Today, contagious diseases in American tend to fall into two categories: the annoying, like the flu or common cold; and the exotic, like SARS or Ebola. To most people born after the 1960’s, pandemics are a thing of the past, or relegated to third world countries. But even 100 years ago, contagious diseases like scarlet fever, meningitis, and diphtheria were a part of daily life – and death.
As early as 1885, the city board of health in Detroit was proposing building a contagious diseases hospital as “an absolute necessity for the treatment of diphtheria and scarlet fever, both of which always prevail to a greater or lesser extent in the city.” A year later, 10 acres of land that were - at the time - far outside the city limits was leased, and a wood frame smallpox clinic was built where the Herman Kiefer Hospital stands today.
Clinics were built as needed during outbreaks of diseases like smallpox and the measles, treating victims until the disease was contained. As the city’s population swelled, due in large part to the number of European immigrants moving to Detroit in the 1890’s, outbreaks became larger and deadlier. At the time, contagious diseases were poorly understood by the public, and reaction to the construction of so-called “pest tents” was not welcomed by neighbors. In 1892, the city’s only contagious diseases hospital was burned down in a fire deemed “suspicious,” but requests by health officials for funds to build a permanent facility were turned down by the city council.
After major outbreaks of smallpox in 1903 and scarlet fever in 1905 pushed local hospitals to the limit, plans for a permanent contagious diseases hospital were drawn up. The $100,000 project called for three buildings – one for scarlet fever, one for diphtheria, and the third for other contagious diseases. Initially, the hospital was to be built on Brush at Alexandrine, where the present-day Children’s Hospital of Michigan is located, but protests and lawsuits filed by nearby residents stalled construction. Eventually, the Brush Street location was abandoned, and the city opted to buy more land along Hamilton, where a smallpox clinic had been built in 1893.
By 1908, a third major disease was causing serious concern in the Detroit health community. Tuberculosis, a highly contagious and often-fatal disease affecting the lungs and pulmonary system had been on the rise for years, spread in part by poor sanitary conditions in the city’s slum neighborhoods. To combat the disease, the smallpox clinic on Hamilton was quietly converted into a tuberculosis hospital.
Treatment of tuberculosis in the days before antibiotics was primitive; it was believed that exposing the patient to clean, fresh air would clear the lungs. Patients were housed in special tents, which allowed for a constant flow of fresh air. The first tent along Hamilton was set up in February of 1908; by August, the New Detroit Sanatorium Tent Colony had eight tuberculosis tents arranged around an administration building, and was filled to capacity. A further six tents were added in 1909, sponsored by the Red Cross, individual donors, and fraternal organizations.
Plans for a permanent hospital started to move forward in 1911 with the construction of the first two pavilions of the hospital. Designed by architect George Mason, the pavilion 1, then known as the north ward, was for the treatment of scarlet fever, and could hold 40 patients. It was connected to the administration building by an enclosed tunnel, and featured modern decontamination areas so doctors and workers don’t take the disease home with them. Initially the hospital was to be named for Guy Kiefer, a city health official who had worked for years to get a permanent hospital for contagious diseases, but out of modesty he declined, and requested that it be named for his father, a well-known physician and civil rights activist.
The Herman Kiefer Hospital for Contagious Disease opened on April 31st, 1911, with an open house that drew thousands of curious onlookers. A few weeks later, over 50 physicians attending the annual clinic of the alumni association of the Detroit College of Medicine inspected the hospital, “Shrouded from head to foot in white sheets like a Ku Klux Klan.” Patients in different stages of scarlet fever were wheeled out and lectured on by Dr. Guy Kiefer. The hospital and its facilities were favorably received by the guests, who declared it one of the most modern and complete hospitals of its kind.
Work started on a pavilion 2 a short time later, which was essentially identical to pavilion 1, except that it was for diphtheria patients. All of the buildings were designed with expansion in mind; additional floors were added as needed over the next few years. Construction continued through 1913, with pavilions 3, 4, and 5, as well as a nurse’s home were added in this time. Pavilion 4 was called a “three-in-one” building, as it was designed to treat three different, small contagious diseases under one roof. A new scarlet fever wing opened in 1915.
1917 to 1920 were difficult years for the hospital. By 1918 the number of cases admitted to Herman Kiefer had risen to nearly 3,500 patients, and the hospital struggled with manpower shortages due to the First World War just as a major influenza outbreak was starting. Staff were often called upon to do work outside of their normal positions; the hospital superintendent helped out in the morgue, and a nurse drove the ambulance when the driver got sick. Treatment periods were long - scarlet fever took about five weeks hospital stay, diphtheria 13 days, and measles two weeks.
By 1919, Herman Kiefer Hospital had grown to include five pavilions. Pavilion 1 housed diphtheria cases, pavilion 2 was for scarlet fever, pavilion 3 for influenza and tuberculosis, and pavilion 4 was for various diseases including erysipelas, infantile paralysis, spinal meningitis, mumps, and measles. Pavilion 5, the receiving hospital, also had a roof garden where an open-air school for the kids was offered. In the winter, they wore “Eskimo suits” of heavy cloth to keep them warm. A maternity ward with 60 beds opened on hospital grounds to relieve overcrowding at nearby hospitals.
While Herman Kiefer Hospital focused on treatment, it also worked to educate the community about contagious diseases, and how they could be prevented. Despite these efforts though, a combination of increased European immigrants and black migrants from the south into poor housing situations caused an increase in the number of smallpox cases. In 1921, voters approved a $3 million dollar bond for the construction of new facilities at the hospital. The Department of Health commissioned architect Albert Kahn to design additions to the hospital, including pavilions 6 and 7, and a modern powerhouse, which were finished in 1922.
The single largest change to Herman Kiefer Hospital was the construction of the current main building along Taylor and the M-10 freeway. Bids for a six or seven story structure were sought in June of 1927 to relieve congestion at the other pavilions and replace the aging tuberculosis houses, some of which dated back to the 1890’s. Construction began in July of 1927, with work expected to take 10 months. Over the fall and winter the main wing of Herman Kiefer Hospital started to take shape, as scaffolding rose around an H-shaped brick building. The outside structure was completed by April of 1928, and interior work continued until the end of the year.
On it’s opening in December of 1928, the $2.75 million dollar hospital was hailed as a “model ford world in design and facilities.” Instead of the crowded wards of the pavilions, where 10 or more patients shared a large room, the new hospital instead had private single and double rooms, adding 500 beds of capacity to the campus. “Sun porches” located on balconies and on the roof aided in the “open air” treatment of tubercular cases, allowing patients fresh air and sunlight. Four surgical suites on the top floor were augmented by spacious glass-enclosed porches, specially designed to allow ultraviolet light in, which was believed to be beneficial to the patient. 30 modern laboratories handled much of the city’s diagnostic work, while an auditorium in the basement was used to demonstrate medical procedures.
By 1930, Herman Kiefer hospital had 1,265 beds spread out over 6 pavilions and the main hospital. A portion of the powerhouse was used for the quarantine and hospitalization of prostitutes who had venereal diseases, a controversial program that was not formally part of the hospital. As medical science advanced, some diseases like smallpox, measles, and yellow fever began to recede, but cases of tuberculosis remained high. The hospital changed the configuration of its buildings as patient requirements dictated, and by the 1940’s and 50’s tuberculosis and polio were the primary concern. In 1951 pavilion 4 was converted from an obstetrics unit to a tuberculosis unit, while pavilion 7 was converted into a polio treatment center, but the number of people awaiting admission to the hospital for treatment numbered in the hundreds.
To meet the increased demand, a new addition onto the main building was announced in 1952. The $2.5 million dollar wing would add 250 beds, mostly for tuberculosis treatment. Initially the T-shaped addition to the west side of the building was supposed to match the original architecture, but for budgetary reasons, it was done in a more modern style. The new wing was dedicated in May of 1954, adding 252 beds with modern amenities such as televisions and power-adjustable beds. At that time, though, the fifth floor of the addition was left unfinished. Polio treatment started to include the use of “iron lungs” in 1958.
Though the number of contagious diseases cases started to diminish in the 1960’s with the introduction of vaccines, people still got sick. Increasingly the patients admitted to Herman Kiefer were very old, indigent, and had social problems. Complaints about alcohol abuse, especially around the holidays, sparked an investigation by the mayor’s office that found that liquor was being smuggled into the hospital by visitors. The building began to deteriorate, as lack of maintenance and funds left routine cleaning to the patients themselves. In 1963, the remaining sun porches were demolished to relieve weight after cracks were discovered in three reinforced concrete beams.
In September of 1968, the Michigan State Department of Health investigated Herman Kiefer for alleged charges including patient mistreatment, maggots in the food, and an infestation of cockroaches. A report in the Free Press described the hospital as “big and old and dreary.” There were only 575 patients “vegetating”, including 94 psychiatric cases sent over from the crowded Detroit General Hospital. Patients had little to do during the treatment period, which usually lasted around five months, as the movie program has been discontinued due to lack of interest. “Nothing about Kiefer was pleasant – from the barbed wire on the top of the psychiatric section roof, to the dirty kitchen in the basement.”
By 1969, the hospital had begun scaling back its tuberculosis clinic operations as the number of cases continued to drop. At its peak in 1928 the hospital recorded 1,756 deaths from communicable diseases, a number which had fallen to under 100. Pavilions 3 and 5 had been vacated and demolished in 1964 to make way for the new Sanders Elementary School built on the southwest corner of the property. Though Herman Kiefer continued handling tuberculosis cases into the 1980’s, most of the hospital campus was converted for other uses, including a general hospital, medical clinic, laboratories, drug treatment center, and state psychiatric ward. Pavilion 2 was sold to the Detroit Public Schools, which used it for a nursing job-training program before closing and abandoning it. The nurse’s home to the south of pavilion 2 was demolished in the 1980’s. At some point the department of vital records moved birth and death certificates into the hospital, becoming its largest tenant. The campus was renamed the Herman Kiefer Health Complex.
In 2003, voters rejected a bond that would have upgraded and renovated the hospital, which was in poor structural shape. Several of the pavilions were vacated as the programs housed in them closed due to budget cuts. A methadone clinic inside the hospital was shut down in 2009, as was a juvenile detention facility. Still, in 2010, an estimated 2,000 people visited the center every day for HIV testing, health fairs, vaccinations, substance abuse counseling, death certificates, and birth records.
It was in 2010 that the city announced it was considering shutting down Herman Kiefer for budgetary reasons, given the age of the building and lack of occupancy. A year later, however, Mayor Dave Bing reversed course, and moved the Department of Health and Human Services out of its location on the east side of the city into Herman Kiefer due to hazardous health conditions inside the building. In July, $800,000 in renovations to the fifth and six floors of the main wing of Herman Kiefer began, with the mayor suggesting the renovation and moving be paid for out of funds taken from Head Start and other programs. The move stirred up controversy as Head Start was already under-funded, and conditions at the Herman Kiefer building were considered worse than the existing building Health and Human Services was located in.
Shortly after the department moved into Herman Kiefer though, in January of 2012, a section of the sixth floor ceiling collapsed on a worker, injuring him. Investigations reveled that the renovations done to the floor had been cosmetic, including patching a hole in the ceiling and painting over it, but the patch eroded away due to flooding on the floor above it. The union representing the worker complained that they had raised concerns about the structural soundness of the room before work was done, but nothing had come of it. It raised further questions about the viability of the building, and why the move had been made in the first place. But the questions became moot just two months later, when in March of 2012, the Department of Health and Human Services was shut down by the city due to massive corruption. A Free Press investigation revealed that funds meant for the poor were instead used by officials for personal expenses including a car, appliances, and home repairs.
Eventually, the roles of the Department of Health and Human Services were taken over by a non-profit agency, but the last of the major tenants at Herman Kiefer were leaving. The health clinic and pharmacy closed in January of 2012, and the remaining office of vital records closed on October 22nd, 2013. Workers immediately began removing equipment and records from the buildings, which so far have totaled over 300 tons in weight.
Today the Herman Kiefer Health Complex is in limbo. Private security guards patrol the grounds to keep out scrappers, and the heat has been turned off to save power. The city has no need for the 8 buildings that make up the campus, some of which are over 100 years old and haven’t been used in years. In March of 2014 the city announced that it is seeking plans to redevelop Herman Kiefer by outside developers. If none of the bids turn out to be viable, the city plans on stripping the building of its metal and demolishing it.