At the end of the Civil War, 360,000 Virginia freedmen and freedwomen were homeless. Exposure, hunger, and dysentery led to high death rates, especially in cities like Lynchburg.
Immediately after the war the Freedmen’s Bureau set up hospitals and dispensaries all over the South. Only one, Freedmen’s Hospital in Washington, DC, later the Howard University Medical Center, remained open after 1868.
In 1869 the Howard University School of Medicine was founded to train “colored doctors.” Seven years later Meharry Medical College was founded in Nashville, Tennessee, for the same purpose. Until the mid 1960s, these two schools trained nearly all of the nation’s¾ and nearly all of Lynchburg’s¾ black doctors.
Because there were so few places where African Americans could get medical training, and because they were excluded from hospital practice except in the few black hospitals, the supply of black doctors remained limited. The shortage of black doctors meant that health care for African American citizens continued to be inadequate.
By 1900, one in six black Virginians lived in cities, usually in crowded, poor neighborhoods where syphilis and tuberculosis ran rampant and infant mortality rates were high. Malaria, yellow fever, tetanus, rickets, and worms were common. So were “low blood” (anemia) and “high blood” (hypertension). Koch’s 1882 germ theory of disease had little effect on the health of poor black Virginians.
Segregation was legal during this period. Health care, too, was divided. Public hospitals like the Central State Hospital for Negro Insane, established in 1870, opened to care for the poor, who were mostly black. Private hospitals cared for whites.
The South was gaining a reputation for backwardness because of its high rates of disease. Many whites blamed the region’s bad reputation and poor health on the supposed inferiority of African Americans.