Image : James Ives

Neanderthals cared for their sick and wounded, and new research suggests this well-documented behavior was more than just a cultural phenomenon or an expression of compassion—it really did help them survive.




To endure the harsh conditions of Ice Age Europe, Neanderthals adopted several strategies, including group hunting, collaborative parenting, and food sharing. New research published in Quaternary Science Reviews is adding another trick to the Neanderthal survival guide: healthcare.

“We argue that rather than simply a cultural trait, healthcare can be seen as part of several adaptations which allowed Neanderthals to survive in unique environments where they lived alongside large predatory carnivores and were often dependant on large [mammals]... as a major food source,” the authors, led by Penny Spikins from the University of York, write in their new study. “Moreover, healthcare may have been a significant factor in allowing Neanderthals to occupy a predatory niche which might otherwise have been unavailable to them.”


Indeed, Neanderthals made Ice Age Europe their home for hundreds of thousands of years, so they obviously did something right. It’s easy to get hung up on their extinction, a process that started about 40,000 years ago, but there’s so much more to Neanderthals than their demise. Their story is one of survival.

It’s no secret that Neanderthals practiced healthcare. And it’s no wonder—they faced all sorts of threats, including those from large and dangerous animals. Neanderthals were also proficient hunters, a practice that presented considerable risks. For Neanderthals, injuries were a part of daily life. But instead of neglecting the injured, or seeing them as a burden to be discarded, they engaged in healthcare.

“We have evidence of healthcare dating back 1.6 million years ago, but we think it probably goes further back than this,” said Spikins in a press release. “We wanted to investigate whether healthcare in Neanderthals was more than a cultural practice; was it something they just did or was it more fundamental to their strategies for survival?”

Evidence collected by Spikins and her colleagues suggests these practices were beneficial for the group as a whole, and consequently an important evolutionary adaptation.


For the study, the researchers analyzed the skeletal remains of 30 previously discovered Neanderthal individuals. These specimens exhibit wounds ranging from mild to severe, yet each of these individuals managed to survive their injuries (paleontologists can visually tell when a broken bone or fracture has healed). In many of these cases, the researchers say it’s highly unlikely that the individual would have survived without help, and that a well-developed system of care had to have been in place.

“The high level of injury and recovery from serious conditions, such as a broken leg, suggests that others must have collaborated in their care and helped not only to ease pain, but to fight for their survival in such a way that they could regain health and actively participate in the group again,” said Spikins.


An excellent example of an individual benefitting from Neanderthal care is the Shanidar I specimen. This individual lived well into his 40s (which is quite old by Paleolithic standards) despite a missing right hand and forearm, a badly damaged leg, blindness in one eye, and probable deafness. This individual would not have survived without daily care and provisioning of food.


“Extended periods of interpersonal care, despite a lack of any overall economic benefit to such care, is also clearly evident in other cases,” write the authors in the study, pointing to the La Chapelle aux Saints I individual, who survived with several debilitating conditions, such as osteoarthritis and extensive signs of disease. Many of the other examples presented in the study are just as striking.

To treat their wounded, Neanderthals likely employed a variety of strategies depending on the nature and severity of the injury. Really bad injuries, like a broken leg, would require fever management, hygiene maintenance, the repositioning of broken bones, and in some cases, limiting blood loss. So yes, the treatments were fairly sophisticated.


“Neanderthals appear to also have been expert collaborative healthcare providers,” the authors write in the study. “Moreover, the visible archaeological evidence is likely to be the ‘tip of the iceberg’ of more common healthcare practices, the majority of which remain invisible to archaeological interpretation.”

Like their modern human cousins, Neanderthal mothers were at risk of difficult childbirths, owing to the shape of their pelvis and the size of the baby’s head. So it’s “likely that they would have had assisted childbirth,” said Spikins, “the role that we now attribute to midwives,” adding that, “Without support, they probably could not have survived the toll that the death rate of mothers and babies could have taken on their communities.”


Treating the sick and wounded, and helping mothers through childbirth, takes a lot of time and energy, but to the Neanderthals, it was a necessity. Because they lived in small groups, the loss of a single individual could be catastrophic. Treating severely injured group members was a matter of overall survival. That’s not to say Neanderthals didn’t act out of compassion—they very likely did. What the researchers are saying is that it served a pragmatic, overarching purpose that helped the group to survive as a whole, and by extension, the entire species.

Thus, healthcare provisioning “was not only a more significant evolutionary adaptation than has previously been acknowledged,” the authors write in the study, it may also have been essential to a species that occupied the northernmost limit of Ice Age Europe. Without the benefits of healthcare, the researchers argue, Ice Age Europe would have likely been inaccessible.


Looking ahead, the researchers would like to learn more about the techniques used in Neanderthal healthcare, and to determine how far back in time these practices can be traced.

Despite their heroic efforts, Neanderthals went extinct, a likely consequence of human encroachment and, ironically, climate change. But their extended run during one of the harshest periods in recent geological history is a testament to their abilities, and a timely lesson for our own species.


[Quaternary Science Reviews]

