During this period (the first half of the 19th century), hospitals were staffed primarily by religious orders. Therefore, when the Colombian government persecuted them, Santo Tomás Hospital was significantly affected. However, in 1864, 1867, 1868, and 1878, the Legislative Assemblies of the Sovereign State of Panama allocated sums of money for the repair of the hospital building and the construction of new wards.

Beginning in 1886, Monsignor Fermín Jované, president of the Board of Directors of Santo Tomás Hospital, acquired a plot of land for the expansion of the hospital, thus initiating a phase of improvement in its facilities.

Political conflicts led to the outbreak of the so-called Thousand Days' War (1899-1902), which affected Panama, a department of Colombia. During this armed conflict, Santo Tomás Hospital served as a primary care hospital; consequently, by the time of Panama's separation from Colombia, the hospital was in a deplorable state.

After Colombia's separation, the United States took control of the sanitation of both the Canal Zone and the cities of Panama and Colón. The Canal Zone government arranged for the Santo Tomás Hospital building to be repaired and expanded. It was also reinforced with new equipment, American doctors and nurses working alongside Panamanians. The level of medical care improved rapidly, as these professionals brought new techniques and knowledge to care for the sick.

• Obstetrics and Gynecology

• Neonatology

• Pediatrics

• Pediatric Surgery

• Maternal-Fetal Medicine

• Emergency care for mothers and children

• Infectious diseases (notably tuberculosis care and complications)

The hospital is regarded as one of the best places to learn about and practice pediatric and maternal care in Panama, with a strong focus on timely, comprehensive, and compassionate treatment for vulnerable populations