When the First Crusade set off for Jerusalem at the end of the eleventh century, the provision of social welfare services was not a public or state function. Care of the sick, insane, dying, orphans, senile elders, the disabled, the unemployed and the destitute was viewed as the family’s responsibility. Only when families had failed did the Church – as a last resort and out of charity – assume responsibility for those in need. Yet, in the Holy Land in the wake of the crusades this traditional form of charity came to be increasingly supplemented by large-scale, organised social welfare. The movement towards institutionalised church social welfare emanated from Jerusalem, and the change was largely the as a result of a single institution — and its imitators.
As the site associated with Christian salvation, Jerusalem inevitably attracted a disproportionate number of people suffering from hardship or crisis. Year after year, countless chronically ill, disabled, destitute and homeless, abandoned and unemployed people undertook a pilgrimage to Jerusalem hoping for a miracle at best, or death in a holy place at worst. Many others who set out in good health became ill, injured, exhausted, destitute or abandoned along the arduous road to Jerusalem. The plight of many pilgrims arriving in Jerusalem was so piteous, that numerous attempts to establish hospices in the Holy City were made over the centuries, all of which proved unsustainable under Muslim rule. In or about 1080, the Benedictines established a hospice in Jerusalem to care for the neediest Christian pilgrims under a monk named Gerard.
Nineteen years later, Jerusalem fell to the forces of the First Crusade. Not only did the trickle of pilgrims to Jerusalem became a flood, thus creating a huge demand for social welfare services, but the political and religious environment was transformed. It became possible to build Christian structures, to openly preach Christianity, and to appeal to Christian patrons for aid and support. Gerard proved a talented, charismatic and exceptional leader. He created an institution which would, in due time, be recognised by the pope as a unique religious order —one of the few not named for its inspired founder. This order was first known as the Hospital of St. John in Jerusalem, but its members were later called simply ‘the Hospitallers’. During its period of militarization, the order was known as the Knights of St. John or the Knights Hospitaller.
This new order was not dedicated to contemplation, learning and education, or the fight against heresy or even preaching and the purification of souls. Rather, the Hospitallers were dedicated to ‘serving the holy poor’. Regardless of their background or social standing in the secular world, members of the order considered themselves ‘serfs’ — or sometimes ‘slaves’ — of the poor.[i] Strikingly, this new order made no distinction between the religion of the poor, vowing to serve all, regardless of creed, colour or race. The members of the new order were admonished to ‘love your enemies and do good to those who hate you’.[ii]
Even after the militarization of the Hospitallers in the late twelfth century, nursing and caring for the sick and injured remained an obligation of all members of the Order of St. John, including the knights. In fact, the hospital’s militarisation caused a major internal crisis lasting more than three decades, from 1171 to 1206. Initially, the Hospitallers appear to have employed mercenaries to fulfil duties such as defending their installations or field hospitals. Gradually, however, the Templar model took root inside the Order of St. John, and full-fledged monks were allowed to bear arms and engage in combat. Yet, despite the addition of knights and castles to the organization and warfare to the agenda, charitable and merciful activities – and above all, health care – remained the raison d’être of the Hospitallers.
Over time, other religious orders with similar missions — albeit rarely with mandates as broad or an ethos as humble — were established. These included the German Hospital (that later became the Teutonic Knights), the Hospitallers of St. Thomas of Canterbury (providing medical care to English crusaders), the Order of St. Lazarus (dedicated to caring for lepers), the Trinitarian Order (dedicated to ransoming prisoners from Muslim captivity and slavery) and the Spanish equivalent, the Mercedarians. Centuries later, the Hospitallers would be imitated by the Salvation Army. Yet none of the medieval orders were as rich, powerful or widespread as the Hospitallers, and none of the others has endured into our own time.
As international organizations, these religious institutions could draw on resources, both material and human, from across Christendom and pool these resources for specific tasks. This allowed them to collect recruits, alms, gifts, grants and patronage wherever available and deploy it in accordance with need. Royal or noble patronage of an institution could be decisive in its success, and truly international orders like the Hospitallers could obtain royal patronage, not from one, but dozens of crowned heads and their magnates — an enormous resource. For example, in one instance, the King of Jerusalem granted half the spoils of a military campaign to the Order of St. John. But it was more common to endow the order with land or other sources of income. The location where the money was raised was unrelated to where it was spent. The international charitable orders could not only take from the rich to give to the poor but also take from the West to give to the East. While this sounds self-evident to us today, in the twelfth century, it was a radical innovation.
[i] Jonathan Riley-Smith, Hospitallers: The History of the Order of St. John (London: Hambledon Press, 1999), 21.
[ii] See note 24, Riley-Smith, Hospitallers, 21.
The bulk of this entry is an excerpt from Dr. Schrader's comprehensive study of the crusader states.