Sunday, October 19, 2014

The Civil War's Black Soldiers: Medical Care

Civil War Series

No doubt, the costliest aspect of discrimination in the Union army was its medical care. Throughout the Civil War medical care was for the most part dreadful, but for black soldiers it was especially horrible and at times reprehensible. Men in the USCT served a disproportionate amount of duty in the most unhealthy environments, suffered from a shortage of qualified physicians and staff, endured the abuse of racist surgeons, and lost countless lives to separate and woefully unequal hospital facilities. All this resulted in a mortality rate from illness of two and one-half times per one thousand men greater than for white soldiers.

Illnesses took a much heavier proportionate toll on the USCT than they did on white volunteer units. Like most new white enlistees, many of the black troops had no previous exposure to the diseases that roared through military camps. Compounding that misery, authorities assigned black commands to the most unhealthy locations, mainly to perform occupation duties, because they assumed they were immune to all tropical diseases. As weeks and months passed in garrison, camp sanitary problems invariably magnified, and the ensuing illnesses inflicted fearful losses among black men in Union blue.

According to official medical records, the surgeons and assistant surgeons in the USCT cared for over 600,000 illnesses and 10,000 wounds among enlisted men. This figure not only understated the number of cases significantly, it excluded health issues among officers of black units from the count.

Serious personnel shortages in the medical area enhanced the burden. Since many white doctors refused to serve in a black regiment and there were so few qualified black physicians, regiments usually functioned with just one or two surgeons, even though the War Department authorized three. Trained nurses and hospital stewards could have eased the workload and maintained proper sanitation in regimental hospitals, but they, too, were in short supply. Volunteer physicians and nurses, who improved the lot for sick and wounded white troops so regularly, seldom offered their services to black regiments. Under these circumstances, it was not unusual for a solitary surgeon to care for an entire regiment, and on a few occasions a soldier had to treat other soldiers because there was no one else to do it.

Despite the small number of health workers, black soldiers almost always received their best care on the regimental level. There were, of course, tremendous demands on the physicians and limited facilities, but the physicians who received commissions in the USCT were for the most part competent. With the entire unit stationed nearby, soldiers had direct channels for their complaints, and regimental commanders could oversee the hospital organization and rectify problems as they developed.

Because of the limited staff on the regimental level, when soldiers became very ill or suffered serious wounds or injuries, medical officers were supposed to send the patients to more advanced facilities, usually division, post, or general hospitals. The problem was that most black commands performed occupation duties and seldom constituted even brigades until late in the war, so that there were few division hospitals for them. Usually the institutions for severe cases were post or general hospitals, which were outside the direct chain of command for the USCT and regularly had separate and grossly unequal facilities for blacks and whites. Physicians who worked at these hospitals were not part of the USCT, demonstrated little concern for the plight of black soldiers, and their neglect caused unnecessary pain, suffering, and even death for their black patients. Time after time, post or general hospitals for black troops were understaffed and extremely unsanitary, and mortality rates were dramatically higher than in adjacent or near by facilities for whites.

As a result of such woeful and discriminatory medical care, nine times as many black troops died of disease as on the battlefield. Over 29,000 lost their lives from illness, with pneumonia, dysentery, typhoid fever, and malaria taking the heaviest tolls on the black ranks. Within specific commands, the number of deaths was sometimes staggering. A black heavy artillery regiment lost over eight hundred men to illness, and one infantry regiment, in service less than one year, suffered 524 deaths, 50 percent of its strength.


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