Benevolent Stewards of Health and Utility

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The Benevolent Stewards of Health and Utility, sometimes colloquially called the Healers of the Realm or the Apricot Ministry, are a division of the Thousand Scales, subordinate to the Honorable and Humble Caretakers of the Common Folk.

The Benevolent Stewards are responsible for public health on the Blessed Isle, a task set them by the Scarlet Empress who determined her populace needed to both benefit from her generosity and see their productivity maximized.

The Stewards consist of two main divisions: one is a system of hospitals in the Isle’s major urban centers, which contain physicians and apothecaries to treat city residents and produce medications; the other is the ‘walking doctors’ which carry medical care into the countryside.

Walking doctors, officially Doctors Walking Barefoot in the Steps of Sextes Jylis, are by far the most numerous medical practitioners in Creation, found across the Blessed Isle. They are drawn from the ranks of citizens and peasants, trained in basic medical techniques, and sent out into the countryside. They are assigned an area which they must cover, often one or more villages, and they reside in and travel between these villages dispensing health care to the population. They spend time as farmers, growing the medicinal herbs they need to treat locals, and this shared agricultural background serves to earn them the trust of the peasantry. On some occasions they will provide referrals for the ill in their areas to ensure they are sent to an urban hospital.

Hospitals are more complex, with specialists in several fields as well as physicians, including alchemists and apothecaries who can produce medications. The staff of these facilities contains a large number of thaumaturges completing their Benevolent Obligation, a requirement of the licenses issued by the Secretariat of Minor Charms and Baubles which demands each medical thaumaturge devote five years service to the Benevolent Stewards. Hospitals provide the same services as walking doctors, but with more resources due to the increased issues in urban areas, and requiring the ill to come to the hospital rather than having doctors travel the streets seeking them out. They also produce large amounts of medications which are both sold to supplement budgets and distributed to both hospital staff and walking doctors so they might reach those in need. Hospitals and the experts within are responsible for the training of walking doctors before they are sent out into the countryside, a process that can take a year or two to complete.

In both rural and urban areas, the Stewards are responsible for a number of aspects of public health. One of the most important is prevention and containment of epidemics and communicable diseases: the lessons of the Great Contagion were not lost on the Scarlet Empress when she built her Realm. Stewards are responsible for advising other departments on matters of hygiene and sanitation, prioritizing removal of waste from inhabited areas and the incineration of bodies during an outbreak. They are also responsible for imposing quarantines on buildings, wards, sometimes whole prefectures in the case of virulent outbreaks, and for distributing cures and treatments in areas where it is thought the tide can be turned or slowed.

Another is the treatment of illnesses which, untreated, threaten death or debility: infections are sanitized and cleaned, bones are set back properly, antidotes to poisons are conveyed, essence twists are unbound with acupuncture before the onset of gangrene. Some preventative care is undertaken, and where time and resources permit care for practical lesser issues can be provided (such as creams to calm back chafing from bearing heavy loads). A number of medicines are mass-produced in hospitals to assist with this task, most with multiple applications to maximize their utility. One of the most widespread being the Tonic of the Roaring Moon, derived from the bile of moon bears (with large amounts of bile imported from the satrapy of Madura), which is administered for treatment of fever, which is otherwise frequently fatal, its digestibility by newborns allowing them to be saved from early death through fever or jaundice. It is also administered to slay parasites such as tapeworms which are common in rural areas, and has a third use in the curing of sore and reddened eyes, its administration known to prevent some forms of blindness.

A third major responsibility is midwifery and husbandry, ensuring the birth of children so that mothers and children survive in health. For walking doctors this responsibility extends to working with livestock, advising peasants on ways to assure fertility and veterinary basics, though often herders will have more knowledge from lifetimes working with such animals.

The Benevolent Stewards are not, however, a universal source of medical aid. While they work to prevent disability, once disability has set in they do not provide care… the Disenfranchised are no longer of use. They receive no treatment whatsoever from the Stewards.

Likewise, there is no geriatric care… the elderly are already approaching death and past their productive years, there is no need to prolong their lives further. The closest thing to such care that exists is the production of analgesic drugs, which are sold at premium rates only to those licensed to buy them by the Empress or Deliberative.

Finally, chronic care is not provided by the Stewards, as there is no eventual solution to the issue and so the expense makes little practical sense… if there is a cure, it may be provided, but in the absence of one the chronically ill must supply their own care.

Despite the fact they do not provide aid to the crippled or the old, the Benevolent Stewards have an excellent reputation amongst the peasants and citizens of the Realm, who are grateful for the assistance they provide. To peasants, there is a saying concerning the three members of the bureaucracy they are most likely to see, The Coming of the Three Imperial Officials: “the Tax Assessor comes to Take, the Black Helm comes to Strike, the Walking Doctor comes to Cure”.

The Stewards, though a large and prevalent ministry, draw little interest from the Realm’s Dragonblooded… the services they provide are in most cases not needed, either because wealthy Dynasts and patricians can afford better care from private physicians or because the ills they treat simply do not affect the Exalted. Idealistic Dragonblooded sometimes seek to join the Stewards, but this is discouraged, for it is not proper for the Exalted to interact so closely with the people on a regular basis, despite the obvious potency of charm-based treatments.

Dragonblooded do sometimes become involved, however, around the peripheries. They are after all brilliant and skilled in ways mere mortals cannot manage, and capable of devising new miracle cures or plotting out epidemic containment schemes. The Stewards are thus involved in sponsoring the research efforts undertaken by several Dragonblooded across the Isle, the most notable of which is the Imperial Physicians’ Collaborative in the Imperial City, which includes five Dynastic sorcerers working together on various medical projects. On its own, Stewards funding is not enough to support such efforts, but it is a welcome supplement to many researchers, and can allow access to patients for final testing of new drugs and theories.

The Stewards have managed thus far to stave off disbandment in the budget cutbacks by the Imperial Treasury, but they are an expensive ministry to operate and one that cannot bring in much coin directly. Their budget has been cut back by more than half, causing many Walking Doctors to revert to simple farming and assisting their neighbours while they wait for the top bureaucrats to sort matters out. The free labour of thaumaturges has become even more vital in producing medicines, though corruption has meant a shift has begun from the more widely useful drugs to those more valuable to the Isle's wealthy.

Head: Benevolent Minister of Health, currently Sesus Athaliah.