In the early 4^th century, during the reign of Constantine, at the time of Christianity’s great expansion, a famine struck the Roman world.  About 30-40% of the population might have been Christian in AD 320.  The famine caused plague to spread.  The Romano-Christian response was charity.  Without discrimination and with great energy, Christians brought food and medicine to the afflicted.  What sort of religion would be so selfless thought non-Christian Romans?  Many converted once they understood the faith.

Catholic charitable works would take several volumes to express.  The list of those involved includes parishes, dioceses, monasteries, convents, monks, friars, nuns, and a long list of lay organisations.  There is no peer in world history to Catholic charity.  In fact, it is an obvious truism to state that Catholics invented the entire concept of charity and welfare.  Stoicism for example, which contains echoes and similarities with Christianity never established any sort of charity and welfare.  It demanded emotionless detachment and acceptance of fate.  It was a fatalist philosophy.

Oblations to the poor developed at the very beginning of Church history.  In the early church offerings to the poor were placed next to the altar at mass.  On certain fast days there was a collection for poor relief.  Fasting often induced wealthier Christians to invest money in poor relief.  Saint Justin the martyr commented that the rich were not only converting but becoming ‘poor in spirit’ by sacrifices and donations to the poor.

Saint Augustine established a hospice for pilgrims, one of thousands in the Romano-Christian world.  The early church ransomed slaves and had clothing ‘banks’ for the poor.  Saint John Chrysostom and Saint Ephrem organised relief efforts during the waves of plague and famine.  Christians, unlike pagans, never left the sick and wounded during times of plague, including burying the dead.  Widows and orphans were taken care of by the early church, along with hospitals being built for the sick in the 3^rd century AD. 

Eusebius the 4^th century ecclesiastical historian comments that the Christian's great deeds for the poor, sick and dispossessed led to many conversions.  The pagans wondered what animated Christians to such works of charity and gentleness.  The would make ‘inquiries about a religion whose disciples are capable of such disinterred devotion.”  Julian the Apostate the mid-3^rd century Roman emperor who persecuted Christians admitted, “These impious Galileans not only feed their own poor, but ours also; welcoming them to their agapae, they attract them, as children are attracted with cakes.”

By the 4^th century the church began to sponsor the large-scale deployments of hospitals.  Every major city possessed a hospital.  They served two purposes, namely to take care of strangers and pilgrims; and to treat the sick and suffering.  This ministering to human needs and illness on such a scale was absolutely unique in world history. 

In places like Rome the Christian woman Fabiola, would go into the streets looking for the poor and sick and take them to the first large public hospital ever seen in Rome – the one she founded.  Saint Basil the great in the 4^th century established a hospital for lepers in Caesarea.  No such institution had existed before anywhere in the pagan world.  Throughout the mediterranean, monasteries played the role of medical institution and pharmacy.  They became sites of medical learning and scholarship. 

Catholic military orders like the Hospitallers became famous during the crusades and after for the size of their hospitals and the quality of their care – given to anyone Christian or not and free of charge.  In Jerusalem alone, the Hospitaller hospital contained over a thousand beds, arguably the largest hospital ever constructed in a single location until the 19^th century.  The Hospitallers and other orders placed a premium on the care for the sick and injured.  Their hospitals came to resemble the modern equivalent and delivered babies, surgeries, daily care, physician visits, food, baths and a regime of hygiene that would not be replicated until Semmelweis in the mid-19^th century, namely cleanliness, the washing of hands and the endless changing and washing of sheets and bedding.

The entire premise of Western civilisation’s ‘welfare state’ is based on the Catholic Church’s massive investment in hospices, hospitals, orphanages, leper sanitoriums and the like.  The scale and scope of the investment over 2000 years is unknown but it is certainly the largest investment in history by an institution until the modern welfare state.  Lives were saved, souls converted, and society humbled and softened.  The entire ethos of Western culture was improved.  Yet, few if any today could be bothered to credit the Catholic church with this most important legacy and innovation – charity, love, succour and support.