Rufaida Al-Aslamia: The First Nurse in the World and Pioneer of Islamic Healthcare

Dr. Syed Mansoor Sarwar

The history of science is evolving to recognize global contributions, shifting away from a solely Eurocentric view and acknowledging diverse knowledge systems and creators, including women and non-European cultures. This broadened perspective requires historians to utilize a wider array of historical sources to uncover previously marginalized narratives. A diverse group of 40 female and 18 male authors utilized this methodology to capture this richer history and uncover lesser-known narratives. Together they identified 52 women scientists whose discovery and production of new knowledge was recovered through primary sources, spanning from 1200 BCE to the early twenty-first century. The University of London Press published their work as “Women in the History of Science—A Sourcebook” in 2023 edited by five white, middle-class women academics with earned PhDs who were educated in American and British institutions.

One of these 52 women scientists acknowledged in this process is Ku‘ayba bint Sa‘d al-Aslamia. The primary source of information about her in the Sourcebook is Kitab al-tabaqat al-kubra (‘Book of the Great Generations’), the earliest and fullest surviving biographical dictionary compiled by the hadith scholar and historian, Ibn Sa‘d (784–845 AD). In online discussions, the name Ku‘ayba has evolved into Rufaida. The exact timing or cause of this transformation is unclear but searching for Rufaida al-Aslamia leads to a figure who aligns with what historians recognize as Ku‘ayba bint Sa‘ad al-Aslamia. Many other Muslim scholars and historians also mention her in their writings, including Ibn Ishaq, Ibn Abdul Barr, Ibn Al-Athir, Ibn Hajar, Ibn Sa’d Al-Baghdadi, and Ibn Habib.

In the annals of history, Florence Nightingale is often celebrated as the founder of modern nursing. While her contributions to the profession are enormous, the true origin of nursing as we know it can be traced back centuries earlier to Rufaida Al-Aslamia, a woman who laid the foundations for organized nursing care in the early days of Islam at the beginning of 7^th century AD. Her legacy in nursing predates Nightingale’s time by over a millennium, and her groundbreaking work offers a profound lesson in patient care, community service, and leadership.

The Early Beginnings of Nursing in Islam

Rufaida Al-Aslamia was born in 597 in Madina, Saudi Arabia, into an affluent family of the Bani Aslam tribe of the Kazraj tribal confederation. Her father, Sa’ad Al-Aslamia, was a renowned physician and surgeon. She was among the women who welcomed the Prophet Muhammad (PBUH) on arrival in Madina. She was also among the first few people in Madinah to accept Islam and was married to Sa`ad ibn Mu`adh, a prominent companion of the Prophet (PBUH) and a leader of the Muslims in Mecca. She passed away in Medina, but the exact date of her death is not well-documented.

Under her father’s mentorship, she acquired significant medical knowledge, becoming one of the first women in her community to gain expertise in clinical and surgical practices. Embracing Islam in its early days, Rufaida was among the first women to dedicate her life to serving the sick and injured. Her reputation as a skilled and compassionate healer quickly spread throughout Madina, and she became a pivotal figure in the early Muslim community.

Rufaida’s nursing career began in 620 AD, when she was in her early twenties, during the time of the Prophet (PBUH). She saw an urgent need for organized healthcare on the battlefield, where injured soldiers often lacked adequate care. Taking action, she established the first field hospital known as “Khaimah Rufaida” in the mosque at Madina, a tent hospital that provided essential medical care to the sick and the wounded during the Islamic battles of Badr, Uhud, Khandaq, and Khaibar. This was not merely a field hospital, but the inception of a structured, system-based approach to healthcare, a concept that would shape modern nursing practices. Sa‘d bin Mu‘adh, a revered companion of the Prophet (PBUH), when wounded at Khandaq, is said to have received treatment at her hands at this facility.

A Pioneer of Nursing Leadership and Systematic Care

Rufaida’s contributions go far beyond caring for the sick. She pioneered a structured system of nursing that combined care for the injured with critical elements of hygiene, sanitation, and patient comfort. The battlefield, with its harsh conditions, was an unforgiving environment for healing, but Rufaida’s insistence on maintaining clean, ventilated tents and providing a regular supply of clean water ensured that soldiers received the best possible care under the circumstances. She understood the importance of environmental factors in healing, a principle that remains a cornerstone of modern nursing today.

Her leadership was also reflected in her ability to organize and educate others. Rufaida founded the first known nursing school in 622 AD, where she trained female companions of the Prophet (PBUH) to care for the wounded soldiers. It was a structured educational initiative that empowered women to take on critical roles in healthcare. The nurses Rufaida trained were integral in supporting the Muslim army, particularly in treating soldiers on the frontlines of battles. Her impact as a nurse educator ensured the survival and success of an organized nursing profession in early Islamic society.

The importance of this educational initiative cannot be overstated. By focusing on training women to provide essential care, Rufaida not only addressed the immediate healthcare needs of the community but also paved the way for gender equity in the healthcare profession. Her legacy embodies the idea that healthcare, especially nursing, is a noble and vital career that requires skill, compassion, and dedication.

Nursing in the Context of Community Care

Rufaida’s nursing efforts extended beyond the battlefield. In peace times, she turned her focus to the well-being of the broader community. She is credited with establishing the first Islamic health center in Madina, where she provided care to children, the elderly, orphans, and those with disabilities. Her holistic approach to healthcare demonstrated her understanding of the social determinants of health; caring not only for physical ailments but also addressing social issues like poverty and neglect. Her work in community care reflects a forward-thinking vision of nursing as a profession that extends to every member of society, regardless of their status or condition.

In addition to her role as a healer and educator, Rufaida’s skills as a leader were also evident. She was often called upon by the Prophet Muhammad (PBUH) to manage care for specific injured companions, highlighting her organizational ability and the trust placed in her by the Prophet (PBUH). According to historical accounts, the Prophet (PBUH) was so impressed with her nursing capabilities that he allocated her a share of the war bounty, an honor usually reserved for soldiers on the frontlines. This recognition underscores Rufaida’s integral role in the Muslim army’s success and the highly respected status she held within the community.

The Legacy of Rufaida Al-Aslamia

Rufaida’s influence on nursing cannot be overstated. Not only was she the first woman to organize and formalize nursing care, but she was also the first to establish a system of nursing education and clinical practice. Her work remains foundational to both Islamic and global nursing practices.

Though much of Rufaida’s legacy was transmitted through oral history, her contributions were rediscovered in 1981 through the work of Dr. Soad Hussein Hassan, the first Arab Ph.D. nurse. This resurgence of interest has led to the growing recognition of Rufaida Al-Aslamia as a pioneer of nursing. Today, her life and work continue to inspire nurses worldwide, particularly in the Muslim world, where she is remembered not just as a nurse, but as a trailblazer who elevated the status of women in healthcare.

Nursing Today: Drawing Inspiration from Rufaida

The world has come to recognize Florence Nightingale as the founder of modern nursing, but it is vital to acknowledge the deep roots of the nursing profession in history. Rufaida Al-Aslamia’s legacy proves that nursing was not merely a profession born in the 19th century but one with a long and rich history rooted in the wisdom of the early Islamic period. Her holistic approach to patient care, her leadership in establishing nursing education, and her profound sense of duty to her community make Rufaida not only the first nurse in the world but also an enduring symbol of compassion, resilience, and innovation in healthcare. As modern nursing continues to evolve, it is essential to look back to its origins and honor the remarkable contributions of women like Rufaida, who laid the foundation for the healthcare system we rely on today.

Rufaida Al-Aslamia’s legacy challenges us to view nursing as not just a profession but a vocation; one that demands a deep sense of compassion, a commitment to social justice, and an unyielding dedication to the well-being of others. Her story is one of triumph, leadership, and an unwavering belief in the value of caring for others. Her pioneering efforts have set the stage for nursing to be recognized as the noble and critical profession it is today. The name Rufaida al-Aslamia has undoubtedly inspired nursing communities worldwide, to the point where the Royal College of Surgeons in Ireland at the University of Bahrain, now awards an annual nursing prize in her honor, the Rufaida al-Aslamia Prize in Nursing, presented to the student who regularly provides superior nursing care to patients. The moment has arrived that like the Hippocratic Oath taken by physicians in the honor of ancient Greek physician, Hippocrates, the nurses should take Rufaida Oath to give respect to the work ethics of Rufaida Al-Aslamia, the pioneer nurse.

Rufaida Al-Aslamia’s life and work remain relevant for nurses today. It is time to acknowledge her rightful place as the world’s first nurse, a true inspiration for generations to come. While this article presents a compelling evidence, further research is needed to fully uncover Rufaida’s extraordinary story. With Saudi Arabia’s recent focus on heritage, it is hoped that future studies will enrich our understanding of Islamic pioneers in nursing.