the Colony (see Fig. 1).
only Gold Coast government archives, but also the An adjunct mining center, situated at Himan-Prestea
extant company records, are conspicuously barren of about 19 miles by branch line from Tarkwa, will not
meaningful statistical series on mortality rates, and be analyzed in this essay. From a tiny African hamlet
even of feeble attempts to count the deaths at a given of several hundred at mid-century Tarkwa grew into
mine on a regular basis. This was not simply a a boom town of over 2000 at the height of the first
problem of lack of manpower and the rudimentary gold rush in the early 1880s. Construction of the
state of statistical science at the time; it also reflected Gold Coasts first railway from Sekondi to Tarkwa
policy preferences and goals. The colonial govern- between 1899 and 1902 added to the growth of
ment wanted to restrict its responsibilities for minis- population congestion and attendant social and
tering to the health needs of the entire African health problems in the gold mining region. With a
population. And so the less said about it the better. total complement of 12,417 workers stationed at
Until at least 1914, the government even had qualms various sections in overcrowded and poorly sanitized

213
214 RAYMONDDUMETT

tent towns along the line of rail. railway construction
itself aggravated the spread of disease. even before the
mining towns reached their peaks of settlement [4].
Only a few of these short-term railway workers (many
from Nigeria and Sierra Leone) stayed on to work at
the mines afterwards. Slowly other young workers,
attracted by the lure of money wages, were recruited
by the mining companies, so that the mines labour
force for Tarkwa and Aboso combined rose to a
complementof5128by 191Oand6681 by 1921.Other
settlers, migrants and hangers-on (wives, children and
petty traders) brought the total population of the
towns. villages and camps strung out along Tarkwa
Ridge (including Tarkwa. Tatnsu, Abontiakoon and
Ahoso) to an estimated and fluctuating total of 26,500.
Obuasi, the second major center covered in this
survey, had been but a tiny clearing in the forest.
inhabited by a few dozen families, prior to the lease
of a great gold mining concession by the soon-to-be-
famous Ashanti Goldfields Corporation in 1897.
Legitimation by the British Government of the Com-
panys monopolistic claim to 100 square mile block
of territory (called an empire within an Empire ) on
the basis of treaties forced on Ashanti chiefs coupled
with extension of the railhead to the 121 mile mark
by 1902 helped turn a small tent town for prospectors
into a bustling mining complex. Both Tarkwa and
Obuasi received world-wide fame as a result of the
great West African gold boom of 19OOHU. By 1904
the AGCs several mining installations had a

I K 0 V I N C t,
HUNI VALLtY 53

Fig. I. Sketch map of the Sekondi-Kumasi railway and the main gold mining centers of Tarkwn and
Obuasi.
 Disease and mortality
regularly employed labour force of 1500, while
Obuasi town boasted a population of at least 5000.
In addition to the usual mining town agglomeration
of miners, their relatives, market stall operators and
fugitives from the law, the main town of Obuasi and
outlying villages contained a labour reservoir of
occasional workers, whom the mine owners could
draw on for piece work or contract labour-fuel
gatherers, porters and tram loaders, etc.-as need
dictated. By 1911 the total population of Obuasi and
surrounding mining villages was estimated at 15,000,
with Obuasi proper at 9000, Ayeinm at 3000 and a
second satellite village of Sansu also at 3000 [S].
Sanitary and housing problems
From the very beginning Ghanas gold rush towns
were beset by an awesome congeries of housing, street
sanitation, sewage disposal, water supply and hy-
gienic problems, commonly compared by officials
with the legendary Greek labours of Sisyphus. The
crux of the issue was that the public health problem
needed to be attacked systematically on many fronts
simultaneously [6]. Yet the colonial government had
neither the resources, nor the will, for anything more
than piecemeal works projects and clean-up cam-
paigns. Even during the Colonys first gold rush in the
1880s medical officers knew enough about the germ
theory to attack the prime sources of disease in
contaminated water in ditches and ravines, impure
supplies of drinking water and poor latrine facilities.
At this time there was practically no hygienic edu-
cation for children or for adults. The burial of
relatives inside the walls or under the floors of
domiciles was a problem that stemmed from tra-
ditional religious beliefs [7]. Water supplies for the
chain of mining villages that sprouted up at the foot
of Tarkwa Ridge in Wassa were not, initially, too
bad, being drawn from the multitude of small rivulets
that flowed from the ridge down into the valley. But
as housing became more congested, drainage and
waste from the compounds filtered back into the
water used for drinking and cooking at mining
villages located further downstream.
Because facilities for sewage disposal and street
drainage were almost non-existent, these miners
shanty towns became the natural dissemination
grounds for a wide range of respiratory and fecal
tract diseases spread by foul water, bacteria-laden air
and contaminated food and soil. Medical authorities
made a clear-cut distinction between the leading
causes of African deaths and the leading causes of
ordinary illnesses, some of which were just beginning
to be recorded at the few government medical centers.
James Fare11 Easmon, M.D., an African physician,
who pioneered in the study of several diseases
common among Africans on the coast, noted that
the ailments most commonly reported and diagnosed
at the hospitals were in order of numbers:
(1) diseases of the feet and lower limbs (chiefly
tropical ulcers); (2) intestinal diseases (diarrhea and
among gold miners of Ghana 21s
dysentery); (3) diseases of the skin (such as yaws)
plus various worm diseases; (4) rheumatism; and
(5) respiratory diseases [8]. (We also know that
Africans suffered from a high incidence of malaria,
but this was more difficult to measure in this early
period and was not a common reason for Africans
reporting to hospital [see p. 2261.) What may surprise
the untutored western observer, is the extent to which
a majority of Africans died from the same groups of
killer diseases of the pulmonary and cardio-vascular
systems that were the scourges of western industrial-
ized countries at this same time. The major causes of
death for Africans in the major coastal towns were (1)
pneumonia; (2) tuberculosis; (3) dysentery; (4)
various fevers; and (5) heart disease and stroke. That
the respiratory ailments ranked only fifth on the list
of cases treated yet first among deaths is probably
explained by the fact that many of the more
numerous minor illnesses and injuries were treated
quickly on an out-patient basis, whilst large numbers
of pneumonia and tubercular cases went undetected
in the early stages with patients coming to hospital
only when death was near. The African populations
were also afflicted by a number of contagious
diseases. The most deadly were smallpox (a disease
which appeared in both endemic and epidemic
patterns and whose deaths among Africans were
greatly underreported from year to year) 191,followed
by influenza. Cholera was never a threat on the Gold
Coast during the years covered here. Typhoid and
paratyphoid did occur and cases were usually
classified on death charts under the label of enteric
fever. A good many of the prevalent endemic and
also epidemic diseases of Ghana had not yet been
identified [IO].
Identification of the symptoms of many of the
tropical diseases was imperfect, which was the princi-
pal reason for the listing of so many causes of death
under the catch-alls pyrexia or fever. It was often
difficult to pinpoint the exact causes of a sick
individuals death (which might have been traceable
to a combination of causes); and a majority of the
cases and fatalities in the mining towns, as through-
out the country, simply went untreated and un-
recorded [ll]. In addition to the basic stinginess and
inertia of the government. Dr Easmon traced the
dearth of accurate data on the causes of mortality
among the general population to (a) the fact that
post-mortem examinations were often regarded as a
desecration of the dead; and (b) to the disinclina-
tion of natives to tell the government anything about
the deaths of relatives or friends lest they be forced
to inter corpses in cemeteries [12]. What has to be
stressed here is that even though mechanized mining
under European companies began on the Gold Coast
as early as 1877, the sickness and mortality patterns
of the African workers were a blank sheet until as late
as 1925. As one report of the 1890s noted diagnoses
about African deaths even in the coastal towns are
as a rule based on hearsay. [and] we are in perfect
216 RAYMONDDUMETT

ignorance about sickness and mortality amongst Ghana) were brought to the Abontiakoon mine of
tribes of the interior [13]. Wassa under the supervision of Governor John
Rodger [15]. The first reliable ethnic breakdowns of
The efects of migratory labour the Wassa and Ashanti labour forces were made in
Maintaining public health in the mining towns was 1911. If we examine the 5 128 workers employed in the
complicated greatly by the migratory and fluid nature Wassa district in that year, we find that indigenous
of the labour forces of a majority of the companies. workers from the Gold Coast proper made up 64.2%
For perhaps the first 50 years of capitalist mining in of the total: of these Fanti men from the central
the Gold Coast, workers remained more closely tied coastal states comprised the most substantial sub-
to the agricultural economies of their traditional group at 18% of the total [16]. At the Wassa mines
up-country villages. Mining company supervisors non-Akan people made up a far larger percentage of
constantly bewailed how hard it was to keep miners, the work force than at the Ashanti mines. For
once trained, on the job for any length of time. example, Liberians (mainly Kru and Bassa men)
They spoke of the constant comings and goings of comprised 16% of all the mineworkers in Tarkwa and
unskilled African workers back to their home villages 9% of the underground workers. Dr Easmon ob-
to take part in the planting or harvest season, to served that the Kru and Bassa laborers suffered less
participate in religious customs or funerals, or simply from disease than many Gold Coasters because they
to visit relatives. Paradoxically, this rapid turnover drank alcohol less. had good personal hygiene and
was cited both as a reason why the mining towns had had a nutritious diet based on fresh fruit and green
become cesspools for the rapid spread of disease and vegetables. After just 4 years of recruiting, the new
as a rationalization why the understaffed company men from the Northern Territories contributed 15%
medical officers could not keep better track of the of the total work force and 17% of all underground
numbers of miners deaths. As will be noted below, labour. As we shall see presently they suffered from
it was the bacterial and viral diseases spread mainly a high disease and mortality rate.
by infected human hosts, rather than the insect-borne In the beginning a far smaller percentage of the
diseases that were the chief mortality problem in the Ashanti Goldfields Companys labour force at
mining towns. And this was aggravated by the fact Obuasi was drawn from foreign lands. In 1911, 39%
that Tarkwa and Obuasi become virtual crossroads of all workers and 51% of the underground work
for meandering porters, construction workers and force were recruited locally from Ashanti, while 29%
diggers during the periods of the gold mining and of the general work force and 22% of the under-
railway construction booms. ground labor were recruited from the Fanti coastal
districts. In 1911, men from the Northern Region
General populations qf mining towns
(Dagombas, Isalas. Dagatis, Mamprusis, etc.) made
Early Gold Coast Census Reports are of limited up just 8% of all mine workers and also 8% of the
use for the questions at hand because base popu- underground force. The substantial increase in the
lations were tabulated according to districts rather Northern Territories component in the unskilled
than towns or cities [14]. Thus the statistics listed mines labor forces at both Tarkwa and Obuasi in the
under the names of major towns, such as Accra, years ahead would have a definite bearing on the
Sekondi and Tarkwa are inflated since they included miners health problem.
the populations of the surrounding hinterlands. Some
Mining town administration
of our best nineteenth century estimates on the
mining towns proper must be culled from scattered The colonial government was slow in grappling
manuscript sources rather than the printed reports. with the problems of slum overcrowding, inadequate
We are further handicapped by the fact that the first street drainage, poor sewage disposal and contami-
census surveys of 1891, 1901 and 1911 neglected to nated water supply in the mining towns, and it was
estimate the ethnic subgroup populations housed in even slower in assessing their impact on the health of
the various wards or zongos under traditional chiefs the African miners and surrounding village popu-
and headmen, so that we have no complete picture on lations. Part of this was tied up with the problem of
ethnic breakdowns in the townships. the mining frontier. During the first 5-7 years of the
Some assistance in this investigation comes from new century, there was still a vacuum of political
surveys of ethnic subdivisions among the male mine power and administrative control at the mining cen-
workers employed by the companies, which give some ters; there was a parallel between Tarkwa-Aboso,
idea of the proportions in the total town populations, Himan-Prestea and the unregulated mining camps of
although allowance must be made for the fact that the American and Canadian West.
local Akan (Fanti and Ashanti) males were more From the start, Obuasi, controlled by a single
likely to have wives and families living with them monopolistic concessionaire-the Ashanti Goldfields
than migrant workers from distant colonies, such as Corporation-was more like a company town than
Southern Nigeria, Liberia and Sierra Leone. A new any of the others; but even the AGC reneged on its
departure was seen in 1907 when small groups of men responsibilities. At Obuasi and at Tarkwa at least
recruited from the Northern Territories (of future three entities-the mining companies, the colonial
 Disease and mortality among gold miners of Ghana
state and to a lesser extent the traditional kings and
chiefs of the surrounding areas vied for municipal
authority, but when the crunch came, each tried to
withdraw from responsibilities for expenditure on
town upkeep, public works and sanitary improve-
ments. It was not deemed appropriate to apply the
Town Councils Ordinances of the Gold Coast in the
mining towns, since these councils (despite represen-
tation by educated African leaders) had experienced
potent popular opposition and a very limited effec-
tiveness even in the three coastal cities where they had
been implemented [17]. There was some variation in
the sanitary administration of the Wassa mining
towns and those of Ashanti. At Tarkwa housing,
street sanitation, sewage disposal and anti-malarial
preventive measures were entrusted almost entirely to
the companies, with some assistance from the local
district commissioner. At Obuasi, because the
Ashanti Goldfields Corporation did not want to
shoulder the entire burden, responsibility was del-
egated to a Towns Sanitary Committee, towards
which the company, the government and the local
people (through municipal taxes), as represented by
the headmen of ethnic subdivisions, made contri-
butions. As at all major towns of the Gold Coast,
small hospitals with a medical officer were also
established at each of the mining towns. But whereas
the doctor at Tarkwa was appointed and paid by the
government, at Obuasi he was employed directly by
the controlling mining entity of that region, the AGC.
THE ADVENT OF SCIENTIFIC TROPICAL MEDICINE
The Gold Coasts anti-maIaria campaign and its
impact in the mining towns
It cannot be emphasized too strongly that the
overwhelming policy emphasis and expenditure by
both the colonial state and the mining companies
during the first two decades of the twentieth century
was geared to improving the housing, water supply,
street drainage, sewage disposal and anti-malarial
protection of the expatriate staff. This coincided with
the revolution in tropical medicine and hygiene that
followed the pathbreaking discoveries of Sir Patrick
Manson on the plasmodium parasite that caused
malaria and of Sir Ronald Ross on the identification
its prime vectors, the mosquitoes Anopheles gambiae
and A. funestus [18]. The figures on European mor-
tality for the Gold Coast for the late nineteenth
century were disquieting enough. Year after year the
number one and number two killers of expatriates on
the Coast were malaria and blackwater fever. Fairly
reliable tables show that from 1881 to 1897 the
average annual death rates for European officials ran
as high as 75.8 per thousand in the Gold Coast and
53.6 at Lagos [19]. This coupled with the high sick-
ness and hospitalization rates plus frequent rest
leaves to the United Kingdom caused many seasoned
hands to lament that effective colonial administration
simply could not be carried on [20]. But the image of
217
West Africa as the White Mans Grave, accurate as
far as it went, enabled officials to gloss over the
greater enormity of the Black Mans Grave. Gover-
nor Mathew Nathan underscored the colonial states
prime mission to Dr Ronald Ross at the commence-
ment of the mosquito eradication and house protec-
tion campaign in 1901: although I dont undervalue
sanitation for natives, as I fear they themselves do,
improvements in the health of Europeans is absol-
utely the first desideratum for general improvement
in these colonies [21].
Commencing in 1900, following the publication of
Rosss findings, the British Colonial Office mounted
a five-fold attack on the disease. This included
(1) an extensive program of public works (improved
streets in the towns with cement drainage ditches and
culverts, the building of new bungalows for Eu-
ropeans and storage tanks for fresh water supply);
(2) enforcement of public health laws and regulations
(mosquito-proofing of European houses, destruction
of mosquito-breeding pools and ditches near those
houses, quarantines where required for epidemic dis-
eases, and use of scavenging squads for regular refuse
collection); (3) education and publicity for improved
personal and family hygiene; (4) expansion of medi-
cal treatment facilities; and (5) the continuation of
tropical disease research, both at universities in
Britain and at research installations in West Africa.
It is mainly the first two of these strategies that
concern us here. This also carried over to the new
mining towns. When officials from the coast made
inspection tours of such mining towns as Tarkwa,
Obuasi, Prestea and Aboso it was mainly the descrip-
tion of public works and sanitary measures of benefit
to the expatriate managers and supervisors that filled
their reports.
Later mining company histories tried to create the
impression that they built model villages with neatly
laid out streets with proper drainage, water supply
and refuse collection for their African personnel from
the very start; but close analysis of both written and
oral data shows that such statements misrepresented
the truth. African workers for the European mining
companies were expected to fend for themselves by
building their own huts of bamboo swish and daub
or by paying for a room or a bed in the domicile of
another African family already living in the native
town. Whether the construction of a South African-
style compound system-as was in fact proposed at
one point by a consortium of the Anglo-Gold Coast
mining companies, but never adopted [22]-would
have altered the hazards of disease for Gold Coast
workers can never be known for certain. But it is
possible to speculate, based on the experience of the
Transvaal in this same period, that the incidence of
respiratory diseases would have been far higher. The
research of Packard has revealed that the initial tight
quartering of workers (with bunks stacked like
shelves) in the overcrowded barracks of the Rand
gold mines compounds during the early twentieth
218 RAYMOND DUMETT

century definitely increased the chances of tubucular complete series available for the first third of the
infection by close contact (231. twentieth century, then the conclusions are fairly
Reinforcing official and company indifference to clear-cut. The first is that there was a dramatic fall in
the awesome problems of African ill-health was that the annual death tolls for government administrators
segment of the scientific establishments anti-malarial between the horrendous 75.8 per thousand for
strategy (based on Robert Kochs native reservoir 1881-97 [26], quoted earlier, and a 14.9 per thousand,
theory) which called for strict segregation of Euro- average death rate for European officials during the
pean bungalows from African residential areas-even first 20 years of the new century. Our figures for
without a compound system. Not only were the European mining company employees-not well
houses of government officials and mine managers defined for the nineteenth century, but probably well
built on the highest hills above the towns with the over 60 per thousand in the 1880s, show an average
coolest breezes and furthest from mosquito breeding mortality of 13.6 per thousand for the I5 year period
places, African houses were actually torn down in 190221916. The second inference is that these
order to provide wide cordons of uninhabited land changes--which the Colonial O&e called the lowest
that would supposedly interrupt the flights of on record-ran parallel to, and were undoubtedly
mosquitoes from African hosts to European victims traceable to the new public mosquito control and
[24]. The segregation strategy was largely ineffective house protection campaigns and to the governments
and it aroused the hostility of educated Africans in promotion of improved anti-malarial hygienic prac-
the coastal towns for its racist overtones. The govern- tices, including quinine prophlyaxis [27]. The evi-
ment liked to argue that as a secondary result their dence was still sketchy regarding the exact causes of
public sanitation programs would ultimately benefit sickness and invaliding among Europeans, but in one
the African as well as the European populations of test of 310 hospital cases conducted in 1910 it was
the major towns and cities. But there was little found that 34.2% were due to mosquito-born dis-
evidence for this in the mining towns or elsewhere eases and 65.8% to other illness and diseases [28].
during the first two decades of the twentieth century. Malaria and blackwater fever were still the leading
causes of death among Europeans; but whereas ear-
Relations between the goaernment and mining towns
lier, according to one estimate, various tropical
with respect to African miners health
fevers had accounted for 66% of the annual Euro-
The colonial governments pro-company, malaria- pean deaths and 59% of the invalidings, in 1914 the
centered laissez-faire attitude showed up clearly in rates were 36% and 21% respectively 1291.
discussions about how best to get statistics on sick- WC must reemphasize, however, that some of the
ness and mortality of the genera1 mining populations. most loyal colonial civil servants questioned whether
The Ashanti Goldfields Company and the Wassa these expansive programs for malaria prevention
companies to a lesser degree, did not like government among expatriates were having even an indirect or
officials, or other strangers entering their properties long range impact on the reduction of disease among
without prior notice and permission. They accepted Africans. At one point the Gold Coast chapter of the
the need for government inspection tours of their Aborigines Protection Society protested loudly that
premises only grudgingly and tried to keep them brief efforts to protect Europeans from mosquito-borne
and perfunctory. Normally government inspectors disease by demolishing large blocks of African houses
accepted the information that mine managers, gave had wreaked tremendous and unfair hardship on a
them uncritically and unquestioningly and afterwards number of town populations.
issued superficial and appropriately glowing reports. People, especially of the poorer classes, were turned out of
This reticence also applied to ferreting out important doors (sometimes by force) in the rains. in some cases
statistical information-especially if it were of a without even the inadequate 24 hours notice, and without
controversial nature. As the G.C. Medical Depart- accommodation being provided elsewhere beforehand. This
led to insanitary overcrowding. 1301.
ment noted sheepishly all mining employees were
under the care of their company doctors and infor- The fact that most Europeans had their own segre-
mation as to sick rates appears to be only obtained gated hospitals, frequent rest leaves, provision of free
through the courtesy of those gentlemen [25]. It was housing (often on the best geographic sites) and
evident to all concerned that no pressure would be provision of piped water supply, and all paid for out
applied. It took another 13 years, and the impetus of revenues and municipal taxes that fell on the mass
of a major health crisis, before the governor took of the people, then it is easy to see why a handful of
the obvious step and ordered the companies to critics, including Governor Sir Hugh Clifford,
send him the basic data that the government was thought that improvements for Europeans had been
entitled to. bought largely at the expense of the indigenous
populations [31]. R. R. Kuczynski, in his pathbreak-
Changing European mortality rates
ing demographic survey doubted whether throughout
If we can accept the rough and approximate figures the first decades of the twentieth century there had
on death rates for European officials in the late been much noticeable reduction in the incidence of
nineteenth century and compare these with the rather malaria amongst West Africans as a result of these
 Disease and mortality among gold miners of Ghana 219

Table 1. Statistics relating to fatal accidents at the mines of the Gold Coast and Asante, 190>1914
Surface workers Underground workers Total mineworkers employed
Total no. No. of fatal Death rate Total no. No. of fatal Death rate Total no. No. of fatal Death rate
employed accidents per 1000 employed accidents per 1000 employed accidents per 1000

1905 9226 6 0.65 3703 21 5.67 12,969 27 2.08

1906 9176 8 0.87 4985 65b 13.04 14,156 73 5.16
1907 8995 II 1.22 6282 31 4.77 15,277 42 2.75
I908 8333 9 I .08 6660 33 4.96 14,993 42 2.80
1909 10,127 5 0.49 5768 54 9.36 15,895 59 3.71
1910 12,060 6 0.49 7078 30 4.24 19,138 36 I .88
1911 11,505 3 0.26 7448 37 4.84 19,153 40 2.09
1912 9945 II 0.12 7688 42 5.46 17,633 53 3.0
1913 8330 7 0.84 7328 66 9.0 I 15,658 73 4.66
1914 7700 IO 1.30 8011 46 5.72 15,741 56 3.55
1905 was the first year in which these Accident Statistics were given. 1904 Mine Rept very brief.
b43 persons died in a single accident. 1906 (22 Dec.) as the result of major flooding at the Aboso Mines, Wassa.
So&s: G.C. Repts on the Mining Industry, 1905-1914.

efforts, even by the 1940s, but he despaired of and enforcement mechanisms [34]. A closer look at
producing any meaningful statistical verification [32]. the records shows that these figures stood for some-
what rare major disasters, as in 1906, for example,
CALCULATION OF AFRICAN MINERS MORTALITY RATES when 43 miners (41 Africans and two Europeans)
were killed in an underground flood at the Aboso
Fatalities in mine accidents
mine [35].
The one category where the companies, prodded by Overall the accident death rates demonstrated fair
the Gold Coast Department of Mines, did keep improvement in operating conditions with a generally
complete and accurate statistics on African as well as downward trend until the mid-1920s when they
European miners from early in the century onwards held fairly steady at relatively low levels to 1937-38
was in mine accidents [33] (see Fig. 1 and Table 2). (Fig. 2). In the first 9 year period for which we have
On the whole, the accident death rates per thousand, figures, 1906-1914, the death rate from accidents for
whether for underground miners or for all people underground miners averaged 6.8 per thousand per
employed at the mines do not appear as excessive in year. This is roughly comparable to accident mor-
comparison with working conditions at Mines of tality rates at the major mines of South Africa during
western Europe or at other African mines of the same the early stages [36]. During the 10 year period 1927
period. Some contemporary experts, zeroing in on to 1937 the average fell to 4.94 per thousand. Mean-
specific years, thought differently. An editorial in the while the accidental death rate for all miners (surface
Mining Journal argued that the high Gold Coast and underground) fell from an average of 3.39 per
accident death rates of 13.04 per thousand for under- thousand during 190614 to 1.7 per thousand
ground miners in 1906 and 9.01 in 1913 were exces- 1927-37. A spike in the graph lines for both under-
sively high, even in comparison with other mines of ground and general deaths by accident per thousand
the world, and were reflective of lax regulations in 1934 is explained by another major disaster. In a

\ I \ I
/
A
w t \
Other causes u ,I \
(disease and \
sickness)
\
\
.

P
Surface other /
(disease and d
sickness)
\ mo--
Underground accid. . . .* 8
0
Surface accid. -0
v I
1925 1930 1935 1940
Year

Fig. 2. Gold Coast miners death rates.

SSM 37,2--G
 Table 2. Deaths and death rates of specific illnesses recorded at mines with full-time medical officers on the Gold Coast, 1925-1937
Pneumonia & Nephritis Malaria
bronchial Bronchitis Heart disease (chronic and and black Total deaths
Years neumonia Tubexulosia and pleurisy Dysentery Pyrexia and stroke acute) water fever 1flUcZa due to illness

~ercenra~e
<, of 1
caues of dearh 10 rota1 deaths
1925 23 23 6 61(b) II3

1926 20 I5 I5 3 6 I 86
% 23.25 17.44 17.44 3.48 6.99 I.16
1927 I5 27 44(c) 2 8 4 5 133
% II.3 20.3 33.08 I.5 6.01 3.0 3.75
1928 29 I8 26 IO 5 4 3 I28
% 23.01 14.28 20.63 7.72 3.94 3.17 2.37
1929 33 IO I4 4 3 89
% 37.07 II.23 15.72 4.49 i.61 5.61 3.37
1930 30 9 6 3 I4 2 2 87
% 34.8 10.34 6.89 3.44 16.09 2.29 2.29
1931 34 II 3 4 3 70
% 48.57 10.0 15.7 4.2 5.71 4.29 i.86
1932 27 I6 9 5 9 2 2 3 8
% 30.68 18.18 10.23 5.68 10.23 2.27 2.27 3.41
1933 21 II IO 7 4 5 5 9 I2 96
% 21.65 II.34 IO.31 7.22 4.12 5.15 5.15 9.28 12.37
1934 39 36 5 L 3 4 IO 8 127
% 30.7 28.4 3.94 I .57 2.36 3.15 7.87 6.3
1935 40 40 5 8 3 3 13 39 187(d)
% 21.39 21.39 2.67 4.28 1.60 0.53 1.60 6.95 20.8
1936 45 26 21 3 6 8 12 4 146
% 30.8 17.8 14.38 2.05 4.11 5.48 8.22 2.7 I44
1937 52 34 6 9 5 14 4
% 36. I 23.6 3.47 0.69 6.25 3.47 9.72 2.7
1938 59 47 4 4 - 25 5 157
% 33.71 26.86 2.29 2.29 - 14.29 2.86
Sources: Schedules G Vital Statistics of Labourers Engaged Locally and Employed at Major Producing Mines with Medical Officers (G.C. Mining Dept. Reps
1925-1938.
Notes: Thhese figures include deaths from all causes other than accidents. Those mines without medical officers (not included here) normally did not report large
number of deaths due to illness. Many of these employed a very small labour force; others worked for only short periods of time; s.ome sent their sick
to the dispensaries of the other mines reported here; Still others did not report their deaths.
bin 1925, owing to inadequate classification of illness deaths, this figure of 61 stands for miscellaneous deaths due to all other (unlisted) causes. 44 of these unnamed
came from the Ashanti Goldfields Corp. For other years the number of deaths due to unnamed cauw can be determined by subtracting the deaths listed
by cause from the total deaths.
Again it is important to note that figures for both bronchitis and pleurisy lumped together as one in official reports. In general bronchitis appears to have
predominated. Of the large number of cases reported in 1927, 43 were reported by the Ashanti Goldfields Company. The reasons for this are unclear.
dThe big jump in total death in 1935 was traced primarily to the Gold Coast influenza epidemic.
 Disease and mortality among gold miners of Ghana
flooding accident at the Ariston Mines of Wassa 45
men were killed. Otherwise, the increase in the total
numbers of accidental deaths 1935, 1936 and 1937
was a natural outcome of a tripling in size of the total
mines labour force since 1930.
Of the causes of accidental death amongst under-
ground miners, the most common were (1) falling
rock and (2) skip, cage and bucket accidents (mainly
falls and cable failures) on the mine shafts. Other
factors which varied greatly in their incidence year
to year were explosions from blasting accidents
(still common today) and suffocation. Major disasters
in which multiple lives were lost were invariably
associated with flooded underground chambers and
cave-ins [37].
The Simpson Report
Incredibly it was not until 1924 that the colonial
state and the mining companies received the jolt that
they needed to include African death rates from
sickness and disease in their annual medical reports.
In July of that year, in conjunction with the Gold
Coasts second serious outbreak of bubonic plague
in two decades, the Colonial Office commissioned
Professor W. J. Simpson of the London School of
Tropical Medicine to conduct a special survey to
investigate both the causes and the incidence of the
plague epidemic and general health conditions
throughout the southern forest zone. This was not
Simpsons first trip to West Africa. Even earlier
(191&11) he had written about the very backward
state of the trading and mining centres in hygienic
arrangements. He noted:
The Sanitary question in West Africa is a large one, and is
something more than the maintenance of the health of the
officials sent out there Another aspect of the question is
the prevention, as far as possible of [all] the inhabitants,
European and native, sickening or dying from preventable
disease, and linked up with both of these is the future
development and prosperity of the country [38].
These practical sentiments were hardly revolutionary,
but they were derided at some levels of government
at the time for smacking too much of the humanitar-
ian view. By 1924, after seeing that so little had
changed, Simpsons tone had turned into anger. In
one of the most thorough and penetrating Gold
Coast public health surveys, directed specifically to
the mining towns, undertaken by an external medical
examiner, Simpson, tramped through every street of
the African as well as European quarters of Tarkwa
and Obuasi, collecting data, not only on general
mortality rates but also on the main causes of illness
and death among African miners. In a damning
summation he concluded that the miners suffered
from severe chronic illness levels as well as a high
death rate, and he discerned that the main causes
were the respiratory and intestinal tract diseases
derived from the generally damp and bacteria-laden
air, foul sewage disposal, proliferation of insects and
micro-organisms, dust-filled and poorly ventilated
221
passages underground and from inadequate fresh
water supply, congested housing, and subpar hospital
facilities.
Castigating the colonial state for failing to take
adequate supervisory responsibility, Simpsons Re-
port on the Sanitary Condition of the Mines and
Mining Villages of the Gold Coast and Ashanti,
printed for the Colonial Office (1925) constituted one
of those rare turning points in the history of public
health administration where a commissioned report
actually propelled policy change. After a painstaking
tour of all the major mining sites of the Colony and
Ashanti, Simpson attributed the high death rates
among African miners to the following causes. First,
there was the presence of anklostomiasis (hookworm)
which, he said increased the vulnerability of it victims
to a host of other diseases by weakening powers of
resistance. It was spread, Simpson declared, by the
constant reinfection of community towels at unsani-
tary latrines. A second, and more serious issue was
the recruitment by unscrupulous company agents of
totally unfit workers from the Northern Territories-
many already showing signs of tuberculosis-who
then collapsed under the strain of grueling under-
ground work at the mines. Third, he condemned the
fact that housing at some of the mining towns was
bursting at the seams to shelter the masses of hastily
recruited new miners, especially from the North.
There had been no planning and mine managers
simply assumed that workers, by hook or crook,
could get by with dingy quarters in the towns.
Much more care, he noted, should be taken to
ensure that there is no overcrowding. Fourth,
Simpson observed, that the high death rates for
miners at the towns of Tarkwa and Aboso were
traceable to all the above causes plus a polluted and
insufficient water supply and inadequate medical
arrangements [39]. He concluded with a spate of
recommendations.
As a consequence of Simpsons Report it appeared
that the African populations of the Gold Coast
and Ashanti for the first time might be considered
almost on an equal footing with Europeans. Prodded
by London, the Accra Government enacted the
Mining Health Ordinance of 1925 and over a period
of time pushed forward new regulations which
implemented most of Simpsons recommendations.
These mandated on-the spot medical examinations
for all labourers recruited outside the Gold Coast
Colony proper. A second order required African
hospital accommodations and a full-time medical
officer for all mines (not simply at major mining
towns) employing more than 500 workers. Thirdly,
all mines were ordered to provide a pure water supply
and decent housing for workers. Plans for new native
villages were to be drawn up with a minimum width
of streets at 30 ft and a minimum distance between
houses of 8 ft. After a reasonable period, the compa-
nies had to show that the floors of all miners cottages
were cemented and provided with at least one bed.
222 RAYMOND DUMETT

Fourthly, the Gold Coast Medical Department took

cognizance of Simpsons call for inspection of all
mines and villages every 6 months by a senior medical
inspector of the public health department [40]. Many
of these recommended reforms would be a very long
time in coming (particularly good housing for all
workers), but a number of the improvements associ-
ated with modern Tarkwa and Obuasi-&modern
wash houses with showers for miners. sewage dis-
posal in place of latrines, piped water supply, etc.
stemmed from the report and follow-up work by
Gold Coast departmental inspectors.

Miners tnortalit~~ tables: the ,firsr statistical surr3ey.s

One immediate reform. of direct pertinence to

I Pncumr,ni:k ? I 4 i
evidence gathered for the present study, derived from
_.
7 Tuhcrculo\l\ I I x v
Professor Simpsons scathing condemnation of the
governments failure to tabulate general mortality 3. Bronchitis and Plcur~\y l2.h% B

data on the African mining labour force on a regular 1. Dysentcr) J.l'i

basis. The recommendation was high time in coming. Fig. 3. Percentage of illness deaths by cause. Figures on
What makes the statistical series on miners sickness bronchitis and pleurisy were lumped together in official
and mortality doubly disconcerting is, not only that mining and medical reports.
it was instituted so late, but that the printing of such
tables was discontinued owing to the exigencies of
ory/pulmonary diseases-pneumonia, tuberculosis
war in 1939. Furthermore, the annual tables cover
and various bronchial disorders--accounted for
numbers and causes of deaths only and fail to include
about 62% of the annual miners deaths due to
non-fatal illnesses. Nonetheless. the knowledge con-
sickness in the Gold Coast (Fig. 3).
tained in these reports proved to be extremely valu-
able in future disease prevention and treatment. In
Epidemic disease und the mining districts
some instances the data provide valuable corrobora-
tion for what had long been suspected in descriptive Of course, these proportions might be upset by the
accounts. In other instances the graphs plotted from occasionally virulent outbreaks of epidemic diseases.
these statistical series lead the modern historian to There were two types of contagious diseases that
new insights and some unexpected conclusions. affected Ghana: (I) those which had the most devas-
tating impact in the dry northern savanna zone, such
as trypanosomiasis (sleeping sickness), cerebrospinal
The data confirm that the respiratory and pulmon- meningitis and relapsing fever [42], and (2) those
ary diseases. which we have seen. were the major such as plague (which hit the Gold Coast in 1908 and
causes of death among the general populations of the 1924), smallpox (1901-02, 1908-13, 1924-26 and
coastal towns, were also greatest nemeses of African 1930-3l), influenza (I918 and 1931-35) and yellow
miners. Far and away the single most lethal group of fever (1910. 19234, 1927-28, 1931-2 and 1937-38)
diseases were pneumonia and bronchial pneumonia that wreaked havoc mainly in the urbanized coastal
which accounted for about 30% of all miners deaths districts [45]. Most of these coastal epidemics did not
in both the Colony and Ashanti. This was followed invade the mining areas to any significant extent,
by tuberculosis and bronchitis which claimed 19.8% although we saw that the plague, which broke out in
and 12.6% of mining population fatalities respect- Accra and Sekondi, spread north to Kumasi by way
ively. We need to underscore here how the heavily of the mining railway, and that it was the plague
seasonal and migratory aspects of mines labour mo- epidemic of 1924 which prompted Simpsons famous
bilization, coupled with congested housing, made the report.
mining towns crucibles for the proliferation of disease Two yellow fever epidemics in 1910 and again in
pathogens [4l]. Other symptomatic ailments shown in 1914 created an ever greater stir in Tarkwa and
the figures with a consistently significant annual Obuasi owing to its reputation for a fearfully high
incidence of mortality were septicemia and pyaemia death rate among anybody who contracted the dis-
(synonyms for blood poisoning), which were com- ease. Very stringent campaigns for the eradication of
mon owing to wound infections following mine acci- A. aegypti (or Stegomia) mosquito breeding places
dents, and pyrexia (the omnibus label for all fevers of were enforced and all Europeans thought to have had
indeterminate origins) and dysentery. There were a contact with known carriers were set apart in quaran-
host of other fatal illnesses (see Table 2) but their tined houses [44]. Still, it was more the spread of
annual incidence varied so greatly that they cannot be panic than any dire results from the disease itself
shown in the figures. Taken together, the respirat- which temporarily disrupted the routine of the
 Disease and mortality among gold miners of Ghana 223

mining companies. In 1933, 1934 and 1935 in the Silicosis

midst of the most devastating influenza epidemic in
the countrys history miners were severely afflicted
(see Table 2) with mortality running as high as 12, 8
and 39 cases in each of the 3 years-the latter figure
close to 21% of all miners deaths for that year. This
was an extreme instance. As Patterson has noted, in
general spectacular epidemics were not the greatest
threats to life and health in Ghana; less dramatic
endemic infections took a much higher toll [45].
The short span statistical series (19251938) pre-
sented here raise a number of intriguing questions as
well as tentative conclusions for the 14 year period.
Figures 2, 4 and 5 show roughly downward-sloping
trends for both general mortality rates and death
rates for specific diseases for all miners. It is quite
likely that the fall-offs would appear more dramatic
if we had figures on African miners mortality
(guessed in some reports at more than 70 per thou-
sand) for earlier decades. The sharply fluctuating
lines in Fig. 2 (based on Table 2), showing simple
percentages of deaths for leading diseases to total
deaths each year, show no marked trends. The graph
lines on European miner deaths, shown in Fig. 4,
being based on a small population of several hun-
dred, are bound to show more random fluctuations
than the data on the general mining population. As
one would expect (Fig. 2) underground miners had
higher death rates for both accidents and other
causes (disease and sickness) than surface miners.
That deaths from illness were so much higher for
them than for surface workers was due, of course, to
the dominance of the respiratory diseases, aggravated
by the inhalation of quartz dust in deep level drilling
and blasting, as well as close contact with human
carriers.
An intriguing question concerns the dearth of
references in both colonial statistical and descriptive
reports to silicosis, or miners black lung disease,
common in many gold mines as well as coal and lead
mines throughout the world. Two key reasons are
that the etiology and clinical treatment of this chronic
ailment were not yet fully understood and that the
symptoms were not readily distinguishable from the
advanced stages of tuberculosis (under which it was
often grouped), so that medical textbooks of the time
tended to classify black lung symptoms under the
archaic label of miners phthisis. We know that the
disease derives from the protracted inhalation from
underground drilling and blasting of dust, sand or
flint containing silicon dioxide which produces nodu-
lar fibrotic tissues on the lungs [46]. But it was not
until the First World War that one or two Gold Coast
doctors started to draw attention to the severe (and
probably concealed) effects of this miners occu-
pational disease on local African workers and the
need to undertake research. W. J. Bruce. Medical
Officer at the Aboso Mine argued that accurate data
on the disease was practically non-existent, but he
concluded that Africans were extremely susceptible
and that almost every miner who worked under-
ground ran the risk of contracting the disease sooner
or later [47].
It strains understanding today why there was not
a greater outcry about this problem. In fact official
and company silence about the widespread preva-
lence of prolonged black lung disease lends credence
to the suspicion of a cover-up. A few doctors
conceded that because the presence of silicosis fibrosis
was difficult to detect without an autopsy, and since

I 0 I I I
1925 1930 1935 I Y4lJ

Year

Fig. 4. Gold Coast miners death rates (all causes). 0: The figures for All miners provided in official
reports are the closest approximation we have for the data on African miners. 0: The figures on European
miners, being based on a small population of several hundred are bound to show more random
fluctuations.
 224 RAYMOND DUMETT

patients in the terminal stages of the disease tended But the miners on the whole were young men who
to develop either pneumonia or tuberculosis, many were drawn from the sturdiest and most resilient age
deaths attributed to the latter two probably could groups in the population. (An important exception
have been diagnosed earlier as silicosis. Dr Bruce were miners drawn from the Northern Territories
suggested that those miners known to be suffering discussed below.) Because the general Gold Coast
from the disease should have been screened and population contained larger segments of the most
prohibited from working underground any longer; vulnerable age groups-the very old and the very
but he was not optimistic about the success of such young-it tended to suffer a much higher death rate
a requirement. For one thing it probably would have from sickness and disease than the miners. It must be
necessitated every mine hiring additional doctors to emphasised, however, that these conclusions are
make detailed tests which they could ill afford. The based on the years following the Simpson Report
plain fact is that mine supervisors and foremen knew when policies towards indigenous miners health re-
that many of their underground workmen were form altered dramatically.
suffering from coughs that were probably symptoms Figures 2 and 4 (also Table 3) show that a marked
of serious disease. Black lung disease was part of the fall-off in deaths per thousand for underground min-
miners way of life in the coalfields of Yorkshire and ers from all diseases (labelled other causes) brought
Pennsylvania as in most gold mines. It was also a well down the general death rate with it during the period
known fact that many miners were a tough lot who 19241937. From this we conclude that the various
were willing (or who saw no choice but) to work sick. public health measures and more accessible hospital
The mine managers resisted all talk of reform because treatment slowly adopted by the mining companies
they feared losing their miners to other companies did have some belated positive effect. Indeed, what is
which would have had few scruples avoiding such perhaps most surprising is that the death rates for
rules [47]. African miners did not differ that much from the
European miner rate during the period of reform (see
EVALUATION OF MINERS MORTALITY STATISTICS
Fig. 4). Thus for 1928-37 we find that the regular
African employees of the Gold Coast mines had an
Having noted these dire facts, it is still possible to average mortality rate from disease of 8. I7 per thou-
conclude that the main body of regularly employed sand, only slightly higher than that for European
wage-earning miners (including underground miners-7.78 per thousand for approximately the
workers) during the late 1920s and 1930s probably same period, 192636. If we look only at African
enjoyed better overall health than the general African underground miners then the mortality rate from
populations of most urban and rural areas as disease was a good deal higher-14 per thousand----
reflected in the very limited general mortality stat- but still close to European general death rates on the
istics of the time. Available evidence suggests that the Coast only 20 years earlier.
general population suffered from the same high inci- Any data on African miner mortality rates per
dence of lethal respiratory and pulmonary diseases- thousand for specific diseases for the period 1924 to
and in about the same proportion-as the miners. 1938 fail to do justice to the far higher death rates for
pneumonia and tuberculosis. which undoubtedly
afflicted African underground miners, during the
preceding 25 year period. The gradual decline in the
combined mortality rate for all three leading pulmon-
ary and respiratory tract diseases (Fig. 5) from I7 per
thousand in 1927-28 to a low of 5.8 per thousand in
1937-38, coupled with a commensurate drop in the
rates for each disease (pneumonia, T.B. plus bronchi-
tis and pleurisy), reflected the belated application of
modern scientific measures to combat these diseases
amongst African workers across a broad front-in-
cluding (1) prevention, (2) early detection (involving
the use of X-rays), and improved hospital treat-
0 , I I ment-which got underway only in the mid-1930s.
1925 1930 I)35 lY40
There is, however, one major flaw in these African
Year miners statistics. The data appears to have been
Fig. 5. Death rates per thousand for pulmonary diseases. 1. based entirely on those miners who died on or near
Combined death rate for pneumonia, T.B. and bronchi- the premises, usually in their cottages or in company
tis/pleurisy. 2. Death rate for pneumonia. 3. Death rate for or government hospitals. It does not include the
tuberculosis. These calculations are based on the death many miners who contracted a disease during em-
figures and base mines labour force figures for Mines with
Medical Officers. Figures for mines without medical ployment at the mines, left the job and died perhaps
officers are not included for the reason that they are spotty years later, many miles away in their home villages
and much less reliable. [48]. One further point is that these statistics, based
Disease and mortality among gold miners of Ghana 225

on the mining industry as a whole, tend to flatten out

the sometimes staggering African miner mortality
data at more poorly administered individual mines-
which the colonial government recorded only on an
occasional basis and seldom, if ever, printed for
public consumption.

Vital statistics on Northern Territories mines labour

Another of the important contributions of the
Simpson Report was to pinpoint for the first time the
unusually high incidence of fatal diseases amongst
the prospective mine workers who migrated south
from the northern Territories. We noted above that
the first northerners had been recruited mainly for the
Wassa mines with government assistance in 1907. In
1911 the Northern Territories component in the total
Gold Coast-Ashanti mines labour force was 2421 or
14%. During the 1920s the Wassa mines stepped up
their recruitment; and in the 1930s the Ashanti
Goldfields Corporation, facing increased competition
for labourers from the expanding cocoa-growing
industry, was also forced to recruit increasingly in the
North. As medical research was to show, however, a
majority of the men who arrived in Wassa or
Southern Ashanti from the North, were, by reasons
of malnutrition and exposure to a variety of bacteria,
already disease-prone to begin with.
Twentieth century investigators confirmed the ear-
lier speculations of the African physician Dr J. F.
Easmon (above) and other doctors that people from
the northern savanna zone were extremely suscep-
tible, especially during and immediately after the
Harmattan season, to nasal and bronchial infections.
Common colds frequently gave way to pneumonia
and tuberculosis either on the long journey from the
region of the Black Volta to the mining districts or to
black lung, once at the mines. Thus, at a time when
death rates for all African miners at the mines of
Wassa and southern Ashanti had been reduced to
about 12.0 per thousand per annum, the death from
all causes for boys recruited in the Northern Terri-
tories stood at a shocking 75.2 per thousand in
1923-24 and 60.48 per thousand in 192425 [49].
Close inspection showed that the annual death rates
per thousand for Northern Territories workers at
particular mines of tire Wassa district were even
worse. For example, at the two mines of the Tarkwa
and Aboso Gold Mining Company, where 671 men
from the North were employed, the average death
rate for the 12 months ending March 1924 was an
unbelievable 103 per thousand. This reflects on the
subpar public health amenities and enforcement of
public health regulations which Dr Simpson had
found at those two towns. At the Abontiakoon Mine
the annual death rate was 65 per thousand [50].
What were the explanations given at the time for
the high sickness and mortality statistics on northern
region mines labourers? Dr Simpson had observed a
considerable proportion of unfit men and youths sent
from the Northern Territories of the Gold Coast,
226 RAYMONDDUMETT
many of whom have tuberculosis, soon break down
from underground work, to which they are not
accustomed, and which is unsuitable for them in their
condition [51]. However, several of the Wassa min-
ing executives, perhaps to divert responsibility from
themselves, wanted it known that northern chiefs and
headmen were also partly responsible because they
sometimes deliberately pressured the weak and sick to
serve at the mines in order to keep the healthiest
able-bodied men at home for life-sustaining agricul-
ture [52]. Another detriment was the lack of sufficient
modern transport (motor lorries, etc.) for those who
had to make the horrendously long journey-
often 300-440 miles on foot. Following these revel-
ations all labour recruitment in the North was halted
for about a year and then resumed under the stricter
guidelines put forward in the Simpson Report. Gor-
don Guggisberg, one of the Gold Coasts most
effective governors (1919-27) took the lead in these
reforms by insisting on (1) preliminary medical
examinations for prospective mine workers in the
North, (2) rejection of all recruits found to be medi-
cally unfit. (3) provision of motor transport with
connexions to the railways, and (4) written regis-
tration of individuals immediately upon recruitment
in their home villages so that no substitutions could
be made with people in ill-health [53]. Company
representatives or agents, who wanted to recruit
labour in the North had to obtain a government
license. With these stricter controls in force the
horrendous number of Northern Territories miner
deaths abated over the next 10 years.
General (total population) mortality votes und health
conditions ut the mining towns
More than 10 years before the British Colonial
Office reassessed its position regarding the need to
maintain statistics on African miners as an occu-
pational group, two or three conscientious medical
officers at up-country posts had come round to the
view that either the government or the companies
should keep tab on general births and deaths at the
mining towns on a systematic basis. But it was little
more than a quixotic gesture when Dr C. S. Dowdell,
the single overworked medical officer for the Ashanti
Goldfields Corporation [54], decided in his own time,
without permission or extra pay, to conduct a demo-
graphic survey-not simply of the regularly employed
miners-but of the entire urban complex of Obuasi
and surrounding mining villages for a one year period
in 1912. Dowdells findings that the general popu-
lation of Obuasi town had endured a much higher
death rate--17.4 per thousand---than the company
had been willing to admit and a higher mortality rate
than that of the AGCs wage labour force helps to
explain the companys disinclination to publish the
results or to sponsor further surveys [55].
Dowdells disclaimer that his findings cast no as-
persions on his employer was not quite convincing.
Obuasi was, in truth a company town, despite every
effort of the AGC to avoid taking full responsibility
for urban health and sanitary expenditure there. It
was not simply that a majority of the villagers
included the miners, and their families; many of
the floating population of Obuasi were, in fact,
occasional contract workers for the company. These
workers and townspeople, along with those from
the Northern Territories, were among the most
wretched and vulnerable to disease of any groups--_
perhaps in the entire colony and protectorate.
They were, in fact, prime carriers. As one governor
was to note many cases of illness appear to occur in
men who are irregularly employed, and who, passing
from mine to mine, seeking a change, spend a few
days at a time loafing about the native villages
enroute [56].
Later studies were to show that Dowdells 1912
town estimate, was in fact probably too low. But, it
was not until 1935 that the first official efforts were
made to calculate general urban mortality rates for
the whole of the Gold Coast, Ashanti and the North-
ern Territories. And it was remarkable to note that
even at this late date two of the four major mining
towns ranked very high on the list of general death
rates. Tarkwa and Prestea led the entire list of 24 total
registration towns with death rates of 85.6 per thou-
sand and 70.3 per thousand respectively in 1935.
Aboso and Obuasi registered general mortality rates
of 36.6 and 31.7 which ran close to the average for
all towns of 31 per thousand in 1935 [57]. It must be
underscored that it was not simply the miners per se.
but the mining towns that were the dangerous nodes
for the spread of disease. Thus Tarkwa with a
relatively small population estimated at from 2 to 6
thousand [58], but with 56 cases of T.B. in 1927-28,
ranked second to Accra with a population of about
60.000 and 92 cases of T.B. [59]. It is worth adding
that Tarkwa also had the very highest infant mor-
tality rates of any major town in the Gold Coast--
another useful statistic made available for the first
time in this same period, 1924-37 [60]. The lower
general mortality rate for Obuasi during these years
would seem to support descriptive evidence that the
Ashanti Goldfields Corporation was able to spend
more than its competitors on amenities such as piped
water supply, and wash houses and so turn the
African township into a relatively liveable and dis-
case-free place of residence.
There are no statistical data by which we can
measure the incidence of non-j&al sicknesses and
disease amongst the population of the mining towns,
but descriptive evidence combined with data for
segments of the general urban population of the Gold
Coast in this period allow us to venture some tenta-
tive hypotheses. We already mentioned the reference
in the Simpson Report to the prevalence of
helminthic (worm) diseases. Several other diseases,
not discussed previously, also deserve mention here.
Although the Gold Coast and Ashanti as a whole
suffered less from venereal disease than other parts of
 Disease and mortality
Africa, the incidence of gonorrhea rose greatly be-
tween 1875 and 1930. And it is clear that the mining
centers of Tarkwa, Prestea and Obuasi along with the
major coastal trading towns became dissemination
points for the spread of venereal disease into sur-
rounding rural areas [61]. It is interesting that cases
of syphilis were concentrated mainly in the Northern
Territories, and were prevalent among miners who
had recently returned to their homelands from the
mining towns [62, p.4751. Diseases of childhood were
extremely common in most of the major towns of the
Gold Coast and we may assume in the mining towns
as well. In one sampling of 1470 school children in the
1920s, medical authorities discovered that 64%
suffered from one defect or another, ranging from
nose and throat problems (with possible later connec-
tions to pneumonia and T.B.), to tropical ulcer and
the common childhood communicable diseases, such
as mumps and measles. The broad issue of malnu-
trition was just beginning to attract notice in this
period. Children also suffered from tooth and gum
disease, from glandular problems, and they desper-
ately needed smallpox vaccinations.
There was probably very little that the medical
authorities or the companies could have done to stem
the tide of malaria amongst the general population
before the advent of the residual insecticide DDT in
the 1940s. Malaria, it must be reemphasized was the
major cause of African sickness despite all that has
been said about the more fatal impact of the respirat-
ory and pulmonary diseases, Instruction about the
mosquito-proofing of houses, use of nets and the
drainage of mosquito-breeding pools and ditches
may have helped the increasing numbers of African
skilled and supervisory staff who were quartered on
the company premises; but would have had little
meaning for the bulk of the labor force and indige-
nous mining towns populations. And the colonial
government certainly did not have the wherewithal
for distribution of quinine on a systematic scale,
except to Africans who worked for the colonial
government. One test for the prevalence of malaria
among the general African population was the ex-
tremely high incidence of enlarged spleens among
children-which reached 34.4% of the population
tested [63]. Although this return was for Accra, where
drainage facilities were notoriously poor, it gives an
indication of country-wide malaria rates, including
those for the mining districts. Malaria and the other
so-called non-fatal diseases amongst Africans were
major causes of mine worker absenteeism and low
performance on the job, and because of their
debilitating effects, they greatly increased a victims
susceptibility to the other more lethal diseases.
CONCLUSION
The results of 40 years of work by the government
and mining companies to improve health and living
conditions at the mines were, at best, mixed and
among gold miners of Ghana 221
uneven. As their central achievement the colonial
authorities exulted in the marked reduction of Euro-
pean deaths-specially those due to malaria. To say
that for more than half of the period surveyed here,
investigation of the causes (let alone individual treat-
ment) of African miners sickness and mortality was
relegated to secondary concern on the health agenda
of the colonial state would be an extreme overstate-
ment. The topic was ignored. Apart from accidents,
between 1895 and 1923 neither the Medical and
Sanitary Department nor (after 1904) the Mines
Department troubled even to keep count of the
annual numbers of African miners who died on the
job. Yet we have seen that the nostrum that the
medical department of the Colony was maintained
solely for the benefit of the European community
was a mere rationalisation and, not even historically
true. We noted that commencing in the 1880s mini-
mal programs for street sanitation, house inspection
and refuse collection had been set in train in the
coastal towns [64]. Considering the importance of
gold mining (which along with cocoa-growing) was
one of the Colonys two most important industries)
it is remarkable that more was not done earlier to
investigate and monitor the health of African mine
workers. Although we lack, thanks to these attitudes,
any statistical data, all the descriptive evidence points
to the fact the worst killers-pneumonia, bronchial
pneumonia, tuberculosis and bronchitis were on Qre
rise among miners throughout the period 1890-1925,
and even afterwards among the general popufution of
what is today Ghana [62, pp.5145191. Even after
1930 the best that can be said is that the incidence and
mortality from these scourges levelled out.
Had anyone questioned early on the reasons for
official indifference and inaction, most mine man-
agers would have pointed out that a majority of their
African workers were part of a large floating popu-
lation of migrant and occasional workers, many of
whom did not work for long continuous periods;
therefore, what good would it do to keep track of
them for purposes of compiling health statistics?
Most miners were not diagnosed for pneumonia and
T.B. (if at all) until the diseases were already in the
advanced stages. Some company spokesmen even
argued that to emphasize regular visits to the infir-
mary in cases of illness or minor injury would be to
encourage malingering or absenteeism. The fact is
that a majority of company managers and govern-
ment administrators viewed African unskilled labor-
ers (particularly those from the far North) as an
expendable resource. If numbers died, whether on the
job or after, they were so many digits who could be
replaced by new recruits from the upper Volta region,
from Nigeria, or even from the French Sudan. As one
mining company doctor put it: we must simply let
it [Tuberculosis] kill the most susceptible and immu-
nize the others in the course of generations, but it is
inconceivable that here we could prevent the sufferers
from going underground. . [65]. The irony is that
228 RAYMONDDUMETT
even in the Union of South Africa at this time, white
corporate managers (for highly practical reasons)
kept better track of the sickness of Black workers
than in the supposedly less racist British Gold Coast
[66]. Only the loss of African skilled workers might
be a cause of some alarm to mine managers; and this
may have been one additional reason why Gold
Coast companies began to focus attention on African
miners health to a more significant degree in the
mid-1930s, as more Ghanaians rose to technical
(engine drivers, winch and separation plant oper-
ators) and supervisory positions.
Based on the reductions in death rates for mine
workers on the regular payrolls, it is possible to argue
that general health and living conditions for African
underground and surface workers (especially at mines
with medical officers), probably did improve during
the 1920s and 1930s [67]. The better accessibility of
doctors and nurses for those afflicted with serious
illnesses or who suffered injury on the job was
undoubtedly important. Certainly the expanding
numbers of African patients treated every year at the
Tarkwa and Obuasi hospitals after 1925 offered some
testament that western style medicine was slowly
gaining acceptance among regular wage-earners [68].
The far more detailed colonial medical reports of the
1930s, buttressed by more complete statistics on
causes of sickness and mortality, were reflective of
enlarged medical and sanitary staffs and new scien-
tific assaults against nearly every disease that afflicted
the general population. Special research units were
established for the study of river blindness, leprosy,
relapsing fever, cerebra-spinal meningitis, trypanoso-
miasis, helminthic diseases, malnutrition amongst
children and, finally, even the allied problems
miners black lung disease and pulmonary tuberculo-
sis in the Wassa mining district in 1939 [69]. There
was a steady multiplication in the annual number of
smallpox vaccinations and by the 1940s systematic
and widespread attention was being given to anti-ma-
larial house protection and mosquito eradication
campaigns in African living areas.
Against the record of improvements must be listed
a number of doubts about deficiencies in the process.
Successes were scored more in investigative research
than in the treatment of large numbers of persons
who were victims of disease. Although the figures on
expanded hospital bed facilities for Africans appear
impressive [70], these were still but an insignificant
percentage in relation to the total town and rural
populations. It is highly doubtful whether a sizeable
number of ordinary people anywhere in the Gold
Coast and Ashanti came into contact with western-
style institutionalised medical care [71]. The numbers
of miners shown in figures here, suggest somewhat
positive trends, but they cover a late period and they
do not go into detail on those mines where health
standards and worker mortality were far worse than
the average [72]. More important, as we have seen,
they do not include the figures on the full-time
migrant (particularly N.T.) workers who died far
from the scene, nor for the unregistered part-time
contract workers and general mining towns popu-
lations. Despite easier access to hospital care, most of
the miners came into company dispensaries only briefly
as out patients where they were treated mainly for
superficial sores and small wounds. As we have seen,
many mine mangers and foremen took a dim view of
absences from the job for reasons of illness. and not
even the doctors encouraged early diagnosis of the
more serious respiratory and pulmonary disorders
that would have required long-term hospitalization.
Progress in mining town housing and sanitary
maintenance followed a chequered course in which
years of steady enforcement of street drainage. refuse
scavenging and sewage disposal regulations might be
followed by periods of laxity and deterioration. That
during the greater part of our period serious differ-
ences of opinion ruffled the nerves of government
officers and mining firm members as to who bore the
primary financial responsibility greatly retarded
cooperation on public works and sanitary mainten-
ance. Nor did the strong tradition of resistance to
municipal taxation by African representatives to
town councils help the situation. Town Sanitary
Committees were appointed to oversee these matters
in Tarkwa and Obuasi. But external inspectors still
complained that such bodies lacked adequate funding
and enforcement powers [73]. Perhaps more promis-
ing was the arrangement at Prestea where the major
companies owned all the miners houses. leased them
out for a small fee. and placed all housing and
sanitation problems under the authority of a single
village master [74].
of Though company and colonial reports emphasised
the continued expansion of model mining villages
for all their African labourers. 1920 40. only a small
number of skilled workers in this period were able to
live in the white-washed and neatly laid out bunga-
lows, glorified in the photographs. Most under-
ground workers, even at Obuasi, were expected to
build their own houses. or rent a room from an older
resident in the overcrowded traditional native town
[75]. The grid system for the layout of streets and
houses was never fully adhered to. so that domiciles
frequently rubbed together without sufficient breath-
ing space between [76]. True. the town sanitary
committees employed scavenging squads to pick up
refuse between the houses. but they had little power
to enforce strict sanitary practices on indrvrdual
house dwellers.
Closely allied with the problem of municipal sani-
tary administration was the even broader issue of
public and private hygienic education. Courses were
introduced in the (mainly missionary) schools and
notices were posted, but the information did not
necessarily reach a wider adult population. The germ
theory of disease and the need to separate by wide
distances drinking and cooking water sources from
washing water and toilet functions were. according to
 Disease and mortality among gold miners of Ghana 229

contemporary reports, still not widely understood
throughout the country [77]. Although septic tanks
and flush toilets were slowly being brought into use
for Europeans at major government and mining
centers, the main thrust of policy was mainly to
increase the number of ordinary pit latrines in up-
country towns and rural areas. At a majority of the
mines one major improvement over other urban
centers during the 1920s was the use of pan latrines
with daily or twice daily removal of nightsoil. These
improvements in sewage disposal were probably re-
sponsible for the general decline in deaths due to
dysentery among miners, suggested in Fig. 3. How far
they may have affected sickness and morbity rates for
other water-borne and intestinal (such as the
helminthic) diseases is unclear in the records. Despite
the improvements, contemporary medical authorities
conceded that public sanitation, maintenance of bac-
teria-free working conditions and pure water supplies
in the mining towns were nowhere near the levels
desired. As late as 1938 the Medical and Sanitary
Department lamented that the tuberculosis problem,
especially in the mining areas was still acute:
It is depressing to have to record that the unsatisfactory
conditions in the rural areas and in the areas surrounding
the mines (especially with regard to housing and overcrowd-
ing in the mining areas) remain practically unchanged
Until the necessary legislation establishing local sanitary
authorities with sufficient power is enacted, conditions
cannot be improved [78].
Acknowledgements-A version of this paper was presented
to the African History Seminar, School of Oriental and
African Studies, London University, 28 October 1992. The
author would like to thank David Moore, Purdue Univer-
sity, K. David Patterson, University of North Carolina,
Charlotte, and Randall Packard, Tufts University, for their
professional advise and consultation.
REFERENCES
This did not mean, of course, that the government
ignored the problems of African illness and disease, but
rather that it was relegated to tertiary and longer
term importance. (See, for example, statements in G.C.
Annual Report for I899, p. 22.)
For some of the most detailed recent work on African
illness and mortality in mining areas see Packard R. M.
White Plague, Black Labor: Tuberculosis in the Political
Economy of Health and Disease in South Africa, Univer-
sity of California Press, Berkeley, 1989. See also Per-
rings C. Black Mineworkers in Central Africa, pp. 14-18,
39957, 80-85, 165-177. Heinmann, London, 1979.
At one point the merchants of the Cape Coast Chamber
of Commerce derided the colonial government
along the line of rail without adequate water supply,
medical or sanitary facilities. The numerous ravines and
depressions were natural breeding grounds for the Aedes
aegypti bellow fever) and Anopheles (malaria)
mosquitoes. Inspectors later noted that rats were preva-
lent at all the railway stations. The spread of the
Bubonic Plague from the coast to Ashanti in 1915 was
traced in part to rapid transport by rats and humans on
the railwav. (See Resident Engineer Bradford to Govr.
Nathan, i3 May 1901; Nathan papers, Box 293-95.
Rhodes House Oxford. For the spread of plague see
G.C. Medical and Sanitary Rept. for 1915, p. 18. Also
Scott D. Epidemic Disease in Ghana, pp. 18-19. Oxford
University Press, London, 1960.)
5. G.C. Rept. on the Census for 1911, p. 28. ADM 51213.
Ghana National Archives. [Hereafter referred to as
GNA.]
6. European medical officers of the nineteenth century
often remarked that Africans of the Gold Coast had
high standards of individual cleanliness. Problems, they
submitted, stemmed from lack of comprehension of the
germ theory of disease and how sickness could spread
from contaminated water and soil coupled with un-
precedented urban overcrowding. (Copy of desp. fr.
Actg. Govr. to Lord John Russell, 1855 (G.C. No. 27):
Accts Papers [2052], XLII, 199, 856; also Sanit. Rept.
for Keta Dist. (30 Sept. 1887) in Accfs Papers
[c.5249-91, LXXII, 6, 1888.)
7. A Towns Police and Public Health Ordinances had been
on the books in the Gold Coast since 1878, but these
laws tended to be laxly enforced by the local police
under whose charge they fell. Rules that turned over the
responsibility for digging public latrines to chiefs were
not always effectively implemented. (See Ord. No. 10 of
1878: An Ordinance for Better Regulating the Peace of
Towns and Populous Places and Promoting the Public
Health; also Town and District Sanitary Reports encl.
in Govr. Griffith (56) to Knutsford, 12 Nov. 1892: CO.
961222.)
8. This report is listed because it was a pioneering effort by
an eminent doctor. One possible omission is malaria,
from which Africans suffered a high incidence of mor-
bidity, though not of mortality. Two explanations for
the omission are that medical doctors did not then have
an accurate method for measuring the incidence of the
disease and that most Africans so bore up with the
recurrence of fever under the disease that they would
not have gone to colonial doctors to report it. (Easmon
J. F. Rept. on Increased Mortality in the Gold Coast,
Encl. in Griffith (I I I) to CO.. 5 April 1887: C.O.
96/180. For a detailed discussion of the career of
Easmon, see Patton A. Jr Dr John Fare11 Easmon:
medical professionalism and colonial racism in the gold
Coast 18561900. In/. J. Afr. Hisr. Stud. 22, (4),
601-636, 1989.
9. David Scott notes major years for smallpox cases
beginning in 1901. (See 14, PP. 666701.) But colonial
medical officers were recording cases iorig before this
time. (See District Sanitary Report for Ada, Encl. in
Acta. Govr. Pike (126) to C.O., above; also District
Sanitary Repts., for Pram Pram, Akuse, and other
for its towns in Govr. Maxwell (14) _ to C.O.. Jan. 1895: C.O.
I

policy of concealment during a period of epidemic 96/254.)

disease in order to placate the fears of the British 10. Many of the most prevalent tropical diseases among
mercantile community. (Cape Coast Chamber of Com- Africans were at least partially understood from about
merce to Liverpool Chamber of Commerce, 30 August the 1880s onwards. Three important exceptions were
1902; Copy in Nathan Papers, Rhodes House, Oxford.) the snail-borne diseases, such as Schistosomiasis, (bil-
In 1913 the governor continued to express concern harzia), trypanosomiasis, and onchocerciasis (river
about the Colonys overly-publicized unhealthy repu- blindness), the vectors of which were not identified by
tation, (Govr. Clifford. 14 Oct. 1913: C.O. Afr. Conf. medical scientists until after the turn of the century. See
Print, lOb8, No. 195, p: 263). for example, Gold Coast Sanitary Reports for the Year
During railway construction, workers were housed in 1889: Reports on individual districts, encl. in Actg.
miserable tent settlements at various construction points Govr. Pike (126) to Lord Knutsford, 2 June 1890; C.O.
230 RAYMOND DUMETT

Y6,2OY.For the best modern survey see Patterson K. D. 26. Prior to 1900 mortality rates for European mmers, as
Health in Colonial Ghanu: Disease, Medicine and opposed to officials were seldom tabulated by the
.Socio-Economic Chunge, 1900.- 195.5. pp. 5-7, 33-83. government. We do have a document estimating the
Crossroads Press, Waltham, MA, 1981. death rates for all European non-governmental person-
II Compulsory birth and death registration laws, even for nel (including missionaries and traders, as well as
the major coastal towns, such as Accra and Cape Coast miners) for the decade 1879-1888. This table shows an
were not introduced until 1912-13; and even then they average decade1 mortality rate of 83.6 per thousand with
were more often honored in the breach. For the law to highs of over 100 per thousand in 1886 and 1887.
be enforced in a particular town there had to be a public (Figures enclosed in Hodgson to Knutsford. 19 Oct.
cemetary in existence and a registrar of births and 1889; C.O. 96j205.)
deaths. There were numerous revisions of the birth and 27 Mortality rates for the European mercantile and rnls-
death registration codes in the 1920s and 1930s. sionary classes also dropped remarkably, but not quite
Kuczynski R. R. Dmqyraphic~ Survey o/ the Brilish to the same degree as those for officials and miners.
Colourrd Empire. 1. pp. 451 452. Oxford University Some argued that of the various classes of Europeans on
Press. London. 194X. the Coast, missionaries incurred the highest death rates
12 Rept. by Dr Easmon. ?I Feb. 1X87: above. Also G.C. over a 50 year span. (See informed discussions on the
.V<V/. & Sat?;/. K~pr. /or IY9?. encl. in Govr. Griffith effects of the mosquito-control and household protec-
(266) to C.O.. 7 Sept. lXY4, C.O. Y6:248. tion campaigns, in Horn A. E. The health of Europeans
I? Go~~rnnlpn/ S<rn:/<rr~Rc~port fbr 1x91. encl. in Griffith in West Africa. The Lmcet, X May. pp. 1356 1358.
(56) to Knutsford, 12 No\. 1892; C.O. 96,222. 1912. Gov. Rodger to S. of S.. I8 Oct. 1909: C.O. Afr.
14 Kuczynski R. R. Dcvwpqvhrc LS~urc~~~ of //IB Briri,sh 940, No. 40, pp. 60--61.
Coloniul Empiw. I. 417 426. Oxford University Press, 28 Medical Rept Encl. in Govr. ClifTord to Sec. of State.
i-ondon, IY4X I4 Oct. 1913 C.O. Afro. Conf. Print. IOOX No. 195,
It; For ri thorough discussion of the genesis of the North- p. 263.
ern Tcrrltorics mints labour problem, see Thomas R. 29 G.C. &fed. R .%n. RPIII. for 190% p. 13: and for Ill.!
Forced iabour tn British West Africa: the case of the p. II.
Northrr:l Territol:es of the Gold Coast. 1906 1927. J. 30 The particular government housing segregation cam-
.4/r. Ifbcr. XIV, 79 103, lY7.3. paign attacked by the Society was directed against
Ih (; C. ,bfitling Dep. Repr. ,fbr 1911. Sch. F. p. 15. African domiciles thought to be houslng the yellow
17 Despite attempts by the colonial government to carefully fever mosquito. PetItIon by Anti-Slavery and Abortgl-
engineer the success of these early town councils nes Protection Society. Encl. in Govr. Thorburn (767)
through the appointment of safe oficial members and to C.O., I1 Dec.. lUl(j: C.O. 96;51 I. (Check exact date.)
the election of loyal African representatives (including 31 Clifford to S. of S.. X Mav 191.3: C.O. Afr. YY9. No. 161,
nlerchants. barristers and chiefs). the councils were p. 250. Hugh Clifl<)rd served as Governor of the Gold
rendered immobile by mass popular demonstrations Coast from 1912 to IYIY. Here, and later a\ Governor
against the imposition of any kind of direct taxes or of Nigeria. he wa\ cone of the most innovative and
hotis< rates. Govr. Hodgson (2X2) to C.O.. 4 July 1x98: independent-minded critics of British administration
(.O. %31X. &vr. Rodger (Conf.) to CO.. 21 Mar. ever to serve in a West African governorship. Another
IQOS: CO. Oh 42X. Ior the continuation of these was Sir William MacGregor, Governor of Lagos. Both
prohletns in the lY70\ see Wraith R. E. Gug~i.+r,q. men wrote lengthy memol-anda on public health ques-
pp. 110 211. 0l;ford University Press, London. 1967. tions with a special emphasis on the health of Africans
IX Ft>r a thorough chronology see Dumett R. E. The 32 Kuczynski R. R. Demoyruphic~ Sut~ <:I. of /hc Briri.\h
campaign against malaria and the expansion of scientific Cohmicrl Empire 1. p. I I. Oxford Universlt) Press.
medical and sanitary services in British West Africa. Oxford, 1948.
1898~1910. IV/. J .4/k. Hi.rr. Slur/. I, 153 197, 1968 33 For reasons of convenience. we have taken the figure5
19 Vital Statistics Respecting Europeans Employed by the for all miners In the government reports as practically
Governments of the Gold Coast and Lagos. 1881 -97. identical with the figures for all d/rrc,trt~ mlncry The
(0. Afr. (W) Conf. Print 727. p. 102. overwhelming majority of deaths every year was for
20 Ciavr. Maxwell (299) to CO.. IO July 1897; C.O. 96,295. Afrxan miners. In the early decades, the number of Euro-
Minute by W. Bailey Hamilton. 29:41884 on Young to pean deaths from accidents ranged from about I 3 per
C.0 25 Aug. 1X84; C.O. 96 15). year and seldom more than 5 per year. In no year did
21 Nathan to Ronald Ross. 30 No\. 1901 Ross Archives, thenumberofEuropeanaccidcntaldeathscomprisemo~e
: ablne! A. Drawer Il. File 13. London School of than 4.5% of the total. The European percentages were
rroplcal Medicine. eben smaller if we look only at underground miner deaths.
22 Meeting ofG C Mines Mgrs. Assn., 4 Aug. 1910, Encl. 34 Quoted in The Mining Jmunrd. pp. 1007 1008, 5 Dee
rn Gobr. to C.0.. 2Y Dec. 1910; C.O. 4fr. Conf. Print. 1914.
660, No 9. Appndx. 2. Also West African Chamber of 35 It was discovered that the underground Hood was
Mines to C..O.. I I Ma-. IYI I. C.O Afr. (W) 666. No. caused by drilling into an abandoned adit level that had
49, pp. 108 IOY. since filled with water. Miraculously. nine African min-
21 Packard pclints out uhen later the incldencc of T.B. fell ers and one European were rescued after an under-
at man) of the Transvaal mines. even with retention of ground entombment lasting 9 days. Following this the
the compound bystern, that this was due to other factors Government passed an Amendment to the Mining
>uch IS the nitroduction of hetter food and pit-head Rights Regulation Ordinance of 1905. stipulating that
changing and wash houses 12. pp. 74-76, I65 1661. no shafts or underground adits into old or abandoned
24 The weaknesses in the practical application of the house workings he made until after inspection and approval by
:,egregation strategy in West Africa are discussed in the Gold Coast Secretary for Mines. enclosures in G. C.
Dumctt [IX. pp. 170 721, and in Patterson [lo, (Separate) to Lord Elgin, 9 Feb. 1907: C.O. 96/455.
pp. 39 401. For a similar criticism of this practice by 36 At the DeBeers Company diamond mines in the 1x90s
a governor of Lagos, see Joyce R. B. Sir William deaths from accidents averaged 6 7 per 1000 employed.
.I-fcr~~Gre~or,p. 233. Melbourne. 1971. But the annual average for the entire diamond mining
25 Memo. by Dr A. E. Horn on the 1910 Medical and work force was said to be I2 deaths per thousand.
Sanitary Rept of the Gold Coast, Accra. 19 Dec. 191 I; Worger W. H. Sour/~ A,frrm.v Cir,, q/ Diumond~ p. 264.
(.O. 96:5 I. Yale University Press. New Haven, 1987.
 Disease and mortality
37. Gold Coast Mining Dept. Reports for the Years.
38. Memo by Simpson on The New Scheme of Sanitary
Organization in West Africa (3 Feb. 1910). C.O. Afr.
Conf. Print 940: No. 92, p. 144.
39. Health of Labourers Employed at the Mines (Sum-
mary of Simpsons findings) in Gold Coasr Medical and
Sanitary Dept. Rept. for April 19244March
pp. 20-21. C.O. 98142.
40. G.C. Med. & Sanit. Rept.,for 1924-25, p. 21.
41. Patterson K. D. Health in Colonial Ghana: Disease,
Medicine and Socio-Economic Change, 1900-1955,
pp. 64-65. Crossroads Press, Waltham, MA, 1981.
42. Cerebro-spinal fever is endemic in the Northern Region
but reaches epidemic proportions from year to year
during the Harmattan season. Major epidemics
occurred in 1907. 1908. 1919 and 1920. (Kuczynski
[I I, p. 4921.)
43. For details see Scott D. Epidemic Disease in Ghana,
1901~1960. pp. 2-8, 39-55, 66675, 187-192. Oxford
University Press. London, 1965.
44. Response to the yellow fever outbreak by the Ashanti
Goldfields Corporation noted in James Mactear
C. W. Mann, 17 May 1910; Mines Corres. Inwards;
AGC 14. 171/21. Also C. S. Dowdell, M.O., Obuasi to
Manager, Ashanti Goldfields Corporation, 25 May
1914; AGC 14. 171135. AGC Papers: Guildhall Library.
45 Patterson K. D. The influenza epidemic of 1918--19 in
the Gold Coast. Trans. Hisr. Sot. Ghana 16, 1977; Also
Patterson [lo. p. 1051.
46 See. for examole. Barth P. S. The Tragedv of
Black Lung. Upjohn Institute, Kalamazoo, MJ. 1987;
Smith B. Digging Our Own Graues; Coal Miners and the
Slruggie oter Black Lung Disease. Temple University
Press, Philadelphia, 1987; Foster J. C. Western miners
and silicosis: the scourge of the underground toiler,
1890.. 1943. Ind. Labor Relai. Rer. 37. 371-385, 1984.
47. Rept by W. J. Bruce, Medical Officer at the Aboso
Mine, I8 June 1917, sub-encl. in Despatch from Govr.
H. Clifford to W. Long, 18 Sept. 1918: C.O. 961592.
48. In interviews with the writer, several of the few older
underground miners who have remained in Tarkwa or
Obuasi after retirement said that the majority of their
former co-workers had returned to their home areas
unon severing emulovment. Dumett R. E. Field Notes,
Tarkwa and %buasi.- Ghana, 1987).
49. Rept 011the G.C. Mines Dept.,for 1924--25, pp. 9910. NO
general tables on mortality rates for Northern Territo-
ries labour were provided in subsequent departmental
reports.
50. Minute by Ellis C. O., 20 June 1924 on Govr. Guggis-
berg (teleg.) to Sec. of State, 19 June 1924; C.O. 96/647.
51. Summary of Simpsons comments: G.C. Med. Sanif.
Repr. for 1924- 25, p. 20.
52. See, for example, letter from Tarkwa and Aboso Con-
solidated Mines to C.O., 1 Feb. 1924, and the same
company to C.O.. 14 April 1924: C.O. 96/651.
53. Govr. Gordon Guggisberg to Duke of Devonshire,
Dec. 1923; C.O. 96/641. Also Tarkwa and Aboso
Consolidated Mines to Colonial Office, 1 Feb., 1924;
C.O. 96/65 1.
54. Dr Dowdell was greatly praised by the Gold Coast
Governor for his efforts to protect Obuasi from Yellow
Fever during the severe epidemic of the disease in 1911.
(Progress Rept. encl. in Gov. Thornburn to C.O., 30
Jan. 1911; C.O. Afr. Conf. Print, 966, No. 38, pp. 73-81.
55. Estimated Population of Obuasi-17,000
No. of Burials in Year 1912-122
Death Rate Per Thousand-17.4
(Source: Rept by Dr Seymour Dowdell to Mgr, AGC,
Obuasi. 4 Mav 1913: AGC 14. 171132; Ashanti Gold-
fields Corp. Papers, Guildhall Library.)
56. Govr. Hugh Clifford to Sec. of State, 8 May 1913; C.0
Afr. Conf. Print, 999; No. 161, p. 251.
among gold miners of Ghana 231
57. Table VI-vital Stats. on 35 Registration Districts: G.C.
Medical Dept. Rept. for 1936-37, p. 14.
58. The first separate census for Tarkwa town was taken in
1921 and listed the population at just 2671. In the
reference to T.B. and other diseases in the medical
reports, it is not clear whether the investigators were
1925, referring only to Tarkwa or to Tarkwa and its sister city
Aboso combined. which was about 6500 total popu-
lation (Kuczynski [l 1, pp. 410454].)
59. Tarkwa had, by far the highest percentage of T.B. cases
to general population of any center in the Colony. G.C.
Med. & Health Reptfor 1927-28, p. 26.
60. In 1927-28, Tarkwa had an infant mortality rate of 382
as compared with 128 for Accra, 142 for Kumasi and,
the next highest, 176 for Koforidua. Infant Mortalit)
Rates for Selected Towns: G.C. Med. & Sanitary Depi.
Rept. .for 1927-28. p. 22 and for 1938, p. 13.
61. Dr Dowdell. the AGC physician, outspoken as usual,
noted that there was a high incidence of venereal disease
among the Europeans working at Obuasi. (Appendices
to draft Bill on Sanitary Regulation at the Mines, encl.
to in Govr. J. J. Thornburn to S. of State, 29 Dec. 1910:
CO. Afr. Conf. Print. 966, No. 9, pp. 19-23.)
62. Kuczynski [I 1, p. 4751: Another point, which Kuczynski
does not note, is that miners with syphilis probably also
suffered a high death rate, but because they died in the
northern region the data was not recorded as a major
cause of miners deaths.
63. G.C. Medical and Health Repr. for 1927--28. p. 29.
64. Patterson K. D. Health in urban Ghana: the case of
Accra. Sot. Sri. Med. 13B, 251--268.
65. Medical Officer, Aboso Mine to P.M.O., 18 June 1917,
sub.encl. in Clifford to Long, 18 Sept. 1918; C.O.
96/592. Quoted in Thomas [15, p. 1001.
66. Packard R. M. Personal Communication. 25 April
1991.
67 The mining towns of Tarkwa and Obuasi received their
first single government medical officers in 1904 follow-
ing the completion of the Sekondi railway. Adhering to
the usual practice of segregation, at Obuasi there were
two adjacent hospitals, one for Europeans and one for
Africans with eight beds. (Rept encl. in Govr Rodger
(227) to Lyttelton, IO May 1904; C.O. 96/417. Rept. on
Obuasi, Appndx. 4 in Thornburn to S. of State, 29 Dec.
1910; above.)
68. Statistical Tables in Govr. Clifford to C.O., II Oct.
1916: C.O. African 1044 Conf. Print. No. 89, pp.
141-42. G.C. Colonial Annual Reports for the years.
G.C. Medical & Sanifary Dept. Repis for the years.
69. G.C. Annual Medical Dept. Repl. _tbr 1939, pp. I 2.
70. In 1890 there had been but five hospitals in the Gold
Coast Colony. (All were for Europeans. but with small
African wards.) By 1915 there were 18 hospitals (incl.
dispensaries) in the Gold Coast, Ashanti and the North-
ern Territories which dealt with a total of 40,407 (both
out and in) patients. By 1939 there were 38 hospitals and
29 dispensaries, of which 32 were for Africans and 6 for
Europeans. The number of both out-patients and in-
patients treated at all government facilities rose to
388,317 by 1939. (G.C. Med. & Sanit. Dept. Repls. for
1915 and for 1939.)
71. According to Hugh Clifford the main group of Africans
who received regular attention from physicians were
the educated classes. It was only at times of epidemic
disease that a sizeable portion of the general
population sought out hospital care. (Govr Clifford to
S. of State, 8 Sept. 1915; CO. Afr. 1037 Conf. Print,
No. 37, p. 55.)
72. See the rare example of death rates per thousand for
individual mines found in Statistics relative to Deaths
of Employees at Mines with a Resident Medical Officer,
encl. in Guggisberg to Devonshire. 29 Dec. 1923; CO.
96164 I.
232 RAYMOND DUMETT

73. By Ordinance No. 12 of 1892 the government made it reflected in Prestea town mortality rates. Furthermore,
a punishable offense to contaminate drinking water Dr Masters glowing tribute to housing and sanitation
supplies with any foreign substance. The governor at Prestea as a model mining town is not fully sup-
complained, however, that the courts seldom imposed ported in other documentary evidence of the period.
fines for infractions. So long as people continued to 75. Oral Interviews. Obuasi, Ghana, May, 1987.
draw their main water supplies directly from rivers and 76. Furthermore, many of the reports gave an overly favor-
from rain barrels, it was difficult to prevent contami- able impression of both housing and health at the
nation of drinking water. (Clifford to S. of State, 16 Ashanti Goldfields because they focussed on the head-
Anril 1914: C.O. Afr. Conf. Print 1013: No. 140 DD. 243. quarters town-Obuasi-but neglected the adjacent
249). The same reluctance or inabilityto punish mfrac- supporting towns, such as Ayeinm, which were said to
tions also pertained to a many other aspects of regulat- be- In a far worse condition: (See Rept. by Dr J. B.
ing working and living conditions at the mines. Alexander On Obuasi. 2627 Nov. 1914. AGC 14.
14. Masters W. E. A model mining village in the tropics. J. I71 137. AGC Papers. Guildhall Library.)
crop. Med. Hygiene XXII, 10, 919. This innovation, 77. G.C. Med. & Sanit. Repts for 1936-37, p. 26.
however, did not appear to have much positive effect on 78. G.C. Med. & Sanit. Rept. for 1937-38, p, 4.
miners respiratory disease, at least in so far as they were