Politics in Medicine: The Georgia Freedmen's Bureau and the Organization of Health Care, 1865-1866

POLITICS IN MEDICINE: THE GEORGIA FREEDMEN'S BUREAU AND THE ORGANIZATION OF HEALTH CARE, 1865-1866 Todd L. Savitt The mortality of the negroes in and near large towns and cities still continues to be very great. The small-pox still rages among them. One colored carpenter in this city [Macon], who employs four hands, said . . . that it was as much as he and his men could do to make the coffins that were ordered from him. New York Times, Jan. 22, 1866 I was sorry to hear that the small-pox had broken out in Athens ... as for the Negroes I don't care how many of themhave it—so they die. It isareal luxury now to know that they are shuffling off their thieving coils. Martin J. Crawford to Mrs. Howell Cobb, Nov. 3, 18651 For the present I do not regard it my duty to assume the charge ofthose cases of smallpox that may occur in the city—it is fully able to provide its own sanitary institutions, and support its own poor. Dr. J. W. Lawton, surgeon-in-chief, Medical Department , Freedmen's Bureau, Georgia, to Dr. A. T. Augusta, assistant surgeon, Lincoln Hospital, Savannah, Nov. 21, 18652 Of all the functions and activities of the Bureau of Refugees, Freedmen and Abandoned Lands (Freedmen's Bureau), provision of medical care should have been the least controversial. Bureau physicians were not enforcing labor contracts, adjudicating disputes between former masters and slaves, or teaching blacks to read, write, and calculate . They were establishing and manning hospitals, dispensing drugs, treating smallpox, cholera, and malaria. Their mandate was to facilitate for blacks the transition from free medical care provided by slave1 Quoted in Alan Conway, The Reconstruction of Georgia (Minneapolis, 1966), p. 64. 2 Georgia, Surgeon-in-Chief, Letters Received Unentered, 1865-67, box 1; hereafter cited as Ga LRU. Civil War History, Vol. XXVIII, No. 1 Copyright©1982by The Kent State University Press 0009-8078/82/2801-0003 $01.00/0 46civil war history owners to self-care, and to ease for whites the problems of providing such care to large numbers of indigent freedmen during the unsettled immediate postwar period. Unfortunately, these ideals, conceived in Washington, were difficult to realize at the state and local levels. In organizing its operation, the Medical Department could not avoid entanglement in the Bureau's political disputes with civil authorities and local white residents simply because it was an extension of that federal agency. Its presence and assistance was necessary, even welcomed, but it was also resented for intruding into local affairs. Moreover, some of the Medical Department's actions seemed calculated to advance political points rather than to help the sick and injured. In addition, Bureau physicians encountered numerous bureaucratic and financial problems as they attempted to establish and maintain their facilities. The losers in all this disorganization and political manipulation during the Bureau's first year of operation were the sick freedmen. They, at times, received poor medical care and ultimately failed to receive assistance in developing medical independence. This situation existed throughout the South. Georgia is only one example. When General William T. Sherman departed Savannah in January 1865 to commence his march northward, the war in Georgiawas unofficially at an end. Governor Joseph E. Brown remained in office until April, however, presiding over the affairs of state as though military defeat and massive property destruction had not demoralized and disrupted the lives of most Georgians. This dislocation was most apparent in the cities and large towns where former slaves—hundreds and thousands of them who had trailed behind Sherman's forces through the state—now remained in expectation of something, though they knew not what. Blacks also began swelling the populations of towns more remote from the path of the Union invaders, especially in the weeks after the official surrender of Georgia to General James H. Wilson in April. With housing, food, and clothing quite scarce even forwhites, and with benevolent masters miles away on remote plantations, the newly freed black people experienced extreme hardships through the cold winter and wet spring months. During the transitional period, when the state and local governments were bankrupt or unwilling to...