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April 26, 2023 by Peter T Young 3 Comments

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.

© 2023 Hoʻokuleana LLC

Filed Under: Buildings, Place Names, Economy Tagged With: Hawaii, Maui, Kula, Tuberculosis, Kula Hospital

April 14, 2017 by Peter T Young 1 Comment

Pu‘umaile Home

“The tubercle bacillus, the germ that causes tuberculosis, is responsible for the loss each year of millions of lives. The spitting, coughing and sneezing of people who have tuberculosis are the chief means of the spread of this disease to individuals, families and even to entire communities.”

“The Territory of Hawaii has a high death rate from this disease as compared with most mainland cities. … The County of Hawaii has the highest rate of the disease of any of the counties in the Territory. During the last five years an average of 67 people died each year on this Island.”

“(T)here are hundreds of people on this Island who have been exposed to tuberculosis and who are potential cases of the disease. There are many people on this Island who have the disease but who do not know that they have it.”

“If the problem is considered not as “cases,” but as individuals who are our neighbors, it becomes a more interesting problem. Who is my neighbor? Last year there were maids, bus drivers, dressmakers, plantation laborers, waiters, students and teachers who had tuberculosis.”

“More than half of the people who have tuberculosis are between the ages of 15 and 45. Think of these young people starting out in new jobs, establishing homes – struck down in the prime of life!”

“Too many people do not know about, nor heed, the warning signals that should send them to a doctor for a physical check-up. Ignorance as to the ways in which tuberculosis is spread oftentimes causes neglect of the early case. Ignorance of the seriousness of the situation keeps the public from taking sufficient action on this problem.” (Chandler, Director, Tuberculosis Society of Hawai‘i; The Friend, July 1, 1939)

“The control or prevention of the spread of the disease is chiefly dependent upon the various district nurses, who not only furnish the Bureau with correct data for reliable statistics, but who supervise cases requiring it, directing them how to avoid infecting others, and observing that all due precautions are maintained in each case.”

“These nurses devote their time to hunting up cases which have not been reported, supervising certain cases, and giving instructions to patients as to how to care for themselves so as not to infect others.”

“The treatment of those afflicted is carried out by seven institutions—three in Honolulu, namely, Pa Ola Day Camp, Free Dispensary, and Leahi Home; one on Hawaii—Pu‘umaile Home; two on Kauai—Lihue and Waimea Hospitals; and one on Maui—the Kula Sanitarium. (Board of Health, 1921)

“The benefits of hospital treatment may be shown by the figures from two of the institutions in the Territory. Out of 103 persons discharged 84 were able to return to work.”

“Pu‘umaile Home, in Hilo, was in charge of Miss Wilhelm and Miss Kate W. Sadler, district nurses for Hawaii, with Dr. L. L. Sexton as medical officer. … A total of 37 cases were handled at Pu‘umaile, some of the patients being Filipinos en route to Honolulu to take steamer for the Philippines. There were 7 deaths, 15 discharged at their own request, 6 for other reasons, and 2 as apparent cures. (Board of Health, 1915)

“Pu‘umaile Home is the only institution for the care of tuberculosis in the Territory that is maintained solely from Territorial funds. One hundred and twenty-two were admitted during the year, with 68 Patients remaining at the end of the period, just double the number as compared with the previous year.” (Report of Governor, 1924)

The original Pu‘umaile Home was built in about 1912 at a site that is now in the vicinity of the old terminal building at Hilo Airport. It took its name from a nearby cinder cone (approximately 50-feet high.) The Home served the entire island.

The Hilo Airport was dedicated in February 1928 and in April 1938 a new facility was constructed at the end of Kalanianaʻole Avenue (at what is now Lehia Park.) (Clark)

“A son of a former pastor of the Finnish National Lutheran church here has been appointed superintendent of a new hospital known as the Pu‘umaile home at Hilo, Hawaii.”

“Well known to most everyone to Hilo is Dr. Carl J. Wilen, superintendent of Pu‘umaile home, who has held that position since July, 1935, when he came to Hilo as the first full-time physician at the sanatorium.” (Ironwood Daily Globe, November 24, 1939)

Some incorrectly suggest that the hospital washed away by the 1946 tsunami; however, it was spared. “The (sea)wall itself was undamaged, and buildings sheltered by it were undisturbed except for minor damage by flooding.” (Wiegel)

“Observers said waves drove 40-feet high over the Hilo breakwater … Water reached 1,000-yards inland, flooded the first floor of the Pumaile Hospital, and wrecked outlying homes of hospital personnel.” (Albuquerque Journal, January 5, 1947)

The Army installed standby generators until power could be restored. Engineers laid 2-miles of emergency pipeline to restore water. Patients were temporarily evacuated by Navy personnel and cared for at the nearby naval air station (Hilo Airport.) (Muffler)

The hospital remained on the shoreline until 1951 when it was relocated into new facilities on the grounds of the Hilo Memorial Hospital, above Rainbow Falls. Shortly after (1955,) Pu‘umaile was combined with the Hilo Memorial Hospital to establish Hilo Hospital (now Hilo Medical Center.)

In 1955, new and more effective drugs were introduced in the treatment of tuberculosis and, as a result, by 1958 the average daily patient census significantly dropped. (Legislative Auditor, 1968) (Pu‘umaile was referred by several names, including Pumaile and Puumaile.)

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© 2017 Hoʻokuleana LLC

Pumaile Home, a county hospital at Hilo-3b14345r-LOC
Pumaile Home, a county hospital at Hilo-3b14345r-LOC
PuuMaile Home-tsunami
PuuMaile Home-tsunami
PuuMaile-PP-40-8-060-00001-1930s
PuuMaile-PP-40-8-060-00001-1930s
PuuMaile-Seawall-1946 tsunami-Wiegel
PuuMaile-Seawall-1946 tsunami-Wiegel
PuuMaile-Seawall-1946 tsunami-Wiegel
PuuMaile-Seawall-1946 tsunami-Wiegel
1929-6-25-Hilo-Airport
1929-6-25-Hilo-Airport
Construction of Hilo Hospital-PP-40-8-047-Feb 27, 1950
Construction of Hilo Hospital-PP-40-8-047-Feb 27, 1950
Construction of Hilo Hospital-PP-40-8-022
Construction of Hilo Hospital-PP-40-8-022
Construction of Hilo Hospital-PP-40-8-021
Construction of Hilo Hospital-PP-40-8-021

Filed Under: Place Names, Economy, General, Buildings Tagged With: Hawaii, Hawaii Island, Hilo, Tuberculosis, Puu Maile Home, Hilo Hospital, Hilo Medical Center

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People, places, and events in Hawaiʻi’s past come alive through text and media in “Images of Old Hawaiʻi.” These posts are informal historic summaries presented for personal, non-commercial, and educational purposes.

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