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At the beginning of World War I the question existed on how to return the military sick and wounded to America. Navy hospitals ships like USS Solace were considered as possible solutions but would have been sorely underequipped for the estimated 5,000 returnable casualties a month.
In their joint report on February 7, 1918 to the Secretary of the Navy, the Surgeons General of the Army and Navy agreed that Navy hospital ships were entirely unavailable for Army purposes as sick transports. Their capacity (roughly 200 beds) being small and their services completely utilized with mobile units of the fleet.
On March 28, 1918, an agreement was approved by the Secretaries of Navy and War providing: (a) that the sick and wounded being brought from France or England to the United States were to be taxied in transports OR hospital ships, whichever might be the most suitable and available, except in special cases where commercial liners might be authorized; (b) the Army was to be in charge of embarkation and disembarkation of all Army patients; (c) the Navy was to be in charge with care of patients while aboard ships.
Established on January 8, 1918, the Naval Overseas Transportation Service (NOTS) was responsible for the transportation of fighting forces, supplies, and sick and wounded personnel. Originally consisting of 72 ships, by the end of World War I there were 342 ships in operation as transports.
Imagine having to provide medical care to hundreds of sick and wounded in dimly lit and overcrowded compartments on a ship that continually pitched and rolled on even the most moderate of seas. This was the job of Navy physicians, pharmacists, and Hospital Corpsmen attached to the Navy transports.
The work of Navy medical personnel on transports was heavy since most surgical cases required three or four changes of dressing daily. The most trying work was that of ministering to the severely wounded, a certain portion of whom expired within a day or two on the trip home.
To assist transportation medical officers in the assignment of sick and wounded aboard ships, embarkation officials were urgently requested to furnish quadruplicate lists showing sources of patients, their rank, company, regiment, organization and diagnosis. Once this information had been supplied, the walking patients were assigned to compartments, the sick to wards, and the disabled carried to beds without a moment’s delay.
A vivid first hand picture of the medical activities aboard a typical Navy transport may be gained from an account of the events aboard USS Susquehanna in 1918. The average naval personnel consisted of 34 officers and 580 enlisted personnel. The average medical department personnel consisted of three medical officers, one pharmacist, and 18 Hospital Corpsmen. The troop carrying capacity was 117 officers, 56 noncommissioned officers, and 2,351 enlisted men.
The greatest threat to crews and patients aboard transports may have been the German U-boat. On May 31, 1918, the transport President Lincoln was sunk by the German submarine U-90. Of the 715 people aboard, 26 were lost with the ship and one officer was captured and taken prisoner by the Germans.
The general average air space for all troop compartments was about 80 cubic feet per person. This was found to be insufficient, especially in rough weather when the hatches had to be battened down. The immediate consequences of this overcrowding were not obvious, but there was no way of ascertaining the latter effects, it seems probable, however, from some of the cases of pulmonary tuberculosis that developed or was aggravated while being transported.
To make the stay of patients aboard more pleasant, representatives of the welfare societies moved from ward to ward during the day showing “moving pictures” and issuing cigarettes, candy, fruit. Underwear, socks, sweaters, pipes, and other items were supplied in almost unlimited quality by the American Red Cross for issue through the medical officer to the returning sick and wounded. In addition, musicians played for the sick and in some cases wards contained Victrolas with records.
Forty-eight hours before arrival in port of debarkation, Army officials were informed by radio of the number and class of patients being transported. At the dock, ambulances—operated by Army personnel, some by Motor Corps girls—could be found waiting to transfer the sick and wounded to the embarkation hospital. As fast as the patients passed over the gangway, they were checked on the passenger list by representatives of both Army and Navy.