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World Wide Hospital Ships

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USNS Mercy

World Wide Hospital Ships

Sometimes it is difficult to understand the scope of American military power relative to that of the rest of the world. This graphic illustrates America's Hospital Ships, and those of the rest of the world. Each image is an accurate depiction of the ship as seen from the side, all to a common scale.
Many centuries before our era, the Athenian fleet included a vessel called 'Therapia,' while in the Roman fleet was a ship bearing the name 'Aesculapius.' Their names have been taken by some authors as indicating that they were hospital ships. All we know with certainty is that at the beginning of the XVIIth century it became customary for naval squadrons to be accompanied by special vessels entrusted with the task of taking the wounded on board after each engagement. It was, however, not until the second half of the XIXth century that the practice really developed. During the Crimean War, more than 100,000 sick and wounded were repatriated to England on board hospital transports. Thereafter, no military expedition was ever undertaken without the necessary ships being assigned to evacuate soldiers from the combat area and give them the medical treatment they might require.
During the First World War, hospital ships were used to an increasing extent, despite the serious disputes and grave incidents which arose between the belligerents in this regard and to which we have already referred. In most instances, passenger liners were converted for use as medical transports. When the Second World War came, hospital ships specially designed for the purpose were built, and consequently the accommodation for patients was greatly improved. Because bases were far apart and hospitals on land in short supply in the Pacific war theater, the American forces brought into service ships which were really floating hospitals, able to give complete medical and surgical treatment.
The international legal definition of a Hospital Ship is found in "Convention (II) for the Amelioration of the Condition of Wounded, Sick and Shipwrecked Members of Armed Forces at Sea" done in Geneva, 12 August 1949. For brevity the second of the four Geneva Conventions done at that time is called "the Second Convention". Article 22 of this Convention states "Military hospital ships, that is to say, ships built or equipped by the Powers specially and solely with a view to assisting the wounded, sick and shipwrecked, to treating them and to transporting them, may in no circumstances be attacked or captured, but shall at all times be respected and protected, on condition that their names and descriptions have been notified to the Parties to the conflict ten days before those ships are employed. The characteristics which must appear in the notification shall include registered gross tonnage, the length from stem to stern and the number of masts and funnels." Article 41 stipulates that "Under the direction of the competent military authority, the emblem of the red cross on a white ground shall be displayed on the flags, armlets and on all equipment employed in the Medical Service. Nevertheless, in the case of countries which already use as emblem, in place of the red cross, the red crescent or the red lion and sun on a white ground, these emblems are also recognized by the terms of the present Convention."
And Article 43 requires that "All exterior surfaces shall be white. One or more dark red crosses, as large as possible, shall be painted and displayed on each side of the hull and on the horizontal surfaces, so placed as to afford the greatest possible visibility from the sea and from the air." The essential thing is that it should be as clear as possible that the vessel is a hospital ship. Similarly, the reference to "dark red" obviously does not mean that a ship on which the red crosses were of another shade would not be protected. This is merely a recommendation intended to increase the effective security of a floating hospital by providing a better colour contrast. It is clear from the records that the lack of an up-to-date system of marking, visible at a great distance, was the cause of most of the attacks made on hospital ships during the Second World War.
There is nonetheless no hard and fast precise definition of a "Hospital Ship" and some vessels listed on the Hospital Ship International (HSI) Fleet Registry are not included here, while some vessels included here are not on the HSI list. The HSI list is an attempt at a comprehensive inventory of medical / health care purpose vessels / craft that are flagged, registered, homeported and/or operate mainly under specific nations or organizations. Ths HSI list characterizes the Italian San Giorgio class small dock landing ships as "not technically a hospital ship this vessel was designed with the purpose of being if necessary converted rapidly into one especially for disaster relief(especially earthquakes)." But this is the case with all amphibious landing ships.
Currently, hospital ships may be conveniently partitioned into five types:
  1. YH - Hospital Launches - A number of countries -- including at least Bolivia, Brazil, Camaroon, Chile, Peru, and Thailand -- operate small Hospital Launches that provide medical assistance to local populations living on rivers or lakes. These riverine and lacustrine craft are not sea going, and may be operated by either the country's Navy or some other governmental department. Two of the Brazilian vessels carry the traditional green cross markings of a civilian hospital ship.
  2. AHL - Small Medical Support Ships - At least three countries - India, Indonesia, and Mexico - operate ocean-going military vessels that are equiped to provide humanitarian assistance medical services, while also serving a domestic sovereignty presence function. These ships do not primarily function as hospital ships, nor are they hospital ships under international law. Of these ships, the Indian and Mexican ships are neither white nor provided with distinctive markings. The Indonesia vessel is not white, and though it is marked by a large red cross, it is also armed, which disqualifies it from protection as a hospital ship under interntational law.
  3. APH - Personnel Transport, Evacuation - Three countries - Germany, the United Kingdom, and China - operate large multi-purpose amphibious support ships that can provide for both combat casualty evecuation and humanitarian assistance medical support. These ships do not primarily function as hospital ships, nor are they marked as hospital ships under international law.
  4. AH - Civilian Hospital Ships - There are currently two entirely civilian hospital ships. The Labor Ministry in Spain operates the Juan de la Cosa to support the Spanish fishing fleet at sea. And Mercy Ships International operates the non-governmental M/V Africa Mercy which provides medical assistance in ports of call in Africa.
  5. AH - Hospital Ships - Three countries - Russia, China, and the United States - currently operate Hospital Ships. The three Russian vessels of the Ob'b class have been largely inactive in recent years, though they have been proposed for commercial charter. The United States operates two very large hospital ships of the T-AH-19 Mercy class. In the 1990s China converted two or three Qiongsha-class Attack Transports into hospital ships, and may have recently purchased an Ob'-class ship from Russia. PLA's first new large Hospital Ship was launched in Guangzhou on 29 August 2007. In August 2008 the Type 920 Hospital ship was reported to have successfully conducted a sea trial. This is the world's second largest hospital ship, after the two American ships, providing China with a major new capability to support amphibious operations.

YH - Hospital Launches

Bolivia - TNBH-01 Javier Pinto Telleria
Bolivia - TNBH-401 Julian Apaza
Brazil - U-16 Doutor Monte Negro
Brazil - U-18 Oswaldo Cruz
Brazil - U-19 Carlos Chagas
Peru - BAP CurrarayChile - PMD 74 Cirujano VidelaPeru - BAP PunoPeru - BAP Morona

AHL - Small Medical Support Ships

India - INS Jamuna
India - INS Nirdeshak
India - INS Nirupak

Mexico - El ZapotecoIndonesia - KRI 517 Teluk EndeAPH - Personnel Transport, Evacuation

Germany - FGS Berlin
Germany - FGS Frankfurt am Main
United Kingdom - RFA Argus
China - Shichang

AH - Civilian Hospital Ships

USA - M/V Africa Mercy
Spain - Juan de la Cosa

AH - Hospital Ships

USA -T-AH 20 ComfortRussia - AH Yenisei
Russia - AH Irtysh
Russia - AH Svir
China - AH Nanyi
China - AH Nanyi
China - AH Nanyi
China - AH Type 320
China - AH Type 920
USA -T-AH 19 Mercy


Dr Ramon REYES, MD,
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