The Indian origins of what was probably the world’s first public health service remind me of Nani A Palkhivala, the distinguished jurist, gazing at the Arabian Sea late one evening from his flat in Mumbai and murmuring despondently, “I sometimes fear that a nation that has once been great can never rise again!”
The greatness he spoke of encompassed both AL Basham’s The Wonder that was India and its extension in The Indianised States of Southeast Asia, the title of George Coedès’ classic account of the Hindu and Buddhist kingdoms of Sumatra, Java, Borneo, Bali, Malaya, Burma and the Indo-Chinese peninsula. Today, India is floundering against an invisible but seemingly invincible enemy while unscrupulous operators fleece hundreds of thousands of weary workers plodding to nowhere. There are not enough hospitals, doctors, nurses or caregivers for the growing burden of dead and dying. But nearly 1,000 years ago, an Indianised Southeast Asian King built 121 rest-houses at 15-km intervals along his 1,000 kms of raised highways, no fewer than 102 hospitals and an engineering marvel of walls, moats and canals to irrigate luxuriant paddies and reinforce the largest urban metropolis in the pre-industrial world.
He was Jayavarman VII (1181 CE-1219 CE), chakravarti (universal ruler) of the Khmer empire of Angkor, the last great Indianised state, spanning today’s Cambodia, Laos, Vietnam and Thailand, with footholds in Myanmar and Malaya. ‘He suffered the illnesses of his subjects more than his own; because it is the pain of the public that is the pain of kings rather than their own pain,’ proclaims a 12th-century stele marking the site of a hospital-temple by the Mekong river. Other steles and other hospital-temples throughout the empire repeat those words in pointed reminder to rulers that the first call on them is to meet the needs of their people. Jayavarman VII did not squander Angkor’s resources on idle statues and extravagant civic reconstruction. He concentrated on public welfare.
A bust of this ‘energetic, ambitious man’ who may have inspired the Bayon temple’s 200 massive faces can be seen in the Musée Guimet in Paris. He was corpulent with heavy features and wore his hair pulled back into a small bun on his head. His father, Dharanindravarman II, had ‘found his satisfaction in the nectar that is the religion of Sakyamuni’, but though Jayavarman was also devoutly Buddhist, his appointment of Brahmans to high positions anticipated the secularism to which India, Angkor’s distant mother country, is constitutionally committed. His concepts of the hospital as temple and of service as worship reflected a deeply held principle common to both Buddhism and Hinduism. Hospital-temples also dispensed administrative and political justice.
Indian self-esteem can do without boastful ultra-nationalist myths about ancestors anticipating and mastering today’s science and technology. There is much in the true past to be proud of. As Sylvain Lévi declared, ‘As Brahmanism has unified India, India in turn has given a kind of unity to the people of eastern Asia. From Persia to the China Sea, from the steppes of Siberia to the tropical islands of Java and Borneo, from the ports of Oceania to Socotra opposite Africa, she has propagated her beliefs, her genius, her civilisation and her stories. Through the long course of the centuries, she has marked a quarter of the human race with her indelible imprint.’ That imprint includes Cambodia’s medical knowledge and the ‘state-sponsored healthcare, well-supported by royal donations’ that appeared in the 12th century, according to Joanna Wolfarth in History Today.
My first acquaintance with Angkor was in the 1970s when Amina Ahmed Kar, sculptor, art historian and wife of Chintamani Kar, renowned artist and principal of Kolkata’s Government College of Art and Craft, sent me a fascinating article on the Angkor Wat complex, the world’s largest religious monument. I was honoured to publish it, but, inevitably, people whispered that Amina would use the published article to apply for a French scholarship. So what? I retorted, its erudition deserved recognition. Whether she applied anywhere I don’t know. But I felt many years later when I lived in Southeast Asia and travelled extensively in the countries that were once Suvarnabhumi, Land of Gold, that her Angkorian Records uncovering the sources of Cambodian culture deserved much wider dissemination.
Amina’s was an academic study without any hint of the nationalism that inspired Bengali scholars like Ramesh Chandra Majumdar, Kalidas Nag and Suniti Kumar Chatterji to form the Greater India Society in 1926 with Rabindranath Tagore’s blessings. A British-Indian academic suggested that their purpose was to show the world that even if Indians were Britain’s slaves, there was a time when they had their own slaves. Sadly, this misreading of history which does grave injustice to eminent pioneers, was strengthened when BR Chatterji wrote condescendingly in India and Java that though ‘Hindus had lost their independence in their own home’, India’s religion, culture, laws and government ‘moulded the lives of the primitive races all over’ Suvarnabhumi so that ‘they imbibed a more elevated moral spirit and a higher intellectual taste…[and] were lifted to a higher plane of civilization.’
So, when a Chinese Singaporean asked at a discussion on my book Looking East to Look West: Lee Kuan Yew’s Mission India whether India was “looking east” to recreate the Srivijaya and Majapahit empires, I promptly assured him that India had not created those empires in the first place. They were unique in the annals of mankind because unlike the Roman or British empires, they were not achieved by conquest. The Indianised States of Southeast Asia were a manifestation of civilisational values peacefully transferred by merchants and mariners, priests and princes. Local chieftains who had imbibed India’s values to such an extent that Basham claimed ‘the whole of Southeast Asia received most of its culture from India’ had created the kingdoms.
Srivijaya, Suvarnabhumi’s first kingdom, flourished from the 8th to the 12th century. It was technologically advanced, traded with China, fostered links with Buddhist Bengal, and even reached out to the Islamic caliphate. Sri Tri Buana, a Hindu Srivijayan prince, established his capital in Temasek, which he renamed Singapura, the lion city. Some chroniclers identify his forebear, Raja Chulan of Kalinga, with Rajendra Chola. Others trace his descent from Alexander the Great and an Indian princess. As Iskandar Shah of Malacca, he was the ancestor of Malaysia’s sultans.
“We are cousins,” King Norodom Sihanouk told Jawaharlal Nehru in 1954. “The Khmer civilisation is a child of the Indian civilisation, and we are very proud of that.” No wonder Western scholars called Suvarnabhumi ‘Further India’ until Kavalam Madhava Panikkar, diplomatist and scholar, coined the term ‘South-east Asia’. He anticipated the raising of national drawbridges that prompted Thailand’s Maha Chakri Princess Sirindhorn, epigraphist and Sanskrit and Pali scholar, to warn me in 1993 that the region prefers the neutral “Indic” adjective. New Delhi’s territorial ambitions might lurk in the modern “Indian”.
Jayavarman II founded the Angkorian empire in 802. But Jayavarman VII, who succeeded Suryavarman II, his cousin and builder of Angkor Wat, rescued it from the ‘sea of misfortune into which it had been plunged’ by invasion and insurrection. He united the kingdom of Kambuja and exalted the cult of the devarāja, or god-king, affirming a strong linkage between monarchy and divinity. Born into the nobility of Mahidharapura (whose site has not been identified), Jayavarman VII, whose posthumous name was Mahaparamasaugata, spent his early years in exile. But he rose to grandeur. The tribute of water being a sign of allegiance, his daily wash-water was provided by ‘the Brahmans beginning with Suryabhatta, by the king of Java, by the king of the Yavanas, and by the two kings of the Chams.’ Java and Cham were nearby entities. Suryabhatta was the chief court Brahmin, and the king of the Yavanas, the Vietnamese emperor.
Health loomed large among Jayavarman VII’s priorities. Perhaps a virulent epidemic also attacked his empire. Perhaps he sought to consolidate political power by earning the gratitude of his subjects. Hospitals may have facilitated conversion to Buddhism. The desire to ease suffering defined the protective and compassionate Buddhist monarch who knows that any contribution to the physical and mental well-being of the people accumulates karmic merit for himself and his kingdom. Perhaps he was just more caring than any modern ruler.
Coedès says the sites of more than 30 of his 102 hospital-temples were identified. The largest of these curative establishments was the temple complex of Neak Pean at the centre of a large, artificial reservoir. Accessible only by boat and consisting of a quincunx of ponds with a central shrine, it is described as “an eminent island, deriving its charm from its lake and cleansing the impurity of sin from those who come to it.” Neak Pean is the architectural representation of the Himalayan Lake Anavatapta which occupies the centre of the world, according to Indian tradition. Gushing out of gargoyles shaped like the heads of animals, its waters are thought to cure all illnesses. This construction was both an act of Buddhist worship and a therapeutic service to the suffering.
The temple-hospitals were placed under the protection of Bhaishajyaguru Vaiduryaprabha, the Buddha who vowed before he entered Buddhahood to help the physical and mental health of all living creatures. Each hospital had a shrine to this incarnation of healing who is still revered by Tibetans and Chinese as ‘the master of remedies who has the brilliance of beryl.’ They were open to all. Donations were welcome but treatment was probably free with hospital edicts claiming that just hearing Bhaishajyaguru’s name cured all ailments. In addition to ritual and spiritual healthcare, they also offered treatment with medicines including honey, butter, oil and molasses. Their inscriptions provided an inventory of staff and supplies, the former usually including two doctors, two apothecaries, eight nurses and six assistants. There were priests, teams of medical workers, guards, cooks, rice-makers and servants. Diagnostic testing by reading the pulse was common.
An inscription at the vast Ta Prohm temple, formerly Rajavihara, constructed in 1186 CE and supported by hundreds of villages and their 80,000 residents, lists royal donations of metals and apparatus that would have been used for alchemy, including mercury sulfide imported from China, and a gold cauldron. Patients were cured by ‘plunging (them) into water and repeatedly washing the head.’ Such inscriptions are a rich store of information on Jayavarman VII’s reign. There is also Customs of Cambodia whose author, the Manchu emissary, Chou Ta–kuan (Zhou Daguan), travelled extensively in the empire but several years after Jayavarman VII’s death when his son, Indravarman II, was on the throne.
Jayavarman VII was the last great Angkorian monarch. The seeds of Khmer decline lay in the rise of militant Hinduism after him, but that is another story. The Ta Prohm temple dedicated to his mother, the Preah Khan to his father, and the Bayon designated as his own state temple together formed an architectural triad symbolising the Mahāyāna view that enlightenment comes from the union of wisdom and compassion, identifying the Buddha with the king himself. Public works, roads, bridges, engineering marvels, water management, hospitals and rest-houses—nothing extravagant or not directly of service to the multitude—served the population while underwriting security by opening up trade routes and enabling him to deal with uprisings.
Banishing illness remained the central purpose of his kingship right to the end. One of his inscriptions says that ‘filled with a deep sympathy for the good of the world’, Jayavarman VII called on all future kings of Cambodia to ‘attain with their wives, dignitaries and friends the place of deliverance where there is no more illness’.
That could also be a prayer for the distant mother country, now in deep distress. It could be a respectful reminder to her to learn from a remote offspring and not neglect the hospitals and rest-houses that were so important to his reign. Only a king like Jayavarman VII who suffers the pain of his subjects more than his own can save a concerned citizen like Nani Palkhivala from being despondent about the future.