For many people during the famine there was a hard choice, death or emigration. Hundreds of thousands of people fled from Ireland in order to survive. People flocked into British ports such as Liverpool. Many arrived in Britain in terrible condition; they carried diseases and needed immediate attention. From Britain many emigrants decided to go to Canada and the U.S. at a cost of £5. There was such a great queue for emigration to America they began setting sail from Ireland to North America. Conditions on emigration ships were terrible. People huddled together on old, overcrowded and unsafe vessels. Food and sanitation were appalling and disease, drunkenness and death were rampant. Some ships even sank on the way. Because of this they became known as coffin ships. When the emigrants arrived to Canada they had to go into quarantine on Grosse Island, on the St Lawrence River near Quebec.

A doctor wrote an account on the condition on the passengers

“”On boarding the boat I found the passengers in a most wretched state of filth and disease. No order or rules had been kept or an attempt on cleanliness. Their excrement was thrown in to the ballast, producing a stench, which made it difficult to stay below for any length of time. I found 26 cases of fever, and received the names of 20 others, including the captain, who died on the passage. The voyage had extended to 72 days. On the landing the passengers at the sheds, I had to send 50 more to hospital and 6 have died since landing. The remainder, though weak, are healthy at present, and have been made to clean themselves, their clothing and bedding, but most of them are without a second change in clothing. The causes, which have produced disease and death among these passengers, are:

1. Want of cleanliness.

2. Lack of food and water and that of unwholesome quality.

3. Overcrowding.

These causes produce fever, and once disease sets in, the stench of the sick, dying, and dead confined the hold (the captain was kept 2 or 3 weeks on board after death), soon made the whole atmosphere unfit to breathe. The captain, from all accounts was unfit to take care of a passenger vessel. He was in ill health and a drunkard. The vessel did not provide the passengers with any food: their own stock was soon eaten. The bunks were badly put up, and came down on starboard side 2 or 3 days after leaving. The vessel itself is the oldest in North England, (83 years old). The numbers of passengers put on board exceeded by 60 or 70 the number allowed to the vessel.”"