This is a history of the health of the people of Pietermaritzburg, a developing city in Africa and capital of the province of KwaZulu-Natal in South Africa. The book covers a period of about 170 years: from a time when a few explorers of European extraction started to settle themselves in a rural southern African valley, through the process of building and establishing a colonial town, followed by an apartheid city, and then a large multiracial and democratically governed metropolis of over 600 000 people. It shows how this process of creating and inhabiting a city changed people's health, for better or worse; and looks at the impact of the built environment, the physical environment, the social and economic environment, and the policy and legal environment on health status. The book examines the history of public health as affected by the process of urbanisation, combined with the peculiar form of social engineering that took place in South Africa, particularly during the Apartheid years.