The origins of Western healthcare

We take it for granted that caring for the sick is a good thing. Why?



The leper priest


We take it for granted that caring for the sick is a good thing. Why?


SIMON SMART: It wasn’t just the poor who benefitted when Christians heeded the lesson of the Good Samaritan and Jesus’ other teachings.

From the beginning, the followers of Jesus saw the sick and the dying as their neighbour, deserving of love and care. In fact, that’s one of the reasons why the early church grew so rapidly.

In 165AD, a terrible plague hit the entire Roman world. It lasted for 15 years. There was another one nearly a century later that ran for almost 20 years. At the height of these plagues, in Rome alone, up to 5000 people were dying every day.

NICK SPENCER: There’s good evidence that during the plagues that ravaged the ancient world, Christians tended to stay in the cities (rich people fled) and looked after plague victims and looked after one another as well. In other words, there was a practical demonstration of this love, which went hand in hand with the theoretical articulation of this love, which slowly and partially reformed the classical mind.

LYNN COHICK: Well Christians believe that each person is made in the image of God, and thus each person should be cared for, even if they are very ill. And so Christians were known to care for people who had the plague, and this shocked pagans, who were really anxious to get out of the way of any kind of sickness – they just would flee a city or a town. And the Christians stayed. That made a real impact on the pagans, who wondered, “How could these Christians love, even at the cost, perhaps, of their own lives?”

JOHN DICKSON: The Christian response to illness wasn’t just an emergency measure. In about 390, the first public hospital in Western Europe was founded in Rome, by a woman called Fabiola.

Fabiola was from one of the seven founding families of Rome, and was one of the wealthiest people in the city. At some point – we don’t quite know when – she became a Christian. She sold everything she had and used the money to help the poor and needy.

When Fabiola opened her hospital, the idea of free public healthcare was so new, so radical, that no-one showed up – they just couldn’t believe it was true! So she went out on the streets, searching for the desperately ill, and sometimes carrying them herself back to the hospital.

Jerome, a distinguished church father and Fabiola’s mentor, wrote warmly of her after her death.

ACTOR (JEROME): She founded an infirmary and gathered into it sufferers from the streets, giving a nurse’s care to poor bodies worn with sickness and hunger – maimed noses, lost eyes, scorched feet, leprous arms, swollen bellies. How often she carried on her own shoulders poor filthy wretches tortured by epilepsy! How often did she wash away the purulent matters from wounds which others could not even endure to look at! She gave food with her own hands, and even when a man was but a breathing corpse, she would moisten his lips with drops of water. Rome was not large enough for her kindness.

JOHN DICKSON: It’s said that at her funeral all Rome turned out, and that the passion of the occasion exceeded Rome’s military parades.

SIMON SMART: For many centuries, Christians were about the only ones in the game. Monasteries and cathedrals were built with hospitals attached, and if you needed one, you’d be nursed by monks or nuns.

Even today, when Western governments mostly take charge of health care for their citizens, the churches are still heavily involved in looking after the sick and the elderly.

But not everyone has found such behaviour praiseworthy. The 19th-century philosopher Friedrich Nietzsche condemned Judaism and Christianity for giving special attention to the sick – turning Nature’s values upside down.

ACTOR (FRIEDRICH NIETZSCHE): This Jesus of Nazareth, the incarnate gospel of love, this “Redeemer” bringing salvation and victory to the poor, the sick, the sinners –  was he not really temptation in its most sinister and irresistible form? Preventing the sick from making the healthy sick – this ought to be our supreme object in the world. But for this it is above all essential that the healthy remain separated from the sick, that they should even guard themselves from the look of the sick, that they not even associate with the sick. The higher must not degrade itself by becoming the tool of the lower.

SIMON SMART: Nietzsche was horrified that Christian compassion had so shaped Western culture, when nature intended the strong to thrive and the weak to disappear.

Maybe Nietzsche’s right, it might not be natural to care for people like this. But when I’m weak and sick, as I’m sure to be at some point in my life, I’m glad to know there are people who’ll care for me.

DAVID BENTLEY HART: People take it for granted that institutions of public welfare, that free hospitals, that care for the poor, is actually a social good, a demand made on us as moral beings whether it’s economically feasible or not, whether it’s socially necessary or not. Nonetheless, we take that for granted.