Changing Landscape of Charity: Istanbul Bezm-I Alem Hospital

In 1845, the Ottomans built a new hospital in Istanbul, Bezm-i Alem Valide Sultan Hospital, which is typically considered the first purpose-built civic hospital in the Ottoman Empire. Founded using the classical endowment (wakf) system, the Hospital epitomized the transitional period between traditional medical charities and modern acts of public assistance. In the early nineteenth century, there was a common perception, particularly among European visitors, that Ottoman hospitals were nowhere to be found, although the classical Ottoman imperial hospitals (darüşşifas) continued to function as general hospitals. Bezm-i Alem Hospital was the first general hospital for the poor that was accompanied by a governmental statement acknowledging the need for such an institution and architecturally stated this intention to a wider audience.

During this time major shifts in the social, cultural, political, and economic affected education, governance, financial administration along with healthcare, and hospitals were in the middle of all these intersecting fields. Bezm-i Alem was in many ways a hybrid: it used the endowment system, which was significantly altered, so its administration and financial structure needed to be conceptualized differently. Architecturally, it used many features of a traditional imperial complex (külliye) but in a completely new way. The medical approach outlined in its seemingly conventional endowment deed had novel concerns relying on modern medical theories. In fact, by opening its doors only to the physically ill as the official public hospital, it came to symbolize a breaking point between the bodily disease and diseases of the mind as understood then. The paper places the Bezm-i Alem Valide Sultan Hospital within the larger context of Ottoman modernization using its unique position within the hybrid medical charity landscape.