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 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
![]() |
They were instantly recognisable from the frosted glass in their saloons. This was fitted to protect the privacy of the patients on board.
![]() |
The 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 alongside the Atlas. © NMM |
![]() |
The Geneva Cross at Long Reach pier. © NMM |
Problems
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.
![]() |
The 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.