Tuesday, May 27, 2014

Kula Hospital

“Man vs. Tuberculosis, the strange, uncanny fight two thousand years of age, is, in Hawaii, in favor of Man. The tremendous exertion, the patience, the attention to incalculable minutae that this mere suggestion indicates is hard to realize unless one is in the fight, but success is on the banners of the Anti-Tuberculosis League of Hawaii at last.”  (Pacific Commercial Advertiser, December 20, 1913)

Tuberculosis attacks the lungs and organs; in the second decade of the twentieth century it was the leading cause of death in Hawaiʻi, with 400 to 500 annual deaths.  (Nordyke)  (Even today, Hawai'i ranks No. 1 with the highest rate of tuberculosis (TB) in the United States.  (HealthTrends))

The campaign against tuberculosis was inaugurated in Hawaii in 1909 as a result of the interest of James A Rath and others at Pālama Settlement in Honolulu.  Stimulated by the Anti-Tuberculosis League of Hawaiʻi, interest steadily grew – the Territorial Government took over the program in 1920.

A number of years ago - though not so very many - when the present Governor Pinkham was president of the Board of health of Hawaii, it was found necessary to survey the ravages of tuberculosis, a disease which to that time had received little attention. A commission was appointed. In an unofficial way it investigated and made a report. The report was alarming.  (MacKaye, Thrum’s Annual 1917)

Tuberculosis was a graver danger than was believed, although since then it has been shown that even that estimate was short of the mark. Mr. Pinkham referred the report to the various counties and urged them to do something to remedy the situation.  There was no answer from Honolulu until several years later, from Kauai not until the present day, and from Hawaii not at all, so far as county government went. (MacKaye, Thrum’s Annual 1917)

But the Maui county supervisors had more vision. There was land available on the slopes of mighty Haleakala and some money that could be spent. The territorial government lent a little bit more. A doctor was employed, a nurse secured. The beginnings of the Kula Sanitarium were made at Waiakoa, on the side of the "House of the Sun," an appropriate site, for medical science has yet to find a substitute for the sun and fair winds in its combat with consumption. (MacKaye, Thrum’s Annual 1917)

“The sanitarium is located at Keokea, Kula, Maui, at an elevation of some 3,000 feet, and is most singularly fortunate in being so situated that the regular trade winds coming between the Island of Lānaʻi and Molokini have a clear ocean sweep of thousands of miles, and reach this elevated area crisp and heavily laden with pure, unused oxygen.”

“It is free from dust, since it does not pass over one acre of cultivated land, and the view, which adds much to the cheer and content of the patients, is simply magnificent.” (McConkey, Report of the Maui County Farm and Sanitarium to the Board of Health, 1911)

The Kula Sanatorium began as a vision of Dr Wilbur Fiske Boggs McConkey, who was a practicing physician treating tuberculosis patients in the Keokea district. During his long drive across the rough roads of Kula in 1909, Dr. McConkey remarked on Kula's suitable climate for tuberculosis patients and began his quest to start a tuberculosis facility.  (NPS)

This first attempt at a sanitarium was a modest endeavor, a little shack protected with canvas, alone in the midst of a rather desolate countryside.  (MacKaye, Thrum’s Annual 1917)

“Two tent houses were built, with canvas sides, wooden floors, and corrugated iron roofing.  A cook-house of rough one by twelve inch lumber was thrown together; this had no floor but had a corrugated iron roof and was luxuriously fitted with an open lean-to and a rough board table, which served as the sanitarium dining-room. Canvas cots were used in the sleeping quarters; the lights were humble barn lanterns. The cook, a Korean, was a patient himself. Six patients from the plantations were accommodated, who took care of themselves.”  (Long)

The first patients were admitted into the then-named Maui County Farm and Sanitarium on September 14, 1910.   The June 1911 Official Patient Report reported 12-patients; over the years, the ethnicity of the patients reflected the Islands’ growing diversity, Americans, Australians, Hawaiians, Chinese, Japanese, Koreans, Filipinos, Porto Ricans, Portuguese and Norwegian.

“We do not encourage the admission of patients suffering from diseases or injuries of a non-tubercular nature, but owing, in the main, to the difficulty which is met with in arranging for the means of transportation of such patients down the mountain to a general hospital, as well as the emergency cases which have been present from time to time, we have found it necessary to admit and care for these in order to avoid what would have caused hardship and extra suffering.” (Report of the Maui County Farm and Sanitarium to the Board of Health, 1913)

“Early in its history Mr. V. Woodburn Herron, a man with some hospital training, took charge as steward, nurse and non-medical superintendent. The sanitarium was a county institution with Dr McConkey regularly constituted physician. This regime lasted some months, when a change of administration brought Mr WE Foster up from Paia to act as superintendent. His wife, a trained nurse, accompanied him. Mr. Foster's untimely demise - he was himself a victim of the disease - ended this arrangement, but not before he had lighted the way for future progress.”  (Long)

With public funds and by private subscription, the Sanitarium staff and its Board of Supervisors built and equipped a plant for the treatment of tuberculosis very favorably comparable to anything on the mainland.  A favorite method of fund-raising/facility building was the contribution of a cottage for an individual by the latter's friends. After the patient has passed through the treatment the cottage became the property of the Sanitarium.  (Long)

In 1926, children were admitted into the Preventorium.  The overall facility was expanded into the Charles William Dickey-designed Kula Sanatorium (one of the largest designed by Dickey in his career,) with the first patients moving in on May 27, 1937.

The facility was designed to accommodate 166-patients in wards and 16-patients in private rooms and had facilities on the porches to accommodate 59-more patients in an emergency.  The primary consideration in treatment was rest, “rest to the body, mind, and lungs.”

The layout of the gardens at Kula Sanatorium was a combination of formal plantings and careful use of indigenous plantings. They were designed by the first registered landscape architect in Hawaii, Catherine Jones Thompson and her husband, Robert O Thompson.

In the 1950s when drugs were developed to control tuberculosis, Kula Sanatorium changed its focus to serving long-term care patients.  In 1960, psychiatric patients were admitted on an experimental basis.

In 1975, tuberculosis services were discontinued and on April 9, 1976, the complex was renamed Kula Hospital.  The Kula Hospital & Clinic is a five story Moderne style hospital ("traditionalism and modernism" popular from 1925 through the 1940s) that serves as a general hospital and clinic to residents within the Kula area.

The complex has acute care beds, 24-hour emergency room and outpatient clinic with lab and x-ray services.  Kula Hospital continues to provide long-term care for its residents.

The image shows an early image of facilities at Lula Sanitarium.  In addition, I have added related images in a folder of like name in the Photos section on my Facebook and Google+ pages.

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