The first nurses to arrive at Army field hospitals frequently found appalling conditions. Water, medical supplies, linens and even food were often meager or difficult to obtain as were disinfectants and sterilizing supplies. Patients too weak or sick to move lay unbathed often without shelter or blankets. A few had bones protruding from their skin while others had dangerously deep bed sores.

Yellow fever increasingly spread among the troops in Cuba. Individuals who had survived yellow fever were believed to be immune and such nurses were desperately needed. In July, Mrs. Namahyoke Curtis, wife of the head of Freedman's Hospital in Washington, DC, recruited 32 black "immune" nurses, many of whom were immediately sent to Cuba. Of approximately 100 immune nurses, three are known to have died as a result of their services.