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XVIII ЮБИЛЕЙНА МЕЖДУНАРОДНА НАУЧНА КОНФЕРЕНЦИЯ ПО
СТРОИТЕЛСТВО И АРХИТЕКТУРА ВСУ’2018
XVII ANNIVERSARY INTERNATIONAL SCIENTIFIC CONFERENCE BY
CONSTRUCTION AND ARCHITECTURE VSU'2018
FIRST HOSPITAL BUILDINGS IN SERBIA AND THEIR PRESENT
PURPOSE AND FUNCTION
Olivera Nikolić1, Ana Momčilović Petronijević2, Aleksandar Keković3
Faculty of Civil Engineering and Architecture - University of Niš
Abstract: The construction of health care facilities of military and civil population
started with the consolidation and development of the Serbian medieval state in the
12th century. The tendency of progress in organised provision of health care to the
population was hindered by the arrival of the Ottomans to the Balkan; for several
centuries the Serbs were therefore forced to treat themselves with traditional
medicines at their homes. Frequent wars and infectious diseases that used to arrive
from the east caused a high mortality rate among the population. A crucial turnover
in the establishment and development of the modern health care system in Serbia
took place in 1830 when the Hatt-i sharif granted Serbia the right to manage
hospitals and other general-purpose institutions.
This paper aims to research the health care facilities that were built in the period
between the Hatt-i sharif adoption to the First World War. The buildings of the first
hospitals in Serbia are important for creating an image of the urban development of
the city and the state in the period in which they were built, and in this context, they
are valuable examples of architectural heritage. The result is classification of objects
of the first hospitals in terms of present existence, use and purpose.
Key words: hospital buildings, Serbia, XIX and XX century, function, purpose,
revitalisation
1. Introduction
The architecture of buildings of the first hospitals in Serbia has not been
sufficiently explored. In that sense, there is little literature, the statements are not supported
by the sources, and the technical documentation of the Ministry of Construction burned
down in the Second World War. This work resulted from a research lasting several years
on the topic of the first health facilities in Serbia after the liberation from Turkish rule in
the Balkans.
Starting from the fact that there are many pavilion-type buildings in the hospital
blocks in Serbia, some of which with their exterior elements of the facade and the roof
1 Olivera Nikolić, PhD student in Architecture/assistant at Faculty of Civil Engineering and Architecture -
University of Niš, Aleksandra Medvedeva 14, Niš , Serbia, olivera.nikolic@gaf.ni.ac.rs
2 Ana Momčilović Petronijević, doctor of architecture / assistant professor at Faculty of Civil Engineering
and Architecture - University of Niš, Aleksandra Medvedeva 14, Niš , Serbia,
ana.momcilovic.petronijevic@gaf.ni.ac.rs,
3 Aleksandar Keković, doctor of architecture / associate professor at Faculty of Civil Engineering and
Architecture - University of Niš, Aleksandra Medvedeva 14, Niš , Serbia, aleksandar.kekovic@gaf.ni.ac.rs
XVIII ЮБИЛЕЙНА МЕЖДУНАРОДНА НАУЧНА КОНФЕРЕНЦИЯ ПО
СТРОИТЕЛСТВО И АРХИТЕКТУРА ВСУ’2018
XVII ANNIVERSARY INTERNATIONAL SCIENTIFIC CONFERENCE BY
CONSTRUCTION AND ARCHITECTURE VSU'2018
reflect the architectural styles from the end of 19th and the beginning of 20th century, it is
presumed that some of the first health facilities were preserved in these blocks of
buildings.
During the development of this work, the historical method, the method of analysis and
synthesis the comparative analysis and the case study method were used.
The results of the work are reflected in the discovery of the atmosphere in which the
first health care facilities in Serbia were built, their architectural analysis and creation of a
classification from the aspect of today's existence, functions and purposes with a focus on
ways of revitalizing and prolonging the life of these buildings.
2. Architecture of first hospitals in Serbia
When in 1832, by Sultan’s edict (Turkish decree) Serbia was granted the right to
establish and build public facilities (churches, schools, hospitals, post offices and printing
shops), the so-called School and Hospital Fund was founded and its purpose was to collect
money for the construction of schools and hospitals. The established hospitals did not start
work in purpose-built facilities, but in rented ones. Therefore, when we talk about the
architecture of the buildings of the first hospitals in Serbia, we have to divide them into:
-architecture of hospitals in private homes and
-architecture of purpose-built hospitals.
2.1. Hospital architecture in private homes
The first civilian hospitals in Serbia were established in private houses which the
owners gave to the municipalities for use. From the descriptions or saved photos we can
conclude that they were mostly ground floor or one-storey houses with the backyard. They
were located in the city cores. Regarding the spatial organization, in terms of the function
of the hospital, they had to fulfill the requirement to have at least one room for patients,
most commonly separated male and female ones, a kitchen, a doctor's room and a room for
a janitor. Very often, it was not possible to find an adequate facility, so the hospital rooms
did not meet the basic hygienic and sanitary conditions, they were moist, poorly lit and
poorly ventilated.
For several cities in Serbia, the location of the first hospitals is known, some of
them still exist, others are destroyed due to various circumstances.
The first temporary civil hospital in Kragujevac started its work in 1844. Shortly
thereafter conditions were created for the establishment of the first District Hospital, which
was opened on November 20, 1860. The hospital was established in an abandoned
building. At first it had six wooden beds, and later twelve. It consisted of two rooms. Based
on the preserved photograph, we can conclude that the hospital was in a one-storey house,
with a rather large base for the houses of that time, in the form of the letter "P", and on the
ground floor it had a passage to the inner courtyard and at least five rooms on the first
floor. Traces of the soot on the facade, from the ground floor to the first floor, indicate the
possibility that the rooms on the ground floor were heated by wood stoves, and that smoke
was taken out of the windows, instead through the chimneys, which supports the claims
about inadequate hygienic and sanitary conditions.
One of the first hospitals was founded in Valjevo in the house of the former chief of
the district, Aleksa Andonović in 1867. In order for the house to satisfy the most basic
needs of the hospital, the owner was instructed to carry out the necessary adaptation, which
was reflected in the installation of double windows in each room, painting the house from
the outside and inside, setting the door where needed, installation of wood flooring in one
room and the stove for heating the "large room". The house still exists in the Trade Zone of
XVIII ЮБИЛЕЙНА МЕЖДУНАРОДНА НАУЧНА КОНФЕРЕНЦИЯ ПО
СТРОИТЕЛСТВО И АРХИТЕКТУРА ВСУ’2018
XVII ANNIVERSARY INTERNATIONAL SCIENTIFIC CONFERENCE BY
CONSTRUCTION AND ARCHITECTURE VSU'2018
Valjevo, in the Knez Miloš street. It is privately owned and is not protected as a cultural
property. Although its ground floor has a function of office space, and the floor has a
function of housing, the facade leaves the impression of a neglected and inadequately
maintained building.
a) b) c)
Fig. 1. – Hospital architecture in private homes: a) The building of the first District
Hospital in Kragujevac, 1910, b) The building of the first hospital in Valjevo, c) The
building of the first civil hospital in Niš - today's (photo by O. Nikolic)
In Niš, the first civil hospital, District Hospital, was founded in the private house of
Mr. Andona at the Nišava quay. According to the description of the inspector of sanitary
institutes in the country, Dr. Janković, "in this house there are 9 good rooms, 3 kitchens
and 3 small chambers; there are plenty of rooms for all hospital needs and can
accommodate up to 40 patients." After equipping, the hospital was opened in July 1881
and it was in this house until it was moved to a purpose-built building in 1910.
The house where the first District Hospital in Niš had been opened, today is privately
owned and is not on the list for the protection of cultural monuments in Niš. Due to
inadequate maintenance the house has not been in operation for a long time
2.2. Architecture of purpose-built hospitals
In order to create the conditions for the construction of permanent hospital facilities
built of solid materials in Serbia in 19th century, towns and cities had to create funds for
construction themselves, they had to find suitable locations, obtain the necessary technical
documentation for the construction, and find funds for the implementation of the house
design. In rare cases, the state financially participated and helped build hospitals. Finances
for materials and construction were obtained through contributions from wealthy
inhabitants or through a tax for the hospital.
The lack of finances has affected the beginning and the end of the construction, as
well as the appearance of the hospital itself. At that time, the hospitals were built as
separate pavilions, so that at the site could be found two or three hospital facilities and a
separate economic part. Special attention was paid to infectious diseases and patients
suffering from them, for which special pavilions were built, away from the main, general
pavilion. In terms of the solution of the base, the buildings were, most often, ground,
elongated, with a one-track or two-track floor plan. The entrance and the staircase were
centrally located, and on the left and right there were separate blocks for inpatients and
outpatients. Within the general pavilion there was also a flat for a doctor and a janitor.
The first purpose-built hospital facility was built in Šabac in 1865, soon afterwards
in Belgrade in 1868. The period is characterized by architecture with the features of
romanticism in Serbian and European architecture. After the first period of Serbian
classicism, in the third quarter of the century, romanticism prevailed as the main and most
XVIII ЮБИЛЕЙНА МЕЖДУНАРОДНА НАУЧНА КОНФЕРЕНЦИЯ ПО
СТРОИТЕЛСТВО И АРХИТЕКТУРА ВСУ’2018
XVII ANNIVERSARY INTERNATIONAL SCIENTIFIC CONFERENCE BY
CONSTRUCTION AND ARCHITECTURE VSU'2018
widespread style. Adopting European architecture, Serbia accepted the new tendency in the
mid-nineteen century - the romantic spirit. The building of the hospital in Šabac, as well as
the building in 19, Džordž Vašington street, have elements of Romatic and Gothic style on
the facade.
Parallel to the characteristics of romanticism, buildings were also built in the spirit of
late Serbian historicism. Such is the facade of the First General Hospital in Jagodina, built
in 1867. The ground-floor building, withdrawn from the street boundary, as the most
prominent motive on the facade has two gradually raised fronts in relation to the main
entrance.
a) b) c)
Fig. 2. – The first purpose-built hospital facility: a) First general hospital in Jagodina
built in 1868 b) First town hospital in Belgrade built in 1868 c) Hospital in Knjaževac built
for the second time in 1896.
The buildings of the first Serbian hospitals built in the last quarter of 19th century do
not differ much in the facade plastics from the residential buildings of that time. In larger
urban areas there are mildly decorated window arches and corners of facades with
elements of classicism. Such were, for example, the pavilions of the hospital in Aleksinac.
In smaller towns, such as the hospital in Knjaževac, there were no ornaments on the
facade, even protruded parts on the facade, with smaller openings than others, contributed
to the impression of a fortified object, which is not a coincidence when we speak of a
hospital in this place, because it was three times destroyed in wars and rebuilt in the same
place.
Hospital buildings, built in the beginning of 20th century in the architectural
expression of the facade, reflect the style of that time - academicism. Such is, for example,
the facade of today's Clinic of the internal medicine of the Clinical Center in Niš, built in
1910 or the facade of the hospital in Loznica, built in 1912 [1].
a) b)
Fig. 3. – Hospital buildings, built in the beginning of 20th century: The main building of
the District Hospital in Niš, built in 1910. b) The district hospital in Loznica, built in 1912.
3. Revitalization of preserved hospital buildings
XVIII ЮБИЛЕЙНА МЕЖДУНАРОДНА НАУЧНА КОНФЕРЕНЦИЯ ПО
СТРОИТЕЛСТВО И АРХИТЕКТУРА ВСУ’2018
XVII ANNIVERSARY INTERNATIONAL SCIENTIFIC CONFERENCE BY
CONSTRUCTION AND ARCHITECTURE VSU'2018
Today's blocks of hospitals or health centers in Serbia in the largest percentage of
cases are at locations that were already selected in 19th century for the construction of the
first permanent hospitals. Within these blocks there are also first buildings for health care
of that region that were preserved. Observing them through today's function and purpose,
the following classification was made in terms of revitalization:
• buildings that are not in operation
• buildings that are in the function of treatment
• buildings that changed their purpose
The question of the function of a historical building, such as the buildings of the
first hospitals in Serbia, is very complex and cannot be solved by the universal model,
because in the choice of architectural heritage there is a wide range of possibilities, that is,
gradations in the stages of adaptation and revitalization [2]. The use of architectural
monuments of the past for modern purposes or their revitalization is a very difficult
problem and it takes a lot of spirit, inventiveness and economic resourcefulness to bring
the monument into life [3]. From this point of view, with regard to the preservation and
prolongation of life of the first health facilities there are many creative examples that will
be described below.
3.1. Buildings of the first hospitals that are not in operation
In Aleksinac, the facilities for the General Department with the maternity ward, the
Chest Department and the Department of infectious diseases were built simultaneously in
1893 as a pavilion-type building. Over time, new facilities that met the needs of modern
treatment were added to the existing location, and the original three buildings were
abandoned. As the building of the General Department and the Chest Department are
positioned towards the roads, it would be easy to do the space conversion. The General
Department building is an elongated, two-track ground-floor building, with a main
entrance from the yard of the hospital. On the facade facing the street there are openings in
certain grids. The roof cover and the roof structure are preserved. In terms of design and
stability, no significant damage is seen on the building.
a) b)
Fig. 4. Two buildings were made according to the same architecture project of the Ministry
of Construction а) District Hospital in Svilajnac; b) Hospital Kursumlija
3.2. Buildings of the first hospitals that are still in the function of treatment
The buildings of the first purpose-built hospitals in Kuršumlija and Svilajnac have
characteristics in several aspects. They were built in a similar period - the hospital in
Svilajnac from 1906 to 1909, and the hospital in Kuršumlija in 1912. Both are today, after
minimal reconstruction regarding the formation of partition walls and replacement of the
roof structure, facilities that serve the function of treatment. The hospital in Svilajnac
retained the purpose of the infirmary, and in the old hospital building in Kuršumlija there is
a dental service. A particularly interesting result of the research is that these two buildings
XVIII ЮБИЛЕЙНА МЕЖДУНАРОДНА НАУЧНА КОНФЕРЕНЦИЯ ПО
СТРОИТЕЛСТВО И АРХИТЕКТУРА ВСУ’2018
XVII ANNIVERSARY INTERNATIONAL SCIENTIFIC CONFERENCE BY
CONSTRUCTION AND ARCHITECTURE VSU'2018
were made according to the same architecture project of the Ministry of Construction,
which is a proof of the statements from the literature that the Ministry of Construction has
produced typical hospital designs.
3.3. Buildings of the first hospitals that changed their purpose
Examples of good practice where the buildings of the first hospitals changed their
purpose and became objects of cultural heritage are the buildings of the first hospitals in
Šabac, Valjevo and Belgrade.
The building of the hospital in Šabac was built in 1865 as the first District Hospital
of the Principality of Serbia. The sources do not include the name of the designer, but it is
assumed that the architect was Jovan Frencl. It is a ground floor one-track building, with
centrally located entrance, elongated, rectangular in base. It is designed in the spirit of
romanticism and is characterized by the use of arched windows and bogen frieze at the top
of the facade walls. In terms of the design, in some parts of the building, the most modern,
constructive assembly was applied at the time - steel carriers with shallow Prussian vaults.
At the ends of the left and right wing, large and well-lit rooms for patients with 12 beds
were designed.
Due to its architectural and urban value, the old hospital building was declared a
cultural monument. In 1981, the Inter-municipal Historical Archives moved in. After
several conservations and restorations, today it is a 1200 m2 building instead of the 427
m2, and besides the space for the storage of archival material, it has workrooms, a library,
a modern reading room, a main auditorium and a furnished gallery space.
The building of the surgical pavilion in the hospital in Valjevo was built in 1910
within the block of the District Civil Hospital. The surgical pavilion was designed by the
famous architect Jovan Ilkić. It was one of the most modern buildings of its time, with a
specific purpose. It is designed as a ground-floor building with a basement and attic,
measuring 42x11.4m. The two main entrances to the building were facing the street, and
opposite, at the end of the hall, there were exits towards the yard of the block. Left and
right of the entrance, reception offices and medical rooms were designed, and on the
corridor that connected them, facing the street, there were rooms for patients. The
operating room was designed as a projected room, towards the yard of the block.
In the external processing, the spirit of academicism is felt through the orthogonal
division on the facade walls and the emphasized front of the main entrances.
The surgical pavilion today is the building of the Historical Archives, and in 2015 in
the left wing of the pavilion, the permanent exhibition "Suffering and Compassion –
Valjevo hospital", whose author is the historian Velibor Vidić, was opened.
a) b) c)
Fig. 5. Buildings of the first hospitals that changed their purpose а) District Hospital
Šabac; b) District Civil Hospital Valjevo; c) First Town Hospital in Belgrade
The building of the First Town Hospital in Belgrade was built in 1868 according to
the design of the architect Jovan Frencl. It was built as a free-standing two-storey building
withdrawn from the street boundary, with closed cubic structure, rectangular base with
XVIII ЮБИЛЕЙНА МЕЖДУНАРОДНА НАУЧНА КОНФЕРЕНЦИЯ ПО
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XVII ANNIVERSARY INTERNATIONAL SCIENTIFIC CONFERENCE BY
CONSTRUCTION AND ARCHITECTURE VSU'2018
protruding vertical staircase to the courtyard. On the ground floor, along the central axis of
the building, there was an entrance hall and a spacious doublereturn staircase protruding to
the yard, around which the utility rooms with toilets were arranged. At each level there
were four rooms of greater width and depth, which served to accommodate patients, and
two smaller rooms for hospital staff and interventions. In terms of facade solution, it is one
of the most beautifully preserved first hospitals with rich facade plastics, inspired by the
medieval romantic and gothic heritage [4].
In the right wing today, the Health Center Stari grad is located [5], and in the left
wing are the offices of the medical society and the Museum of the Medical Society with a
permanent exhibiton on 360 m2.
Conclusion
The buildings of the first hospitals in Serbia are some kind of monuments of the
health culture of the Serbian people. After centuries of national medicine and not applying
achievements of modern civilization, they represent the foundation of the development of
the modern Serbian state and modern treatment.
Although of modest dimensions and spatial organization, equipment, as well as
decorative facade plastics, these facilities were modern buildings of their time and fulfilled
the conditions for smooth operation and functioning of the hospital. They were built of
solid materials and new constructive solutions were often applied. The surprising fact is
that despite numerous wars and bombing, many of the first civilian health care facilities
have been preserved. Their value has been recognized through numerous conservation
works in the last twenty years, many of these objects have restored usable value.
Equally interesting are examples of buildings that are still in the function of health
care and protection, as well as buildings that have become cultural facilities by changing
their purpose.
The buildings of purpose-built facilities, in terms of revitalization, are in a better
position than the first health facilities located in private homes. The cause of the problem is
the ownership of these buildings. In order for these two categories of buildings to be in an
equal position, the assistance from the state and competent ministries is necessary.
Since the structure of the Ministry of Construction for this period was destroyed and
lost, in the absence of technical documentation, the conclusion of this paper on the
existence of type designs and case detection is interesting. The further course of the
research is to find other preserved buildings of the first purpose-built hospitals, as well as
their history.
REFERENCES
[1] Chorilic Lj., District hospital in Loznica (1882 -1997), Healt center „Dr Milenko
Marin“, Loznica, 1997. (in Serbian)
[2] Tomoslav Marashovic, Aktivni pristup graditeljskom nasleđu - Active approach to
architectural heritage, University in Split, Split, 1985, pp. 130 (in Croatian)
[3] Slobodan M. Nenadović, Zaštita graditeljskog nasleđa - Protection of architectural
heritage, Faculty of architecture Belgrade, Belgrade, 1980, pp. 146 (in Serbian)
[4] Mirjana Rotar Blagojević, Nastanak prvih zdravstvenih kompleksa i zgrada u
Beogradu u XIX i početkom XX veka, Acta hist. med. stom. pharm. med. vet., 2014 ,
no. 33, book 1, pp. 85 (in Serbian)
[5] Jovanovic S J., Serbian medical society’s museum of Serbian medicine, Acta med-hist
Adriat 2006, 4(2), pp. 323-330
