A hospital ship is a ship designated for primary function as a floating medical treatment facility or hospital. Most are operated by the military forces (mostly navies) of various countries, as they are intended to be used in or near war zones.[1] In the 19th century, redundant warships were used as moored hospitals for seamen.
The Second Geneva Convention prohibits military attacks on hospital ships that meet specified requirements, though belligerent forces have right of inspection and may take patients, but not staff, as prisoners of war.[2] [3]
Hospital ships possibly existed in ancient times. The Athenian Navy had a ship named Therapia, and the Roman Navy had a ship named Aesculapius, their names indicating that they may have been hospital ships.[4] [5] [6]
The earliest British hospital ship may have been the vessel Goodwill, which accompanied a Royal Navy squadron in the Mediterranean in 1608 and was used to house the sick sent aboard from other ships.[7] However this experiment in medical care was short-lived, with Goodwill assigned to other tasks within a year and her complement of convalescents simply left behind at the nearest port.[8] It was not until the mid-seventeenth century that any Royal Navy vessels were formally designated as hospital ships, and then only two throughout the fleet. These were either hired merchant ships or elderly sixth rates, with the internal bulkheads removed to create more room, and additional ports cut through the deck and hull to increase internal ventilation.[7]
In addition to their sailing crew, these seventeenth century hospital ships were staffed by a surgeon and four surgeon's mates. The standard issue of medical supplies was bandages, soap, needles and bedpans. Patients were offered a bed or rug to rest upon, and given a clean pair of sheets. These early hospital ships were for the care of the sick rather than the wounded, with patients quartered according to their symptoms and infectious cases quarantined from the general population behind a sheet of canvas. The quality of food was very poor. In the 1690s, the surgeon aboard Siam complained that the meat was in an advanced state of putrefaction, the biscuits were weevil-ridden and bitter, and the bread was so hard that it stripped the skin off patients’ mouths.[7]
Hospital ships were also used for the treatment of wounded soldiers fighting on land. An early example of this was during an English operation to evacuate English Tangier in 1683. An account of this evacuation was written by Samuel Pepys, an eyewitness. One of the main concerns was the evacuation of sick soldiers "and the many families and their effects to be brought off". The hospital ships Unity and Welcome sailed for England on 18 October 1683, with 114 invalid soldiers and 104 women and children, arriving at The Downs on 14 December 1683.[9]
The number of medical personnel aboard Royal Navy hospital ships was slowly increased, with regulations issued in 1703 requiring that each vessel also carry six landsmen to act as surgical assistants, and four washerwomen. A 1705 amendment provided for a further five male nurses, and requisitions from the era suggest the number of sheets per patient was increased from one to two pairs.[7] On 8 December 1798, unfit for service as a warship, was ordered to be converted to a hospital ship to hold wounded French and Spanish prisoners of war. According to Edward Hasted in 1798, two large hospital ships (also called lazarettos), (which were the surviving hulks of forty-four gun ships) were moored in Halstow Creek in Kent. The creek is an inlet from the River Medway and the River Thames. The crew of these vessels watched over ships coming to England, which were forced to stay in the creek under quarantine to protect the country from infectious diseases including the plague.[10]
From 1821 to 1870, the Seamen's Hospital Society provided HMS Grampus, HMS Dreadnought and HMS Caledonia (later renamed Dreadnought) as successive hospital ships moored at Deptford in London.[11] In 1866, HMS Hamadryad was moored in Cardiff as a seamen's hospital, replaced in 1905 by the Royal Hamadryad Seamen's Hospital. Other redundant warships were used as hospitals for convicts and prisoners of war.
The Royal Navy institutionalised the use of hospital ships during the first half of the nineteenth century. Hospital ships were generally superior in their standard of service and sanitation to the medical provision available at the time for convalescent soldiers. The modern hospital ship began to emerge during the Crimean War in the 1850s. The only military hospital available to the British forces fighting on the Crimean Peninsula was at Scutari near the Bosphorus. During the Siege of Sevastopol almost 15,000 wounded troops were transported there from the port at Balaklava by a squadron of converted hospital ships.
The first ships to be equipped with genuine medical facilities were the steamships HMS Melbourne and HMS Mauritius, staffed by the Medical Staff Corps and providing services to the British expedition to China in 1860. The ships provided relatively spacious accommodation for the patients, and were equipped with an operating theatre. Another early hospital ship was in the 1860s, which aided the wounded soldiers of both sides during the American Civil War.
During the Russo-Turkish War (1877–78), the British Red Cross supplied a steel-hulled ship, equipped with modern surgery equipment including chloroform and other anaesthetics, and carbolic acid for antisepsis. Similar vessels accompanied the 1882 British invasion of Egypt and aided American personnel during the 1898 Spanish–American War.
During a smallpox outbreak in London in 1883, the Metropolitan Asylum Board (MAB) chartered and later purchased from the Admiralty two ships, and, and a paddle-steamer,, which were moored in the Thames at Long Reach, near Dartford,[12] [13] and remained in service until 1903.[12] [14]
Hospital ships were used by both sides in the Russo-Japanese War of 1904–1905.The sighting by the Japanese of the Russian hospital ship Orel, illuminated in accordance with regulations for hospital ships, led to the decisive naval Battle of Tsushima. Orel was retained as a prize of war by the Japanese after the battle.
During World War I and World War II, hospital ships were first used on a massive scale. Many passenger liners were converted for use as hospital ships. and were two famous examples of ships serving in this capacity. By the end of the First World War, the British Royal Navy had 77 such ships in service. During the Gallipoli Campaign, hospital ships were used to evacuate wounded personnel to Egypt, Malta or England.[15]
Canada operated hospital ships in both world wars. In World War I these included SS Letitia (I) and which was deliberately sunk by a German U-boat with great loss of life, despite the hospital ship's clearly marked status. In World War II, Canada operated the hospital ship and SS Letitia (II).[16]
The first purpose-built hospital ship in the U.S. Navy was [17] which was commissioned in 1921. During World War II both the United States Navy and Army operated hospital ships though with different purposes.[18] Naval hospital ships were fully equipped hospitals designed to receive casualties direct from the battlefield and also supplied to provide logistical support to front line medical teams ashore. Army hospital ships were essentially hospital transports intended and equipped to evacuate patients from forward area Army hospitals to rear area hospitals or from those to the United States and were not equipped or staffed to handle large numbers of direct battle casualties. Three of the Navy hospital ships,,, and, were less elaborately equipped than other Navy hospital ships, medically staffed by Army medical personnel and similar in purpose to the Army model.
The last British royal yacht, the post World War II, was constructed in a way as to be convertible to a hospital ship in wartime. After her decommissioning, Peter Hennessy discovered that her actual role would have been as Queen Elizabeth II's refuge from nuclear weapons, hiding amidst the lochs of western Scotland.[19]
A development of the Lun-class ekranoplan was planned for use as a mobile field hospital for rapid deployment to any ocean or coastal location at a speed of 297 knots (550 km/h, 341.8 mph). Work was 90% complete on this model, Spasatel, but Soviet military funding ceased and it was never completed.
Some hospital ships, such as and Esperanza del Mar, belong to civilian agencies, and do not belong to a navy. Mercy Ships is an international non-governmental charity (or NGO).
Hospital ships were covered under the Hague Convention X of 1907.[20] Articles of the Hague Convention X specified the provisions for a hospital ship:
According to the San Remo Manual on International Law Applicable to Armed Conflicts at Sea, a hospital ship violating legal restrictions must be duly warned and given a reasonable time limit to comply. If a hospital ship persists in violating restrictions, a belligerent is legally entitled to capture it or take other means to enforce compliance. A non-complying hospital ship may only be fired on under the following conditions:
In all other circumstances, attacking a hospital ship is a war crime.
Modern hospital ships display large Red Crosses or Red Crescents to signify their Geneva Convention protection under the laws of war. Even so, marked vessels have not been completely free from attack. Notable examples of hospital ships deliberately attacked during wartime are in 1915, the in 1941, and in 1943.
While any ship can be designated and marked as a hospital ship, many ships are permanently dedicated to that function.
| Navy | Ship (class) | Year | Capacity | Capabilities | Image |
|---|---|---|---|---|---|
Brazil | U15 Pará | ||||
| U16 Doutor Montenegro | |||||
| U18 Oswaldo Cruz (Oswaldo Cruz) | 1984 | ||||
| U19 Carlos Chagas (Oswaldo Cruz) | |||||
| U21 Soares de Meirelles | 2009 | ||||
| U28 Tenente Maximiano | 2010 | ||||
| China | Nankang (833) (Qiongsha) | Classed as an "ambulance transport" | |||
| (865) | 2004 | Classed as a "medical evacuation ship", converted container ship with 14 "medical modules" | |||
| (866) (Type 920) | 2008 | 300 hospital beds, 20 intensive care beds | 8 operating theatres, X-ray, ultrasound, CT, hypothermia, hemodialysis, traditional Chinese medicine, and dental facilities | ||
| Nanyi (12) (Anshen) | 2020 | Classed as a "medium sized hospital ship" | |||
| tba (13) (Anshen) | 2020 | Classed as a "medium sized hospital ship" | |||
| Indonesia | KRI dr. Soeharso (990) (Tanjung Dalpele) | 2003 | Former (LPD), capable of receiving up to 2000 patients | 5 operating rooms, 6 polyclinics, 51 medical specialists | |
| KRI Semarang (594) (Makassar) | 2018 | ||||
| KRI dr. Wahidin Sudirohusodo (991) | 2021[21] | ||||
| KRI dr. Radjiman Wedyodiningrat (992)[22] | 2023 | 124 Beds, additional 350 Beds in Emergency Case | 2 ERs, 5 ORs (+ Pre/ Post), ICU, HCU, X-ray & CT-scan, Pharmacy, 8 Polyclinics, and Laboratory. | ||
| Myanmar | UMS Shwe Pu Zun | 2012 | 25 | 1 CT scanner, 1 minor eye operation room, 1 minor operation theater, 1 major operation theater, and 1 intensive care unit[23] [24] | |
| UMS Thanlwin | 2015 | 25 | 1 CT scanner, 1 minor eye operation room, 1 minor operation theater, 1 major operation theater, and 1 intensive care unit | ||
Peru | 1976 | Converted 1861 steamship, found on Lake Titicaca | |||
Russia | Yenisey (Ob) | 1981 | 100 | 7 operating rooms | |
| Svir (Ob) | 1989 | 100 | 7 operating rooms | ||
| Irtysh (Ob) | 1990 | 100 | 7 operating rooms | ||
United States | (Mercy) | 1986 | 1,000 | 12 operating rooms, digital radiological services, a medical laboratory, a pharmacy, an optometry lab, an intensive care ward, dental services, a CT scanner, a morgue, 2 oxygen-producing plants | |
(Mercy) | 1987 | 1,000 | 12 operating rooms, digital radiological services, a medical laboratory, a pharmacy, an optometry lab, an intensive care ward, dental services, a CT scanner, a morgue, 2 oxygen-producing plants | ||
| Vietnam | Khánh Hòa - 01 (Hospital Ship 561)[25] | 2013 | 200 | Operating room with satelline connected, intensive care, pressure isolation room, medical laboratory, treatment room, defibrillator room, dental service, Endoscopic room, pharmacy. radiology. | |
| Ship (class) | Year | Capacity | Capabilities | Image | |
| Mercy Ships | Converted 2007 | 82 | 5 operating theaters, 1 intensive care unit, 1 ophthalmic unit, a CT scanner, x-ray, laboratories[26] | ||
| MV Global Mercy | 2022 | 199 | 6 operating theatres, 102 acute care beds, 7 ICU beds, and 90 self-care beds. The hospital also features dedicated classroom spaces and simulator labs with state-of-the-art technology for enhanced training of local medical professionals.[27] | ||
| Ministry of Labour (Spain) | Esperanza del Mar | 2001 | 17 | 1 operating theatre, ICU facility | |
| 2006 | 10 | 1 operating theatre, ICU facility |
It is common for naval ships, especially large ships such as aircraft carriers and amphibious assault ships to have on-board hospitals. However, they are only one small part of the vessel's overall capability, and are used primarily for the ship's crew and its amphibious forces (and occasionally for relief missions). A warship with hospital facilities does not have the protected status of a hospital ship.[28] A primary example of the varied military-based hospital services available at sea is found aboard several types of US naval ships;
More examples from various other national navies include;
