Steel. Coal. Labor. Three rivers. These are the well-known elements from which the city of Pittsburgh was constructed. But what about the role of philanthropy?

The new book, “A Gift of Belief: Philanthropy and the Forging of Pittsburgh,” edited and co-written by Kathleen W. Buechel, explores this subject in great detail.

This story, however, isn’t only about great men and their money.

The region’s first hospital was founded by the Sisters of Mercy, a congregation of women who arrived from Ireland and moved to Uptown in 1847. They offered medical care regardless of a patient’s faith or ability to pay. Four of the founding sisters died in the first year, as they selflessly treated victims of a typhoid pandemic that raged through the city.

“The fact that so many of those sisters died in the first year of the hospital in the epidemic — it’s heartbreaking,” says Buechel.

They weren’t just being compassionate; they were advancing the science of medicine, too. They emphasized the importance of sanitation and hygienic wound care, which was cutting-edge treatment at the time.

“A Gift of Belief” was edited and co-written by Kathleen W. Buechel.

The Sisters of Mercy’s hospital evolved into today’s UPMC Mercy in Uptown — which is undergoing a massive expansion to become a worldwide hub for vision care research.

The book, in many ways, is the culmination of Buechel’s almost 30 years involved in philanthropy.

“When I was at the Alcoa Foundation, I often brought people to Pittsburgh to see approaches that were being incubated here that were relevant to community problems encountered in other cities. And it just occurred to me that Pittsburgh is such a rich teaching and learning laboratory about philanthropy and that many the tools I was using originated years ago in Pittsburgh.”

The book is divided into chapters about different kinds of philanthropy, written by different authors (including Buechel), such as The Gendered Dimensions of Women’s Philanthropy by Jessie B. Rainey, The Grassroots Safety Net by Jared N. Day, and The Art of Downtown Revitalization by Angelique Bamberg.

“I think we found that there’s an enduring commitment to treating Pittsburgh as a work in progress,” says Buechel. “And that it isn’t just the titans and their foundations that have carried on that legacy, it’s everyday individuals — people whose names we don’t know — who founded the institutions, many of which continue to this day.”

“So many orphanages and charitable institutions were founded by people (often women), or congregants of something like the First Presbyterian Church and other religious or faith-based organizations and they created a grassroots social safety network.”

For example, the Protestant Orphan Asylum, established in 1832, would change its name in 1969 to Pressley Ridge.

Pittsburgh was (and is) fortunate to have so many civic-minded philanthropists who remained committed to the region, even when some family members moved elsewhere.

In many instances, they helped seed the city’s revival after its near-total industrial collapse in the 1970s and 1980s. For example, the Carnegie and Mellon fortunes planted what would become Carnegie Mellon University, without which Pittsburgh’s rapidly growing robotics and computer science industries likely wouldn’t exist.

Yet, there are times when philanthropists had to learn from mistakes.

“I’m thinking of the development of the Cultural District,” says Buechel. “It was originally thought of as a ‘Cultural Acropolis’ in the Lower Hill by the Civic Arena. The backlash in clearing the land for the Civic Arena persuaded philanthropists to abandon that strategy and to look Downtown and do something else. Pittsburgh lived with the legacy of what happened in the Lower Hill, and what happened Downtown is a result of this more sensitive approach.”

One thing that struck Buechel in her research, was that philanthropic efforts don’t always show results right away — sometimes, not even for a long time. That doesn’t mean they’re not working.

“Change takes a long time to occur,” she says. “(Creating) the Cultural District took three decades. Riverlife is in its 25th year of creating riverfronts that are cherished by all. Philanthropists played key roles in all those; their patient capital was required. You have to stay committed and continue to devote resources to things that matter.”

She also noticed that some of our problems have stayed constant, no matter the era.

“What’s old is s new,” says Buechel. “Some of the early issues in terms of health disparities and economic dislocation and gaps that exist in our community are still with us. I like to think we are finally reckoning with the root causes of some of those, looking at prejudice and segregation and their effect on the disparities in Pittsburgh today.”