Rediscovering – and digitising – a common medical history

20 November 2018 | Story Lisa Boonzaier. Photo supplied. Read time 7 min.
This X-ray of a pair of conjoined twins is part of a collection of clinical photographs recently digitised by the UCT Pathology Learning Centre. These twins, who were joined at the abdomen, were later successfully separated in the first operation of its kind in South Africa at the Red Cross Children’s Hospital in 1966.
This X-ray of a pair of conjoined twins is part of a collection of clinical photographs recently digitised by the UCT Pathology Learning Centre. These twins, who were joined at the abdomen, were later successfully separated in the first operation of its kind in South Africa at the Red Cross Children’s Hospital in 1966.

UCT’s medical school – the oldest in South Africa – has for more than 100 years trained doctors, treated patients and advanced medical science. While the walls of this pre-eminent school and its teaching hospital will never speak, a collection of recently uncovered images offers fascinating insights into not only the history of medicine in South Africa, but also our society across decades. Working with UCT Libraries’ Digital Library Services (DLS), researchers at the Pathology Learning Centre (PLC) have digitised this collection to make it public so that it can serve as research material for a variety of disciplines.

Dr Jane Yeats, a virologist and curator of the PLC, and director of the PLC, was initially employed by UCT to digitise a collection of bottled tissue and organ specimens. One day, when she requested from the Department of Surgery some of the filed records that accompany the bottled collection, she got an unexpected addition.

From the outside the files were indistinguishable; they were all small, faded-green and ring-bound. But unlike the files she had asked for, the ones she hadn’t been expecting were packed with cards displaying photographs of body parts, organs and surgeries; x-rays; illustrations taken from textbooks; and, mainly, patient photographs – all annotated. Among them was an x-ray of conjoined twins, photos taken four years apart of a woman who’d undergone oesophageal reconstruction, a young child – his face in shadow – with a parasitic cyst on his spine.

When Yeats recovered the full collection, she discovered that the cards totalled around 7 000. They detailed surgical procedures, documented methodologies and showed the people and pathologies moving through the medical school and hospital between the 1920s and 1970s.

An interdisciplinary treasure trove

Yeats realised the value of what she was looking at and decided the images needed to be digitised. “This collection will be of value to disciplines such as medical history, medical anthropology, sociology, arts, politics and more,” she says.

Yeats believes the collection was initiated by Professor Charles Saint, the Faculty of Medicine’s chair in surgery appointed in 1920, and was used as a teaching tool between then and the 1980s, when this collection was mothballed and relegated to a storeroom.

 

“The problem was clear to Yeats and Clark: How do we give other researchers access to this resource, which has so much research potential, while respecting confidentiality.”

“You would never get clinical photographs like this anymore,” Yeats says, looking at a photo of a seated Xhosa woman in traditional dress smoking a traditional pipe.

“There are not a lot of photos like this in the collection, but I think the surgery department was trying to make a point here. Around the ’40s onwards, there was a surge in cancer of the oesophagus, mainly in the Eastern Cape, and there was a lot of research trying to figure out why. One of the theories was that pipe-smoking of the locally grown tobacco was the cause, and somebody took a series of photos with this in mind,” Yeats continues.

“This is an example of the sort of information in the collection that might interest a researcher, but not primarily from a medical point of view.”

In addition to Yeats, the collection has a champion in Michaela Clark, a visual studies graduate from the University of Stellenbosch, who was appointed as a research assistant to digitally archive and curate it. Clark first saw the collection while she was searching for a topic for her master’s thesis. Her research looked at the visual portrayal of venereal diseases in this collection.

The problem was clear to Yeats and Clark: How do we give other researchers access to this resource, which has so much research potential, while respecting confidentiality. Some of the patient photographs are revealing, and most of the people are identifiable, says Clark.

The solution seemed to lie in a digital repository that could allow researchers – from any discipline and anywhere in the world – to access the information, but with limitations.

A solution of two parts

To make the collection available in a way that would meet their requirements, Yeats and Clark needed advice on the tools available for sharing it. Kayleigh Lino and Erika Mias, then digital curation officers at DLS, recommended a dual-system solution using the web-based open-source applications Access to Memory (AtoM) and Omeka.

The entire collection is described in AtoM@UCT, but, for confidentiality, visual examples are only provided when they do not reveal the patients’ identities. The collection is searchable and indexed, which means researchers can query, group and organise the collection in different ways. This is key, as it allows researchers to identify patterns in the data, says Clark.

Omeka then adds another layer to this archive: curation. “Omeka gives us a blank slate to talk about the pictures and show the research possibilities,” says Yeats. It is on Omeka that the PLC presents the curated selection of images as exhibits.

This collection of historical clinical photographs has fascinating stories to tell, says Yeats. “By carefully framing these images in exhibitions on Omeka, and describing them in AtoM@UCT, we hope to offer a respectful engagement with our material to showcase its value beyond the medical field.”

“The collection is about Groote Schuur. It’s about the people of Cape Town, the early days of the medical school and the academic hospital,” says Yeats. “Thousands of people went through that hospital, and the surgery department documented quite a lot of them and their conditions. It’s a common history.”

 

Visit the online curated exhibition...

Browse the full collection...


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