The Byzantine Empire is primarily known for its political and religious machinations, but how many of us knew that it was one of the first societies to offer its citizens some form of what we now call universal healthcare?
Beyond their renowned art and architecture, the Byzantines made other significant contributions. Their legacy and contributions extend beyond aesthetics and go deep into social welfare.
A remarkable healthcare system flourished within the empire, providing free medical care to the poor. This ensured that access to life-saving treatment wasn’t determined by financial means, preventing people from dying simply due to lack of funds.
Why did the Byzantine Empire place such emphasis on healthcare?
This might sound revolutionary to an American audience used to the notion of private healthcare, however, the Byzantines’ belief in free healthcare for the poor stemmed directly from Christianity.
Rooted in the Christian values of charity, compassion and assistance to those in need, this system of free healthcare for the poor was a truly revolutionary model of social welfare by the standards of the medieval world.
The concept of free healthcare in the Byzantine Empire was not just a political decision of a progressive ruler. It gradually emerged from a deeply-rooted Christian faith and the belief that philanthropy should be at the core of a society that proudly calls itself Christian.
Inspired by teachings such as the directive of Jesus Christ Himself to care for the sick and needy, the Church of the Byzantine Empire worked with the official administration to establish hospitals.
Hospitals in the Byzantine Empire were known as ”nosokomeia” which is the Greek word still used to this day to describe hospitals in Greece and Cyprus.
Apart from the nosokomeia though, the Church in the Byzantine Empire established hospices and other charitable institutions that would support the sick and needy. These facilities were designed to serve those who could not afford the medical treatment that those of the higher social classes could.
This ensured that poverty did not bar access to care, something that, unfortunately, is still not the case in some places around the world.
The Byzantine hospitals or ‘nosokomeia’
The first hospitals of the Byzantine Empire appeared as early as the 4th century AD.
A notable example of one of the first hospitals established in the Byzantine Empire was St. Basil’s ”Basileias” in the city of Caesarea, which provided shelter as well as free medical care for the sick and homeless of the city and its surroundings.
By the 6th century, hospitals had become widespread across the Empire, with the capital city of Constantinople having some of the most advanced facilities in the entire Byzantine world.
Byzantine hospitals were very well-organised institutions that indeed resembled modern healthcare facilities. They featured separate wards for men and women to offer patients privacy. They also included specialised departments for different illnesses, similar to today’s separate wards and departments in bigger hospitals.
The hospitals of the Byzantine Empire were actually run by properly trained medical staff, including physicians and nurses, who took good care of those most in need of support.
Major hospitals like the Pantokrator Monastery in Constantinople even included teaching facilities for medical students, where younger individuals could get a first-hand and on-the-ground education that would equip them with the necessary skills to become physicians or nurses.
But most importantly, these hospitals offered free treatment to the poor.
Wealthier patients were charged fees based on their wealth, but no one was turned away because of inability to pay, something that we sadly see to this very day in some parts of the world.
This inclusive universal approach reflected a deeply rooted Christian belief of the Byzantines that illness was something that affected people regardless of their social class and that healthcare was a moral obligation that a Christian society should offer to its members.
Beyond hospitals, the healthcare system of the Byzantine Empire also extended to rural areas through monastic clinics.
There were even specialised institutions that were designed for specific health needs, such as leper houses and maternity clinics, where women could give birth to their children.
The Church also employed deaconesses and social workers, who were known as ”paravolanoi.” Their task was to provide home care for the sick and elderly in a similar manner to today’s care providers.
This innovative and revolutionary approach of the Byzantine Empire towards healthcare inspired later European hospital systems.
