Arkansas Tuberculosis Sanitorium
|Arkansas Tuberculosis Sanitorium|
|Building Style||Cottage Plan|
|Architecture Style||Art Deco & Colonial Revival|
|Peak Patient Population||1,017|
At the first semi-annual meeting of the Arkansas Tuberculosis Association in Little Rock on January 26, 1909, the Association deliberated on a “Bill for an Act to provide for the location, erection, organization, management and maintenance of a State Sanatorium for the treatment of tuberculosis in the State of Arkansas…” The bill had been prepared by Senator Kie Oldham at the urging of Judge Joseph M. Hill. (Hill had been diagnosed with tuberculosis in 1905, and moved to Arizona as a result. It was the move to Arizona that convinced him that Arkansas needed its own sanatorium.) The bill, which was Act 378 of the Legislature, was approved by Governor George Donaghey on May 31, 1909, and appropriated $50,000 for the establishment of a tuberculosis sanatorium and $30,000 for two years of maintenance. Unfortunately, due to a lack of funds in the treasury for the project, the Board of Trustees had to wait until the following fiscal year to begin work on the facility.
The site chosen for the Arkansas Tuberculosis Sanatorium echoed the locations chosen for sanatoria in the eastern U.S., especially around Saranac Lake, New York. The site was in a mountainous area away from large cities where the air would be fresher, supposedly bringing better relief from the disease. A pamphlet issued by the Arkansas Tuberculosis Sanatorium c.1925 touted the facility’s location by saying:
"The site of the Arkansas Tuberculosis Sanatorium near Booneville is a beautiful one, 900 feet above sea level, among the pines, high enough for refreshing breezes in summer and not high enough for the cold fogs of winter; with a bountiful supply of excellent water and perfect drainage. The climate the year round is unexcelled by any in the South or West, free from the winter’s dampness of the Gulf coast and from the sand storms and enervating heat of the South arid regions, and the blizzards of those farther north."
However, before construction could begin, two large obstacles had to be overcome – building a road to access the site and securing a supply of water. A route for the road was selected on December 21, 1909, and a pond was built south of the sanatorium, which was pumped full of water from the Petit Jean River, to provide water. Construction then began on the buildings that the plans called for, including an administration building, one ward building, two A cottages, two B cottages, five tent houses, four cabins and a superintendent’s cottage. Dr. John Shibley was chosen to serve as the first head of the State Sanatorium, and the first patient was admitted on August 2, 1910, with the formal opening held on September 1, 1910.
The number of patients at the sanatorium quickly increased. In August 1910, a total of 16 patients were admitted, 27 patients arrived in September, 22 in October, and 19 in November. It was not long before patients had to be turned away because there was not any room to house and care for them.
However, the problem of the growing number of tuberculosis cases across the state was not felt just at the sanatorium in Booneville. In Little Rock, for example, tuberculosis was also a problem, according to a 1914 survey. From 1909 to 1913, Little Rock alone lost an average of 101.6 people to tuberculosis each year (an average of 45.3 whites and 56 blacks). The report stated that “the State Sanatorium for Incipient Cases at Booneville has a few beds available for cases from Pulaski County. The County authorities are to be commended for using their full quota of beds at this institution.”
Pulaski County was beginning to take active steps to fight the disease, including the establishment of the Pulaski County Anti-Tuberculosis Society, which was “composed of individuals organized for the purpose of fighting the white plague in Pulaski County.” The Society was “supported by donations and the proceeds of the Red Cross Seal sale,” and its “activities to date (1914) have consisted of a limited campaign of education, the engaging of a visiting nurse, and plans and preparations for the operating of a free dispensary, which was opened in September 1914.”
The creation of the Arkansas Tuberculosis Sanatorium was a reflection of the progressive stance that Arkansas had taken against some of the most prevalent diseases of the period, a stance that was often ahead of many other states. The earliest buildings built at the Arkansas Tuberculosis Sanatorium around the time of its founding consisted of two main types – frame buildings and “tent houses” according to the 1913 Sanborn map. To the southeast of the driveway were located the Administration Building, Hospital Building, Goldman Pavilion (patient housing), the Superintendent’s Cottage, two Women’s Cottages, and a water tank, all of which were frame, except for the water tank. Frame construction would have been ideal for the first buildings at the Sanatorium, since they would have been easily constructed and there was an abundance of timber on “The Hill.”
To the northwest of the driveway, were three Men’s Cottages and nine tent houses. Only one of these buildings, one of the Men’s Cottages labeled “Cottage Sebastian” on the 1913 Sanborn map, was apparently all frame construction. The rest of the buildings, according to early photographs, had low frame walls with large flaps, hinged at the top, which opened out to provide airflow through the buildings. The buildings were crowned with gable roofs. The tent houses would have been easy to construct to allow the sanatorium to be operational in a short amount of time, and they would have also provided as much fresh air as possible to the patients, the latest treatment for tuberculosis.
However, with the increasing number of tuberculosis patients around the state that needed to be served and the wider variety of cases being seen, it soon became apparent that more buildings needed to be built at the sanatorium. To aid in this the 1913 legislature appropriated $15,000 for a hospital to be built to care for “the far advanced and hemorrhagic cases.” The building had a capacity of twenty-four patients and was named Kie Oldham Hall after Senator Oldham who had worked tirelessly to get the sanatorium established. In addition to Kie Oldham Hall, $4,000 was appropriated for “a small but satisfactory” laundry so that the laundry would no longer need to be done by hand.
The late 1910s and early 1920s brought additional new construction to the sanatorium, including Echols Hall, a twenty-four bed building costing $5,000, and the gift of Mrs. W. J. Echols of Fort Smith in memory of her husband, and a $21,000 water plant and a $12,000 dairy. The dairy had an “excellent herd of twenty-one cows” that provided enough milk for the 114 patients living at the sanatorium. However, the facility was still growing as an average of approximately 400 patients were being accepted each year for treatment.
Because the sanatorium was also seeing an influx of children as patients, Judge Hill proposed to the Belle Point Lodge, Free and Accepted Masons in Fort Smith, on December 10, 1922, at the time of their 75th anniversary celebration, that the Masons build a building at the sanatorium for the care of children. The Masons accepted the proposal and a twenty-four bed building, which cost approximately $57,000, was built and formally dedicated on September 21, 1924. Furnishings for the building were also donated by Masonic lodges and Order of the Eastern Star chapters around the state.
The changing treatments for tuberculosis were reflected in the construction of the Kelley Building built in 1927. The building was originally known as the Occupational Therapy building, and was used for occupational therapy, a form of treatment that came about in full form in the early 1920s. With occupational therapy, patients who were confined to their beds could also enjoy some activity. Occupational therapy allowed patients to make things while in bed (i.e., leather-working, knitting, crocheting, or embroidery) to pass the time, releasing built-up tension, or even be able to support themselves. Even though the Kelley Building was a gift to the sanatorium, it was kept secret for almost ten years.
Surprisingly, even though the sanatorium was run by the State of Arkansas, treatment was not free. The same c.1925 brochure gave the following information on costs. “The treatment will be strictly up to date and the tables will be supplied with the best the markets of the state afford. The terms are $10.00 per week. This pays for lodging, board, medical treatment, nursing and plain laundry. Bona fide residents of the state suffering from tuberculosis and unable to pay for maintenance may be admitted free on written order of the County Judge of their county, setting forth these facts, in which case a charge of $5.00 per week for one-half the maintenance will be made against the patient’s county.”
Holidays were special occasions for the patients during the 1920s. At Thanksgiving, for example, “the program for the day began with a Sunrise Service of song and prayer in which patients, staff, and employees joined in offering up thanks to the Creator for the blessings bestowed upon them during the past year. …Once more the fine Thanksgiving dinner, served in the main dining hall left nothing to be desired. The hospital and the ambulant buildings sent over all their patients that were able to attend, and plates were laid for 210 patients. …Last on the day’s program came the picture show – “Ben Hur” – re-booked especially for the occasion by Dr. Stewart.”
Even though additional buildings to accommodate a larger number of patients were built throughout the 1920s, it was not long before overcrowding became an issue again. The overcrowding at the Booneville facility also caused some counties to put in measures to do some of their own care of tuberculosis patients. In Craighead County, for example, according to the August 1937 issue of the Sanatorium Outlook, “Craighead County will have 13 Burr Cottages built by the WPA. Eight will be built on the county farm for patients who are waiting a chance to enter the Sanatorium.”
The WPA’s efforts at Wildcat Mountain greatly aided the fight against tuberculosis in Arkansas by allowing more patients to be adequately served and treated. However, it was not just the WPA that aided in providing adequate facilities for the sanatorium. Beginning in 1935, it was the PWA that began to drastically transform the Arkansas Tuberculosis Sanatorium campus into the massive facility that is present today.
In August 1935 officials at the sanatorium filed an application with the Arkansas PWA through E. Chester Nelson, an architect in Fort Smith, for $24,300 in grant funds for improvements at the facility. It was estimated that the total amount needed for the proposed projects would be $54,000, although the sanatorium already had some funding on hand to complete the projects. According to the Sanatorium Outlook, “Five items are proposed in the application… The application proposes the construction of an addition to the present office building; a new ice and refrigeration plant and bakery to be attached to the present administration building and the purchase and installation of equipment; construction of a new laundry building; altering of McGehee Hall, and the reconstruction of the Occupational Therapy building, now called the Kelley building, to make it a building to accommodate 18 patients and the necessary equipment.” By the end of 1935, the grant had been received and “bids were opened for construction, and the contract has been given to Cooper Construction Company, of Booneville.”
By the end of 1936, much of the work planned under the initial PWA grant was completed, including the Kelley Building, which was finished by October.According to the Sanatorium Outlook, “the building has two large wards that accommodate nine patients each, separated by serving room, individual lockers, and chart room.” Considering the work began on January 30, 1936, it was completed in a very timely manner.
By early 1938, in order to keep up with the new buildings that had been built, along with new buildings that were being planned, it was determined that improvements needed to be made to the facility’s water supply. “Work on the project for enlarging the Sanatorium water supply lake began December 9 . The clearing and cleaning of ground preparatory for the moving of dirt is well under way and the steam shovels for the work are already (Dec. 28) on the grounds.” It did not take long for the improvements to be carried out and by July “finishing touches are being added to the Sanatorium dam, and by the time this appears in print the project will probably be completed. …According to the present design it will impound approximately 100,000,000 gallons of water, as compared with its previous capacity of about 39,000,000 gallons, when the water reaches spillway level. …The raising of the dam was done by WPA labor.” The WPA did further infrastructure improvements later in 1938 when “Presidential approval of a …project for hard surfacing three miles of highway inside the Sanatorium grounds has been received. The road will be laid out according to plans prepared by the State Planning Board in connection with the building and improvement plan.”
During the special session of the 1938 Legislature, Senators Lee Nichols of Booneville and Leo E. Nyberg of Helena, who was himself suffering from tuberculosis, fought for the passage of the Nichols-Nyberg Act, which appropriated $1,200,000 to fund an extensive building program at the sanatorium. To supplement the appropriation, the PWA awarded the sanatorium a grant of $948,071, which allowed “the sanatorium to complete an extensive building program [that] will give the state the most adequate state tuberculosis institution with regard to facilities and capacities in the United States.”
The architectural firms of Haralson & Mott of Fort Smith and Erhart & Eichenbaum of Little Rock were selected to complete the designs of the buildings (they had actually already been selected for the main hospital building, later named the Leo E. Nyberg Building), and the rendering of the Nyberg Building was proudly displayed in the May 1938 issue of the Sanatorium Outlook. It was said that the building would have “…523 beds; 115 single rooms and 204 double rooms. The building will have six stories including ground floor in the central wing and five stories including ground floor in each of the side wings. The building is to be of modern hospital design and the construction is to consist of reinforced concrete beams, columns and slabs.”
The feverish pace of progress on the new construction continued throughout 1939. Bids for the construction of the cannery building and the twelve doctors’ cottages were received on May 11, and although the three bids received for the construction of the cottages were rejected, J. H. Leveck of Little Rock was awarded the cannery contract with a bid of $27,900. Construction bids for the nurses’ home and two employees’ dormitories were received June 8, and the cottages were soon back on track with construction being “well under way” by August. In fact, at the June 8, 1939, meeting of the sanatorium board of trustees, contracts totaling $316,267.56 were awarded.
Also by August 1939, “preliminary plans for a new administration building and commons building and a 120-bed building for ambulant patients were approved subject to revision.” The contract for the construction of the administration building was awarded August 17 to the Manhattan Construction Company of Muskogee, Oklahoma, which had the low bid of $35,795, and the contracts for the commons building and the patient’s building (Hamp Williams Building) were awarded on September 22. The Manhattan Construction Company, with a bid of $157,990, received the contract for the commons building, while the patient’s building was awarded to the Harmon Construction Company of Oklahoma City for $124,831.
By the end of 1939, projects were starting to be completed, an amazing accomplishment considering that construction had begun a little over a year before. The new power plant was to be ready on October 1, and on December 15, “the board accepted as complete the cannery, power plant, employees’ barracks, guinea pig piggery, and twelve employees’ cottages.” Also, by late 1939, the hospital building was almost complete, and the progress was poetically described in the November 1939 Sanatorium Outlook along with an extensive description of the building’s features.
The dedication ceremonies for the new sanatorium buildings were scheduled for July 4, 1940, with the keynote addresses to be given by Dr. W. A. Doppler, Field Director of Health Education Service of the National Tuberculosis Association and Governor Carl E. Bailey.Dr. J. D. Riley, superintendent of the sanatorium, served as master of ceremonies while the North Little Rock high school band provided musical entertainment. It was estimated that over 3,000 people attended the ceremonies.
Although Arkansas now had the largest tuberculosis facility in the country, the disease was still a serious force to be reckoned with. During Dr. Doppler’s address, he indicated that “during the First World War 70,000 Americans were killed and during the same time 100,000 died from tuberculosis.” In fact, Senator Nyberg, who conceived the idea of the building campaign while a patient at the sanatorium, and for whom the main hospital building was named for, died of the disease before the construction was finished. Nyberg’s legacy in fighting tuberculosis was eloquently stated by Representative Ernest Maner in a January 15, 1941, address delivered to the House of Representatives.
The scale of the Arkansas Tuberculosis Sanatorium was significant for being the largest tuberculosis sanatorium in the United States by the time the PWA buildings were finished in the early 1940s, and it remains the largest extant tuberculosis sanatorium today. By 1938, the sanatorium had a movie theatre along with its own water supply, and it eventually got its own wastewater treatment plant and heating plant. A post office (State Sanatorium) was established in 1927 and remained in operation until 1968. The Commons Building also had a store for the sanatorium’s residents. A dairy was established by 1926, according to the Sanborn maps, and other farming operations were also in place. An ice plant was also located in the same building as the kitchen and dining rooms and the administrative area. The sanatorium also had its own laundry.
Housing was provided for the workers and families, especially after the PWA expansion in 1938-1940, through cottages, apartments, dormitories, and barracks. The theory was to keep everybody isolated at the sanatorium as much as possible in order to help prevent the spread of the disease beyond the facility’s boundaries. Frank Ryan notes in his book The Forgotten Plague that “the single most important achievement of such institutions [sanatoria] – a very real and dramatically effective one – was the isolation of the infected from other potential victims.” The scale of the facility at Booneville, which allowed it to offer so many more services than other sanatoria, allowed it to take very seriously the concept of “isolation of the infected from other potential victims.”
The number of buildings on the campus is much larger than other identified tuberculosis sanatoria around the country, and illustrates the wide variety of buildings needed to provide the proper treatments, goods, and services, to the sanatorium’s staff and patients. The size of the facility is a reflection of the progressiveness of Arkansas in battling the disease and the fact that some of the individuals who were influential in getting the sanatorium established had personal experiences with the disease. From the very beginning of trying to establish a tuberculosis sanatorium in Arkansas, the state looked for approximately 1,000 acres for the facility. The fact that the bill for the establishment of the sanatorium was being pushed by Judge Joseph M. Hill (who had been diagnosed and treated in Arizona for tuberculosis) meant that the people seeking to establish the sanatorium had first-hand knowledge of what was needed in a sanatorium. Tuberculosis was a serious disease in Arkansas and there was always a waiting list for treatments. It wasn’t until the completion of the PWA expansions in 1938-1940 that “the waiting list [was] now controllable and persons with serious cases of tuberculosis need no longer die.”
The dramatic reductions of tuberculosis cases and deaths as a result of the use of antibiotics continued into the 1960s as well. According to the book, The Last Crusade, “by 1967 tuberculosis was causing only fourteen new cases and 4.1 deaths per 100,000 per year. From the time reliable record keeping began to be possible, around 1900, both new cases of tuberculosis and deaths from it had been declining at a rate of from 4 to 6 percent a year; and with the introduction of antibiotics, the falloff rate doubled.” Again the reduction in cases was reflected in Arkansas. By 1966, Pulaski County had the largest number of cases reported that year at 44, while the other counties only had one or two new cases to report.
The 1960s also started to bring about the end of the Arkansas Tuberculosis Sanatorium. The last major construction project at the facility took place with the construction of the Judge Joseph M. Hill Building in 1963-1964. It was built as a surgery/intensive care unit at a cost of approximately $700,000, and was funded through monies saved by the sanatorium out of its operational funds. The building was built on the site previously occupied by Meriweather Hall, which had been built in the 1920s, while two residences that stood on the site were moved to Nature Lane, where they remain today.
By the mid-1960s, the patient population at the sanatorium had decreased dramatically. In 1965, the sanatorium was rated by the Public Health Service as having 847 beds. However, only an average of 374 beds were occupied in 1965, and $1,783,098 was expended on operation of the sanatorium during the 1965-1966 fiscal year. As a result, many aspects of the institution were gradually phased out. The bakery, post office, and various other buildings were closed as operations were scaled back. In 1968, the dairy was closed and all of the cattle and equipment were transferred to the Arkansas Department of Corrections.
The last patient was discharged from the Arkansas Tuberculosis Sanatorium on February 26, 1973, and Act 320 of the 1973 legislature was passed to “Transfer Title to the Arkansas Tuberculosis Sanatorium to the State of Arkansas; to Transfer Jurisdiction and Control Over the Sanatorium From the Department of Health to Mental Retardation-Developmental Disability Services, a Division of the Department of Social and Rehabilitative Services; to Abolish the Board of Trustees of the Arkansas Tuberculosis Sanatorium; and for Other Purposes.” The sanatorium officially closed on June 30, 1973, and when it closed it was estimated that 70,000 patients had passed through its doors.
Although the Arkansas Tuberculosis Sanatorium closed on June 30, 1973, it was not long before the campus was put to use again, opening as the Booneville Human Development Center (BHDC) in July 1973. The facility is one of six human development centers around the state that provide residential services to people with developmental disabilities. The BHDC currently serves a maximum of 159 people with developmental disabilities, age 19 or older. The facility is able to provide people who are ambulatory with no severe medical needs a variety of training programs, including on-campus and off-campus trainee positions, and a variety of living arrangements from a dormitory setting to semi-independent cottage and apartment living. The BHDC still provides these services today, and utilizes the vast majority of the buildings on campus. 
Facts & Figures
First Patient Admitted - August 1910
1910 Patient Population - 64
1959 Patient Population - 1,017
Last Patient Discharged - February 1973
One little-known resource available at the Booneville Public Library is the bound copies of the Sanatorium Outlook. A bi-monthly publication of the Arkansas State Tuberculosis Sanatorium in Booneville, the newsletter has articles of interest to patients and families alike, as well as listing admissions and discharges.