Even with these improvements the conditions aboard such a ship were often deplorable. One surgeon's mate aboard one of the first British hospital ships described the conditions in these words, "They languished in want of every necessary comfort and accommodation.Were pent up between decks in small vessels where they had not room to sit upright; they wallowed in filth; myriads of maggots were hatched in the putrefaction of their sores, which had no other dressing than that of being washed by themselves in their own allotment of brandy; and nothing was heard but groans, lamentations, and the language of despair, invoking death to deliver them from their miseries." After the conditions of such ships were recognized they continued to steadily improve. These improvements were often brought about by health and sanitation commissions.
Many other countries, such as, Spain, Britain, and France used hospital ships long before the United States did. The first American hospital ship was built in 1803 and commissioned as the U.S.S. Intrepid. It was not until the Civil War that the true American hospital ship came to be. Some of these ships were operated by the navy and some were operated by the army, while others were operated by sanitary commissions. In later years the Red Cross was given control over some ships to use for medical purposes. Over the years hospital ships continued to be put to use all over the world, and the numbers of ships used continued to grow, as well. By World War I over two hundred ships of all types and from all nations were used as hospital ships. .
The ships used during World War I were much improved from the ones used in previous wars. The ships used during this war are very similar to the ones used in the present. They varied largely in size from a 4,182 bed ship to small ones used in canals. Many of the hospital ships in World War I were torpedoed and sunk.