Sunday, February 26, 2012

A Brief History of South Africian Nursing Trade Unionism

A Brief History of South African Nursing

By Moipone Tlapu NEHAWU Trade Union (July 2000)


The theme of the National League for Nursing National Co
nference on Nursing Education: "Community Building and Activism, "is a timely topic in this chaotic and changing world.

Even in South Africa, where confusion and violence often prevail, where there are many voices within liberation struggle. Nursing is part of this activism. The many voices create debate, and it is through this debate that South African people will be able to clarify their ideas.


The black nurses struggle in SA was subtle as most of the nurses are apathetic because they see themselves as being part of an elite profession isolated from community struggle. Nurses were unable to bring change in the communities in either health sector or society at large despite their numerical numbers / advantage some of the apathy, argument goes lies in the militaristic origins of Nursing as exemplified by the career of Florence Nighgtigale (Noixeba Lubanga) 1999.

The South African Nursing Organisation /Association where officials were predominately white, saw themselves as an exclusive group whose interest were identical with those of the ruling class and the government in power blacks had no power and influence on those who made the laws,and had no voting right. Nursing leaders in S.A. have actively discouraged Nurses from becoming politically involved and challenging the apartheid health care system. They have repeatedly involved notions of professional neutrality to justify this attitude. According to these leaders, the nurses professional image must be maintained at all cost despite any Social, economic and political changes.

Nurses should remain in the Nursing only Organisation so as don't mix with more progressive leaders from other professional world.

In 1920's African Women worked initially as domestics in South' Africans growing cities because they encountered the least resistance from men and women of other racial groups in this kind of work, and every white family aspires to have a servant, there was an ever growing demand. In Johannesburg and other centers, the
churches set up native girl's industrial schools, in which girls were taught the rudiments of housekeeping. By the 1920's female African domestic servants were becoming the most in Rand and other Urban Centres.


Black Nurses did not belong to the white^only S.A. trained Nurses Association (SATNA) which was founded in 1913. Realizing they could not belong to the SATNA, the African Nurses led by a graduate Nurse form Victoria hospital at Lovedale, decided as early as the 1920's to form their own Organisation, the Bantu Nurses
Association (BNA). In 1930, hospitals in around Johannesburg were training African Nurses, and the white Matron directors of Nursing) held meeting to discuss the feasibility of forming an association like BNA. Lowles (1933) P23 recalls how they decided it would be better to "lay emphasis upon the formation of wayfarer detachments (i.e Girl Scouts) than institute an association for black nurses instead the matrons emphasized the Witwatersrand branch of SANTA should elect a white Nurse to represent Bantu Nurses.

In 1932 after the black nurses struggle to convince "White Matron" to continue with Bantu Nurses Association there were finally allowed to affiliate with SATNA. In the early 1940's S.A. faced a severe Nursing crisis. Contributing factors were poor living conditions, low salaries, shortage of nurses, restriction on marri
ed nurses, and nurses leaving the profession. As a direct result of dissatisfaction with SATNA, BNA started a movement in 1942 to form a new organisation along trade union lines.

This organization convened a meeting in Re
d cross hall Johannesburg on the 30th August, 1942, with a view to organizing the Nursing Profession as a trade Union the main speaker was a representative form Garment workers Union, (GAWU) he stressed the fact that nurses were exploited by their employers, and many of the long suffering nurses immediately reacted favorably to this sympathetic technique (Nonceba Lubango 1991)

SATNA leadership together with the government joined forces to undertake a tour to address nurses on the subject of Trade unions. During this visits speakers warned Nurses that the political aura associated with unions was contrary to the spirit of Nursing (Searie 1965) (10 - incidentally this is still the believe today in the year 2000) what worried the government and SATNA leadership was the thought that Nurses might adopt a "trade union mentality" and might be persuaded to strike to improve their situation.

Following this the government gave 1943 Nursing Bill priority (Marks 1988). Origin 1988). The South African Act nO. 45 of 1944 followed. The South African Nursing Association (SANA) replaced SATNA. SANA was announced to be a compulsory body for all nurses with creation of SANA, BNA was effectively eliminated.
Even at that time there were those who contested the achievements of the ACT "origins (1988) noted that Charlotte Searie, then the Director of Nursing in Transvaal and already a dominant figure in SANA and founder of SANC was explicit on the reasons.

She argued that non European Nurses, Bantu/Blacks" were only included on equal basis in the 1944 Act at the time there were very few of them and because the Nurses were assured by the Provincial authorities responsible for hospital services that the authorities did not intend training black nurses for full certificates.


SANA developed a highly bureaucratic structure that stifled progress within the organisation. Nurses continued to express their discontent in the form of strike despite SANA constraints.

Blacks Nurses working at the Alexandra clinic in
Alexandra Township just outside Johannesburg went on strike in 1947. The Alexandra strike was prelude to others that followed.

In 1949, student Nurses at Victoria hospital Lovedale went on strike to protest the unfair dismissal of a nurse who had presented a petition of grievances to the hospital administration.

The kind of intimidation to which union minded Nurses were subjected was demonstrated in 1961 Nurses, strike at king George Tuberculosis hospital in Durban, the strike was called to protest an incident in which matrons of the Nurses, residence severely caned 12 students Nurses allegedly for arriving in class few minutes late. Skilled and unskilled hospital workers supported the nurse's demand for expulsion of matron.

With assistance from the local hospital workers union, the nurses made several demands.
They wanted the policy of unequal eating facilities abolish
ed. The African Nurses were given lower quality meals, were required to bring their own eating utensils, and paid more than whites for then- boarding and lodging. They also demanded raises in their scandalously low salaries. They demanded extension of maternity leave to unmarried pregnant women in order to prevent fatal illegal abortions. They wanted UIF, they demanded and end to the degrading practice that required African employee to make a cross when collecting their paychecks, instead of signing for them. Finally they demanded that African (Black) Nurses to receive the same prophylactic treatment against TB that was given to all other employee (Luckaardt and wall, 1980).

The Nurses received support from local and international communities. Some of their demands were met, but the hospital superintendent refuse to fire the matron. 22 nurses were fired, and nurses were threatened with dismissal if they belong to a union. Nursing authorities argued that trade unions could not act on behalf of nurses as that was the duty of SANA. Yet it took a trade union to help nurses to improve condition of service.


Internationally the struggle continued in 1946 the American Nurses Association established an economic security program for bargaining purposes. In England Royal College of Nursing is the professional association that won certification as independent trade union in 1977. British Nurses were also represented by trade unions that are affiliated with the trade union congress. According to Unison the struggle is been taken over by Unions such as Unison.

In Australia, Royal Australian Nursing Federal is affiliated with the Australian council of trade union.
In South Africa the 1978 Nursing amended ACT (no 50) made strike action by nurses a statutory offense with fines of up to R500, 00 one year jail or both (warning 1983).


The coming to power of National party in 1948 had a number of effects. On nursing black nurses had always been discriminated against for despite equal training, their salaries were far lower than those of whites and their training facilities were inferior. To foster apartheid 1957 Nursing Act of 1957 was passed separate registers were created for different ethnic groups namely Africans, Colored/Asians and whites black nurses were barred from holding office on central board of SANA (19 sutten, 1986). The pass system required blacks to carry at all times a "pass book" containing the person's identify and employment record. Failure to produce the "passbook" when requested by a police officer was a criminal offense.

Between 1955 and 1956 many Nurses joined the Women's league of ANC and the Federation of South African Women to fight "Pass Law" Protest meetings took place at many hospitals. At the meeting of non-white Nurses held in January 1955 at King Edward VIII hospital in Durban, tempers rose to such an extent that the police. Were called but women had quitted down the time the police arrived. The hospital superintendent than announced that the Nursing Council had informed him that all black Nurses who were not in possession of their identity numbers need not finance them' (South African Institute of Race Relation Survey, 1958-1959).

Now white nurses at Johannesburg's Baragwanath hospital also held protest meetings and announced that they would refuse to complete the forms the Federation of South African Women decide to support the Nurses and arrange a demonstration in support of Nurses.

The African townships were co-ordinated off from the hospital, roadblocks were setup. ANC Women's League and 500 Nurses organised a big demonstration at organises a big demonstration at Baragwanath hospital, where they met with hospital Matrons and explained the reasons for resisting the proposed legislation. The Matron wrote back to Nursing Council and the proposal was withdrawn for time being.

In 1978 Act provided for non-racial Nursing Council represent South African Citizens, this provision effectively excluded many registered African Nurses who, interms of S.A. Law were citizens of independent homelands. African Nurses actively opposed forced recognition into separate white Nurse's domination of SANA.

When these homeland nursing association were formed, the African Nurses who worked in the homelands or the so-called independent states received no financial assistance from SANA even though had been paying annual dues to this body for decades. Most Nurses paid the homeland association and the SANA for incase they need to work in S.A at some point.

In the 1980's the were many changes in spite of the legislation many nurses follow the waves of trade union activism. They joined union such as Black Health and Allied Workers union, the National Education and Allied Workers Union and Baragwanath workers union..

The question that remained unanswered is that do nurses need to be unionised, and to be poliicised Nurses, and especially Nurses leaders who regard political participation as alien to Nurses, and who regard politics and power to be incompatible to Nursing, sector and maintain a powerless nursing professional corps.

The government of National Unity has announced free health care for all mothers and children up to five years without consultation with those responsible for providing this health care-that, is Nurses and without adequate prior notification of health services nor the Nurses insisted on improved staffing of health facilities increased budgets and increased supplies of medicines. This "free health Services" whatever its merits in theory, might disempower and disillusions Nurses who are now called upon to render services to many more people, without the necessary staff, facilities, equipment, or drugs.

The only way, in which Nurses could prove their need for more staff, more equipment and more medicines would be to compile and present statistics of their workloads before and after this announcement was made. Unless Nurses can succeed in satisfactorily proving their increased workload, health-care planners will continue to assume that the services cope with the available facilities and equipment Nurses also need to communicate these statistics to positions and other decision makers.

Since politicians determine health care policies allocate health care budgets and decide where and when health care facilities will be expanded, they influence the health care system both directly and indirectly.


It is very important to develop new curriculum of training Nurses, the paradigm shift should focus, on content base education, in addition the Curriculum should cover politics and, also develop all-rounder Cadre, who might be able to fit in all spheres in life, to be orientated in all comers of life.

The broad aim of operation 4000 was to recruit professionals amongst those professionals to be organised Nurses cover a very big number NEHAWU has a serious challenges to develop Nurses and recruit more into the organisation.


CAPE TOWN June 18 1997 - SAPA


The now defunct South African Nursing Council - the regulatory body for the nursing profession under apartheid - on Wednesday apologised unreservedly for undermining human rights "from time to time".

In a submission to a Truth and Reconciliation Commission hearing in Cape Town, the SANC also proposed that appropriate reparation be made to victims of council violations. It did not elaborate.

Disgracefully, the British Royal College of Nursing (RCN) continued to foster close links with the 'Whites only" nursing union until the end of Apartheid. COHSE. NUPE and NALGO had impeccable records in opposing Apartheid South Africa

200 Nurses sacked in South Africa 1961

200 African Nurses Told To Leave Union or Be Sacked

September 1961 COHSE: the health care union Journal report

THE South African Congress of Trade Unions reports that 200 nurses at King George V Hospital,
Durban, have been given an ultimatum to resign from the Hospital Workers Union, a non-white body, or be dismissed.

Previously 20 nurses were sacked following a strike and meal boycott by African, Indian and coloured nurses at the hospital, in protest against the caning of nurses and very low wages (an African nurse receives about £12 a month, plus board and lodging; a labourer receives as little as £5 a month).

In the middle of July the Hospital Workers' Union, an affiliate of S.A.C.T.U., submitted a memorandum to the hospital authorities asking for increased wages and improved conditions of work. The demands ranged from £1 to £1 10s. a day increased wages; maternity allowance; unemployment pay; workmen's compensation; infectious disease allowance; 3 weeks' annual leave; improved food; shorter hours of work; recognition of the Union. (The demands varied according to the different categories of employees, staff nurses, maids, nurses, clerical workers, cooks, labourers, and so on.)

African nurses and labourers at the hospital decided to boycott food supplied to them on August 5, after the caning of 11 African nurses by a white sister-tutor because they were "not too bright at classes". The hospital was brought to a standstill when the African nurses marched to the superintendent demanding the expulsion of the sister-tutor and calling on him to investigate their grievances.

They were joined by Coloured and Indian nurses and all the non-white staff : labourers, clerical workers, cooks etc. The demonstration lasted about 8 hours, during which time hundreds of police were called out. the chief of police addressed the workers but was unable to persuade them to return to work.

The superintendent at last arrived, and after a great deal of argument agreed to investigate their grievances. He stated that he was not prepared to negotiate with the Union. The workers then returned to work, but the nurses living in the hospital started a boycott of their food and decided to continue this until their demands are met, food being supplied by sympathisers.

A second demonstration took place 10 days later when some 300 non-white nurses marched to the superintendent's office to demand the transfer of the sister-tutor from the nurses' home. Before this march took place, uniformed police patrolled all wards at the hospital and an armed contingent of police in a riot van was outside the hospital. The superintendent refused to see the nurses, and all the demands of the workers have been rejected on the grounds that they are "politically inspired".

The nurses are continuing the struggle. They ask for protests to be sent to the hospital authorities and for support for their demands, and also for donations. The address of the Hospital Workers' Union is 311 Lakhani Chambers, 2 Saville Street, Durban, South AfricaA. The Union will pass on all protests received.

It Should be noted that during this period the Royal College of Nursing (RCN) maintained links with the Whites only nursing union in South Africa



Sir—The following is a copy of a letter I sent to the Superintendent of King George V Hospital, Durban, South Africa, on November 16, 1961, after reading an account of events at the hospital in your Journal:

Sir—The P.S.I, is an international federation of trade unions and professional associations of civil servants and public employees, including nurses and other hospital workers. Its affiliated organisations number 75 and 37 countries throughout the Western world. The total membership is 2.4 million.

In the Journal of the British Confederation of Health Service Employees (issue of September/October 1961) I read an amazing and shocking story of the caning of nurses followed by a naturally justified rebellion by well nigh the whole staff of your hospital and by the irruption of the police into the hospital. This appears to be about the ugliest incident that, together with many others, illustrates the thoroughly bad relations between an employing authority and its workers. The relationship appears to be characterised by intimidation against organising in trade unions and the refusal to grant fair conditions of employment.

Words are inadequate to express the indignation that such action arouses in all people who value human rights and human dignity. I know that Apartheid interferes with the normal functioning of civilised life and I can visualise that in some instances employers lack the independence or the courage to resist a damnable policy imposed on them from above.

However, the administrator of a hospital is in a position- that enables him to wield authority and power in accordance with the dictates of conscience, even in opposition to higher authorities whom racial prejudice has made unreasonable.

The incidents of August 5 and 16 last provided copy for an unseemly page in the professional journals of nurses and hospital workers. It is in your power. Sir, to redress a bad situation and to enable the editors of those journals to report on something good and hopeful coming out of South Africa by virtue of your own action. I appeal to you to use your power to that effect.



(Picture Nurses protest apartheid and the segregation of their profession, South Africa, 1958

COHSE banner on Anti Apartheid demonstartion early 1980's