Although a modern state of the art hospital today, the original buildings were a Convict Station housing workers at the Kowie Harbour development. The premises were converted to a mental institution during 1891. For nearly three decades, Port Alfred had the largest convict station in South Africa. Five hundred prisoners of many races, aged from seventeen to seventy, toiled in the quarry, and were used to strengthen the breakwaters and build the stonewalls seen today along the banks of the river. Men serving life sentences at the Kowie, were guarded by British soldiers. Used as a mental hospital. In 1901 during the Anglo Boer War, some of the hospital buildings were used by the British Military as a Confinement camp to accommodate Boer refugees. In early 1900’s the name changed to the Kowie Mental Hospital and in 1919 the medical superintendent of the hospital was instructed to establish sports facilities inside the hospital grounds for patients and staff. In 1924 it was decided to transfer all white patients to Robben Island, and this process took about 4 years, thereafter only black patients were admitted. One white patient refused to be transferred and remained to do occupational therapy a building was named after her Annie Lombard. Patients were referred to mental hospital from all around south Africa. In 1984 the inpatient portion of the psychiatric hospital closed and only out-patient facilities remained.