Young Black boys slept back to back in cramped rooms at the House of Reformation for Colored Boys, a juvenile correctional institution in Cheltenham, Maryland. The boys were allowed to bathe once a week, often sharing towels. As punishment, they were held in isolation cells, crawling with bugs, for days. Many Cheltenham inmates contracted tuberculosis, despite warnings to the facility’s management about unsanitary conditions.
At least 86 boys died of tuberculosis at Cheltenham from 1887 to 1936, according to a Capital News Service analysis of death certificate records.
The health conditions of Cheltenham are expected to be among the areas explored by a special investigative commission, approved by Maryland lawmakers earlier this month. The commission is due to submit a report to the governor and Maryland General Assembly by 2029. Capital News Service journalists began examining the health issues in January through archival research and data analysis of historic documents.
Thousands of young boys were incarcerated at the House of Reformation, now known as Cheltenham Youth Detention Center. For many years, the facility lacked a full-time physician and competent medical staff. “We were shocked to find the hospital without a single attendant, in our opinion, with the training or knowledge necessary to take care of the sick. There were four or five patients in bed at the hospital, some apparently were very ill,” a March 5, 1935, grand jury report said.
“Although a Doctor visits them every day or two, the sight of them lying there, possibly waiting for death, made a most disagreeable impression upon each of your committee members,” the grand jury report said. The facility’s purported nurse never graduated from high school and was a former plumber and factory worker, according to a 1934 report by the Child Welfare League of America.
The Child Welfare League, grand jury investigators and other independent monitors blamed Cheltenham management for doing little to curb the deaths by tuberculosis.
“It is probable that some boys have acquired this disease at Cheltenham,” according to the 1934 Child Welfare League report. “Until the management has provided enough medical service and adequate diet, over a period of several years, and can prove that those with this disease contracted it before admission, this presumption will be justified.”
A Baltimore grand jury regularly inspected Cheltenham and, as early as 1926, called for transferring boys with tuberculosis to hospitals. There were obstacles. Henryton State Hospital, the only colored sanatorium in the state, refused to accept inmates, according to a 1929 letter.
“It would be a grave mistake to accept this type of case,” the hospital’s superintendent wrote in a letter. “I am strongly opposed to accepting cases, at Henryton, from correctional institutions.”
The reports from the Baltimore grand jury in the mid-1930s criticized Cheltenham management for the “disregard for mentality and health of boys when crowded in the dormitories.”
The grand jury from 1935 reported there were 402 boys at Cheltenham at the time, “many of whom had venereal diseases and tuberculosis.”
By the late 19th century, tuberculosis was the leading cause of death across the United States, killing one in seven Americans. The disease was referred to as consumption because it appeared to “consume” the body. Black communities across the United States were disproportionately affected by the epidemic. In 1916, Black people in Maryland were dying of the disease twice as often as white people, according to the Maryland Association for the Prevention and Relief of Tuberculosis.
“There was this astonishing rate of tuberculosis among Black Americans, and that it posed a threat to white populations,” said Dillon Prus, a medical student at the University of Connecticut, who wrote an honors thesis on the racialization of tuberculosis.
Prus said racially discriminatory rhetoric during the epidemic described the high rates as the “Negro Tuberculosis Problem.” “But also on a more ideological level, there was this idea that the black race was inferior, that it was uniquely susceptible to tuberculosis,” he said.
It’s possible most of the Cheltenham boys had tuberculosis, even if they didn’t show signs of illness, before they reached the facility, Prus said. The poor management at the institution complicated the situation.
“If you’re living in a space where you’re not bathing, there’s not enough room and one person starts coughing, it’s game over for the rest of them,” Prus said.
Tuberculosis deaths were substantially higher at Cheltenham than at the all-white boys correctional facility, House of Refuge for Juvenile Delinquents, now the Charles H. Hickey, Jr. School in Baltimore County. In 60 years, the House of Refuge reported an estimated 26 deaths within the facility, with mention of no more than a dozen cases of tuberculosis, most of which ended in recovery, according to a CNS analysis of annual and biennial reports from Hickey.
An 1894 Hickey report said “no epidemics of any kind have broken out.”
Reports from Cheltenham were starkly different. “We cannot condemn too strongly the health conditions, especially tuberculosis at this Institution, some of which the authorities are not responsible for,” a 1934 Cheltenham report read.
A 1915 Cheltenham annual report described how “boys who are committed to this institution are supposed to be sound mentally and physically. … However, many have been received in declining health owing to the fact that there is no other place to care for them.”
“This state of affairs should not exist.”
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