Date Posted: 31.12.2012

THE young man died, in what is now northern Vietnam, after a ten-year battle with Klippel-Feil syndrome, a rare congenital disease that leads to weakened bones and fusion of the spinal vertebrae. He contracted the illness as a child and before he was adolescent he was paralysed from the waist down. By the time of his death he had lost almost all use of his arms.

This might be just another story of disease and death, where it not for the fact that this young man, recently exhumed by archaeologists, lived and died more than 4,000 years ago and left behind an extraordinary record of disabled care: as he grew more ill and incapacitated, the frail young man must have been tended by the rest of his tribe. His debility was such that he had to be fed, cleaned and clothed by others. When his group moved to another hunting ground, he had to be carried. On cold nights he had to be brought closer to the fire. By the end of his life, almost entirely disabled, he was wholly dependent on others.

These were primitive people, living a Stone Age existence. They had no metal and survived by fishing and hunting. Yet far from treating the disabled young man as a burden, an unproductive outcast or a useless mouth to feed, they appear to have nursed and nurtured him through his long and crippling illness as a matter of course and to have seen him as a valued member of society, whatever his disability.

Prehistoric society is assumed to have been a brutal, Darwinian struggle, in which only the fittest survived. The bones of this chronically ill young man tell a different story, perhaps suggesting that "care in the community" is not the invention of modern society, but as old as humanity itself.

We tend to assume that healthcare and provision for the disabled are comparatively recent concepts, reflecting a linear progression from savagery to sympathy. We congratulate ourselves for the Paralympics and see each new wheelchair ramp as a step up. We regard the National Health Service, rightly, as a mark of civilisation in contrast to systems where healthcare depends on geography, luck or money.

Yet if the bones tell a true story, then care for the infirm may be the human norm, a type of behaviour more natural than the war of nature long assumed by historians and philosophers. That period in human history when the disabled were mocked, neglected, ostracised or even eliminated represents not a reversion to an earlier form of behaviour, but an aberration, a deviation from the normal human instinct to care.

Human history tends to focus on episodes of cruelty and violence, but it may be that empathy was also central to early human life and that the injured, sick or incapacitated were cared for not out of piety, or guilt, or self-conscious morality, but because that was the normal, practical, human thing to do. In prehistory, the nurse may have been just as important a figure as the fighter and hunter.

The anthropologists Lorna Tilley and Marc Oxenham, of the Australian National University, believe that the body found in Vietnam, known only as "Burial 9", reveals not only a tolerant and supportive attitude towards disability but suggests that the young man himself must have had a strong sense of his own value to the community despite his illness and a strong determination to survive.

The body excavated at the Man Bac site south of Hanoi is only the latest and most striking discovery in what has been called the "archaeology of healthcare". A Neanderthal man, who died perhaps 45,000 years ago, was excavated in Iraq and found to have had a withered arm from birth, only one eye and other serious injuries. He lived to the remarkable age of at least 50, but could never have done so without community support. Perhaps he was a chief, receiving special treatment, but the same cannot be true of the "Windover Boy", a child skeleton found in Florida with evidence of spina bifida, who nonetheless survived, with help, to the age of 15.

The skeleton of a Homo Erectus woman excavated near Lake Turkana in Kenya and perhaps as much as 1.7 million years old hints at what may be the very earliest known story of human healthcare. Her bones show that she suffered from Vitamin A overdose (the consequence of eating carnivore liver), which slowly disabled and eventually killed her. This ancestor of humanity could not have survived so long without the aid of others.

Each of these cases hints at a combination of community care and a will to overcome illness or disability that feels remarkably modern. Projecting our own emotions on to the distant past is unscientific, but this looks remarkably like compassion.

In Ancient Greece people with disabilities were publicly ridiculed. Spartan children born with bodily impairments were exposed and left to die. Under Roman law people with intellectual disabilities had no legal rights. Christianity brought a more charitable attitude, yet the disabled were still shunted to the margins, excluded and isolated in institutions.

The idea that disabled people were unproductive and inferior would reach its barbarous climax under Hitler, with the forced sterilisation of people with disabilities starting in 1933 and the murder of some 275,000 "useless eaters" with "lives unworthy of living" under the unspeakable T4 program. The Nazi euthanasia centres, where the disabled were condemned in the name of science, seem to stand at the opposite historical pole to primordial man in his cave caring for his disabled kinsman on the innate understanding that his, too, was a life worth living.

Thomas Hobbes, the 17th-century philosopher, held that Man's natural state was that of "continual fear and danger of violent death" and that the life of man was "solitary, poor, nasty, brutish and short". Selfishness was the central compulsion of existence.

The archaeological record suggests Hobbes was wrong. The life of "Burial 9" was short, to be sure, but it was neither solitary nor brutish. As the recession forces ever more difficult choices over the funding of care for the vulnerable, it is worth recalling that we have not invented care in the community, but returned to it.

Source : The Australian, December 29th 2012