Hektoen International

A Journal of Medical Humanities

Because of their race

Ceres Alhelí Otero Peniche
Mexico City, Mexico


Photo by Top Sphere Media on Unsplash

When in 1948 the National Party came to power in South Africa, the all-white government put into effect the racial segregation laws known as apartheid. The non-white population was forced to live, work, and spend their free time in separate neighborhoods. This divided the country’s population into four main racial categories: “native,” referring to non-white people who came from India and other British colonies; “colored,” meaning black inhabitants; “Asian,” referring to those from Japan and China; and the “white” population.

Indian and black medical students, two of the most impacted social groups, had formerly received free government medical education before apartheid. But when the Bantu Education Act came into effect in 1953, they were denied this opportunity. The Bantu Education Act excluded non-white students from white academic institutions; the “native” and “colored” medical students were forced to stop their studies at the Health Sciences Faculty at Fort Hare University.

The Medical University of South Africa (MEDUNSA), which was at that time considered to provide a lower quality of education, accepted these rejected students and trained them. Senior medical students provided training in subjects such as anatomy, physiology, and physiopathology. But despite these good intentions, the strategy did not work. Although MEDUNSA proposed forgiveness of half their student loans if they completed the program, many students still dropped out.

Only after the opening of the Bantustans, the neighborhoods where “native” and “colored” people were forced to live separately, did these students continue with medical school. Lebowa, a Bantustan whose fully black government sponsored the establishment of a medical orientation program, helped these students. They received the highest quality of medical education and encouragement to complete their degree. During the same period, students organized grassroots initiatives and joined anti-apartheid organizations to fight for their own rights as students, but also for equal access to healthcare for all South Africans.

After graduation, trainees worked in local clinics and were paid monthly in addition to serving as interns in other South African hospitals. The graduation rate had never been higher. In 1990, when apartheid came to an end, “colored” and “native” medical students were finally accepted into all-white academic institutions. But the support of local communities was critical to the education of young doctors and the provision of healthcare during the long years of legalized segregation.



  1. Digby, Anne. “Black Doctors and Discrimination under South Africa’s Apartheid Regime.” Med Hist. Apr 2013;57(2):269-90. PubMed Central (PMC). Accessed December 23, 2022. doi: 10.1017/mdh.2012.106.
  2. Tobias, PV. “Apartheid and Medical Education: The Training of Black Doctors in South Africa.” Int J Health Serv. 1983;13(1):131-53. doi: 10.2190/FCEQ-9W7L-WD9P-5CP9.
  3. Editors, History.com. “Apartheid.” History, last updated April 20, 2023. https://www.history.com/topics/africa/apartheid.



CERES ALHELÍ OTERO PENICHE is a first-year medical school student at Tecnológico de Monterrey in Mexico City. She is interested in studying plastic surgery, internal medicine, or general surgery. In her free time, she enjoys reading, painting, visiting museums, and is passionate about writing.


Summer 2023  |  Sections  |  Moments in History

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