Military Hospital Ships
The USNS Mercy and Comfort
Hospital ships provide afloat, mobile, acute surgical medical facilities when called upon to the United States military. There have been additional medical vessels serving in other roles - ambulance vessels, rescue ships, and evacuation ships.
Geneva Convention Status
Specific restrictions for a hospital ship are outlined in Article four of the Hague Convention X:
- The ship must be clearly marked and lighted as a hospital ship
- The ship should give medical assistance to wounded personnel of all nationalities
- The ship must not be used for any military purpose
- The ship must not 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
- Belligerents will establish the location of a hospital ship
As well, the convention established that during times of war, hospital ships would be exempted from dues and taxes imposed on vessels in the ports of the states that ratify the treaty.
Recently - the San Remo Manual on International Law Applicable to Armed Conflicts at Sea was adopted in June 1994 by the International Institute of Humanitarian Law after a series of round table discussions held between 1988 and 1994 by diplomats and naval and legal experts.
According to the San Remo Manual, 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.
U.S Military Needs in WWI
During the first World War (aka “The Great War”), hospital ships were first used on a massive scale – but in WWI, hospital ships were mainly used to transport sick and wounded military personnel from the Theaters of Operations to Hospital facilities in the United States.
World War Two again saw use of hospital ships, but their use was based on who operated them - the Navy wasn’t the sole branch of the United States Military to operate hospital ships, for a time the Army also operated them [in fact, the Army operated a fleet of ships of its own, see Ship Hull Classifications – The Rest of the Armed and Uniformed Forces].
U.S. Military Needs in WWII
During World War II, the Army decided it was their own responsibility to transport their wounded, and so wanted to arrange evacuation with their own ships. There were a total of 27 hospital ships in operation for the evacuation of Army casualties.
The Army Transport Service operated 24 hospital ships which were manned by civilian crews (employees of the Army Transport Service) and Army medical staff, and the Navy operated 3 Hospital Ships (Comfort, Hope and Mercy) that were manned by the Navy but staffed by the Army Medical Department. However, as noted, the Navy and Army operated hospital ships with different purposes - Navy 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, while 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.
Most of the U.S. Military’s hospital ships started out as craft with a different role, and renovated to become hospital ships. The three Navy Hospital Ships (AH-6 USS Comfort, AH-7 USS Hope and AH-8 USS Mercy) were the only vessels built as hospital ships for the U. S. Army fleet - the 24 U.S. Army-operated Hospital Ships were converted from other types of ships. The three Navy ships staffed by the Army served in the Pacific during WWII, while 24 Army ships served first in Atlantic Theaters, with some later being transferred to the Pacific, while others were decommissioned when no longer being needed for evacuation of patients from the European Theater. By the end of WWII, the Navy had 15 Hospital Ships in operation.
For that matter, some Navy hospital ships were prior Army vessels. For example, when the Spanish-American War broke out , the passenger ship John Englis was purchased by the United States Army for use as a hospital ship, and renamed Relief. In 1902, the Navy acquired the ship and operated it as USS Relief until 1918, when she was renamed to Repose to allow the name of Relief to be assigned to AH-1 USS Relief.
Today's Need for Hospital Ships
Though today the United States Navy operates only two dedicated hospital ships (T-AH-19 USNS Mercy and T-AH-20 USNS Comfort), hospital / medical ships of many types have been part of the United States Navy at least since 1801 (the Navy operated its first Hospital Ship during the years of the Tripolitan War [1801-1805]). Both the Comfort and the Mercy are play a role in the U.S. Navy’s Military Sealift Command (MSC). The ships are operated, navigated, and maintained by a civil service mariner staff, or CIVMAR. These are federal government employee who pursues a civil service Navy career. These are United States government-owned ships that support the Navy's warfighters around the world. The Navy command is responsible for the hospital and it’s staff.
The USNS Comfort and Mercy normally sit pier-side with a reduced number of crew personnel. Typically there will be 18 CIVMARs and around 50 Navy hospital crew aboard to maintain the ship in a “ready status”. When called into action, the ships will add more than 60 CIVMARs and over a thousand military medical staff and render aid wherever needed. The USNS Mercy is based out of San Diego California. The USNS Comfort is based out of Norfolk, Virginia.