Colonial power

The hospitals

The hospitals were an important part of the health care system on St. Croix, St. Thomas and St. John. There were three types of hospitals: garrison hospitals, plantation hospitals and hospitals for lepers.
The hospital at estate North Star, St. Croix.
The hospital at estate North Star, St. Croix, 1831. Danish National Archives, Den Vestindiske Gælds Likvidationsdirektion (“Royal West India Debt Liquidation Directorate The West India Debt Liquidation Directorate”), archive no. 681, Likvidationskommissionen (“West Indian Debt Liquidation Commission The Debt Liquidation Commission”) for St. Croix, Sager og rapporter vedr. de enkelte plantager på St. Croix (“Files and reports concerning individual plantations on St. Croix Cases and reports concerning the individual estates on St. Croix”) 1787-1847, North Star 1831-1832, serial no. 46.17.53, case nos. 450 and 509. Bar code: 8011327891]

Regardless of which type of hospital was involved, the hospital was not a place anyone wished to be. Until the end of the 1800s, the hospital was a place where the risk of dying was far greater than if you were treated at home. That’s how it was in Europe, and that’s how it was in the Caribbean. Therefore, hospitals were also primarily intended for population groups that did not have a family to take care of them, or which served others. They might be the poor, soldiers or enslaved laborers. All others were treated at home and taken care of by the family.

The garrison hospitals

Beginning around the middle of the 1700s, there were three garrison hospitals in the Danish West Indies, one in each of the three towns of Charlotte Amalie, Christiansted and Frederiksted. The first one was established on St. Thomas in 1743, and the others in the period of about 1759 to 1772. The structure of the three government hospitals seems for all essential purposes to have been maintained during the entire Danish period.

Report with drawing of a hospital

A report about the garrison hospital in Frederiksted from 1780 provides a rare insight into what this type of hospital looked like, and how it was arranged (see illustration below). The hospital building itself – on the drawing below called “den gamle bygning” (“the old building”) – was approximately 25 meters long and approximately 6 meters wide. It was built of pine logs and covered on the roof and walls with pine shingles, which was common in the colony. There were large windows on the building’s long sides, so the wind could keep the temperature down inside. The foundation was brick.

Banana leaf pillows

In each of the three sick wards, there were eight beds. The bedclothes were a sheet and a pillow stuffed with dried banana leaves. The staff consisted of the garrison surgeon, the “landlord” and a number of enslaved laborers. The surgeon kept an eye on everything medical, while the landlord was responsible for purchasing food and overseeing food preparation and cleaning. It was the enslaved laborers, however, that were responsible for the majority of the work, i.e., cleaning, food preparation and caring for the sick.

In addition to the hospital building itself, the hospital also had a kitchen, a building for the enslaved laborers and a large kitchen garden, where the enslaved grew food for themselves and herbs for the sick.

The plantation hospitals

Most plantations had a hospital or sickroom where the enslaved laborers were admitted if the plantation owner or the overseer thought they were sick enough. The plantation doctor only came by once or twice a week to attend to the sick, or if acute disease broke out. It was the nurse that managed the plantation hospital on a daily basis, and she was also an enslaved laborer.

Plantation hospitals could look very different, but they often had two rooms with beds, one for men and one for women, and a kitchen where the nurse prepared medicine and food for the sick (see illustration above).

Also penal institutions

The plantation hospitals also functioned as penal institutions. There was often a “bøie”, i.e., a pillory, in the hospital, where enslaved laborers could be locked up as a milder form of punishment than whipping. In addition, the hospital often had bars on the windows and the door was equipped with a lock. The purpose was to frighten the enslaved away from lying about being sick in order to avoid working.

The leprosy hospitals

It is not known when leprosy first appeared in the Danish West Indies, but in any event the disease was present from 1768 onward. Beginning around 1810, there was a desire for a special hospital for the lepers on St. Croix. But the first “leprosarium” (hospital for lepers) in the colony is known from St. Thomas. It was on the peninsula Hassel Island and was in use 1833-1861. It was a very small, poorly-maintained and isolated hospital with about 10-20 regular residents. Subsequently, the lepers were transferred to a specially isolated building at the new municipal hospital in Charlotte Amalie.

Scandalous hospital on St. Croix

On St. Croix, a hospital for lepers was still sought, but it was first opened in 1888 on estate Richmond outside Christiansted. However, a thorough examination of the hospital in 1903 showed that the conditions were so poor that it was almost scandalous. For that reason, the Order of Odd Fellows in Denmark collected funds for the establishment of a new and satisfactory hospital for lepers, which opened in 1909.


Niklas Thode Jensen, For the Health of the Enslaved: Slaves, Medicine and Power in the Danish West Indies, 1803-1848. Copenhagen: Museum Tusculanum Press, 2012.

Torben Geill, “Spedalskhed i Dansk Vestindien” (“Leprosy in the Danish West Indies”), Dansk Medicinhistorisk Årbog, 1977. pp. 140-167.

The military hospital in Frederiksted, c. 1778, drawn by Peter Lotharius Oxholm.
The military hospital in Frederiksted, c. 1778, drawn by Peter Lotharius Oxholm. Danish National Archives, Rentekammeret (“Chamber of Revenue “), archive no. 303, Kort og tegninger (“Maps and drawings”) 1600-1920, map no. 337.326.