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The Holy Infirmary after the Knights

Updated: Jan 19, 2022

One of the highlights of the Order of St. John’s long stay in Malta was undoubtedly the way they completely revolutionised the local medical scene. This was best epitomised by the Sacra Infermeria, the hospital they built in Valletta, which at one point in time rose to fame as one of the best hospitals in the world. Although by the close of the 18th century, the Sacra Infermeria would enter a decline, mainly due to the Order’s worsening financial situation, the building would go on to play a vital role in the island’s history in the centuries that followed, including in the treatment of the sick and injured for a further 120 years.

The French

Following the ousting of the Knights from Malta by Napoléon Bonaparte in 1798, the Sacra Infermeria was taken over by French troops to be used as a military hospital, known as the Grand Hopital. French rule proved unpopular, and the Maltese soon rebelled. For two years, Malta would once again experience a siege, although this time it was the French who were besieged inside the harbour cities, while the Maltese held the countryside. Because the locals were poorly armed, they set out to starve the French rather than engage them in direct attacks. With the British also entering into the picture with a naval blockade, the French would soon face severe food shortages. Starvation and disease had a disastrous effect on the health, morale, and combat capability of their troops. A lack of sufficient nutrition led to various illnesses, such as scurvy - caused by Vitamin C deficiency - and night blindness, caused by a lack of Vitamin A. The Maltese even cut off Valletta’s water supply via the aqueducts, with the horrible quality of drinking water from the city’s cisterns resulting in widespread acute dysentery. New hospitals had to be created for the increasing number of invalided troops. The diet of beef and mutton in these hospitals was soon replaced by horse and donkey meat, and eventually horse-flesh soup. By the time the French capitulated in 1800, there was nothing to feed the patients except for beans.

The British

When the British entered Valletta in 1800, the military authorities took over all public buildings for their use, including the Grand Hopital, which they renamed the Station Hospital, and where they immediately put up 350 of their sick troops. Over the following years, however, the number of patients treated here was so low that most of the building was used for other purposes. The Long Ward served for some time as a rope-walk, where ropes, mainly for use by the British navy, were manufactured. A few years later, a considerable section of the same area, as well as part of the basement, were let to a wine-making business to be used as a store for Marsala wine. In the 1860s, the Station Hospital underwent a number of important structural alterations intended to improve sanitary conditions. This included the addition of new windows and improved ventilation, as well as the construction of the long open stone balcony which is still visible along most of the side overlooking Mediterranean Street.

The Crimean War

The first major conflict in which the Station Hospital would prove its worth was the Crimean War between 1854-56. Shortly after the commencement of hostilities, and in anticipation that Malta could be used for the evacuation of British wounded soldiers, orders were received to prepare enough hospital beds for several thousand men. The first batch of wounded troops from Crimea arrived in November 1854. By this time, the wine stores had been cleared from the Long Ward to make room for the constant flow of wounded. Several Maltese doctors are known to have joined British Army surgeons in the Crimean battlefields and hospitals, while students of medicine and surgery at the University of Malta were given permission to attend the Station Hospital to enhance their training whilst assisting in the treatment of casualties.


Another important event that took place at the Station Hospital in the late 19th century was a scientific discovery. The causes of Mediterranean Fever, as it was then known, were attributed to many different possibilities, but the real cause had still not been ascertained until Surgeon-Major (later Sir) David Bruce, working in a small laboratory in this building, announced in 1887 that he had discovered the microbe of the fever in the spleen of some British soldiers, although, at this point in time, no one knew how the infection was being transmitted. This mystery would only be solved several years later by the prominent Maltese doctor and archaeologist Sir Temi Zammit, who discovered that it was originating from unpasteurised goats’ milk. The disease is nowadays referred to as Undulant Fever or Brucellosis, in honour of Sir David Bruce.

World War One

1914 saw the start of World War One, and although Malta was not to be on the frontline, it was destined once more to play a vital role in the evacuation and medical care of wounded servicemen. In 1915, Turkey joined the Central Powers and entered the war against the Allies. The decision was taken to invade the Gallipoli peninsula, but what ensued was a disastrous military campaign that saw thousands of casualties on both sides. The former Sacra Infermeria was again to prove its worth and thus re-live moments reminiscent of its past life. Due to its proximity to the harbour, it was used as a sorting base for the wounded arriving in hospital ships. These were then distributed to the numerous other hospitals and convalescent camps spread all over the island, although the most seriously wounded were kept and treated here as it was deemed too risky to move them. There were in Malta during the whole of World War One over 300 surgeons and 1,000 nurses, and almost 140,000 casualties from the Gallipoli and Salonika campaigns received treatment here, earning the island the nickname of ‘Nurse of the Mediterranean’.