Missionary Hospitals in Kashmir: Testimonials of how far we have come and how far we still need to go in terms of healthcare

By Nissar H. Gilani

Medical historians are quite sure that prehistoric people had no concept of Public health, though they had health problems just as we do today. Frankly, their lifestyles and life spans, the diseases would have been different from those we have today. Prehistoric people used medicinal herbs in those days. Limited evidence suggests that they used herbs and substances from natural resources as medicines.

The history of hospitals started before the Middle Ages in many parts of the world starting with Greece and Rome. Initially, some prayer places were dedicated to the sick and unwell. Several early cultures developed institutions to care for the sick. Greeks started from temples of worship, where the sick sought divine and natural cures. Christians believed that on the last day God would judge according to the love one had shown to those in need. In this connection, many local missionaries in Europe assisted the unfortunate and uncared persons. Over the centuries Christians in many parts of the world developed some places as hospices and subsequently created more specialized hospitals for the sick and needy. Early hospitals met their expenses from the revenue of lands that local priests had donated. Mediaeval Islamic Society maintained hospitals and was known as “Bimaristan”, often contracted to “Maristan”, from the Persian word “Bimar”, ill person.

The first known Islamic care centre was set up in a tent by AL-ASLAMIYAH  during the lifetime of Prophet Muhammad (peace be upon him) during the battle of the ditch  (Ghazwah Khandaq). She treated the wounded in a separate tent erected for them. The first Islamic Society maintained hospitals were founded in Baghdad Iraq during the reign of the Khalifa Haroon Al Rashid (786 to 809). According to a Governor of the caliph, Islamic hospitals had become common by the 82’s, subsequently, Muslims considered supporting hospitals as a mark of true piety.

After the Muslims conquered Sassanid Persia in the 7th century, they came in contact with distinctive sets of teaching. Impressed by Nestorian medical skills, they adopted many Syrian medical traditions, teaching methods, scientific texts, and hospitals as a model for shaping institutions. Although Islamic hospitals evolved from Christian institutions, they experienced a unique development. Deferred strikingly from their new Istanbul counterparts by including separate sections for mental patients. Gradually, the psychiatric wards became the most prominent features of such hospitals. Islamic hospitals served several purposes, a centre of medical treatment, a convalescent home for those recovering from illness, and a retirement home giving basic maintenance for the needy. All the hospitals in Islamic countries were mostly financed from the revenue of pious bequests called Waqfs.

KASHMIR  HOSPITALS

The idea of constructing a hospital in Srinagar struck Britishers in the year 1865. Dr William J Elmsile, who died at the young age of 42, was unable to get accommodation for his proposed hospital in Srinagar because both the ruler and his subjects were deadly against setting up a missionary hospital in Srinagar. Sensing the mood of the people and government, Dr. Elmsile started treating patients in a tent, it was an uphill task but slowly he gained the confidence of both patients and the public.

Maharaja Pratap Singh finally under the pressure from influential Britishers, allotted land for the construction of a hospital on the hill Top of “Rustom Gari” Drugjun (Dalgate) Srinagar. Dr. Theodore Maxwell, the successor of Dr. Elmsile worked tirelessly in the hospital and later due to the personal efforts of another British doctor Edmund Downes constructed the first building of the mission hospital at the Drugjun hill. It will be pertinent to mention here that the renowned physician of Kashmir late Dr. Ali Mold Jan Fazilli has served in this hospital twice soon after finishing his medical graduation, as told by Rauf Fazilli, nephew of Dr. Ali Jan.

Feeling encouraged, missionaries showed a lot of interest to carry on hospital work elsewhere in Kashmir valley. Sir Francis Younghusband,  a British national who was a resident Commissioner in Srinagar in his book “Kashmir as it was”, written in 1908,  says: “Conspicuous above the European quarter stand the group of buildings known all over Kashmir as Dr. Navy’s hospital and Mission hospital which with Mr. Biscoe’s school is the most sincerely appreciated of all the efforts which Europeans have made for the welfare of the Kashmir people. Last year no less than 22735 new outpatients were treated and the total number of visits amounted to 25 6280. One thousand seven hundred and sixty-four inpatients, of whom 476 were females were are also treated; and 5038 surgical operations were performed sometimes over 200 outpatients and on a few days over 300 outpatients were treated in a single day. These figures speak for themselves. They show the confidence the people now have in this wonderful institution, and the steady practical good it’s doing. The heads of the hospital are the brother; Dr. Arthur and Dr. Ernest Neve and they are assisted by Dr. Rawlence, Miss Nur Nevi, Mr Robinson, Mr S Wilson and 54 native assistants and servants.”

The hospital was founded in 1865 by Dr. Elmsile, who for many years fought an uphill battle in starting the institution, but at length gained the confidence of the people and of the late Maharaja. Dr. Downes succeeded Dr. Elmsile and carried the work forward. In 1881 Dr. Neve took it up. In that year, 10800 new patients were treated, there were two 23,393 visits, and 1418 operations were performed. Year by year since then the good work has progressed: the original mud-buildings have gradually been replaced by the present solid masonry structures. And the steady growth of the number of in-patients and the readiness with which upper-class women remain in the hospital, testify to the confidence which the institution is now regarded. It is now renowned throughout the north of India and is a splendid testimony to the steady thorough, and preserving work of two self-sacrificing men.

Sir Walter R Lawrence in his book, The Valley of Kashmir (1895) writes, “it is only of late years that the Kashmiris have begun to recognize the benefits of the western system of treatment, and the growing belief in the efficacy of the European methods is due to the devotion and skill of the medical missionaries in Kashmir. Even now the mass of the people believes in their own doctors, many of whom are men of considerable ability and experience. There are 300 hakims or doctors in Kashmir, and as a rule, the profession is hereditary. Their system is based on the Greek system of medicine, and have known cases in which some of my subordinates have derived great benefit from the skill of Kashmiri Hakim. Once when I was in great anxiety, a deputation of Kashmiris begged me to allow a well-known Hakim to treat my son. They argued that this Hakim has never failed to cure the disease.”

Over the years Missionaries extended medical services and in this connection, an exclusive hospital for leper patients was established in the year 1891 on the peripheral banks of Nigeen Lake in Baghwanpora area of Srinagar. Both the Government and the church of missionaries managed the hospital. In 1892, John Bishop Memorial Hospital was rebuilt in the town of Islamabad on the land allotted by the Government at the request of, commander in chief of the British army. The earlier hospital building was damaged due to floods. Five years later in 1897, a (Zanana) women’s hospital at Nawakadal was constructed to celebrate 60 years of Queen Victoria’s rule. A special ward of obstetrics and gynaecology was shifted from the state hospital situated at Hazuri Bagh. The hospital has since been closed and presently it houses Government College for Women.

Earlier, the Church of England (Zenana) women’s Missionary society hospital was established in Rainwari within the same campus of Dr. Neves hospital that was functioning from 1865. The hospital has gone through a total revival and presently a super speciality hospital stands operative serving hundreds of patients daily. Seeing the selfless work of E M N, Tyndale Bisco bestowed the Title of the Florence Nightingale of Kashmir to her. Decades later St. Joseph hospital was started in 1921 by Franciscan Missionaries at Baramulla, Kashmir.

Eight years later in 1929, a sanatorium at Tangmarg for patient’s of tuberculosis was established. Subsequently, after some time government decided to improve the health care system in Kashmir and accordingly approved the construction of a major hospital in the heart of Srinagar city, and an estate of Hadow carpet factory was acquired for the purpose, and Mr. Marquis of Linlithgow, the then viceroy of India on Oct 15, 1940 laid the foundation stone and finally the hospital was inaugurated by the successor of the viceroy Lord Waver, on 11th of October 1945. Over the years, the State Hospital (SMHS) has added a number of medical faculties, besides the first medical college set up, near it and is associated with the hospital, commonly known as Hedowun hospital.

It was an uphill task for the Britishers to establish hospitals in Srinagar that stand as perhaps their most remarkable legacies and thus leaving behind a decent healthcare delivery framework. Over the years, a lot of progress has been made in health services in Kashmir. In this connection, of late many new medical colleges in some districts of Kashmir province have come up. Prestigious Sher-i-Kashmir Institute of Medical Sciences at Soura, now Deemed University, has been functioning dedicatedly since 1982 and providing excellent patient care service to the community. The women’s exclusive hospital, the “Lalla Ded” is getting hundreds of new admissions on a daily basis, besides the children hospital at Sonwar Srinagar, which is offering excellent patient care. Government psychiatric hospital housed in Barack’s of the central jail Srinagar at Botraj colony, Badamwari Srinagar is doing a commendable job for treating mentally sick patients. Doctors at Bone and Joint hospital at Barzalla Srinagar are operating and treating patients with bullet and spinal injuries, and alike, day in and day out. There are so many other colleges that have come up in both the private and public sectors, like Government Dental College at Shereen Bagh, Kaksari, Srinagar that was established in the year 1985/86. Two government recognized colleges of the Indian System of Medicine are offering five-year courses to students wanting to pursue alternative medicine. A nursing college and a few paramedical colleges have also come up.

There is no doubt that the missionary hospitals laid a solid foundation for the future development of healthcare in Kashmir. But there is still a long way to go to address the loopholes of the existing healthcare systems and ensure that everyone has access to quality healthcare.

References and readings

1. “Kashmir as it Was” by Younghusband 1908
2. “Valley of Kashmir”  by Sir Walter Lawrence
3. Kashmir under Sunlight and Shade by Tyndel Biscoe