By 1975 New York City had run out of money. The City of New York faced a fiscal crisis that precipitated massive budget cuts to almost all public services. With the budget problems too big for the City to solve itself, the Emergency Financial Control Board was created to rein in spending. Run by New York State, the ECFB successfully slashed the City’s budget, defunding libraries, schools, welfare programs, public transit, hospitals and more.

One of those cuts was Sydenham hospital, a Harlem based health center that historically served and employed African Americans. Sydenham Hospital was founded in 1892 as a private hospital corporation but by 1949 due to shaky finances it became a part of the municipal hospital system. This meant that Sydenham became both funded by and controlled by local taxpayers and voters- or so they believed.

Edward I. Koch was elected Mayor in 1977 with the promise to revive the City.  Soon after taking office he announced that Sydenham Hospital in Harlem and the Metropolitan Hospital in East Harlem were to be closed. That same year, Harlem was designated a health disaster area by President Jimmy Carter’s Secretary of Health, Education and Welfare, Joseph Califano.

Harlem residents had been working with City government for decades to improve local healthcare outcomes and services to little avail. The Harlem Health Alliance was led by Marshall England, a long-time public health advocate with a focus on Manhattan’s poorer residents. He created a plan to improve Harlem’s healthcare system at the behest of Mayor John Lindsay, but the plan was never implemented. In the 1970s, Harlem residents worked with the Comprehensive Health Planning Agency, but still saw their healthcare quality decrease.

The Koch administration announced plans for new ambulatory clinics in Harlem, but it later became clear that these new clinics were meant to replace the much larger Sydenham and Metropolitan Hospitals. Despite the dwindling availability and level of care, healthcare costs continued to rise for Harlem residents.

The closure announcements immediately led to a backlash from Harlem residents. They formed groups like A Coalition to Save Sydenham that lobbied politicians, organized picket lines and tried to raise awareness of the implications of closing Sydenham. The Committee for Interns and Residents held a one-day walkout.

Although the hospital eventually closed in 1980 after years of debate between City and State government, protests grew in the lead up to its closure, ultimately resulting in an occupation by neighborhood residents who feared the loss of a vital part of their community. During the occupation the NYPD’s surveillance unit, the Bureau of Special Services and Investigation (BOSSI), created a number of 16mm black and white films to document the events and those involved.

Metropolitan Hospital in East Harlem was saved and still operates today but Sydenham could not be saved. In a final move, demonstrators forced their way into the building and began a 10- day occupation to halt the closure of the hospital.

The desperation of this move becomes more understandable when one compares the healthcare statistics of Harlem residents to other New York City neighborhoods. In 1977, the infant mortality rate in Harlem was twice that of the borough of Manhattan. The overall death rate in Harlem was 54% higher than other Manhattan neighborhoods, like Kips-Bay and Yorkville. Rates of tuberculosis infections in Harlem residents were more than twice that of the entire City in 19. Despite this glaring inequality, the City and State governments planned to close not one, but two public hospitals in Harlem against the wishes of the local taxpayers.

Although healthcare and poverty rates have improved in the City over the last 40 years, Harlem residents still suffer from higher infant mortality rates and premature deaths, less access to healthcare and far higher rates of asthma and other chronic conditions when compared to other parts of the City. In times of crisis, already underserved neighborhoods like Harlem get hit harder than others, further delaying the achievement of equitable healthcare outcomes for all New Yorkers. It is also in times of crisis that disparate communities come together in pursuit of a common goal. To those fortunate enough to have escaped the worst effects of the COVID-19 pandemic and its economic impact, please consider how you might be able to help those in dire need.

Years after he was no longer Mayor, Ed Koch famously said that closing Sydenham was a mistake.