Hospitals during the Islamic era

The idea of a hospital as an institutional place for the caring of the sick has not been recorded in antiqiuty. There were sanatoria and 'travel lodges' that were attached to temples where the sick were attended to by attendant priests. Most of the therapy in these sanatoria consisted of prayers and sacrifices to the gods of healing especially to Aaescalapius. Cures that ocured were thought to result from divine interventions.

A large number of hospitals were developed early during the Islamic era.They were to be called 'Bimaristan' or 'Maristan'. The idea of a hospital as a place where sick could get attention was totally adopted by the early Caliphs. The first hospital is creditied to Caliph Al-Walid I an Ummayad Caliph (86-96 AH 705-715 AD), by some it was however considered no more than a leprosoria because it allowed the seggregation of lepers from others. It did have on staff 'salaried doctors' to attend the sick.

The first true Islamic hospital was built during the reign of Caliph Harun-ul-Rashid (170-193 AH 786-809 AD). Having heard of the famous medical institution at Jundishapur already described above the Caliph invited the son of the chief physician, Jibrail Bakhtishu to come to Baghdad and head the new 'bimaristan' which he did.It rapidly achieved fame and led quickly to developments of other hospitals in Baghdad.

One of these the 'Audidi' hospital was to be built under the instructions of the great Islamic Physician Al-Razi. It is said that in order to select the best site for the hospital he had pieces of meat hung in various quartters of the city and watched their putrefaction and advised the Caliph to site the hospital where the putrefaction was the slowest and the least ! At its inception it had 24 physicians on staff including specialists categorized as Physiologists, oculists, surgeons and bonesetters. When Djubair visitied Baghdad in 580 AH/ 1184 AD he recorded that this hospital was 'like a great castle' with water supply from the tigris and all appurtenances of Royal Palaces.

One of the largest hospitals ever built was the Mansuri Hospital in Cairo it was completed in 1248 by the orders of the Mameluke ruler of Egypt, Mansur Qalaun. It was most elaborate. It had a total capacity of 8000 people ! The annual income from endowments alone was One million dirhams.

Men and women were admitted to separate wards. Irrespective of race religion and creed or citizenship (as specifically stated in the Waqf documents) nobody was ever turned away .There was no limit to the time the patient was treated as an inpatient ! (what a contrast from present HMO's !). There were separate wards for men and women and medicine, surgery, fevers and eye diseases had separate wards. It had its own pharmacy, library and lecture halls. It had a mosque for Muslim patients as well a chapel for Christian patients!

The Waqf document specifically stated: 'The hospital shall keep all patients, men and women until they are completely recovered. All costs are to be borne by the hospital whether the people come from afar or near, whether they are residents or foreigners, strong or weak, low or high, rich or poor, employed or unemployed, blind or sigted, physically or mentally ill, learned or illiterate. There are no conditions of consideration and payment; none is objected to or even indirectly hinted at for non-payment. The entire service is through the magnificence of Allah, the generous one.'

As to the physical conditions of these hospitals especially those established by princes, rulers and viziers it can be stated that some of these were luxurious and were actual palaces that had been converted to hospitals. Even contemporary Europe could not boast of a single hospital that came close to the facilities that were provided in these intitutions. Some of them especially in Baghdad, Egypt and Syria had furnishings were similar to those in the palaces.Most of theser being under the patronage of the viziers, sultans and caliphs were no doubt inspired by the Islamic teaching of the welfare of the poor and needy. The Quran tells us:

'You shall not attend to virtue unless you spend for the welfare of the poor from the choicest part of your wealth' (3,92) and again: 'O you who believe spend (for the poor) from the worthiest part of what you have earned and what your crop yields, and do not give away from its unworthy parts- such that you yourselves will not take until you examine the quality minutely- and know that Allah is not in your need and all praise belongs to Him.' (2,267).

As to the salaries of Physicians here is some information from authentic sources. The annual income of Jibrail ibn Bakitshu who was the Chief of Staff at a Baghdad hospital during the reign of Mamun ArRashid (d c.e 833/218 A.H.) as recorded by his own secretary was 4.9 million dirhams. His son also a doctor lived in a house in Baghdad that was air-conditioned by ice in summer and heated by charcoal in winter ! A resident by comparison who was supposed to be on duty for two days and two nights a week, was paid 300 dirhams a month. (Remind you of Denton Cooley and his fellows ?).

Adapted from the book: "Islamic Medicine" by: "Husain F.Nagamia"