The greater traffic to North America was managed mainly by non-Italian foreign companies, more organized and technologically advanced. Needless to say, the transport of migrants was entrusted to the oldest ships, with an average of 23 years' sailing. These almost disarmed steamers - or better, "death ships" - which could not contain more than 700 people, loaded more than 1000 desperates that left without any certainty of reaching their destination. And many perished in the tragic sea voyages, between the late 19th and early 20th century.
On emigrant ships, throughout the 19th century, there were no infirmaries, clinics or pharmacies; between 1897 and 1899, more than 1% of the arrivals in New York were rejected and sent back to Italy because reduced in poor condition by the hardships and sufferings of the voyage.