Illness and death among the enslaved

Life as an enslaved laborer in the Danish West Indies was not only characterized by hard work, brutal punishment and powerlessness. But also by diseases, incapacitating work injuries and death’s constant presence.
Clothes washing in the stream, St. Croix ca. 1844.
Clothes washing in the stream, St. Croix ca. 1844. Notice the woman at right in the background who has swollen legs because of elephantiasis. Colored drawing by Frederik von Scholten with the title “Bitling near West-End, Santa Cruz”. Maritime Museum of Denmark, file no. 000034248.

During the entire slave period, more enslaved laborers died in the Danish colony than were born. That is witness to how poor the enslaved laborers’ living conditions were. It was also why it was necessary to continue to import new enslaved laborers to replace the deceased ones. Most of the other Caribbean colonies that produced sugar had the same problem, because the sugar cultivation was particularly taxing for the enslaved.

Infant mortality

The reason for the high mortality among the enslaved laborers in the Danish West Indies was especially that many small children died. High infant mortality was more the rule than the exception most places in the 1700s and 1800s, including in Denmark. But among the enslaved it was particularly high, up to forty percent of the dead were under five years of age.

The enslaved children died of many different diseases. One of the major killers was what the doctors at that time described as “fever” and “diarrhea”. Both terms can be symptoms of a great number of diseases, so they do not explain in themselves what was wrong. A frequent cause of death was intestinal worms, and that indicates that hygiene was a major problem in the enslaved laborers’ existence. Intestinal worms enter the digestive system with contaminated food and water.

Poor hygiene: dung heaps and watercourses

Poor hygiene was not uncommon at the time, but among the enslaved it is seen, for example, in problems with the drinking water. The enslaved laborers in particular got drinking water from watercourses and wells. But latrine pits and dung heaps were often nearby, and during tropical downpours they ran over and contaminated the drinking water. It was not made better by the fact that the watercourses were also used for clothes washing, bathing and watering the cattle. In contrast, the Euro-Caribbeans’ drinking water was rainwater collected in large cisterns.

Infectious diseases: measles and smallpox

Another cause of death among the enslaved was infectious diseases, for instance, measles epidemics. Prior to 1800, smallpox was also a widespread and feared disease that returned at regular intervals and claimed the lives of many children. However, when smallpox vaccination was introduced in the Danish colony in the first decades of the 1800s, it almost succeeded in stopping the disease entirely, especially on St. Croix. It was a rare success story in an otherwise sad tale of many failed attempts at keeping diseases away and suppressed.

Causes of death and work injuries among adult enslaved laborers

Among the adults and elderly enslaved, the reasons for the high mortality were something else. For example, tuberculosis and lung disease were more frequent causes of death than fever and diarrhea. This is not surprising, despite the tropical climate, because tuberculosis breaks out precisely in people who live close together, are poorly nourished and have a weak immune system. The immune system is weakened with age and particularly through exhausting physical work, such as the enslaved laborers’.

The more direct work injuries were also frequent, but they were rarely a cause of death. The injuries could be all forms of muscle pain, sprains, fractures, abscesses, wounds and hernias. The type of injury among the enslaved laborers that caused the greatest problems for the doctors were tropical ulcers on the legs, which ate their way to the bone and would rarely heal. Often the only solution was to amputate the leg.

Special diseases of the enslaved

Finally, there were a number of diseases thought at the time to affect only enslaved laborers and not Europeans. These were, for example, elephantiasis (filariasis), called “elephant foot”, a parasitic disease that causes grotesquely swollen legs or sex organs. Another disease in the same group was yaws (frambesia tropica), a tropical disease in the same family as syphilis that infects by touch and results in large, raspberry-red, weeping sores.


Niklas Thode Jensen, For the Health of the Enslaved: Slaves, Medicine and Power in the Danish West Indies, 1803-1848. Copenhagen: Museum Tusculanum Press, 2012.

List of vaccinated enslaved laborers on the royal plantation Hermon Hill, October 18, 1842.
List of vaccinated enslaved laborers on the royal plantation Hermon Hill, October 18, 1842. The names marked with an asterisk (*) indicate that the enslaved laborer still needs to be vaccinated. Danish National Archives, Den vestindiske gælds likvidationskommission (“The West India Debt Liquidation Commission”), Sager og rapporter vedr. de enkelte plantager på St. Croix (“Files and reports concerning individual plantations on St. Croix “), Hermon Hill 1841-1847, serial no. 46.17.33.