Taluk Headquarters Hospital (THQH), Punalur, holds a legacy that stretches back over a century. Established in 1921, during the reign of Maharaja Sri Moolam Thirunal Rama Varma (1885–1924), the respected ruler of the princely state of Travancore, the hospital stands as one of the oldest healthcare institutions in Kerala. Located in Punalur taluk, the largest taluk in Kerala, the hospital was originally founded to serve a geographically challenging and socially underserved region. The southeastern hilly belt of the state, where Punalur lies, has long faced significant developmental disadvantages, especially in terms of access to quality healthcare. This hospital emerged as a crucial secondary care center for the region, providing a medical lifeline to its people — particularly vital for the 21 tribal settlements it serves, out of the 23 in the entire Kollam district. Today, with a sanctioned bed strength of 419, THQH Punalur routinely handles more than 426 inpatients and receives 2,500 to 3,100 outpatients daily — the highest outpatient load among all taluk hospitals in Kerala. The hospital has grown not only in capacity but also in its commitment to equitable healthcare, continuing its foundational mission to serve the most backward and remote populations of southern Kerala with compassion and clinical excellence.