Early history of hospitals ... Happy Deepavilli!

Historically the care for the sick tended to occur within temples and other religious establishments. This I believe was largely related to the tendency to associate illness and healing with spiritual events. Thus the early concept of hospitals in Europe was nothing like what we encounter nowadays.

The earliest evidence of a specially constructed facility for the care of sick was apparently in Sri Lanka. This was early as the 3rd to 4th Century BC. According Wikipedia, the Carakasamhita (Compendium of Caraka) and descriptions by the travelling monk Fa Xian, India probably had the first "organized cosmopolitan system of institutionally-based medical provision" in the world. This was approximately at the turn of the first millenium. Europe continued to develop their hospital concept largely as part of the religious establishment, the modern hospital concept seen in Asia and Persia never really took root until the social and civic reforms following the French Revolution.

This perspective is important to have as we look at the continued evolution of health care provision. The usually eurocentric portrayal of medical history tends to convey the fallacious idea that all things good flowed out of Europe. This is only true to a certain extent because of the renaissance and the industrial revolution. But it is important to recognize that that renaissance was deeply rooted in wisdom that had originally flowed westwards from Asia.

This is a good account to read:
Medicine and Society in the Medieval Hospital by Tatjana Buklijaš (2008)

India was very much where the action was in the development of the modern hospital concept. And they were more than half a millenium ahead of Europe.

Nice to know that....especially as we head towards the Deepavalli celebrations.

Happy Deepavalli all!

Happy Deepavalli!!!

Happy Deepavalli!! Happy Harvest!!

Today my Hindu friends celebrate Deepavalli. With this celebration of Deepavalli, the third of our ethnic groups complete their festivals during this time of year (the earlier ones being Zhongqiujie and Hari Raya). There is really no great mystery surrounding the clustering of these festivals during this part of the calendar. They all probably had their origins as autumnal agricultural festivals which subsequently took on spiritual and religious (or national) significance.

Deepavalli's roots are shrouded in mystery, but most believe it has its origins as a harvest festival.

Autumn is a significant time of year in the agricultural calendar of the northern hemisphere. Crops planted in Spring ripen and are collected in the harvest. Agricultural communities celebrate this gathering of the harvest through various thanksgiving feasts. Often lights are featured, as in Deepavalli, perhaps as a recognition of the lengthening nights as Winter approaches. Even the Jewish communities celebrate a Festival of the Ingathering. This subsequently became the Feast of the Tabernacles which they use to commemorate the exodus out of Egyptian slavery.

But what of the harvest in Singapore? We have left our agricultural roots long ago.

We need to remember that our plenty of today is a harvest of the seeds sown by the previous generation. As we continue to reap the harvest despite the economic downturn, we should remember those who had planted seeds with foresight and diligence. Some thanksgiving in due.

But going forward, we should also be very mindful of what we are sowing for the next crop. So here's my plea to the leaders of today. Do not look just at the short term gains as indicated by superficial metrics. This has tended too much to be the management norm of today. While there is little doubting the longer term mission spelt out by our senior political leaders, the middle management levels have tended too much to just focus on short term metric indicators of performance. It's tempting to do so because individual performance looks good, but too much preoccupation with short term goals may ultimately undermine our very existence.

So where medical education and practice is concerned, let us please look at look the ultimate future of our health care system. Let's not screw it up or (as frighteningly overheard coming from a very senior person in YLL), cause it to implode.

Happy Deepavalli, all. And have a great weekend.