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Containing smallpox in Victorian London

'This loathsome disease'
Smallpox in Victorian London
The smallpox ships
The River Ambulance Service
Patients and staff
The end of the hospital ships
The return of smallpox?
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The River Ambulance Service

The service

Needing a reliable way to move patients out to the ships, the MAB started the River Ambulance Service. During 1884-85, the Board built three bases next to the Thames.

These acted as reception centres for patients from different parts of London. Each had a riverside wharf, from where the sick could be taken off by paddle steamer.

Patients brought to the West and North Wharves were transferred to the South Wharf, from where the steamers made daily journeys to the hospital ships. 

The wharves

Wharf Location Area covered
South Rotherhithe South London
North Poplar Central, North and East London
West Fulham West London

The Albert Victor ambulance steamer at Long Reach pier
View full size imageThe Albert Victor at Long Reach pier. © NMM

South Wharf could accommodate medical staff and 24 patients. The pier at South Wharf extended 90 metres (300 feet) into the river, so that the steamers could stay afloat whatever the state of the tide. A similar pier was built at Long Reach.


The steamers

The ambulance ship Geneva Cross seen from South Wharf

View full size imageThe Geneva Cross seen from South Wharf. © NMM

The MAB bought a fleet of paddle steamers, including the Red Cross, the Geneva Cross and the Albert Victor.

They were instantly recognisable from the frosted glass in their saloons. This was fitted to protect the privacy of the patients on board.

Upper hospital deck of the Geneva Cross ambulance ship
View full size imageThe upper hospital deck of the Geneva Cross. © NMM

The steamers were fully-equipped ambulances, and the most rigorous measures were taken to safeguard the patients and prevent infection of any healthy person.

As most patients were not diagnosed with smallpox until the rash appeared, they were at their most infectious by the time they came to South Wharf.

The trip from South Wharf to the hospital ships took two hours, and was far more comfortable than any land trip could have been in those days.

The journey

The Red Cross ambulance ship alongside the Atlas
View full size imageThe Red Cross alongside the Atlas. © NMM
When times were quiet, a single daily sailing was usually enough. During epidemics, all the steamers worked flat out. They carried not only the sick but also food and other supplies from London to Long Reach.

The ambulance steamer Geneva Cross at Long Reach pier
View full size imageThe Geneva Cross at Long Reach pier. © NMM
In 1893, a busy year, the steamers travelled a total of almost 35,000 kilometres (22,000 miles) between the wharves and the hospital ships. They transported 2100 patients, 5500 visitors and staff and 98 tons of supplies.



The service had many problems. The steamers needed frequent repairs, often because of collisions with other, less careful vessels. 

The weather often caused delays, as the steamers could not leave during the thick fogs that enveloped the Thames. These delays usually lasted just a few hours or a day at most, but were very inconvenient for the patients.

Side view of the Atlas Hospital Ship during the big freeze of February 1895
View full size imageThe Atlas and Long Reach pier during the big freeze of February 1895. © NMM

Far more serious was the big freeze of February 1895, when huge floating sheets of ice made it too dangerous for the steamers to risk the journey.

Patients were marooned at the South Wharf for two weeks before they could go out to Long Reach. Thankfully, no epidemic was raging at the time.


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