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• In 1940, the highest-ranking recorded "causes of death" in the Territory were heart diseases, cancer, and kidney failure. 122/

• In 1942, during the second World War, diphtheria involved 90. The following year, mosquito-borne dengue affected scores. 123/

• In 1950, the top reported "causes of death" were heart diseases, cancer, and stroke. 124/

• In 1958, acute poliomyelitis struck 77. 125/

Health Measures

The following anti-disease actions parallel similar developments on the U.S. mainland, but with some features distinctive of Hawaii and the native Hawaiian people.

• In 1899, after the annexation of Hawaii to the United States as a territory, the first sewers were laid in Honolulu, then a city of 40,000. 126/

• In 1902, what is now Leahi Hospital opened on the mauka slope of Diamond Head in Kaimuki, Honolulu, as the Home for the Incurables, with four wards. It was a private institution created with contributions from nine wealthy businessmen of the haole oligarchy and $750 from the Board of Health. 127/ The proportion of tuberculous patients rose from 50 percent initially, to 100 percent in 1950, when the Territorial Government built a new hospital wing and assumed operating expenses for the hospital, with free medical care for TB patients. 128/ In 1968, the hospital became a State institution of the University of Hawaii School of Medicine. In 1976, it was transferred to the Staff Department of Health. 129/

• In 1908, the U.S. Congress generously provided $300,000 for the ambitious U.S. Leprosy Investigation Station on the Kalaupapa peninsula, Molokai. Only 9 of the 700 patients at the settlement agreed to participate in the Station's investigations, and then only for a few days, so the elaborate facility was compelled to shut down after only two years. 130/ In l980, the U.S. Ccnqress approved the recommendations of a commission that Kalaupapa be preserved indefinitely for the remaining leprosy patients there, and then become an historical and cultural reserve under the U.S. National Park Service. 131/ Active cases of leprosy are now treated at Leahi Hospital in Honolulu, but some patients are still championing the right to remain in the non-hospital, rural cottage setting of Hale Mohalu in Pearl City on Oahu. 132/

• In 1911, the first resident intern was appointed in Hawaii at the Queen's Hospital, a haole medical graduate from California. 133/

• In 1914, the first public health nurse was appointed by the Board of Health. 134/

• In 1916, the first school of nursing in Hawaii started at the Queen's Hospital. 135/

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