Hospital Ships in the War on Terror

By Grunawalt, Richard J. | Naval War College Review, Winter 2005 | Go to article overview
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Hospital Ships in the War on Terror

Grunawalt, Richard J., Naval War College Review

Sanctuaries or Targets?

Employment of military hospital ships in support of the war on terror is militarily, politically, and morally appropriate. White ships adorned with the red cross or red crescent are internationally recognized as protected platforms engaged exclusively in the care and treatment of the casualties of war or the victims of disaster, whether natural or man-made. Despite the humanity of their mission, outdated rules of conventional and customary international law, designed for a bygone era, hamper their effectiveness and imperil their safety. This enquiry examines these problems in the context of the war on terror and an adversary intent on destroying such "soft" targets as hospital ships in order to create the maximum in shock and horror. A brief overview of the development of the law pertaining to hospital ships is provided as well, with emphasis on rules governing methods of identification, modes of communication, and means of defense.


The special protected status accorded to hospital ships during international armed conflict has a long and storied past. The utility of vessels especially designed or equipped to care for and transport wounded and sick soldiers and sailors has an even more extensive history. Indeed, there is some evidence that both the Athenian and Roman fleets employed vessels as hospital ships.

Early Development (1868-1949)

By the seventeenth century, vessels especially configured to care for the wounded following engagements at sea routinely accompanied naval squadrons.2 Pictet noted that by the time of the Crimean War (1853-56) "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.3

It was not until 1868, however, that the international community sought to cloak ships engaged exclusively in the care and treatment of the wounded, sick, and shipwrecked with formal immunity from capture and destruction. Following adoption of the Geneva Convention for the Amelioration of the Condition of the Wounded in the Armies in the Field of 1864, a diplomatic conference was convened in Geneva for the purpose, among others, of extending to naval forces at sea the protections accorded in that treaty to wounded combatants on land.4 That effort produced a convention entitled Additional Articles Relating to the Condition of the Wounded in War of 1868, which was never ratified but set forth basic precepts that continue to inform the law of armed conflict relative to hospital ships.5 Principal among them is that "vessels not equipped for fighting which, during peace the government shall have officially declared to be intended to serve as floating hospital ships, shall... enjoy during the war complete neutrality, both as regards stores, and also as regards their staff, provided that their equipment is exclusively appropriate to the special service on which they are employed."6 Although it was not in legal force, belligerents in both the Franco-German War of 1870-71 and the Spanish-American War of 1898 agreed to accept and abide by the 1868 accord.

By 1898, there was growing recognition of the need to revise and expand the 1864 Convention, and the International Committee of the Red Cross (ICRC) began the task of drafting an expanded version. This effort was overtaken, however, by the czar of Russia's initiative to convene the First Hague Peace Conference, which drafted and adopted, among other instruments, the 1899 Hague (II) Convention with Respect to the Laws and Customs of War on Land and the Regulations Annexed Thereto7 as well as the 1899 Hague (III) Convention for the Adaptation to Maritime Warfare of the Principles of the Geneva Convention of 22 August 1864.8 Given the failure of the 1868 Additional Articles to gain ratification, the Hague (III) Convention was the first successful attempt to extend to the maritime environment the formal protections applicable to medical facilities and the wounded and sick in the field on land.

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