FOUNDED BY an Edinburgh-trained doctor, the Nazareth Hospital in Israel has treated people of all faiths for 150 years. Chitra Ramaswamy talks to one of the many Scots who have helped to nurture it
IN her immaculate retirement flat in Edinburgh’s Comely Bank, Dr Runa Mackay is talking of her long history with a remarkable hospital on a hillside in Nazareth. In 1955 she arrived in what for centuries had been a leading centre of Christian pilgrimage to find a struggling Arab town with a population of 40,000, flooded with Palestinian refugees.
It had only been seven years since the foundation of the state of Israel. Mackay intended to work at the hospital for just six months. She ended up staying for 20 years.
“I arrived three days later than expected because of terrible fog,” she recalls. “I had told Dr Bathgate that I’d be wearing a red straw hat, and three days later there he was, still waiting. He said he had seen lots of ladies with red hats but somehow knew that none of them was me.
“We set off for Nazareth in the hospital car and every so often he would stop in front of some shed and say ‘here we are!’,” she remembers with a throaty laugh. “I was getting worried but eventually we got to the hospital on the hill and it was lovely. There were two wards, about 120 beds, one operating theatre, and no running water. Scrubbing up for an operation meant the nurse coming in with a jug of hot water to pour over your hands. We would boil instruments on a primus stove and anaesthetics were a little chloroform sprinkled on a mask. Politically things were awful, but somehow you just got on with it.”
This year, as the crisis in Gaza continues despite last week’s ceasefire between Hamas and Israel, the Nazareth Hospital celebrates its 150th anniversary. It is the oldest hospital in Israel, founded during the Ottoman Empire. It began its life as just four beds in a tiny rented house, set up by a missionary doctor and his wife who treated patients on their floor and tucked them up in their children’s beds to recover. Today it looks rather different: a sprawling general hospital with 147 beds and more than 400 staff. Though it remains Protestant in mission and ethos, these days all the staff are local and the vast majority are Palestinian Arabs.
The hospital has always, throughout its long and turbulent history, treated everyone who comes through the door, regardless of background, ability to pay, or religious beliefs – a reason frequently cited for its survival against the odds. That it has continued to flourish through a century and a half of war, political instability, and religious divide is indeed extraordinary. But equally fascinating are its enduring links to Scotland.
The story begins with an impoverished Armenian Turk called Pacradooni Kaloost Vartan or, as his great-grandson John Vartan calls him, PKV. He was born in 1835 in Constantinople, the son of a tailor who went on to learn English from an American missionary and work as an interpreter during the Crimean war. A new book by BBC World Service journalist Malcolm Billings to commemorate the 150th anniversary describes how “the expatriate community of Christians in Constantinople, including significant numbers of Scots, eased his path to Edinburgh”.
And so after the war PKV ended up in Edinburgh, a “new town” with bold Georgian symmetry and a peerless reputation in medicine. Interest in medical missionary work was growing, and the Edinburgh Medical Missionary Society (EMMS), loosely formed in 1841, adopted PKV as one of its students. He took lodgings in a boarding house on Clarence Street with various members of the Free Church, attended lectures at the Royal College of Surgeons, and trained at 39 Cowgate, a dispensary in an old whisky shop. “I did not see so many drunkards cursing and swearing in the neighbourhood as I used to in my student days,” PKV wrote of the Cowgate years later when he returned to visit Edinburgh.
“It was a hugely formative time,” explains his great-grandson, who only found out in the mid-nineties about his family’s history in Nazareth when he was handed a carved rosewood camel that once stood on his great grandfather’s desk in Nazareth. “Edinburgh is the city that turned him into a doctor. But he found the study difficult. The Latin names of bones and blood vessels must have been very tricky for him.”
After a spell in Beirut, the EMMS sent PKV to Nazareth. He arrived in the early 1860s with only his instruments and a small amount of money from the society. The average life expectancy in the small, neglected town was 22. The nearest doctor or hospital was in Damascus or Beirut.
“He started treating people immediately in his house,” Vartan says. “He did all sorts of things; introducing reinforced iron girders to the building of houses, designing crutches, making his own surgical tools. He even discovered an iris, which is named after him. He also ran his own pharmacy and apparently some of his patients dipped the prescriptions he wrote in water and then ate them, thinking that was the medicine.”
Is it true he converted far fewer people than he healed? “Absolutely,” Vartan says proudly. “Which is precisely the way it should be.”
All the while, the EMMS was sending over money, books, and medicine. And the Scottish link would continue to grow. On a brief return trip to Edinburgh in 1867, PKV fell in love with a Scottish daughter of the Manse, Mary Anne Stewart. They were married in a house on Scotland Street on 2 June and left together for Nazareth just a few hours later.
“She was a fantastic woman,” continues Vartan. “She bore him ten children, five of whom died under five. She would care for her husband’s patients at home, make flower pictures to raise money, and teach English. They were devoted to each other and to their mission. Apparently she once said it was lucky their house had walls made of elastic because they never turned anyone away. They had huge faith, and they needed it.”
In his book, Billings describes how Mary Anne was praised by locals for “introducing a little of the civilisation of Edinburgh into Nazareth”.
In 1906, the 25 acres of hillside land that PKV had been pursuing for his beloved hospital were finally granted, though he would not get to see it completed before his death in 1908. The EMMS bought the plot of land and continued to own it until a few years ago, when it was given to the hospital. The Nazareth Hospital is still registered in Scotland, however, and the bond forged more than 150 years ago continues.
“The connection with Scotland is amazing,” says Joy Fraser who in the 1980s worked at the hospital as director of nursing. Like Mary Anne, she is the daughter of a Free Church minister. “But the real joy now is that the hospital is run by and for locals. It truly belongs to the Nazarene people. It was always very modern in its outlook, which is why it has survived,” she adds.
Vartan agrees. “The familial attitude at the hospital is astonishing. Nearly everybody in Nazareth has been treated there at some point. A large proportion of people who work in the hospital were born there. And several generations of families work there, which is wonderful to see in such a divided part of the world. It’s a powerful thing to see Muslims, Christians, Jews, and Druze all standing around the same table.”
For Mackay, a neat, softly spoken, and steely woman in tartan trousers, the Nazareth Hospital kick-started a lifelong love affair with the Middle East. She never married or had family of her own. Instead she worked as a missionary doctor in Israel, Lebanon and the Occupied Territories, witnessing everything from the Six Day War to the birth of the Intifada. At the age of 91 she remains an active advocate for Palestinian rights and still heads for the east end of Princes Street every Saturday lunchtime to protest against the treatment of women in Afghanistan.
Her memories of the Nazareth Hospital could fill a small book. “It’s always been known as the English hospital, which is rather annoying for the Scots,” she laughs. “That’s because there was a so-called Scottish hospital in Tiberias.”
She recalls the hospital doorman translating her morning bible stories into Arabic “until I learned Arabic myself and realised he wasn’t translating what I was saying at all”. She encouraged young Arab women into nursing, and tried to stop mothers in the villages from applying donkey dung to their babies’ umbilical cords, because it resulted in neonatal tetanus. She talks of sacks of rice that would mysteriously appear when the hospital ran out of money, arguing with patients about paying – “of course if they couldn’t, we treated them anyway” – and shouting at a man who refused to give blood to his wife: “I bullied him into it in the end.”
Mackay studied medicine in Edinburgh at a time when penicillin had just been discovered. Today she feels as much an Arab as she does a Scot. She last visited Nazareth in September for the 150th anniversary celebrations, arriving in a wheelchair to reminisce with some of her surviving colleagues.
“Though I trained as a paediatrician I ended up working in obstetrics at the hospital because that’s where I was needed,” she says, ever the pragmatist. “We delivered so many babies that the population actually spiked. People would come from all over Galilee, often by any means. I remember seeing a cement mixer pull up in front of the hospital once.” She laughs and shakes her head. “Of course, they have a big car park and an ambulance at the hospital now. I suppose it all keeps changing, which is rather wonderful.”
• Vartan of Nazareth by Malcolm Billings, Paul Holberton Publishing, visit nazarethtrust.org for more information