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Waqf and the Bimaristan system

From the 8th to the 12th CE centuries, healthcare in the Muslim world reached a level of excellence unsurpassed in previous history. During this period, great physicians and pharmacologists created a remarkable corpus of knowledge and made important contributions to medicine.

‘Bimaristans’ (hospitals) were also impressive. The Al-Mansouri Bimaristan in Egypt, for instance, could accommodate up to 8,000 patients at any one time regardless of gender, ethnicity, social status, age or religion. These healthcare facilities, in which only qualified physicians could practice, provided separate wards for different diseases, especially contagious ones. Each ward had additional sections for convalescents. What is more, Bimaristans were the first-ever to archive patient records and their treatments.

Finally, Bimaristans underwent regular inspections by authorities to follow up on patients, their food, medications and the service they were receiving. Such sophistication could not have been achieved without Waqf (endowment) support. To illustrate, the Waqf annual spending on the Al-Mansouri Bimaristan was estimated to be one million dirham.

 The struggle with healthcare in OIC countries today

OIC countries face numerous healthcare issues including a lack of financial resources, an inadequate number of trained healthcare workers and poor infrastructure, to name a few (see Table 1).

Table 1: OIC Health Report 2017

OIC Non-OIC developing countries Developed countries
Health expenditures (as a percentage of all government expenditures) 8.4% 10% 18.4%
Density of health workers (per 10,000 people) 26 39 125
Hospital beds (per 10,000 people) 10.8 27.2 56.1

Source: OIC

One of the conclusions drawn from the OIC Health Report 2017 is that taking healthcare to the next level requires fundamental reforms in the health financing system.

Waqf needed but with a different approach

Obviously, Waqf can play the same role as in the past to finance the healthcare system. Nonetheless, applying the following strategies should improve the efficiency of Waqf financial resources channeled to healthcare:

  • Empowerment through the impact-investing paradigm: Using their financial resources, Waqf can of course build, equip or just cover hospitals’ operational expenses. Building synergies with Islamic finance institutions can arguably generate a higher social return on investment compared to a simple cash donation. Potential synergies include co-financing, subsidizing or guaranteeing healthcare social investments and entrepreneurs.


  • Standing on the shoulders of science: Leveraging the latest advances on behavioral economics, digital marketing and design thinking applied to social innovation allows the provision of better healthcare services and builds a stronger health ecosystem consisting of donors, financial institutions, regulators and healthcare professionals, among others.


  • Prioritizing the use of the UN SDGs: As mentioned previously, healthcare challenges in OIC countries are diverse and complex. It is important to set priorities and to channel Waqf funds and efforts to address urgent and important needs first. The UN Sustainable Development Goals (UN SDGs) framework offers a solid enough grounding to map the challenges, set priorities and report progress not only for healthcare (SDG 3) but also for other related fields such as poverty (SDG1), nutrition (SDG2) and water and sanitation (SDG6), among others.


This article was originally published at IFN Volume 15 Issue 28 dated the11th July 2018 (

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