What sparked your interest in emancipation and its medical consequences for freed people?
I was working as a research assistant on the Harriet Jacobs Letters Project out of Pace University under the tutelage of Jean Yellin, and was assigned to annotate Jacobs's life while she was in Alexandria during the Civil War and Reconstruction. I began noticing many of Jacobs' references to the sick and suffering conditions of former slaves. When I consulted the historiography on this subject, there were no references to it, so I began to do the preliminary research in my first few years of graduate school, and it later became my dissertation, and now a book.
I realize you can only estimate how many freed slaves became ill and how many died. What’s your sense of this terrible toll following emancipation?
It doesn’t ever lend itself to a clear figure or a pure statistic. There’s no balance sheet with an accurate number in large part because, during the war, there was no federal policy or protocol to count the number of dead free slaves. There was no accounting system. On one level, it’s completely unknowable.
Even during the postwar era, when the Freedman’s Bureau [keeps some records], we only see the number of people who are sick or die based on the number of people physicians come in contact with and were hospitalized. For example, a doctor in Orangeburg, South Carolina worked with forty-three people a week, and then one day a week would take a ferry to a rural location, and he’d actually write in a note, “I don’t know how many I’ve seen.” Or they would lose the record. They would send the number to Washington, and Washington would say we never got the number. So the numbers were jumbled and lost in the administrative workings even when there was counting.
So the numbers are hard to get at. I’m confident that over a million people were treated in this period (1862-1870) and that’s a low estimate. I know also that, according to one annual report, that 60,000 freed slaves died in the smallpox epidemic, but again that’s a really low number because, on the ground, I’m seeing local reports from the Sea Islands, for example, that nearly a quarter of that population died. And I saw records from doctors saying that they can’t keep accurate records.
The 600,000 figure for the number of people who died in the Civil War has been revised [recently] to 720,000, but that’s counting only soldiers. I’m saying that these [additional] soldiers that you’re counting are not dying from battle [but] from disease. If disease becomes the criteria to count mortality, why are we not counting the thousands and thousands of black freed people who died of similar diseases during this war?
We in the twenty-first century need to expand the categories of who is [counted as a casualty]. We’ve been using categories of the nineteenth century. The whole point of African-American history of the last century is that we can’t use those categories. We have to be more interpretive and more creative in the way we ask certain questions. Of course, when you ask a question based on nineteenth-century criteria, you’ll never get a number on black people, so you need to ask different kinds of questions to get to that number.
And weren’t there about four million emancipated slaves?
Yes. On the eve of the Civil War, there were four million slaves. Five hundred thousand were emancipated during the war. Slaves in the border states were not emancipated at first. That was a gradual process.
After reading your book, it’s surprising in a way that the morbidity and mortality were as low as about a million of these freed people suffering and at times dying of illness.
I think it was actually much higher. These are only people who turned to the Medical Division for support. Surely there were tens of thousands of other freed slaves who were doubtful about going to the Bureau for support or who relied on the support of their family or kin networks or who were in areas without the presence of federal officials to help them or who were getting support of former abolitionists so they wouldn’t have to turn to the government. Again, this number is really low.