Ivory-towers are places of seclusion. Its inmates are often busy in their own pursuits, unaware of the world outside. Critics often equate hospitals to ivory-towers, both from a position of strength and weakness. Regardless, hospitals house suffering as well as joy, pain as well as curse, deaths as well as births. In this blog I explore stories and trivia behind some such hospitals outside of India. (For India please see a previous blog here). I have made this selection based on my collection of postage stamps. Each hospital is unique and offers a different-stroke (like a popular sitcom from 1970s) in our medical history.
1. When did we have our first ivory-towers ?
Ancient healers practiced in temples or places of worship. Healing was closely related to religion, magic, and supernatural. Hospitals were an extension of monasteries. We find earliest descriptions of a separate building for them in the Roman era. Roman army built such buildings for the wounded soldiers. Public health-facilities were to follow. Reigning monarchs established earliest such facilities as a charity for destitute and lepers. Today, archeological remains of such buildings exist in Europe, Syria, and Iran. However, two such oldest surviving institutions are from medieval period in France (Hotel-Dieu est. 829 AD)and England (St Bartholomew’s est. 1123 AD) .
As hospitals grew and became more important, governments took them over. First Hotel-Dieu in Paris (est. 829) was a charity to shelter poor. Church provided funds for it to run. Six centuries later, it had became too crowded and unmanageable. In 1505, monarchy took it over. A few years earlier in 1443, Chancellor of Burgundy established Hôtel-Dieu de Beaune as a response to war, famine, and plague. In 1123 Rahare, a courtier of King of England, Henry-I established St Bartholomew’s hospital or Barts. About 400 years later, monarchy took over all monasteries and their hospitals. This changed funding source to royalty. Today all health facilities are under UK’s NHS.
2. A Small hospital with a tragic history and four postage stamps
Falkland Islands, is a British territory located near Argentina. Less than 4000 people live in these islands. First health-facility on the island was Victoria cottage, originally built in 1912. British army expanded it in 1914 as King Edward Memorial (KEM) hospital. It was made of wood, and it had no fire-exits. In 1984, a devastating fire destroyed the entire structure. Fire also led to tragic death of a nurse Barbara Chick, and seven others. Rebuilt in 1987, today KEM hospital has 29 beds (18 for acute care, 7 for long care, 2 for ICU, and 1 each for maternity and isolation). This facility is also a referral location for Antarctica, Tristan and South Georgia.
3. Abandoned or destroyed by politics, revolution, and war
A stamp from Iceland shows a Leprosy hospital inaugurated in 1898. It was converted into barracks in 1940 by occupying British forces. It was destroyed and burnt to ground in 1943.
Cuba
Let’s rewind to 1936, when tuberculosis was a formidable disease. Patients sought private sanatoria, tucked away in the mountains, far away from the cities. Fulgenico Batista, who controlled Cuba in 1936 declared that he will built a “government sanatorium” with 1000 beds, so that “there is a bed for every tubercular”.First brick for this colossal sanatorium was laid in 1937, it was still not ready in 1944. Batista left the country the same year, as his chosen successor could not win elections.
Batista staged another coup in 1952, and regained power. Sanatorium was now complete. This ivory-tower, jutted out of the hills. Batista named it after himself and inaugurated it in 1954. However, this 1000-bed sanatorium only had 400-500 patient-beds (remaining were in staff-hostels). In the meantime, treatments for tuberculosis had changed. We had antibiotics, and did not need sanatoria. Batista also fled to Portugal after 1959 Cuban revolution. Revolutionary Government in Cuba abandoned this sanitorium, and briefly converted it to a school. Today it is a health-hotel and a more of a curiosity. Post-revolution Cuba has focussed on public health, smaller facilities and polyclinics. A postage stamp from Cuba in the panel shows one such polyclinic, constructed in 1965.
Iceland
Leprosy was a dreaded disease in Iceland. In 1898, Iceland, had a population of about 70,000 and about 250 had leprosy. Danish fraternity financed the construction of Laugarnes Hospital to fight and eradicate the disease. At that time of completion, this wooden building was largest structure in the country. By 1929, there were only 37 remaining cases. In 1940, when British invaded Iceland, they occupied the building and converted it in barracks. A massive fire in 1943 destroyed the building, without any casualties. In 1998, Iceland issued a postal stamp in its remembrance.
4. Ivory-towers in Himalayas, Only two stamps to show
There were four Himalayan kingdoms between India and China: Nepal, Sikkim, Tibet and Bhutan. Their proximity to the British was in the same order. Today, Bhutan is the only remaining kingdom. Nepal has became democratic, Sikkim and Tibet are parts of India and China respectively. British established first modern hospital in India in 1664. It took 200 years more to initiate first one in any of the Himalayan kingdoms.
Nepal
Rana’s of Nepal supported British during India’s 1857 war of independence. This earned them freedom. As a further reward, British decorated Bir Shumsher, then Prime minister of Nepal. He established Bir Hospital in 1889, first in a Himalayan kingdom. Initially Indian doctors staffed Bir Hospital. Over the years, it grew, and now is Nepal’s National Academy of Medical Sciences.
Sikkim
In 1849, two British physicians Campbell and Dalton entered Sikkim, without permission of the Chogyal, then Sikkimese King. Their detention led to a war. Sikkim lost this war, became a British protectorate. Government established its first hospital in 1917, and named it after Sir Thudop Namgyal, (STNM) reining Chogyal monarch till 1914. India merged Sikkim as its state in 1975, and expanded healthcare in the state. Today Sikkim has a medical college, and In 2019, state inaugurated a new 1000-bedded STNM hospital.
Tibet
Tibet had its own ancient system of medicine. It was an enigma for the British, as its geography was unknown till 1903-04. Modern medicine entered Tibet in 1904, when British established a dispensary in Gyantse in Southern Tibet. Later, in 1936 Lhasa had first British doctors. China merged Tibet as its autonomous region in 1951 and currently governs its healthcare system.
Bhutan
Bhutan has always stayed independent. For long, it had closed its borders for all foreigners, and followed traditional medicinal practices. It was only in 1951-52, that Bhutan had its first doctors of modern medicine. These doctors were Bhutanese nationals, who were trained in medical schools in India. First hospital in Bhutan was opened in Thimphu in 1961. Monarchy upgraded it in 1972, and named it as Jigme-Dorji-Wangchuk-National-Referral-hospital (JDWNRH). Today Bhutan has 28 hospitals, and it does not allow any privately owned health facilities.
5. Common names in the Commonwealth
What’s in a name, that which we call a rose by any other name would smell just as sweet“
We do not know if above quote by English playwright Shakespere is true. Across the commonwealth, British established various hospitals and many of these share a common name. Wiki lists 34 Victoria, 4 King George’s and King Edward’s each, 9 Princess Margaret’s, and 17 Queen Elizabeth’s. This list is likely to be incomplete. However, numbers are likely to be proportional to duration and hospitals available for inauguration during their reins. Some have had their reincarnations and name changes. Two such examples are from St Lucia and The Bahamas.
St Lucia is an island country of about 180,000 people in the Caribbean. Since 1887, and till covid-pandemic, Victoria was its largest hospital. While a new hospital was ready in 2019, shifting to a new facility was getting delayed. Covid pandemic hastened this delayed transition. As covid struck, entire hospital shifted to Owen King’s European Union hospital (OKEUH), leaving Victoria to care for Covid. Owen King is not a Royal, but a surgeon from St Lucia. Today Victoria is retrofitted as a dedicated covid / respiratory hospital.
Bahamas is an archipelago, home to more than twice as many people as St Lucia. Its hospitals have a chequered hospital history. It’s first hospital (called African hospital) was made for the arriving salves. This facility had a short stint from 1780-1836. Then came Pauper hospital, and an asylum, that was named as Victoria Jubilee hospital in 1893. It gave way to Bahamas General hospital in 1908, and a New Bahamas General hospital in 1952. Finally, it was renamed as Princess Margaret hospital in 1955.
6. More white than ivory – University hospitals
If hospitals are ivory, university hospitals are of a higher order. These combine health-care delivery, with teaching and research. In some countries university hospitals also known as teaching hospitals or medical-colleges. There were more than 30 university hospitals in Europe in early 1600s, and subsequently more were added. Two of these are depicted in the following panel. Affiliate hospital of Humboldt University was established in 1709, and university itself in 1810. Various luminaries like Virchow, Biswanger, and Koch have all worked here. In 1756, Turku hospital was established. It was second only to Copenhagen in all of the Nordic countries. These were to become a global phenomenon.
Japanese established National Taiwan University hospital in 1895. Today it is a leading centre for heart transplantation. Centre Hospitalier et Universitaire de Yaoundé or CHU in Cameroon Africa is a new university in equatorial Africa. A Presidential Order established it in 1965, while it started functioning only in 1978.
7. A Health-facility for children
Till about a hundred years ago, care for children was linked to that of mothers. While first orphanages were set up in mid 1400s, there were no specialised child health centers. Hôpital des Enfants Malades in Paris, France, which opened in 1802 was a first child hospital. It was followed by others in London (1852), Pennsylvania (1855), and Toronto (1875). Pediatrics started to separate from adult medicine. In Greece, pediatrics department was created in 1879, and first Children’s hospital in Greece (Agia Sofia) was established in 1938. Iceland had its first children hospital only in 1957.
8. Early healthcare facilities in the new world
Columbus discovered the new world in 1498, and he first reached an island he named as San Salvador. It is currently in The Bahamas. Soon thereafter other islands and the mainland was discovered. Over next two centuries English and French colonised the north, Portuguese and Spaniards south.
Colonisers from the old world carried diseases such as small-pox and malaria to the new world. They brought back syphillis. Early health-facilities were set up in the regions most frequented by the explorers. First ten hospitals in the Americas came up between 1503 and 1533 in Haiti, Mexico and Guatemala.
Latin America
Missionaries were the first to explore newer lands. They established hospitals in Peru (Nacional dos de mayo, 1538), Chile (San Juan de dios 1552) and in Bogotá Columbia (1564) . Portuguese religious charity Santa Casa had set up a first hospital in Brazil in 1539. Such facilities in North America were to come up much later.
North America
It was to take another 100 years to establish first hospital in North America in Quebec in 1639. US was still more than 100 years away. Public hospitals were setup in NewYork (Bellevue) and Louisiana in 1736, and a private hospital in Pennsylvania in 1751. More public health-care facilities in New York (1771), John Hopkins (1773), and Boston (1796) were to follow suit. New York hospital of 1771 is today known as Columbia / Presbyterian New-York–hospital.
Equatorial Africa and Australia were the last continents to be discovered, and colonised. Again, missionaries and humanists were the first to establish medical systems. They were followed by the red-cross and more recently local governments
Its my endeavour to have more philately material on global health-facilities, especially in Africa and Australia. Please do watch out this space for more.
A very informative and interesting writeup,Sir.
Hospitals are still the most sought after buildings by humans. Learnt a lot from this piece of writing