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Friday, 7 August 2015

The "Imagine" Reality Check: Health Care Infrastructure Part 1, Hospitals

 Singer/songwriter John Lennon wanted people to "imagine there's no heaven...no religion too." Applying that vision specifically to what the world would be like without the Christian religion, I will examine what it would mean for health care in the West

   I will not claim that Christianity can take credit for all the medical knowledge and advancements that exist in the world.  China, the Indian subcontinent, Egypt and Greece from ancient times held a body of medical knowledge that developed independently of that in Medieval Europe.  One example of their crossing paths occurred when British doctor, Edward Jenner, used the preventative technique of variolation (applying a small amount of a small pox pustule to a skin scratch of a healthy person) common in Chinese medicine.  Eventually, that practice led to the introduction of vaccines for smallpox, followed by other types of vaccines according to the same rationale [1].

   Nevertheless, one of the things we take for granted in our medical system, the hospital, is a direct legacy from Christianity.  Having a specialized facility where very ill people can be cared for when they are unable to stay at home is something we expect to find in every decent sized town or city in the West.  How did this come to be?
Freerange Stock photo
   The first public [where care was given free of charge] hospital was established by Christian leader Basil the Great in the fourth century A.D. in what is now Kayseri, Turkey.  The institutions prior to that one could not truly be called hosptials.  For example, ill people were welcomed in temples of the Greek god Asclepius.  However, there is no evidence that trained physicians attended them; instead the hope for the patient came only in proximity to the god of healing.  There is evidence that if a patient was not expected to survive, he would be turned away at such a temple because it would bring impurity to the holy place. [2] The Romans did have hospitals called valetudinarian, but they were intended for soldiers only.  The state and wealthy people funded these institutions that were deemed crucial to the maintenance and expansion of the Empire.
   When Basil constructed the complex of buildings we could call the first hospital, it was known as a “new city.”  According to Robert Louis Wilken, it “included medical facilities for the sick staffed with nurses and physicians, living space for the elderly and infirm, a hostel for travelers, a hospice for lepers who had been driven from the city because of disfigurement, a church and a monastery” as well as kitchens, baths, stables and storehouses for supplies. [3] Basil the Great was building upon an early tradition within Christian monasteries of the East, where medical care for both monks and members of the community was part of their ministry.  This idea spread to some monasteries in medieval Europe as well.
   The first hospitals in France were established by church leaders and were known as Hotel-Dieu (hostel of God); they particularly reached out to the poor and needy.  Admittedly, some basic knowledge of sanitation in hospitals was lacking during the medieval period, but the idea of quarantine during the Black Plague appears to have been derived by clergy in Vienna going back to the societal laws contained in the books of Moses, especially Leviticus.  The isolation of a sick person so that his illness could not spread to the healthy population, given as a directive from God, was thousands of years ahead of the scientific knowledge of the spread of germs. [4]
   Turning to the new world, the first hospital in North America was built in Mexico City in the early 1500’s and named after Jesus of Nazareth.  In Canada, an order of Catholic Sisters established the first Hotel Dieu in Quebec City in 1639.  The first US hospital would appear to have no religious affiliation since Benjamin Franklin is credited with its founding.  But even this is misleading. Benjamin Franklin cannot be separated from the faith in which he was raised.  He believed that faith had to lead to action and service to one’s fellow man. Says biographer John Fea, “Although he [Franklin] never returned to the Calvinism of his childhood, the religion of his parents leavened much of his adult thinking. Franklin believed in a Creator - God who possessed great wisdom, goodness, and power. This God not only created the world, but sustained it.” [5]
   In my very own city, there are three hospitals, two of which have distinct Christian roots.  Freeport Hospital was originally a sanatorium to treat people with tuberculosis, often called consumption, but the person who spearheaded its founding was Rev. Dr. Oberlander.  This pastor was distressed by the deaths of children and adults in the community and gathered physicians to see if better treatment could be put in place for those struggling with this illness [6].  St. Mary’s Hospital, as its name suggests, was birthed as a ministry of the Roman Catholic Church, through the Sisters of St. Joseph of Hamilton, in 1924.
   Since many hospitals doubled as teaching and/or research centres, many of the medical innovations and standards of care that we are accustomed to also rest on the foundation of the institution of the hospital.


Another fundamental aspect of medical care in the West is the nursing profession.  Next time I will outline the links between nursing care and Christian faith in action.

[1] Kate Kelly. The History of Medicine: Early Civilizations (2009), p. 84-85.
[2] Gary Ferngren. Medicine and Religion: A Historical Overview. Baltimore, MD: Johns Hopkins UP, (20140, p. 91-92.
[3] Robert Louis Wilken. The First Thousand Years: A Global History of Christianity. Yale University Press (2012), p. 159-160.
[4] Leviticus 13-15 can be consulted for more detail.  See also Grant R. Jeffrey, The Signature of God  (1998), pages 145-6
[5] By John Fea. “ Religion and Early Politics: Benjamin Franklin’s Religious Beliefs.” Pennsylvania Heritage Magazine Volume XXXVII, Number 4 - Fall 2011.  Accessible on the web by clicking here.
[6] William V. Uttley. A History of Kitchener, Ontario (1937), p. 404-405.


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