The colony’s first major health crisis came in 1789, with the outbreak of smallpox. While the British settlers seemed mysteriously immune, the disease devastated the Gadigal people and other Aboriginal groups. One of the most poignant stories is that of Nanbaree, a young Gadigal boy who arrived at the hospital with his ailing father.

While his father succumbed to the illness, Nanbaree stayed with the settlers, eventually joining explorer Matthew Flinders on his voyages of coastal exploration in 1802–03.

Another tragic figure was Arabanoo, a key liaison between the British and the Gadigal. Despite his efforts to bridge the cultural divide, Arabanoo fell victim to smallpox in May 1789, highlighting the devastating impact of introduced diseases on the First Nations peoples.

The arrival of the Second Fleet in June 1790 brought further challenges. Nearly 300 of its passengers were gravely ill, with 90 dying shortly after arrival—casualties of overcrowded, disease-ridden ships. Early Sydney lacked the infrastructure to deal with such an influx of patients, and the hospital overflowed with the sick and dying.

A cemetery from this time is believed to have existed somewhere in The Rocks, a silent testament to the fragility of life in the colony’s early years.

As the colony grew, so did its medical facilities. In 1816, a grand new hospital was constructed on Macquarie Street. Here, female convicts worked as nurses, providing care in conditions that still fell far short of modern standards.

Two of these buildings remain today: NSW Parliament House and the Mint Museum, living monuments to the evolution of healthcare in New South Wales.

From its humble beginnings as a timber-and-canvas structure to the grand sandstone hospital of Macquarie Street, the story of Sydney’s early medical care is a testament to the grit and ingenuity of those who worked tirelessly to heal a growing colony.

Head up the stairs in the corner of the Colony exhibit to see the transition from a stark penal colony to the thriving Port of Sydney Cove.