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Following the First Battle of Bull Run, volunteers from the Women's Central Association of Relief (WCAR) of New York witnessed the government's lack of sanitation and medical supplies. WCAR President Henry W. Bellows had traveled to Washington, D.C., intending to discuss matters regarding his organization. Meeting with Secretary of War Simon Cameron shortly after Bull Run, he instead discussed creating a Washington, D.C. organization that would provide advice and assistance to the Union military regarding medical care and general welfare. The organization would become the U.S. Sanitary Commission, approved by President Abraham Lincoln on June 13, 1861.
The U.S. Sanitary Commission, the only civilian-run organization recognized by the federal government, would serve as the focal point for civilian assistance to the military. U.S. Sanitary Commission volunteers advised on the physical and mental health of the military, assisted in the organization of military hospitals and camps, and aided in the transportation of the wounded. They distributed medical supplies, food, and clothing where needed. All of this was accomplished at no cost to the government, thanks to donations and fundraising activities.
Led by an executive board overseeing inspectors and field agents, U.S. Sanitary Commission branches in larger cities coordinated the efforts of local aid societies. Some existing regional aid societies, including the WCAR, would serve under the U.S. Sanitary Commission. Not everyone liked the idea of taking orders from Washington. Some organizations continued to function more or less independently, such as the U.S. Christian Commission which provided relief to both sides. On July 4, 1865, the U.S. Sanitary Commission ended its work. The last official act was the publication of its history in 1866.