Part I: African American Healthcare in West Virginia, 1870-1960
As the African American population increased in West Virginia, the need for medical care in the Black community intensified. The Mountain State’s Black population skyrocketed from roughly 18,000 in 1870 to nearly 118,000 by 1940. During the Jim Crow Era, West Virginia had more African American healthcare providers and hospitals than any other state in central and southern Appalachia. However, racial disparities in healthcare still existed, with Black West Virginians experiencing higher death and infection rates than White West Virginians. [1]
Like public schools, most medical facilities were segregated prior to integration in 1954. In 1944, 124 hospitals nationwide treated only Black patients. In Appalachia, West Virginia had one of the highest state populations of African Americans and, as a result, had better healthcare options for Black patients compared to the rest of Appalachia. In West Virginia, 11 private hospitals—mostly in the southern part of the state—served Black patients and employed Black doctors and nurses. West Virginia was the only state during the Jim Crow Era to fund specialty hospitals with all Black staff. Two public hospitals treated specific ailments among African Americans, the Denmar Tuberculosis Sanitarium and Lakin State Hospital for the Colored Insane. The state funded three hospitals to care for coal miners and industrial workers, which cared for Black patients in separate wards. [2]
Medical and Nursing Staff of State Colored Tuberculosis Sanitarium, Pocahontas County, W. Va. June 1930. West Virginia & Regional History Center.
Through the mid-20th century, most White nursing programs, medical schools, and hospitals excluded African Americans. In 1900, 10 out of 432 nursing schools in the United States accepted African American students. By 1941, only 40 accredited nursing schools in the United States accepted Black women. For the first half of the twentieth century, nursing education in Appalachia was typically not provided in a formal, academic setting. There were no national or state standards in place, so nursing programs varied widely. West Virginia did not require nurses to graduate from an accredited program, so most nurses were educated in in-house hospital diploma programs. Only if a nurse wanted to work for a national or international organization did they need to graduate from an accredited program and pass a Board exam. [3]
Several small, private, African American hospitals offered in-house nursing programs in the early 20th century, including those in Cabell, Kanawha, McDowell, and Mercer counties. This enabled young Black women to receive professional training and find employment in-state. West Virginia was one of the first southern states to support racial integration in medicine. By the 1950s, a few White nursing programs and hospitals in West Virginia admitted Black students and hired Black nurses. [4]
For Black men wanting to train as physicians, there were very few options in the country. By 1920, two schools, Meharry University in Nashville and Howard University in Washington, D.C., graduated more than 90% of the country’s African American physicians. In 1928, there was one African American physician to every 3,125 African Americans while there was one White physician for every 805 White people, and this was skewed to the northern states where most Black physicians practiced. In the same year, White people had access to fourteen times the hospital beds compared to Black people, with one bed for every 139 White Americans and one for every 1,194 African Americans. [5]
African American doctors and nurses were not allowed to become members of the West Virginia State Medical Association or the West Virginia Nurses Association. In response to the segregated medical societies, Black doctors formed the West Virginia Medical Society in 1905 for African American doctors, dentists, and pharmacists. In October 1934, 29 Black nurses representing 7 West Virginia counties met in Charleston to establish the West Virginia Colored Graduate Nurses Association. Mrs. Mattie Boggs was the first president. Boggs was from Huntington and graduated from the Meharry Nursing School in Nashville, TN. She served as the supervisor of women at both Lakin State Hospital and Barnett Hospital, and later was a school nurse with the Cabell County Board of Education. In 1954, with the national end of segregation, African American and White professional nursing and medical associations officially merged. [6]
Dr. George Holley earned his medical degree at Howard University and operated a small sanitarium in Hinton, WV. He is pictured here with his wife Georgia and two sons, George William Jr. and Charles Amos. History of Summers County, West Virginia, 1984.
Changes in the 1920s and 1930s caused many of the small hospitals to close their nursing education programs. In the late 1910s, the National League for Nursing Education released its first Standard Curriculum for Schools of Nursing. As a result, many states assessed the nursing programs within their states and changed their state standards. The West Virginia State Nurse’s Association did a study of the state’s nursing programs and adopted a standard curriculum in 1927. These new regulations added new requirements that many small hospitals were unable to provide. That and the impact of the Great Depression meant that, by the end of WWII, there were no nursing schools in Appalachia open to African American students. This coinciding with the decline of the coal industry in the mid-century decreased healthcare options for Black residents until desegregation. In West Virginia, between 1931 and 1942 there were 204 Black nurses employed in the state for a population of 118,000-121,000 African American residents. [7]
While segregation stayed in place until after 1954, there were some early attempts at desegregation in medical care and education in West Virginia. Before 1950, African Americans nurses found employment almost exclusively in Black hospitals. But with few Black hospitals in West Virginia, the options were limited. Larger state hospitals like Lakin and Denmar employed up to ten nurses, while small private hospitals usually had just two or three on staff. Integration in West Virginia’s hospitals began at the Welch Miners Hospital, which hired Black nurses as early as the 1930s. But integration was not supported by all West Virginians. When St. Francis Hospital in Charleston hired three Black nurses in 1950-1951, twenty White nurses walked off the job in protest. Administrator Sister Helen Clare held firm and filled the vacancies rather than fire the Black nurses. [8]
St. Francis Hospital, Charleston, W. Va. Published by The S. Spencer Moore Company, c. 1918. West Virginia & Regional History Center.
St. Mary’s Hospital in Clarksburg, the first nursing school in West Virginia to accept students of color, admitted two Black students in 1949. Between 1953 and 1969, St. Mary’s admitted thirty more Black students, twenty-two of whom graduated. Barbara Jean Williams Flewellyn, class of 1957, recalled that African American students “were not treated any differently in their assignments of living quarters, patients they cared for, or manner of guidance and discipline.” Although St. Mary’s nursing program was integrated, students still experienced racial segregation outside the hospital’s walls at local restaurants and theaters. [9]
Part II: African American Hospitals in West Virginia
Due to segregation and the high demand for medical care in the African American communities, Black doctors set up practices and hospitals to care for members of their communities. Most African American hospitals in Appalachia were small, accommodating between 10 and 30 patients. At times, the hospitals with good air flow, heat, and electricity were the best buildings within an African American community. [10]
Prior to the mid-1880s there was only a small population of African Americans in southern West Virginia. It was the rise of the commercial mining industry, and its related industries, that brough more Black laborers and their families into the region. By the late 1880s, the Black population had grown so much that some communities had a majority Black population. Around 75% of West Virginia’s Black population lived within 100 miles of Bluefield. Due to the increasing population of miners and industrial workers in the southern part of the state, Bluefield had a high concentration of medical facilities, particularly those that treated African American patients. Segregation required separate medical facilities. There were two White hospital and two Black hospitals, plus a significant number of Black physicians, dentists, and pharmacists. Bluefield was the only city in West Virginia that had two Black hospitals operating at the same time. [11]
Bluefield’s White hospitals were opened first. Bluefield Sanitarium, considered the flagship institution for care, was opened in 1902 by Dr. J. Franke Fox on Bland Street. The hospital moved once to a new property in 1907 and then a new hospital building was constructed on Ramsey Street in 1913. St. Luke’s Hospital opened in 1904 on the corner of Raleigh and Bland Streets by Dr. Charles M Scott. The original building was expanded twice, in 1910 and 1915, before a new building was constructed for the hospital at Bland and South Streets in 1925. While White patients had two options by 1904, it would be several more years before the two Black hospitals opened their doors. [12]
The two White hospitals in Bluefield, Bluefield Sanitarium and St. Luke’s Hospital, were better equipped compared to their Black counterparts. Neither hospital accepted Black patients, but the Sanitarium would sometimes perform surgeries that could not be provided by the two Black hospitals. In those cases, the Sanitarium would perform the surgeries, but the Black patients were not allowed to stay to recuperate. They were immediately transported back to Lomax or Providence hospitals once they were awake from the anesthesia. This was often detrimental to the condition of the patients, especially since there was no ambulance service, and patients were often transported in the hearses of local undertakers. [13]
To meet the needs of Black patients, Edwards Hospital, or Mercer Sanitarium, was founded sometime by the year 1912 by Dr. Nathaniel L. Edwards on Scott Street in Bluefield. Edwards arrived in Bluefield in the early 1900s and was appointed by the governor to represent West Virginia at a tuberculosis convention in 1920. After Edwards’ death around 1920, Mercer Sanitarium continued to operate under Drs. J.E. Hereford, W.A. Brown, and C.A. Rogers. By 1927, Mercer Sanitarium no longer operated, and C.A. Rogers ran Providence Hospital on Scott Street with his wife, Madeline Rogers, as superintendent. A few years later, Providence Hospital moved to a brick building further up Scott Street that could hold 25 patients. [14]
Providence Hospital in Bluefield. West Virginia Bureau of Negro Welfare and Statistics, 1933-1934 Report.
Eugene W. Lomax opened his Bluefield hospital in a frame house on Bland Street by the year 1915. He attended medical school at Shaw University in Raleigh, NC, and interned at Freedman’s Hospital in Washington, D.C. He had a medical practice in Fairmont, WV, for two years before moving to Bluefield in 1907. In 1926, Lomax replaced the original building with a new brick hospital. Doctor Lomax died soon after the new building was completed on September 30, 1927. The hospital was then run by Dr. William Andrew Brown and the institution was renamed the Brown Hospital, then later renamed again to Saint Mary’s Hospital. The updated hospital could accommodate fifty patients and had two ambulance entrances and a home to house the hospital’s nurses on site. Other special features included six private rooms and a sun parlor containing four beds for recuperating patients. Brown’s Hospital had a nursing school until the 1950s that earned a Class-A rating from the WV Board of Nursing and was the only such hospital program to be accredited by the state. [15]
In addition to the concentration of hospitals in Bluefield, two black hospitals served southern West Virginia in Kimball and Charleston, Harrison Hospital and Crichlow Hospital, respectively. Dr. Roscoe Conkling Harrison was born in North Carolina on February 19, 1880, and grew up in Raleigh where his grandfather owned a farm that he purchased after his emancipation from slavery. He also lived and attended school in Alabama and Tennessee before he moved to West Virginia when he was 17. He attended Bluefield Colored Institute and worked in the mines between school sessions to pay for his schooling and support his siblings. After graduating, Harrison attended Meharry Medical College in Nashville, earned his medical degree in 1904, and then returned to the West Virginia coalfields, where he knew there was a need for medical care. He set up a practice in Kimball right after graduation and, in 1913, he established a hospital for African Americans with 20 beds. He and seven other doctors performed more than 300 major surgeries in the first 18 months of the hospital’s operation. In 1915, Harrison raised $5,000 for a new 20-bed hospital and designated 10 beds for free care to poor, working-class Blacks. In addition to running his hospital, Harrison was appointed by West Virginia governor John J. Cornwell as Examining Physician on draft boards in 1917 and 1918, was the president of the Flat Top Medical Society and the State Medical Society, and was a member of the commission to establish the Denmar Tuberculosis Sanitarium. [16]
Harrison Hospital in Kimball, WV. Kimball, West Virginia.
After Dr. Harrison passed away in 1923, Dr. Dodford Dismukes took over the hospital. Dismukes was from Alabama, graduated from Howard Medical School in 1921, and completed an internship in surgery and was on the surgical staff of Freedmen’s Hospital in Washington D.C. in 1921. He successfully campaigned for a new 50-bed hospital, which opened in 1930 and boasted a radio in every room. The new hospital was named Henrietta Dismukes Hospital, after his mother, and cost $75,000 to build. Dismukes constructed the hospital after making an agreement with Bluefield Sanitarium that Black patients would be sent to Dismukes for surgery as long as Dismukes built a modern and fully equipped operating and surgery suite. The agreement fell through, however, and Dismukes filed a lawsuit against Bluefield Sanitarium for breach of contract because it had reneged on its promise to send African American patients to Dismukes. The jury found in favor of Dismukes, but only awarded him $4,000 instead of the $150,000 he requested to cover the loss of building the new facility. With that financial loss, the facility closed in 1935 due to insolvency brought on in part by the Great Depression. [17]
Until 1950, no Charleston-area hospitals accepted African American patients as equals. Dr. Benjamin Augustus Crichlow established the first Black hospital in Charleston around 1913. The hospital, which included an operating room, initially occupied the second and third floors of his family home but later moved to a separate building. Dr. Crichlow closed the hospital in 1918 after he became medical superintendent at the West Virginia State Colored Tuberculosis Sanitarium at Denmar, where he worked for 17 years. When Crichlow returned to Charleston, he reopened a private practice, but not the hospital. [18]
Superintendent and Staff, State Colored Tuberculosis Sanitarium, Pocahontas County, W. Va. June 1927. West Virginia & Regional History Center.
A second hospital was later opened in Charleston because the White-owned hospitals were overcrowded and there was demand for a hospital to care for Black patients. Known as Community Hospital, it opened on November 5, 1924. It was established by laymen, not physicians, and its mission was to provide care rather than make profit. It was reportedly a modern facility with the capacity to treat 30 patients. It closed sometime in the late 1920s. [19]
An additional hub of African American workers was Huntington because it was the western terminus of the Chesapeake & Ohio Railroad. With laborers moving to the region to work for the railroads, the Chesapeake and Ohio Railroad Employee Hospital Association was founded in 1897 to offer medical care to its employees. Employees paid a small monthly rate, and the association would offer pre-paid care. The C&O constructed two hospitals in Huntington and Clifton Forge, VA. The Huntington hospital opened in 1900 in a former residence built by Peter Cline Buffington, the city’s first mayor, at the intersection of 6th Avenue and 18th Street. [20]
The C&O Hospital initially refused Black patients, causing a lack of medical options for African American workers. Of the five hospitals in Huntington, all either denied Black patients or provided segregated care, and did not allow for Black physicians or nurses. In 1909, an African American coal miner named Walter Brown fell from a train at the C&O railroad and was severely injured. The C&O Hospital refused to admit him and the man lay unattended for hours until the Kessler Hospital finally allowed him in. Brown died on the operating table due to the long wait for treatment. After this experience, Dr. Clinton C. Barnett started planning to open a hospital for African American patients with Clara Matthews, his second wife and a trained nurse. [21]
Dr. Barnett was born November 30, 1869, in Virginia to formerly enslaved parents. His family moved to Huntington in 1871. Barnett attended the University of Michigan at Ann Arbor and then Howard University, where he received his MD in 1899. After graduating, he initially worked at the West Virginia Hospital for the Insane at Weston before returning to Huntington in 1902 and beginning his medical practice. The two-story frame house that became the Barnett Hospital was originally purchased by Barnett’s first wife, Kate A. Whiting. When she died in 1909, she left the property to her husband. Barnett remarried to Clara, who had graduated from Virginia Seminary and College, then trained as a nurse at Lincoln Hospital School of Nursing in New York. Clara Barnett obtained her West Virginia nursing license and supervised the nurses in the hospital. [22]
Barnett Hospital and Nurses Training Home, Huntington, W. Va. June 1919. West Virginia & Regional History Center.
The hospital had an X-ray room, an operating room, and between 25 and 30 beds; this later expanded to 50 beds and two operating rooms. Ten doctors and eight nurses were affiliated with the hospital. In 1918, Barnett Hospital opened a nursing school led by Clara, one of the few nursing programs located within a black hospital. In 1925, the Barnetts expanded and improved the hospital building. However, also in 1925, the WV Governor appointed Dr. Barnett to be the first superintendent for the Lakin State Hospital for the Colored Insane. In the late 1920s, the Barnetts leased the hospital to the City of Huntington for use as a city hospital, but the hardships of the Great Depression took a toll. During the Depression, the mortgage company took ownership of the building, although the city continued to lease it as a city hospital and provide free care during the decade. The finances finally failed, and the hospital faced foreclosure. It closed in August 1939, four years after the death of its founder, Dr. Barnett. Clara Barnett continued to work as a nurse until at least 1938. [23]
Eventually the C&O hospital accepted Black patients. When the C&O hospital outgrew the original building, they built a new four-story hospital building at the end of the 1920s. At that point, the original building was used to house Black patients. The Association closed its hospitals in the 1960s. In 1971, the building was renamed to Doctor’s Memorial Hospital in honor of three Huntington doctors who were killed in the 1970 Marshall University plane crash (Drs. H.D. “Pete” Proctor, Ray R. Hagley, and Joseph E. Chambers). Four years later, the hospital was purchased by Marshall University for use by the new medical school. The building was demolished in 2001 to make way for a student parking lot. [24]
After Brown v. Board of Education in 1954, hospitals began to integrate along with the rest of American society. Separate hospitals and medical education programs were no longer necessary, and new opportunities opened for the next generation of Black West Virginians. While many of these small hospitals have faded into the background of memory or been lost to demolition, during the first part of the twentieth century, they were crucial services to Black communities. With West Virginia having one of the largest populations of African Americans in Appalachia in the early century, it is unique in having the largest number of hospitals and educational opportunities for Black residents during the last decades of segregation. In addition, these medical services supported the economic boom of West Virginia in coal and industry.