On the night of 28 April 1945, the 6,000-ton U.S. Navy hospital ship Comfort (AH-6) steamed beneath a clear, moonlit sky some 40 miles south of Okinawa. She was loaded with casualties from the bitter fighting ashore and the growing toll that kamikazes were taking on Allied ships.
Barely two years old, the Comfort had been converted to a hospital ship and commissioned as such in May 1944. Like her sisters Hope (AH-7) and Mercy (AH-8), she combined naval-civilian crews with Army medical staff. She had plied Pacific war zones around New Guinea and the Philippines, and now was three weeks into Operation Iceberg, the conquest of Okinawa.
Crewmen heard a single aircraft approaching but paid little attention. The Comfort was painted white the length of her 418-foot hull, bearing red crosses and illuminated as a noncombatant.
The unidentified plane—a single-engine type—came in extremely low. It overflew the ship at barely masthead height, then pulled up, circling twice. With enough altitude, the pilot nosed over and dived.
It was no buzz job. He held his dive into the Comfort’s superstructure, smashing through two decks. Everybody but one person in an operating room was killed. Fatalities throughout the ship totaled 28, including six nurses, with an additional 48 personnel injured.
Amid the wreckage was the body of a Japanese Army first lieutenant. Recent scholarship identified his plane as one of 12 suicide bombers launched from Formosa that day.
The Comfort buried her dead at Guam and, following temporary repairs, set course for Los Angeles. She returned to the western Pacific shortly after VJ Day.1
The Comfort’s ordeal was the worst suffered by the 39 U.S. hospital ships in World War II, but perhaps there was some solace in the fact that she was part of a long and honorable tradition. Her heritage extended back to antiquity.
Athens to the Age of Fighting Sail
Excepting nuclear power, hospital ships span the evolution of naval propulsion, from the creaks and groans of oars and sails to the sooty mess of coal to today’s high-pressure steam turbines.
The hospital ship mission evolved from the days when badly injured sailors often were tossed overboard to clear the decks, into the more modern goal of returning casualties to duty.
The Athenian navy deployed a vessel named the Therapia, indicating a medical purpose, though specifics are lacking. Subsequent Roman sources refer to the Aesculapius, presumably named for the god of healing. The ship’s dates are uncertain, but Rome dedicated a temple in the god’s name in 289 BC.
Roman military medicine languished for centuries until the infusion of Classical Greek influences. Civilian doctors received low social accord in contrast to their military counterparts. But the Roman Army maintained a medical corps of physicians and hospitals, with vague references to practitioners following ships to sea.
In the 2nd century AD, the Greek physician Galen studied in Egypt and adopted Hippocrates’ approach. Galen’s influence in Rome was enormous. In the military, triage evolved with instruments including scalpels, forceps, probes, and cups for bloodletting. Presumably, such knowledge filtered from legions of the Roman Army to its naval component (Rome never had an independent navy).
Into the 16th century several navies deployed dedicated hospital ships. Two or more sailed with the Spanish Armada in 1588, one of which ran aground. France also deployed such vessels, but apparently not to the extent of Britain.2
Britain’s Royal Navy probably took the lead in the 17th century. The hospital ship Goodwill seems the first noted, serving with the Mediterranean Squadron circa 1608. From about 1665 on, Britain maintained two hospital ships at a time, increasing to six at century’s end.
Then, as now, hospital ships lent themselves to other noncombatant uses. During the British evacuation of Tangier, Morocco, in 1683, the hospital ships Unity and Welcome received civilians fleeing the city as well as wounded troops.3
British hospital ships proliferated, with 22 known in the 18th century, continuing into the 19th. After the 14 February 1797 Battle of Cape St. Vincent, HMS Victory was found unfit for combat. She was outfitted as a hospital ship, holding French and Spanish prisoners before restoration as a man-of-war, becoming Vice Admiral Horatio Nelson’s famed flagship at Trafalgar in 1805.
Probably the Royal Navy’s first modern vessels fully equipped for the medical role were HMS Melbourne and Mauritius. Manned by the Medical Staff Corps, the steamships supported the British expedition to China during the Second Opium War in 1860.4 Growing awareness of antiseptic methods and sterilization made a major difference in the mid- to late 19th century, and perhaps a dozen British hospital vessels were in use between 1899 and 1902, through the Boxer Rebellion and Second Boer War.
Healing Ships for a New Nation
The nascent U.S. Navy recognized the need for hospital ships early on. During President Thomas Jefferson’s campaign against Tripolitan pirates in 1803, Commodore Edward Preble designated a captured ketch for hospital duties, naming her the Intrepid. Sixty years later, the Civil War required hospital ships on both sides. The side-wheeler Red Rover housed Confederate soldiers for a floating battery at New Orleans in 1862. Captured by the U.S. Navy at Island No. 10, she was converted to a 200-patient floating hospital with surprisingly modern facilities, including operating rooms, galleys, laundries, and even an elevator. Her skipper reported, “The boat is supplied with everything necessary for the restoration of health for disabled seamen.”5
The Confederacy fielded at least one hospital ship. Shipping magnate Cornelius Vanderbilt’s Star of the West, chartered to the U.S. government in 1861, was seized by Rebel forces off Matagorda Bay, Texas. She was renamed the CSS St. Philip, remaining in service as a hospital vessel until scuttled to block Mississippi’s Tallahatchie River in 1863.
The Spanish-American War saw the commissioning of the Navy’s first post–Civil War hospital ship, the USS Solace (AH-2). Converted from commercial service and commissioned just prior to the war’s outbreak in 1898, she shepherded wounded and ill servicemen from Cuba to the U.S. East Coast. She continued to serve into the early 20th century.
The U.S. Army also provided hospital ships in the Spanish-American War, a conflict that remains noteworthy for the huge disparity between combat and noncombat deaths: 345 to 2,910, respectively. Army hospital ships helped deal with the growing crowd of disease-stricken soldiers. Businessman B. M. Baker of Baltimore offered his British-flagged Missouri, which was gratefully accepted by the Army surgeon general.
Global Wars = More Beds Needed
In World War I, most hospital ships were converted liners. Despite international treaties, 26 of these vessels from eight nations were lost to mines or torpedoes, mistaken identity, or sailing error. They included 16 British Commonwealth vessels; Austro-Hungary lost three; the Netherlands and Russia lost two apiece; Greece, Italy, and Germany each lost one.
Certainly the largest hospital ship sunk by enemy action was HMHS Britannic, the 48,000-ton sister of the ill-fated Titanic. The Britannic struck a mine in the Aegean in November 1916, losing 30 of 1,035 souls on board.
Probably the most egregious hospital ship sinking was that of the Canadian Llandovery Castle off Ireland in June 1918. Oberleutnant Helmut Patzig’s U-86 knowingly torpedoed the ostensibly off-limits vessel, then rammed lifeboats and fired on survivors, leaving only 24 alive out of 258.
An officer on board a passing vessel recalled, “It was something we could never have imagined . . . particularly the nurses: seeing these bodies of women and nurses, floating in the ocean, having been there some time. Huge aprons and skirts in billows, which looked almost like sails because they dried in the hot sun.”6
Veering away from vessel-conversion, the U.S. Navy built its first specifically designed hospital ship, the USS Relief (AH-1), commissioned in 1920. At 10,000 tons, capable of embarking 550 patients, she was among the most capable of such vessels anywhere. Administratively, she was also significant as she ended the previous policy of hospital ships being commanded by medical officers.
After spending the first 14 months of U.S. involvement in World War II with the Atlantic Fleet, the Relief steamed to New Caledonia early in 1943. She would go on to receive five battle stars for her service in the Gilberts, Marshalls, Marianas, Palaus, and off Okinawa.
World War II was the first conflict in which militaries sustained more combat than noncombat fatalities. (In World War I the U.S. ratio was 45 percent combat losses.) Military medicine had evolved significantly by World War II, including wide distribution of sulfa drugs and penicillin. Consequently, mortality was curbed, though the reality of war remained. Nurses, many only 22 or 23, were exposed to severe wounds inflicted by explosives during industrial-age warfare. Some bore the emotional scars for the rest of their lives.
Navy and Army hospital ships provided different services. As described in an official Army account: “The Navy ships were truly floating hospitals, with complete medical, surgical, and neuropsychiatric facilities; additionally, by stocking medical supplies, the Navy ships would act as resupply points for other vessels. The Army hospital ships were less elaborate, conceived as evacuation vessels—hospital transports—and served effectively in that role.” But the Army ships made significant contributions, returning about one-sixth of the 388,000 evacuees to the United States during 18 months of 1944–45.7
During World War II, 25 hospital ships from seven nations were lost to all causes, including seven British Empire and six Italian vessels. Japan’s three such losses included the “relief ship” Awa Maru, sunk in error by a U.S. submarine in Taiwan Strait on 1 April 1945. The USS Queenfish (SS-393) had attacked in fog, taking the former liner for a destroyer. The Awa Maru’s lone survivor admitted the vessel was carrying military supplies, and the submariners noted thousands of floating bales of rubber—a clear violation of international law. Nonetheless, the sub skipper was court-martialed, found guilty of negligence, and received a letter of admonition.8
Little appreciated is the use of tank landing ships (LSTs) in medical roles (despite their sailors’ grim joke that LST meant “large slow target”). LST(H)s, configured for casualty treatment and evacuation, were not designated hospital ships because they did retain armament. Their minimal sick bays usually were tended by one or two pharmicist’s mates. With additional personnel, 150 cots could be installed, but when necessary up to 370 cases could be accommodated in troop quarters and on the tank deck.
Some 150 LST(H)s supported Operations Neptune-Overlord, transporting 41,000 casualties from Normandy—the equivalent of double an LST capacity. The ships provided initial screening of each casualty, who could be forwarded to a hospital ship or transport.
Some of their major operations in the Pacific included deployment as “augmented LSTs” at Tarawa in 1943, the Philippines in 1944, and Iwo Jima and Okinawa in 1945. Surgical teams included up to five physicians, with 35 pharmacist’s mates.
Anticipating a huge butcher’s bill for the potential invasion of Japan in November 1945, 36 LSTs were to be designated LST(H)s. The Operation Olympic LSTs would embark a complete surgical team with medical personnel and supplies for transport of wounded from landing beaches on Kyushu. Operation Coronet, the invasion of Honshu, was slated for early March 1946.9
Korea and Vietnam
When the North Korean Army launched an “Asian Blitzkrieg” across the 38th parallel into South Korea on 25 June 1950, U.S. forces in the western Pacific were caught shorthanded, but the response back home was prompt and effective. While the Navy suddenly found itself short one hospital ship when the Benevolence (AH-13) sank in a collision off San Francisco that August, three others nonetheless quickly deployed to Korea—the Haven (AH-12), Consolation (AH-15), and Repose (AH-16).
The Consolation departed Norfolk on 14 July, arriving at Pusan on 16 August. As probably the first hospital ship with a helicopter platform, in December 1951 she received the first battle casualty flown directly to a hospital ship, via Marine Corps helicopter. In her 20 months of Korean duty, the Consolation treated 15,000 patients and many more outpatients.10
In September 1950, at the time of the Inchon landing, the Haven was quickly taken from reserve and recommissioned. She supported amphibious forces until January and then cycled to and from the United States three times into 1954. The Haven received nine battle stars for her Korean service.
The Repose was a mainstay throughout the conflict, leaving San Francisco on 2 September 1950 and arriving at Pusan on the 20th. She evacuated casualties to Yokosuka four days later. During operations at Inchon in 1952, a report from the vessel noted, “Patients are flown directly to the ship for major surgery and post-operative care with such further surgery as may be necessary.” The Repose remained in the western Pacific until 1954.11
LST(H)s, so successful in World War II, also served off Inchon. British medical support in the Korean War included HMHS Maine, probably the first hospital ship off Korea, arriving in July 1950. Also present during the conflict was the civilian Danish vessel Jutlandia, an aging converted Italian liner. She treated nearly 5,000 patients from 24 nations, and also accepted Korean civilians.12
Two U.S. Navy hospital ships deployed to Southeast Asia during the Vietnam War: the Repose and Sanctuary (AH-17). The Repose, in her third war, set records along the way. She was called from Da Nang on 29 July 1967 to accept casualties from the devastating fire on board the USS Forrestal (CVA-59). On 29 August 1967, she admitted a new high of 112 patients, the previous record being 98. Other records followed: her 9,000th safe helicopter landing in November 1968 and 10,000th two months later. In 44 months of operations through October 1969, the Repose admitted 22,600 patients, including nearly 8,500 wounded in action; more than 13,000 of her patients were returned to duty. In addition, 1,700 Vietnamese were treated on board.13
A Repose nurse, Lieutenant (junior grade) Leanna Crosby, summarized her experience:
The sea service is just what I was looking for . . . it provides an opportunity to work in the best-equipped hospitals. After we’ve spent some at sea, there’s a tendency to forget that we are afloat, as treatment and care of patients is the same as in a shore-based hospital.
It’s like living and working in a community where we have started our own society. I enjoy this type of duty . . . and feel it is a choice assignment for a Navy nurse.14
The Sanctuary had missed World War II by a few days but reported to the Seventh Fleet in April 1967. She remained through successive 90-day line periods, mostly off the northern provinces of South Vietnam. Her unofficial motto was displayed near the helo deck: “You find ’em we bind ’em. Open 24 hours.”
After March 1970, the Sanctuary was the only hospital ship in Vietnamese waters, expanding duty to 120-day line periods before departing for San Francisco a year later.
Following decommissioning in 1971 and reactivation in 1972, the Sanctuary became the first U.S. Navy ship with a mixed-sex crew. She was struck from the Naval Vessel Register and sold in 1989.
The German Helgoland, staffed by Red Cross personnel, also was on hand during the Vietnam War to serve victims of the conflict. With a typically sized staff of 40, between 1966 and 1972 the Helgoland treated some 70,000 outpatients.15
Modernization and Mission Versatility
In addition to the United States, at least seven other nations currently operate hospital ships, including six in Brazil, four in China, three in Russia, plus various numbers in India, Indonesia, Peru, and Vietnam. Meanwhile, Spain maintains two vessels supporting the fishing fleet, and the Mercy Ships charity organization provides humanitarian assistance worldwide.16
Today’s AHs are far beyond the capabilities of any such vessel previously envisioned. The U.S. Navy’s Mercy-class ships, the USNS Mercy (T-AH-19) and Comfort (T-AH-20), were built in the mid-1970s as commercial tankers. In 1986–87 they became the Navy’s first new hospital ships in 40 years. At 900 feet long and 69,000 tons, they displace four to ten times their predecessors, well over twice the tonnage of a World War II Essex-class aircraft carrier. Both were christened in honor of prior AHs, each becoming the third to bear her name.
The ships served in Operations Desert Shield and Iraqi Freedom and have responded to 9/11, Hurricane Katrina, humanitarian crises in the Caribbean and Pacific, and other catastrophic events.
In 2018, the Navy considered decommissioning both AHs or scrapping one to maintain the other. Congressional opposition not only saved the ships but also led to some upgrade funding. That was money well spent.
One AH is allotted to each coast, the San Diego–based Mercy under Captain John Rotruck, and the Norfolk-based Comfort under Captain Patrick Amersback. On 18 March 2020, President Donald Trump announced their possible activation in response to the coronavirus emergency. On completing scheduled maintenance, they arrived in Los Angeles and New York within 13 days, considerably sooner than the “weeks to come” estimate floated in the media. The Mercy arrived at San Pedro Bay on the 27th; the Comfort at New York’s Pier 90 on 30 March, following a few days of required dredging in the harbor.
The Mercys bring enormous capability to any port. With 1,200 military and 60 civilian staff, they possess 1,000 beds, a dozen operating rooms, an ICU, a laboratory, dental service, and even a morgue.
Combining mobility and capability, the United States’ two hospital ships should remind Americans why they maintain a navy that often performs duties beyond its primary role of keeping freedom of the seas.
1. Dale Harper, Too Close for Comfort (Victoria, BC: Trafford Publishing, 2001); Mike Yeo, Desperate Sunset: Japan’s Kamikazes Against Allied Ships, 1944–45 (Oxford, UK: Osprey, 2020), 249.
2. Jack McCallum, Military Medicine: From Ancient Times to the 21st Century (Santa Barbara, CA: ABC-CLIO, 2008), 150.
3. “The Evacuation of Tangier,” Weapons and Warfare.com, https://weaponsandwarfare.com/2017/09/10/the-evacuation-of-tangier-ii/.
4. McCallum, Military Medicine, 150.
5. Naval Order of the United States, “An Overview of U.S. Navy Hospital Ships,” www.navalorder.org/articles/2016/8/28/an-overview-of-hospital-ships.
6. Obituary, CAPT Kenneth Cummins, RN (Ret.), The Independent, 18 December 2006, www.independent.co.uk/news/obituaries/capt-kenneth-cummins-428973.html. Patzig and his watch officers were indicted after the war but escaped to avoid prosecution.
7. Mary Ellen Condon-Rall and Albert Cowdrey, The Medical Service in the War Against Japan (Washington, DC: Center of Military History, 1998), 388–89.
8. Clay Blair, Silent Victory: The U.S. Submarine War Against Japan (New York: Lippincott, 1975), 810–13.
9. “LST(H) Casualty Evacuation,” GlobalSecurity.org, www.globalsecurity.org/military/systems/ship/lst-h.htm.
10. “USS Consolation (AH-15),” Korean War Educator.org, www.koreanwar-educator.org/topics/docs/hosp_ship/usscon/uss_consolation.htm.
11. “A Review of Two Years’ Operations of the USS Repose (AH-16) in the Korean Theater of Operations From 20 September 1950 to 20 September 1952,” Internet Archive.org, https://archive.org/details/REVIEWOFTWOYEARSOPERATIONSOFUSSREPOSEAH16/page/n9/mode/2up.
12. “Jutlandia, the Danish Hospital Ship,” Korean War Educator.org, www.koreanwar-educator.org/topics/docs/hosp_ship/jutlandia.htm; “Hospital Ships in the Korean War,” Korean War Educator.org, www.koreanwar-educator.org/topics/docs/hosp_ship/hosp_ship.htm; “Maritime History Notes: America’s Hospital Ships,” Yahoo.com, https://finance.yahoo.com/news/maritime-history-notes-americas-hospital-132854306.html.
13. Hospital Ship Repose Cruise Book 1969–1970, 5,
https://archive.org/details/CRUISEBOOKOFTHEUSNAVYHOSPITALSHIPREPOSEREPUBLICOFVIETNAM19691970/page/n7/mode/2up.
14. “Navy Nurse at Sea on USS Repose (AH-16),” Gjenvick-Gyønvik Archives, www.gjenvick.com/Military/NavyArchives/Articles/NavyNurses/1966-07/NavyNurseAtSea-USSRepose-AH16.html.
15. H. C. Nonnemann, “The German Hospital Ship Helgoland in Vietnam,” Springer Link.com, https://link.springer.com/chapter/10.1007/978-3-642-67093-0_48.
16. “Mercy Ships,” https://www.mercyships.org.