Ellis Island Immigrant Hospital
The Ellis Island Immigrant Hospital was a United States Public Health Service hospital on Ellis Island, in New York Harbor, that operated from 1902 to 1951. The hospital is part of the Statue of Liberty National Monument. While the monument is managed by the National Park Service as part of the National Parks of New York Harbor office, the south side of Ellis Island, including the hospital, is managed by the non-profit Save Ellis Island Foundation and has been off-limits to the general public since its closing in 1954.
Constructed in phases, the facility encompassed both a general hospital and a separate pavilion-style contagious disease hospital. The hospital had two functions: treating immigrants who were ill upon arrival, and treating immigrants with conditions that were prohibited by immigration laws. These latter patients were stabilized and often sent back to their home countries. Between 1902 and 1951 the hospital treated over 275,000 patients; there were approximately 4,000 fatalities and 350 babies were born there.
The immigrant hospital was run by the Marine Hospital Service, which was re-organized and expanded in 1902 and became the Public Health and Marine Hospital Service. The name was shortened in 1912 and became the United States Public Health Service. All of the doctors at Ellis Island were part of the commissioned corps of the United States Public Health Service. Nurses and all other medical personnel were employees of the PHS. The PHS doctors conducted the line inspection, the medical examination of arriving immigrants, and treated detained immigrants in the hospitals.
Efforts to restore the hospital buildings and other structures on the island are being made by the Save Ellis Island Foundation. The hospital complex has been open to the public on a limited basis for hard hat tours since 2014, provided by the Save Ellis Island Foundation.
History
Need
Prior to being an immigration station, Ellis Island was the site of Fort Gibson, an 18th-century fort which was part of the New York Harbor defenses along with the Battery, Fort Wood on Bedloe's Island, and Fort Jay on Governors Island. By the late 19th century, Fort Gibson was obsolete and the island was used by the Navy to store munitions.The need for hospitals as part of the immigration process was well-established when the new Ellis Island Immigration Station opened. In the 1860s, New York State sent sick immigrants from the main entrance facility at Castle Clinton in the Battery to a separate purpose-built and very effective new hospital facility. The Verplanck State Emigrant Hospital on Ward's Island, which opened in 1864 was constructed in the pavilion style, a hygienic layout promoted by Florence Nightingale in her Notes On Hospitals and hailed by the New York Times as the exemplar of a modern hospital.
As the number of immigrants increased, it was decided that the US government had to take control of immigration. In 1882 the US government passed the Immigration Act of 1882. It excluded any immigrant who was "likely to become a public charge", effectively denying entrance to prospective immigrants who could not demonstrate their ability to work and would require government assistance to survive. The law also barred immigrants who were convicts, those convicted of political offenses or who were "idiots, psychopathics, or afflicted with a loathsome infectious or contagious disease". It also established a head tax to be paid to the federal government, which replaced one charged by New York State, which was declared unconstitutional in 1875 as per Henderson v. Mayor of City of New York, 92 U.S. 259. The local administration, however, was to be carried out by state officers designated by the various states involved.
The Immigration Act of 1891 formalized previous immigration laws and gave full authority to the US government, including the ability to enforce the laws and to deport immigrants who did not meet the requirements. The Marine Hospital Service, later renamed the US Public Health Service, was charged with administering the new immigration laws for the federal government.
First immigration station
The original immigration station on Ellis Island opened January 1, 1892. It was built reusing several of the structures from Fort Gibson. A shellhouse was converted into a hospital for the insane, the gunners quarters became the surgeon's house, a shellhouse became a dining hall and another shellhouse became a detention facility for immigrants awaiting deportation. A 40-bed hospital was constructed from "a series of wooden structures surrounding a garden".In 1890 when the US government and the State of New York processed immigrants jointly at the Barge Office, patients with contagious diseases were sent to hospitals operated by the New York City Department of Health and to Long Island College Hospital in Brooklyn, which was then also called the Immigrant Hospital. The hospitals involved were called “Contract Hospitals.”
Reconstruction and expansion
New hospital on Island 2
On June 15, 1897, the wooden immigration station on Ellis Island was destroyed by fire. The Buffalo Evening News reported that all 40 patients were safely evacuated and taken to Bellevue Hospital. By September, the treasury's supervising architect, James Knox Taylor, opened an architecture competition to rebuild the immigration station. The competition was the second to be conducted under the Tarsney Act of 1893, which had permitted private architects to design federal buildings, rather than government architects in the supervising architect's office. By December, it was announced that Edward Lippincott Tilton and William A. Boring had won the competition. Tilton and Boring's plan called for four new structures: a main immigration processing facility in the French Renaissance style, as well as the kitchen and laundry building, main powerhouse, and the main hospital building The plan also included the creation of a new island, upon which the hospital would be built, south of the existing island.The Main Immigration Building and structures on Island 1 were completed and opened in December 1900. Work creating Island 2 was completed in 1898. Work then started on the hospital and other buildings. The new hospital was built between February 1900 and March 1901 and included an outbuilding and a surgeon's house. "The hospital outbuilding included a laundry, linen room, and autopsy room. The surgeon's house was designed and constructed with a basement; a parlor, kitchen, pantry, dining room, library, and hall on the first floor; and five bedrooms, hall, and bath on the second floor." Work on these buildings was completed at the end of 1901, but they did not open until 1902 because of delays during construction.
The immigrant hospital was initially staffed by the Marine Hospital Service, which became the U.S. Public Health Service PHS). It was one of the first facilities in the country to employ a full-time female physician, Rose A. Bebb. Physicians treated a wide range of disease, from measles, tuberculosis, trachoma, scarlet fever, Favus, and diphtheria, to tropical diseases imported from around the world. The hospital was an extremely effective institution. Its mortality rate was on par or better than most comparable hospitals. In 1917, Wilson, a PHS physician stationed at Ellis Island, conducted a study of the hospitals. He wrote that "Although the incidence of cross-infection contracted in hospital has not entirely ceased, it has reached such a low point that it is believed a description of the hospital, with special reference to the provisions to prevent the spread of disease, will be found interesting and instructive."
The PHS used advanced methods in medicine as they developed. They used fluoroscopy and x-rays; there was an autoclave that could sterilize four mattresses at a time. For many immigrants, new medical equipment was unfamiliar and scary. According to one New York Times article, "those less fortunate had to submit to physical inspections that required stripping off all of one's clothing – an entirely foreign concept, particularly to many immigrant women. This is why there were female physicians stationed on the medical inspection line. Some immigrants had no idea what X-ray machines did; others were fearful that their clothing – or the money sewn inside its seams – would be stolen."
The volume of immigrants quickly overwhelmed Hospital 1's capacity of 125 beds. As the number of immigrants increased, the number of "psychopathic" or "insane" patients grew as well. Because their entry in the US was prohibited by immigration law and because these patients needed to be housed in a separate facility, a new secure ward was required. The psychopathic ward, situated between the hospital outbuilding and the main hospital on Island 2, opened in 1907. The administration building was added in 1906–1907, which added another 125 beds. However, the number of immigrants nearly doubled, leaving the hospitals still extremely overcrowded. Between 1908 and 1909, a third building was constructed that has several names, originally called the hospital extension it was renamed Hospital Number 2 because it was almost the same size and layout as the first hospital. It had a capacity of 125 beds. When it opened it enabled the PHS to distribute patients to hospitals 1 and 2 and use the administration building for its original purpose. When Hospital 2 was completed, the facility had a capacity of 300 beds.
Contagious disease hospital on Island 3
Hospital No. 1 was designed as a general hospital. The PHS intended there to be a companion, separate contagious hospital, as was the practice in the civilian hospitals, such as Johns Hopkins Hospital, after which Ellis Island's hospitals were modeled, but the government would not fund a contagious hospital. With no facilities to treat infectious or contagious disease patients on site, Ellis Island maintained its contract hospital relationship with the Health Department of New York and Long Island College Hospitals which had been caring for Ellis Island contagious disease patients since 1890. In 1903 New York announced that it wanted to terminate the agreement because the number of patients being sent to New York strained their capacity. The Bureau of Immigration considered the most practical solution was to build a third island, separated from Island 2 by a ferry basin. In response, the surgeon general indicated that an island "with an outside limit of 410 feet from the present island and with 200 feet of clear water space between the two islands, would be amply sufficient to ensure freedom from danger of contagion according to modern ideas of hospital construction. Contemporary hospital design and medical knowledge indicated that a single building was less desirable than a series of several small pavilions, where various diseases could be treated in isolation from other wards." The island measured. The ferry basin was later infilled.The area chosen was between Island 2 and Liberty Island and adjacent to the Jersey City waterfront area known locally as Black Tom. Infill and construction was started but New Jersey claimed title to the area and New York and New Jersey went to court over this riparian rights issue. The government would not permit construction to continue until the land issue was resolved. In 1904, the courts ruled and determined that the location of the proposed Island 3 was indeed part of New York. The immigration department now had clear title and construction was resumed, By the end of 1909 island 3 and the new contagious disease hospitals were completed, but insufficient funds had been allocated to connect the utilities and purchase furniture and equipment for the facility. Congressional authorization for the required funds was not achieved until 1911 and the hospitals opened later that year.
The Island 3 buildings included eight two-story-pavilions designated for measles patients, three isolation wards, a morgue and autopsy building, a medical office building; and a three-story administrative building that contained the admitting and discharge facilities, residences for nurses, single doctors, and a small operating room. New York then officially terminated its contract with the Bureau of Immigration and all patients arriving at Ellis Island were treated either in the general hospital or the contagious disease hospital. 1912 was the first full year that the hospital complex was completely open.