A few people with leprosy from Caledon were sent to the Island at the end of 1845 and were joined by others from Port Elizabeth in January 1846. Most of the chronically sick people sent to the Island were old ex-slaves and the ‘lunatics’ were overflows from prison infirmaries on the mainland.
The lepers were housed in the old stables, “lunatics” occupied the old prison next to the church, chronically sick men in the guard house, overseer’s house, a converted lime kiln and another two cottages. Chronically sick females were housed in the Commandant’s residence after he left the Island. By May 1847 the total number of patients on the Island was 194. Seventy two (72) of these were chronically ill people, 68 were ‘lunatics’ and 54 were people with leprosy.
The number of staff on the Island was small and all three patient groups were expected to assist with nursing, carrying water and landing stores, mending and washing clothes and performing other general chores. Medical attention and the diet that was provided was reportedly inadequate. Given the overall isolation of the Island, staff members were able to exercise great control over the lives of patients. All in all, the social and medical profile of the patients shows that the Island as a General Infirmary was used more as a place of exclusion than of healing.