In 1936 Sr.Friedericke planted the palm trees which are still standing in front of the hospital. She (apparently) was a very keen gardener, and saw to most of the gardening and the paving around the hospital.

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At the beginning of the 1940's, the hospital had 80 beds, which again proved inadequate, and by 1942, construction was again underway, and by 1943, the hospital boasted with 90 beds, which were constantly full resulting from a bitter cold winter bringing cases of bad influenza. At the same time, scarlet fever and small pox broke out among the children. 1946 brought and remodeling and renovation to single rooms. On July 14, 1947, the Prime Minister of the Union of South Africa, Jan Christiaan Smuts, visited the Roman Catholic Hospital, writing this entry: 'I leave my best wishes for the welfare of this charitable institution. God's blessing for the Superior and the Sisters of this hospital.' In his address to the Sister Superior he said: "I take off my hat in respect for you and your co-workers. I say: God bless you. I know a good thing when I see one. Here's a good thing. It was a great honor for me, and a priviledge to be able to visit your hospital" He was particularly impressed by the efficiency and cleanliness of the hospital and its very modern equipment.

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In July 1954, the surgeons had to move to new operating rooms. The new surgical theatre brought up to date sterilizing, light , air and cooling installations. There was also a new x-ray machine installed. More and more lay nurses, besides the religious Sisters, were appointed who tended to the sick.

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In 1955, the first lift in South West Africa, was installed by Otis, and was placed next to the Theatre at RCH. The original lift is still in use, although some modifications were done in 2000 to keep it going. During that time the running water (cold) was put into the rooms.

Towards about the end of 1968, a new hospital was build at Katutura, and was considered the most modern hospital in Southern Africa. This was also the first hospital to have an intensive care unit. Even the patients from the Roman Catholic Hospital who at that time needed intensive care, were directed to Katutura Hospital.

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1960 saw another thorough renovation which was completed in 1961 and was claimed to 'meet the latest requirements. In 1962 a surgery table was donated and installed by the German Federal Republic, and in 1964 from the same source came the generous gift of an x-ray intensifier, which was still unknown to the South African doctors.