{"id":866180,"date":"2026-07-16T13:11:16","date_gmt":"2026-07-16T11:11:16","guid":{"rendered":"https:\/\/businesstech.co.za\/news\/?p=866180"},"modified":"2026-07-16T13:11:19","modified_gmt":"2026-07-16T11:11:19","slug":"the-250-year-old-hospital-that-is-the-oldest-of-its-kind-in-south-africa-still-operating","status":"publish","type":"post","link":"https:\/\/businesstech.co.za\/news\/lifestyle\/866180\/the-250-year-old-hospital-that-is-the-oldest-of-its-kind-in-south-africa-still-operating\/","title":{"rendered":"The 250-year-old hospital that is the oldest of its kind in South Africa still operating"},"content":{"rendered":"\n

Fort England Psychiatric Hospital is a psychiatric facility located in Makhanda, formerly known as Grahamstown, in the Eastern Cape Province of South Africa. <\/p>\n\n\n\n

It is recognised as the oldest psychiatric facility in South Africa that is still in operation today.<\/p>\n\n\n\n

The hospital was established in September 1875, originally named the Grahamstown Lunatic Asylum and celebrated its 150th anniversary in 2025.<\/p>\n\n\n\n

Between 1875 and 1960, the hospital remained a relatively small institution, with patient numbers approximately 240 in the early 1900s. This number increased to around 700 by the late 1960s.<\/p>\n\n\n\n

Historically, the hospital\u2019s public history and heritage have been largely shaped by the achievements and careers of its medical superintendents. <\/p>\n\n\n\n

During the 19th century, the second superintendent, Dr Thomas Duncan Greenlees, served from 1890 to 1907 and gained both national and international acclaim for his administration. <\/p>\n\n\n\n

However, he also published dehumanising depictions of chronic patients to promote eugenic theories and advocate for the “elimination” of these patients from asylums.<\/p>\n\n\n\n

In the 20th century, several notable psychiatrists managed the hospital, including three who later became national Commissioners of Mental Health: Dr de Vos, Dr Vermooten, and Dr Pienaar. <\/p>\n\n\n\n

Other well-known superintendents included Dr Gillis, Dr de Villiers, and Dr Huskisson.<\/p>\n\n\n\n

The hospital operated under a highly regimented daily schedule that dictated work, leisure, dining, and sleep. <\/p>\n\n\n\n

Historical records indicate that in the hospital’s early days, once patients were classified as “chronic” cases with no prospect of recovery, the institution utilised them as an unpaid workforce. <\/p>\n\n\n\n

This patient labour was reportedly valued by administrators both as a therapeutic measure to keep patients occupied and as a cost-saving strategy to reduce labour expenses.<\/p>\n\n\n\n

During the late 19th and early 20th centuries, records indicate that the hospital admitted a significant number of migrants and immigrants, many of whom spoke foreign languages like Greek, Italian, and Spanish.\u00a0<\/p>\n\n\n\n

This is said to have created communication barriers that doctors often failed to address with translators. Instead, they relied on observing patient behaviour and their willingness to follow simple labour commands.<\/p>\n\n\n\n

Prison beds used for the mentally ill in the Eastern Cape<\/h2>\n\n\n\n
\"\"<\/a><\/figure>\n\n\n\n

For much of its history, the lived experiences and stories of the patients themselves were excluded from the hospital’s heritage and records. <\/p>\n\n\n\n

Previously, historical records were limited to casebooks at the Western Cape Archives from 1890 to 1918. <\/p>\n\n\n\n

Recently, however, researchers discovered 200 case files concerning chronic male patients who were institutionalised from the late 1890s\/early 1900s until their deaths as late as the 1950s.\u00a0<\/p>\n\n\n\n

These files have allowed for the reconstruction of a more humanised history, revealing stories of patient agency.<\/p>\n\n\n\n

These stories reveal attempts to escape, self-initiated leisure activities, and the preservation of personal identity, as well as families’ active efforts to maintain emotional bonds.<\/p>\n\n\n\n

Earlier this year, over 100 mentally ill patients in the Eastern Cape were held in prisons instead of psychiatric hospitals due to a shortage of available beds, according to health authorities.\u00a0<\/p>\n\n\n\n

Health and judicial authorities reported that the Eastern Cape had the highest concentration of individuals held in correctional facilities, with 186 state patients out of a national total of 407-437.<\/p>\n\n\n\n

These individuals were declared unfit to stand trial and should have been receiving treatment in specialised psychiatric institutions, such as Fort England Psychiatric Hospital.\u00a0<\/p>\n\n\n\n

However, the limited capacity of public mental health facilities resulted in many patients being placed in correctional centres, which are not designed for long-term psychiatric care.<\/p>\n\n\n\n

According to a presentation to the Portfolio Committee on Correctional Services, “state patients” are individuals declared by a court to be unfit to stand trial or not criminally responsible due to mental illness. <\/p>\n\n\n\n

The presentation noted that when beds are not immediately available in psychiatric hospitals, these patients may be temporarily housed in correctional facilities. <\/p>\n\n\n\n

It also highlighted ongoing delays in transferring patients to appropriate mental health institutions, as well as the limited number of facilities available to accommodate them.<\/p>\n","protected":false},"excerpt":{"rendered":"

The oldest psychiatric hospital in South Africa is over 250 years old and still in operation.<\/p>\n","protected":false},"author":127,"featured_media":866239,"comment_status":"open","ping_status":"closed","sticky":true,"template":"","format":"standard","meta":{"_sma_x_autopost_status":"posted","_sma_x_autopost_error":"","_sma_x_post_id":"2077712859505594849","_sma_x_attempts":1,"footnotes":""},"categories":[9876],"tags":[25823,23428],"class_list":["post-866180","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lifestyle","tag-fort-england-psychiatric-hospital","tag-makhanda"],"_links":{"self":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/866180","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/users\/127"}],"replies":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/comments?post=866180"}],"version-history":[{"count":15,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/866180\/revisions"}],"predecessor-version":[{"id":866520,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/866180\/revisions\/866520"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/media\/866239"}],"wp:attachment":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/media?parent=866180"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/categories?post=866180"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/tags?post=866180"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}