South Carolina State Sanatorium
|South Carolina State Sanatorium|
|Building Style||Cottage Plan|
Motivated by the national anti-tuberculosis movement, the General Assembly of South Carolina allocated $10,000 to fund a state sanatorium in 1914. The sanatorium opened in 1915 with one “open-air ward of frame construction” and the capacity for sixteen white male patients. A wood-frame Administration Building, a private residence for the superintendent, and a small farm completed the complex. Located in State Park, the property consisted of two hundred acres. By 1919, the legislature appropriated funding for the addition of a women’s pavilion for sixteen patients as well as an infirmary with the capacity for twelve male and twelve female patients. The infirmary was designed for the care of bedridden patients. Also operating as a communal resource the building included a kitchen and dining room with a capacity for 100 people. The fully operational farm also served the entirety of the sanatorium. It produced dozens of crops, raised chickens and pigs, and later featured a 200-ton tile silo. The dairy, originally comprised of one cow, was another area of early expansion for the property. Some strands of tuberculosis were spread through unpasteurized milk, making the modern diary facility an important medical feature for the sanatorium.
The sanatorium remained a racially segregated institution throughout its thirty-eight year history as a state operated facility. The method of segregation, however, often varied The original method of segregation at the South Carolina Sanatorium was isolation by exclusion, as no blacks were admitted from 1915 to 1919. Despite the hospital’s exclusionary policies, the black community continuously requested tuberculosis treatment from the state by submitting patient applications to the South Carolina Sanatorium. When the South Carolina Sanatorium did expand to meet the healthcare needs of African Americans, the method of segregation was constantly negotiated with the hospital’s growth and development of the built environment.
In 1919 the South Carolina Sanatorium built its first separate infirmary for severely ill patients, following the national trends pavilion-plan of sanatorium construction. As the sanatorium continued to grow, multiple infirmaries were built to segregate bedridden patients from those with more moderate cases of tuberculosis. Medical specialist believed segregating terminally ill patients would reduce anxiety and depression levels in patients with moderate cases of tuberculosis, enhancing their ability to recover. Significantly, the South Carolina Sanatorium never allocated sufficient resources to maintain the recommended level of medical segregation within the hospital’s African-American facilities, reducing the quality of care for African-American patients.
As an early improvement to the landscape, the South Carolina Sanatorium installed paved walkways in 1920. These sidewalks, which included covered and uncovered segments, were praised by the administration for reducing the health risks of dust and dirt and improving the aesthetics of the grounds. Despite these benefits, portions of the black facilities remained without sidewalks through the 1940s. While sidewalks may seem trivial in comparison to today’s standard of medical technology, seemingly simple improvements to the landscape of the sanatorium were considered important medical strategies against a disease with no cure.
The pavilion-plan design of the South Carolina Sanatorium accommodated growth, such as the expansion of African-American facilities, with the addition of new buildings. Built over several decades, each building’s design varied. Some buildings offered more personal privacy like individual lockers; others offered more comfortable social spaces like communal living rooms. Despite the eclectic composition of building styles. In 1927, the institution opened Campbell Hall, a children’s ward for white patients. On-site staff housing at the South Carolina Sanatorium shaped the social structure of authority at the institution by creating separate and distinct spaces for doctors, nurses, and support staff. Employee housing also provided separation between staff and patients, as well as separation among the races.
The PWA (public works administration) Building opened in 1938 with room for 250 patients, doubling the sanatorium’s capacity. The six-story brick building had a variety of patient wards with varying degrees of privacy. The building featured modern office space for doctors and nurses, a receiving lounge for guests, and a large cafeteria.84 The architectural design of the building incorporated both traditional and modern medical technologies for treating tuberculosis. Sun porches were incorporated into every patient floor and an extensive surgical department designed for the sixth floor. The expansive U-shaped PWA Building became the focal point of the hospital grounds and was considered a crowning accomplishment for public healthcare in South Carolina. By 1942 the sanatorium reached the height of its patient capacity under state control, providing 550 total patients beds: 328 for whites and 222 for blacks.
By the late 1970s, advances in medicine sufficiently suppressed the tuberculosis death rate in South Carolina for both races. Without the state’s need for a tuberculosis treatment facility, the property transitioned into a corrections facility for women in 1984. Portions of the site are still standing, left vacant since the departure of the Department of Corrections in 2002. Some buildings remain in use as offices for the South Carolina Department of Health and Environmental Control. Significantly, in 2007 the South Carolina Budget and Control Board deemed several structures on the site as safety hazards of no economic value. The state sanctioned the demolition of twenty-four structures. Many of the buildings were dilapidated remnants of the African-American facilities. 
- Noll, A.(2013). The South Carolina Sanatorium: The Landscape of Public Healthcare In the Segregated South. (Master's thesis).