Hospital ship - WikiHQ

upright=1.3|thumb|[[United States Navy hospital ship USNS Comfort in 2009.]]

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. In the 19th century, redundant warships were used as moored hospitals for seamen.

The Second Geneva Convention of 1949 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.

History

Early examples

thumb|Tangier circa 1670. Hospital ships were used during the evacuation of the port in the 1680s.

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. During the Renaissance, the Spanish employed an immense carrack, the capitana or flagsip of the squad of Málaga, as a hospital ship during the 1535 conquest of Tunis.

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. 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. 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.

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.

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. 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.

Modern hospital ships

thumb|right|300x300px|HMS Melbourne, the first modern hospital ship, served during the [[Second Opium War. Excerpt from The Illustrated London News about the ship (click to read).]]

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. and remained in service until 1903.

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.

World Wars

thumb|right|[[RMS Mauretania (1906)|RMS Mauretania as hospital ship HMHS Mauretania during World War I.]]

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.

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).

thumb|250px|left|HMHS Aquitania in World War I service as a hospital ship.

The first purpose-built hospital ship in the U.S. Navy was which was commissioned in 1921. During World War II both the United States Navy and Army operated hospital ships though with different purposes. 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.

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).

International law

thumb|right|Non-government hospital ship

Hospital ships were covered under the Hague Convention X of 1907. Articles of the Hague Convention X specified the provisions for a hospital ship:

Hospital-ships must be painted white. Military hospital ships must have a green band; ships operated by approved relief societies and similar must have a red band.
Ships must fly a red cross flag in addition to their national flag.
The ship should give medical assistance to wounded personnel of all nationalities.
The ship must not be used for any military purpose, or interfere with or hamper enemy combatant vessels.
Belligerents, as designated by the Hague Convention, can search any hospital ship to investigate violations of the above restrictions.

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:

Diversion or capture is not feasible
No other method to exercise control is available
The violations are grave enough to allow the ship to be classified as a military objective
The damage and casualties will not be disproportionate to the military advantage.

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.

Current hospital ships

As of the early 21st century, hospital ships remain in limited but active service, primarily operated by naval forces and humanitarian organizations rather than as commercial vessels.

While any ship can be designated and marked as a hospital ship, many ships are permanently dedicated to that function.

Current military hospital ships

{| class="wikitable" style="align-center"

!colspan="6"|Military hospital ships

! Navy

! Ship (class)

! Year

! Capacity

! Capabilities

!Image

|rowspan="6"|Brazil

|U15 Pará

|frameless

|U16 Doutor Montenegro

|frameless

|U18 Oswaldo Cruz (Oswaldo Cruz)

|1984

|frameless

|U19 Carlos Chagas (Oswaldo Cruz)

|frameless

|U21 Soares de Meirelles

|2009

|frameless

|U28 Tenente Maximiano

|2010

|frameless

|rowspan="5"|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

|frameless

|Nanyi (12) (Anshen)

|2020

|Classed as a "medium sized hospital ship"

|tba (13) (Anshen)

|2020

|Classed as a "medium sized hospital ship"

| rowspan="3" |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

|frameless

|KRI dr. Wahidin Sudirohusodo (991) (Sudirohusodo)

|2021

|Full load 7,200 tons, up to 643 personnels, 159 patients, 4 ambulances (OFE), 3 mobile hospitals (OFE), 1 mobile decompression (OFE), 1 mobile X Ray (OFE) as well as 2 LCVP units, 1 RHIB unit and 2 Ambulance Boat units.

|2 ERs, 5 ORs (+ Pre/ Post), ICU, HCU, X-ray & CT-scanner, Pharmacy, 8 Polyclinics, a morgue and Laboratory.

|frameless

|KRI dr. Radjiman Wedyodiningrat (992) (Sudirohusodo)

|2023

|124 Beds, additional 350 Beds in Emergency Case

|2 ERs, 5 ORs (+ Pre/ Post), ICU, HCU, X-ray & CT-scanner, Pharmacy, 8 Polyclinics, a morgue and Laboratory.

| thumb|254x254px

| rowspan="2" |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

|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

|2013

|200

|Operating room with satellite connected, intensive care, pressure isolation room, medical laboratory, treatment room, defibrillator room, dental service, Endoscopic room, pharmacy, radiology.

Current non-military hospital ships

{| class="wikitable" style="align-center"

|+Non-military hospital ships

! Agency/NGO || Ship (class) || Year || Capacity || Capabilities || Image

| rowspan="2" | Mercy Ships link=Mercy Ships|35px

| Converted 2007

| 82

| 5 operating theaters, 1 intensive care unit, 1 ophthalmic unit, a CT scanner, x-ray, laboratories

|frameless|200px

|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.

|left|thumb

| rowspan="2"|Ministry of Labour (Spain)

| Esperanza del Mar

| 2001

|17

|1 operating theatre, ICU facility

|frameless|200px

| '

| 2006

|10

|1 operating theatre, ICU facility

| frameless|200px

Other shipborne hospitals

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.

A primary example of the varied military-based hospital services available at sea is found aboard several types of US naval ships;

thumb|220px|USS Abraham Lincoln, a Nimitz-class aircraft carrier

; United States Navy;

– USS Gerald R. Ford, first in the class, has an on-board hospital that includes a full lab, pharmacy, operating room, 3-bed intensive care unit, 2-bed emergency room, and 41-bed hospital ward, staffed by 11 medical officers and 30 hospital corpsmen.
– Each carrier has a 53-bed hospital ward, a three-bed ICU, and acts as the hospital ship for the entire carrier strike group. In one year, the medical department of handled over 15,000 out-patient visits, drew almost 27,000 labs, filled almost 10,000 prescriptions, took about 2,300 x-rays and performed 65 surgical operations. There is not much variation among the ships of the class. The first ship, has 53 beds, plus 3 ICU beds, and the last ship, has 51 beds, plus 3 ICU beds.

thumb|150px|USS Bataan, a Wasp-class amphibious assault ship

(LHD) – These ships have 6 operating rooms, 14 ICU beds, 46 hospital beds, 4 battle dressing stations, medical imaging (i.e.:X-ray), a fully functional laboratory, and a blood bank. The ship can expand its medical complement to 600 beds, making it the second largest hospital at sea, second only to actual hospital ships.
amphibious assault ship (LHA) – This is the newest and largest class both in the USN and the world. However, the first two ships of the class, and , had the size of their medical facilities reduced, in favour of larger aviation facilities. The on-board hospitals of these first two vessels will have 2 operating rooms and 24 beds. It is unknown if this design change will affect the expanded capability for additional beds, nor what size the medical facilities of future ships of the class will be.
(LPD) – 24 hospital beds.

More examples from various other national navies include;

; Argentine Navy

– Icebreaker which can be deployed as a hospital ship.

; Royal Australian Navy

– This class is based on the Juan Carlos I-class design, and has 2 operating rooms and a hospital ward.

; Royal Canadian Navy's future Protecteur-class replenishment oiler are based on the German Berlin-class ships will have medical facilities including operating rooms, labs, pharmacy and patient (45) beds. The interim support vessel MV Asterix have the similar medical features (5 hospital beds).

; People's Liberation Army Navy

Several armed s are fitted out as "ambulance transports".
Shichang – a multi-role training ship built in 1997. Deck space can accommodate modular medical units and can be used as a medical treatment facility, but the primary role is aviation training. The layout is very similar to RFA Argus (see below).

thumb|150px|Dixmude, a Mistral-class amphibious assault ship

; French Navy

– On board hospital is NATO Echelon level-3, with 69 hospital beds, 7 ICU beds, and an additional 50 beds if needed. The ship also has medical imaging capabilities, such as X-ray, CT-scan and ultrasound.

; Italian Navy

aircraft carrier – Has an on-board hospital with 2 operating rooms, 1 intensive care unit, laboratory, pharmacy and a 32-bed hospital ward.
logistic ship – On-board hospital is NATO ROLE-level 2+, with operating room, intensive care unit and a laboratory.

; Japan Maritime Self-Defense Force

– These ships have 2 operating rooms, 2 ICU beds, 35 hospital beds, 1 battle dressing station and several medical imaging (i.e.:X-ray) stations.
– These ships have 1 operating room, 1 ICU bed, 8 hospital beds.
- These ships have 1 operating room, 2 ICU beds, 6 hospital beds.

; Spanish Navy

– Has a 40-bed hospital on board.

; Royal Navy

thumb|RFA Argus (A-135), circa 2007

Royal Fleet Auxiliary ship – This ship would be a hospital ship were it not for its armaments. However, it is instead designated as a 'Primary Casualty Receiving Ship' (PCRS). The vessel is classed as a NATO ROLE 3 Medical support vessel and is to be replaced in 2024
Berlin-class replenishment ship Frankfurt am Main - Following a fire destroying the Frankfurt's MERZ, the Navy opted to equip the Frankfurt am Main with a new generation integrated MERZ (iMERZ), build into the hull of the ship. It's equipped with two operating rooms, medical imaging capabilities and a hospital ward. The German Navy plans to equip the Frankfurt's two sister ships with an iMERZ during routine maintenance.

References

External links

Australian War Memorial – Sinking of the Centaur
WW2 US Hospital Ships
US Army Hospital Ships in WWII
New Zealand Hospital Ships (chapter of official history of WWI)

History

Early examples

Modern hospital ships

World Wars

International law

Current hospital ships

Current military hospital ships

Current non-military hospital ships

Other shipborne hospitals

See also

References

External links