The care of the sick was carried out by the deacons and widows under the leadership of the bishop. This service was not limited to members of the Christian congregation but was directed toward the larger community, particularly in times of pestilence and plague. The first office created by the church in Jerusalem was the Diaconate. It spread rapidly throughout the entire early church. There is an early report that while the heathen fled the plague at Alexandria, “most of our brother-Christians showed unbounded love and loyalty” in caring for and frequently dying with the victims.
During the Middle Ages the monasteries took over and created a new institution, the hospital. The growing number of pilgrims to the Holy Land and the necessity of care of their numerous sick, who had fallen victim to the unfamiliar conditions of climate and life, led to knightly hospitaler orders, the most important of which was the Order of the Hospital of St. John of Jerusalem (later called the Knights of Malta). The service for the sick, which was carried out by the knights was over and above their military service for the protection of the pilgrims. It was not elaborate. In connection with the orders of mendicant friars, especially the Franciscans, civil hospital orders were formed. Other hospitals were founded as autonomous institutions under the leadership or supervision of local bishops. The meaningful centralization of the different existing institutions became necessary with the growth of cities and was most frequently undertaken by city councils. The laity began to take over, but the spiritual and pastoral care of the patients remained a major concern.
In the realm of the Lutheran Reformation, the medieval nursing institutions were adapted to new conditions. The office of the deacon was supplemented by that of the deaconess; and these offices of service were considered part of the polity of the church of the New Testament. The Counter-Reformation brought a new impulse for caring for the sick in the Roman Catholic Church. Special orders for nursing service were founded—e.g., the Daughters of Charity, a non-enclosed congregation of women devoted to the care of the sick and the poor, by Vincent de Paul, who was a notable charismatic healer. A great number of new orders came into existence and spread the spirit and institutions of ecclesiastical nursing care throughout the world as part of Roman Catholic world missions.
From the beginning the Christian congregation cared for the poor, the sick, widows, and orphans. The Letter of James says: “Religion that is pure and undefiled before God is this: to visit orphans and widows in their affliction.” Widows formed a special group in the congregations and were asked to help with nursing care and other diaconal - or faith active in love and service to all. In addition they performed congregational tasks as long as they did not need help and care themselves.
The Christian church founded orphanages during the 4th century, and the monasteries took over this task during the Middle Ages. They also fought against the practice of abandoning unwanted children and established foundling hospitals. In this area, as in others, a secularization of church institutions took place in connection with the spreading autonomy of the cities. In the Reformed churches the establishment of orphanages was furthered systematically. Following the great wars of the 17th century, the orphanages were reorganized pedagogically with the founding of a modern system of secondary schools. Some vigorous Christian leaders responsible for remote and barren areas are transforming the impoverished villages into prosperous communities. Their Christian leadership led to establishing schools, roads, bridges, banks, stores, agricultural societies and industries. These efforts provided a significant contribution to the development of modern welfare, which in the 20th century was mainly the responsibility of state, communal, or humanitarian organizations but this secular effort is now being dismantled with the hope that the churches will restart by nurturing their Christian roots following ideas planted by Jesus. Such good works by other religions is to be expected.
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