Frederick Law Olmsted, the executive director of the United States Sanitary Commission, set up a system of hospital ships for wounded and sick soldiers in the American Civil War. The USSC was a private agency that cooperated closely with the U.S. Army.
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City of Memphis and Fanny Bullit
Between 6 and 16 Feb 1862, the Union advanced across the country and captured Forts Henry and Donelson. Upon hearing word of the battle, members of the Sanitary Commission in Cincinnati gathered supplies, volunteers and procured a steamer passengered by the most senior members of the commission at the Cincinnati branch. Upon arrival at Fort Donelson, the commission learned that insufficient means were taken to treat and transport the wounded. The Union's two army "hospital" ships, the City of Memphis and Fanny Bullitt, had not been furnished to serve as such ships and were merely empty vessels on which vast numbers of wounded suffered. Supplies were distributed, and 80 wounded were transported back to Cincinnati on the steamer with doctors and nurses to tend to them. The boat traveled from Mississippi to Ohio.
Tycoon and Monarch
In April 1862, the Union's victory at Shiloh resulted in the outpouring of hospital transports to the city. The two transports refitted and dispatched by the Sanitary Commission were joined by a fleet of private, army, and state hospital ships. The Tycoon and Monarch were the Commission's first refitted hospital ships. Sympathy, benevolence, patriotism and a desire to ease the suffering of our nation's troops was the only thing these groups shared in common. Following this event, the Sanitary Commission began outfitting any hospital ship, army, state, association, or voluntary, and if necessary, they operated the ships as well. All of the army's ships used as hospital transports were refitted and initially supplied through the direction of the Sanitary Commission. Funding came from the army, Sanitary Commission, state, and volunteer organizations. The army transferred at least one ship to the Sanitary Commission, the steamer Daniel Webster No. 1. Even the Red Rover, a river boat captured by the Union Army, was well equipped and initially staffed by the Sanitary Commission until the ship was sold to the navy.
St. Philip
These were not the first hospital ships employed by the Civil War governments; previous ships used as hospitals, like the hospital ship CSS St. Philip (formerly the Star of the West) in September 1861 and April 1862, retained patients for long periods of time (30–90 days easily) and stayed on station rarely travelling. The Sanitary Commission used their steamers as a means of bringing wounded further back behind supply lines, keeping wounded on board for as short a time as possible, from 1–7 days. Men and women of all races, some hired while others volunteered, served throughout the hospital ships and hospitals of the Union as nurses.
The Western Sanitary Commission was a private agency based in St. Louis that was a rival of the larger U.S. Sanitary Commission, doing much the same work. It was led by abolitionists and focused more on the needs of Freedmen.
The Hospital Transport Service
The Sanitary Commission, at the request of the army, created the Hospital Transport Service. It acquired 16 medium and large boats and converted them to hospital ships. Its first major operations came in the Peninsular Campaign of spring 1862, when it serviced casualties from General McClellan's Army of 100,000 men after a series of battles.
The Sanitary Commission quickly organized large fleets of ships and created a network system of routes to move wounded. Rivers and ocean connecting the Union became highway over which the wounded steadily traveled further North.
When possible, few embarkation points were used. Ships were assigned schedules and maximum patient allowances. If a ship embarked more patients than allowed, even though space permitted, her crew would be required to notify the receiving station. Several ships were kept in reserve, used only when another ship was unable to continue to make a journey. Thus a very predictable and organized system grew. On the Pamunkey River, 19 hospital transports working on a fixed schedule, moved 700 wounded a day, every day. Of particular interest, the ships had far greater capacity, some 600 more wounded could have been crammed onto some of the ships. But, this was frowned upon by the organizers as such a number would overcrowd the ship, overtask the medical staff, erode the quality of care, and place an unexpected burden on the receiving hospital. Thus, in theory some 70,000 wounded could be moved from Virginia in 100 days to hospitals in five states as far north as New York. A second inland force of about 16 hospital ships moved patients along riverways north to Missouri, Ohio, and Kentucky.