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ANALYSIS OF AEROMEDICAL EVACUATION IN THE KOREAN WAR AND VIETNAM WAR TlES IS Fred M. Clingman Captain, USAF AFIT/GLM/LS/89S-9

S".......
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144

AFIT/GLM/LS/89S-9

ANALYSIS OF AEROMEDICAL EVACUATION IN THE

KOREAN WAR AND VIETNAM WAR

THESIS Fred M. Clingman Captain, USAF AFIT/GLM/LS/89S-9

Approved for public release; distribution unlimited

The contents of the document are technically accurate, and no sensitive items, detrimental ideas, or deleterious information is contained therein. Furthermore, the views expressed in the document are those of the author and do not necessarily reflect the views of the School of Systems and Logistics, the Air University, the United States Air Force, or the Department of Defense.
AoCeSSon For TIMS TAB DTIC ORA&I Unannoulc ed
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AFIT/GLM/LS/89S-9

ANALYSIS OF AEROMEDICAL EVACUATION IN THE KOREAN WAR AND VIETNAM WAR

THESIS

Presented to the Faculty of the School of Systems and Logistics of the Air Force Institute of Technology Air University In Partial Fulfillment of the Requirements for the Degree of Master of Science in Logistics Management

Fred M. Clingman Captain, USAF

September 1989

Approved for public release; distribution unlimited

Acknowledgements I offer my thanks to the various libraries around the I

local area which provided me with much of my information. thank the library staff of the AFIT Library, who provided

information and helped me to obtain information from other libraries in the country. I extend my appreciation to the Research Center and Air Alabama. They took great

staffs of the Air Force Historical University Library at Maxwell interest in AFB,

finding necessary information. Jerry Peppers, in helping my

I extend a very special thanks to Mr. thesis advisor for his assistance me to complete this research.

and expertise important,

More

I want to

thank him for showing me the importance of studying and learning from the past. Finally, Karen, I thank my wife Nora and children Billy and

for their understanding and patience.

Fred M. Clingman

ii

Table Of Contents Page Acknowiedgements .......... ................... ................... .. .. .................. .. ii v vi vii 1 1 3 8 8 9 .. .. .. ... . . . 11 11 12 15 17 19 21 24 26 34 46 51 .. 60

List of Figures .................. List of Tables ............. Abstract ................. I.

.................... .......................

Introduction .................

General Issue ............. ............... Background .............. ................. Specific Problem. ....... . ............ Investigative Questions ......... .......... ........... Scope of the Research ......... II. Methodology ............ ...................

Introduction .......... ................ Specific Methodology ...... ............ Presentation .............. ................ III. Korean War . ............ ..................

Introduction ........ ................ *17 Types of Injuries and Disease Encountered Chain of Evacuation in the Korean War . . Aeromedical Evacuation Process in Korea . Forward Aeromedical Evacuation .... Intratheater Aeromedical Evacuation Intertheater Aeromedical Evacuation Specific Problems Encountered ind Lesson Learned ...... ....... IV. Vietnam War ............ ...................

Overview . *.........*.*.....................60 Types of Injuries and Disease Encountered 61 Disease .......... ................ .. 63 Wounds ... ......... 67 Aeromedical Evacuation Process in Vietnam 69 Forward Aeromedical Evacuation .. . . 71 Tactical and Intratheater Evacuation 98 Strategic and Intertheater Evacuation 106 Specific Problems Encountered and Lesson Learned ... ........ .. 111 iii

Page V. Conclusions and Recommendations .... ....... 117 .. 117 123 125 .. 127 133

Investigative Question Answers ......... ................ Conclusions ........... Glossary ................. Bibliography ............... Vita ................... ....................... ..................... .........................

iv

List of Figures

Figure 1. 2. 3. 4. 5. 6. Army Medical Evacuation Flowchart .. ........ ................... ........... ...... .. ..

Page 23 37 41 50 62 .. 95

Map of Korea ..........

Request for Air Evacuation ....... U.S.

Army Evacuees to the United States .... South Vietnam Vietnam ...

Four Corps zones in

....... ........ ..........

Air Ambulance Units in

List of Tables Table 1. 2. 3. 4. 5. 6. 7. 8. U.S. Army Wounded Evacuees Received in the ......... United States By Causative Agent ... .. Page 20 21 38 48 .. . .
.

Number and Percent of U.S. Army Wounded Evacuees by . . Type of Traumatism (2 Sept 1950 - 31 Dec 1953) Monthly Medical Air Evacuation in FEAF ...... ..

Percentage Distribution of Evacuees Received in the United States (2 Sept 1950 - 31 Dec 1953) Evacuees from Japan-Korea Received in the U.S. ...... by Service (2 Sept 1950 - 31 Dec 1953) U.S Army Evacuees (2 Sep 1950 - 31 Dec 1953)

48 49 63

Hospital Admissions for All Causes, U.S. .................. Army (Vietnam) ........... Approximate Number of Man Days Lost From Duty By Cause Among U.S. Army Personnel in Vietnam, .................... 1967-1970 .............. Selected Causes of Admissions to Hospitals and Quarters Among Active-Duty Army Personnel in .............. .... Vietnam, 1965-1970 ....... Percent of Deaths and Wounds According to Agent ........... Vietnam Jan 1965 - Jun 1970 ......
Evaualios by ALmy Air Ambulances in Vietnam . .

..

65

9.

66 ..
.

10.
ii.

68
97

12.

Patients Evacuated by PACAF Aircraft .. .......

.. 104

vi

AFIT/GLM/LS/89S-9 Abstract This study examined aeromedical Korean War and the Vietnam War. and the Vietnam, tory, evacuation during the the Korean

The two wars,

are the most recent in

our country's his-

and will most likely be the type of conflict we as a the future. The purpose of logisin of in

nation will be committed to in

this research was to identify and describe the major tics and operational factors of aeromedical

evacuation

the Korean War and the Vietnam War. successful logistic activities in

The identification aeromedical evacuation

each of these wars permits a comparison between the wars. The description and identification of factors and the

comparison between the wars provides that may be encountered of past experience mistakes future. Chapter III examined aerouedical Korean War. This includes in in

insight to problems From the study

future conflicts.

these two wars we can learn from the in the

and successes and avoid the same problems

evacuation in

the

forward aeromedical

evacuation,

intratheater aeromedical aeromedi~al evacuation.

evacuation and intertheater

Chapter IV examined aeromedical Vietnam War.

evacuation

in

the

The military services examined in Army, and Navy. vii

this chapter

are the Air Force,

Chapter V compares and contrasts methods of aeromedical evacuation used in conclusir each war. The chapter closes with and provides for, aeromedical

based on the comparisons to improve,

reco.-endations evacuation in

and prepare

future wars.

viii

IF WE ONLY ACT FOR OURSELVES, TO NEGLECT THE STUDY OF HISTORY IS NOT PRUDENT; IF WE ARE

ENTRUSTED WITH THE CARE OF OTHERS IT IS NOT JUST. SAMUEL JOHNSON

ix

AN ANALYSIS OF AEROMEDICAL EVACUATION IN THE KOREAN WAR AND VIETNAM WAR

''

I.
Issue

Introduction

General

A historical

study of aeromedical

evacuation during the some insight for in future simi-

Korean War and the Vietnam War may prcvide improving aeromedical lar conilicts. evacuation procedures

The two wars,

the Korean and the Vietnam, and will most

are the most recent in

our country's history,

likely be the type of conflict, conflict,

as opposed to a worldwide the future. pre-

we as a nation will be committed to in a crucial

The study of past events is paring for possible situations in

element in

the future.

Unless we understand the events of yesterday, the difficulties of tomorrow are distorted, and the successes of tomorrow may be delayed indefinitely (5:29). Jerome Peppers writes in his book;

If the nation is to escape or even minimize the blunders of the past, it cannot neglect to study its mistakes. .erefore, we must recognize that, for logistician., the study of military logistics history is vitally important because of the nature of the problems faced by military leadership. The study of military logistics history will help the logistician, and the student of logistics, to more readily identify current problems and it will suggest potential avenues of solution to those problems. Further, and perhaps far more important, the study will help logisticians create more effective logistics systems for tomorrow (58:iii).

There are many different definitions for the term logistics. The concept of logistics is it not an easy one to

understand nor is people.

interpreted the same by different

DOD 500.8 defines logisitics as:

The functional fields of military operations concerned with: (1) Material requirements; (2) Production planning and scheduling; (3) Acquisition, inventory management, storage, maintenance, distribution and disposal of material, supplies, tools, and equipment; (4) Transportation, communication, petroleum, and other logistical services; (5) supply, cataloging, standardization, and quality
(6) (7) control; commercial and industrial activities and

facilities including industrial equipment;

vulnerability of resources to attack damage

This definition of logistics covers many different

areas. The medical services, in the Korean and Vietnam

Wars,

had more control over the items listed in the definiThis was because the maand other items were

tion than did most other units.

teriel, supplies, equipment,

people,

only used and many times only understood by the medical sevices. Aeromedical evacuation was only a part of the but a very important and

medical services in the two wars,

critical link in medical logistics. In every war fought there have been both individuals killed and wounded. Evacuation methods, and in the more represent an

recent wars aeromedical

evacuation procedures,

integral component in the capability of military forces to treat the wounded and save lives. The ratio of deaths to

deaths plus surviving wounded (deaths hits) was 29.3 percent Korean War, of killed in to 3.1 in 5.6 in in World War II,

as a percentage 26.3 percent

of in the

and 19.0 percent in action (KIA)

the Vietnam War.

The ratio was 1

to wounded in

action (WIA)

World War II,

1 to 4.1 in

the Korean War,

and 1 to by

the Vietnam War (51:52).

Aeromedical

evacuation,

quickly getting the wounded to treatment areas, ficant beneficial contributor to these findings.

was a signiA wounded The

person's chance of surviving improved with each war. injured's chances better than in of recovery in Vietnam were

2.2 times World War II, The use of a

Korea,

4.5 times better than in World War I (40:).

and 8.5 times better than in aeromedical

evacuation increased with each war and is

notable contribution to the improved chance of recovery. Background During the Civil War Assistant Surgeon Jonathan Letterman, after observing the wounded took the first lie uncared for as long as

a week,

steps toward a system of evacuating His plan, first

the sick and injured from the front lines. used at the Battle of Antietam, ambulances. His plan, 1864, 1898.

used field stations and

officially adopted by the United

States Army in American War in evacuation",

was standardized during the Spanish The system was based upon a "chain of

where the wounded were carried from the battle From there, field ambulances carried

area to aid stations.

them to clearing stations,

and from there they were trans(27:29).

ferred to field hospitals for further treatment

Evacuation from the field hospitals to the base and general hospitals was dependent upon rail The Civil War was the first war in and water transportation. which United States

military forces used specially designed ambulance wagons for the evacuation of the wounded from the front 246). lines (41:243-

This system was the beginning of many of today's evacuation had become

evacuation techniques and aeromedical a very important The first airplane was in A French medical link in that chain.

evacuation of wounded military personnel by World War I at Flanders on April officer, Dr. Chaissang, 18, 1918.

had drawn plans for He super-

the modification of two French military planes.

vised the modification of the planes which provided enough space for two wounded soldiers behind the pilot's cockpit.

The patients were inserted through the side of the fuselage. Aeromedical extent in evacuation of wounded was used to a very minor

World War I because of the lack of a practical The airplanes The fuse-

airplane available for this type mission.

used were all converted military tactical models.

lages were too narrow to hold stretchers and they were all of open cockpit design. The patients would also have to be

exposed to the cold air (18:2-3). The first successful air ambulance in the United States

was created by Captain William C. Oaker and Major William E. 4

Driver in 1918.

They converted a Jenny biplane by removing

the rear cockpit and rearranging equipment so a standard army stretcher would fit into the area. This airplane was

used giving assistance to pilots who had crashed in remote areas where the converted Jenny could land reasonably near by. Crashes occurred frequently during this period because

airmail routes had just begun and flights were attempted in all kinds of weather and at night without proper flying instruments or pilot training. The use of the ambulance

plane allowed a doctor to fly to the injured pilot, treat him on the spot, then have him flown to a hospital, if necessary (18:3).

Even though the use of the airplane as a means of transporting wounded and sick had made significant advancements since World War 1, at the beginning of World War II many military authorities believed the air evacuation of patients was not only dangerous but medically unsound and militarily impossible. General David Grant, the first Air

Surgeon of the Army Air Forces, proposed an air evacuation service which was met with much opposition in the upper levels of the Army. Grant kept pushing for an air evacu-

ation system and in June of 1942 he was successful (18:8). Grant's first problem was locating planes. There was a

shortage of warplanes and none could be spared for the ambulance service. Military transport planes (C-46, C-47, These planes brought supplies 5

and later C-54) were used.

and troops to the front and then usually flew empty back to base. The planes were equipped with litters to carry the equipment. Grant

wounded and provided a supply of medical

pushed for the use of nurses to care for the wounded being evacuated by air. This was against the opposition of many

generals who believed women belonged on the ground and in rear echelons. Grant insisted and the recruiting of nurses

for the new Army Air Evacuation Service was begun on an urgent basis. first He was present for the graduation of the February 1943. New hospi-

class of flight nurses in

tals were built alongside many airstrips

to provide for med(18:9-11).

ical attention to wounded during flight stopovers The first U.S. in

large scale air evacuation operation by the a combat situation was in New Guinea

Army Air Force in

August 1942.

The Fifth Air Force

evacuated more than seven days

13,000 patients

over 700 miles to Australia in

during an Allied counter-offensive (64:103). By 1943, the air evacuation of wounded.

against the Japanese

service began to move That year 173,500 wounded

significant numbers

and sick personnel were air evacuated back to the United States. The following year 545,000 wounded and sick were 1945, before the war ended, 454,000

air evacuated and in personnel (a

rate of one million per year)

were evacuated

This process had shown that aeromedical viable alternative.

evacuation was a

One of those convinced of the impor-

tance of air evacuation was General Dwight D. Eisenhower, Commander of the Armies that invaded Europe. Speaking of

the record 350,000 wounded air evacuated from D-Day to victory he said, "We evacuated almost everyone from our and it has unquestionably (18:11). In saved

forward hospitals by air,

hundreds of lives - thousands of lives" Helicopters were rarely used in

World War II.

November of 1943 the Sikorsky R-6 was the first flown in a pilot, litter a test flight for evacuation purposes. medical attendant, and two litter

helicopter It carried The

patients.

was attached to the outside of the helicopter to easy loadiChg and unloading. During the flight

accommodate the patients

could be seen by the crew and a two-way inter-

com system was used for communication with the patients (64:103-104). medical Harman. The first helicopter used as a rescue and in April 1944, by Lt. Carter

evacuation device

He was one of the first helicopters.

Army Air Forces pilots

trained in Force, U.S.

He flew for the 1st Air Commando in India. On 23 April he flew

Army Air Forces, new litter

one of the unit's

bearing helicopters to pick up about 25 kilometers west

a stranded party with casualties, of Mawlu, Army's first Helicopters Burma.

On his return he had completed the U.S.

helicopter medical evacuation mission (22:9). became the primary aii evacuation instrument in

Korea and Vietnam for all U.S.

military services.

Air evacuation of military patients continued after the end of World War II. On 7 September 1949 the Secretary of in

Defense directed that evacuation of all sick and wounded, peace and war, choice.

would be accomplished by air as the method of

Hospitals ships and other means would only be used (64:104). The use of air evacuown.

in unusual circumstances

ation had finally come into it's Specific Problem

The purpose of this research was to identify and describe the major logistics and operational aeromedical War. factors of

evacuation in the Korean War and the Vietnam logistic activities

The identification of successful

in aeromedical

evacuation in each of these wars permits a The description and identi-

comparison between the wars.

fication of factors and the comparison between the wars provides the answer to the question: What can be done in

future wars to better prepare and improve the logistics and operations of aeromedical Investigative Questions The following investigative questions guided the research to answer the basic problem stated above. 1. 2. 3. What means of aeromedical evacuation (types of
aircraft) were used in each war?

evacuation?

What types of injuries were incurred in each war? What types of medical equipment were used in the evacuation in each war? 8

4.

In each war, what types of medical personnel (doctors, nurses, medics) were involved in the air evacuation and what were their responsibilities? What were the organizational structures of the agencies, of each of the services, given the responsibility of aeromedical evacuation in each of the wars? How was information necessary for a successful aeromedical evacuation communicated in each of the wars? What were the aeromedical evacuation learned in each conflict? lessons

5.

6.

7. 8.

Were the lessons learned in the Korean War applied effectively in preparing and conducting the Vietnam War?

Scope of the Research The medical in services performed in an exceptional manner

both the Korean War and Vietnam War. medical supply,

The medical perand many other

sonnp,1, hospital systems, medical

functions all contributed

to the success of medical Even though these of

operations and logistics in

both wars.

other areas were an integral part of the accomplishments the medical in services in the two wars,

they were not included

this research.

Only aeromedical

evacuation was included. addition

There were other types of evacuation used in to aeromedical evacuation in

the Korean and Vietnam Wars. (soldiers on foot, and ships) combat

The other types of evacuation vehicles, important other vehicles, in

animals,

were very

the evacuation of wounded in

both the Korean

and Vietnam Wars, research.

but they were not included in

this

"-'he aircraft employed in

as the helicopter,

aeromedical

evacuation,

such

were often used for the movement of and for other essential combat support

troops and supplies, tasks. Their uses in

other assignments were not included in

this research.

10

II. Introduction

Methodology

The methodology used in analysis technique.

this research is

the historical the systematic

"Historical research is evaluation,

and objective location, dence in

and synthesis of evi-

order to establish facts and draw conclusions (9:260).

concerning past events"

Data is

broken down into two categories,

primary data

and secondary data. are now gone, standpoint, it in is

Although many of the people of the past

attempting to study dat,& from a historical necessary to attempt to reconstruct as

closely as possible the actual situations of their timeRecords of the words these individuals spoke and wrote, testimony of friends and acquaintances, and the personal the

records they have left behind are all considered primary data. Secondary data are the thoughts of others not inattendance at a historical event. The use of of the

volved or in

primary data tends to strengthen the reliability research (42:87),

while secondary data can be found much

easier and more quickly (26:135).

Jerome Peppers writes;

We must be cautious about one important factor. No matter how well-done the research, or how carefully conceived the writing, we can never be completely certain nor can we ever be in complete agreement, about what actually happened in the None of us can fully and days of the past. faithfully recall impressions, perceptions, or emotions which led to certain decisions. Particularly this is true for the writer who might 11

not have been present at the event or place of decision (58:iii). There historical are usually two types of evaluation when using research data. First, a judgement must be made This is referred to

as to the authenticity of the document. as external criticism (42:88). Second,

an evaluation must in

be made of the accuracy and worth of the data contained the document. (9:264-265). This is referred to as internal criticism external

In this research

criticism should not

be a difficulty due to genuineness

of the data selected. Three of

Internal criticism will be much more of a problem. problems identified by Borg an4oGall the observer,

are the competency

individuals purposely biasing an observation,

and tendency for some individuals to exaggerate their role in a situation. This exaggeration is often not intentional

but reflects the experience concerned (9:265-267).

from the view of the individual the Durants and the of the and

Even though overstated, "Most history is

convey the thought that, rest is prejudice"

guessing,

(24:12).

Obtaining many sources

same event often will reduce the exaggerations, incompetencies reports. Specific Methodology The following is

biases,

of many of the individuals writing the

an outline of the specific methodology this thesis.

used to ga'hpr and evaluate data in I. Searched for related literature 12

A.

Previewed indexes, abstracts, books, journal articles, magazine articles, transcripts, and historical documents relating to aeromedical evacuation in the Korean and Vietnam Wars. 1. Air Force Institute of Technology Library, 2. 3. 4. 5. 6. 7. 8. WPAFB, OH. Maxwell AFB, AL.

Air University Library, Kettering Medical ing, OH. Montgomery

Center Library, Dayton,

KetterOH.

County Library,

United States Air Force Academy Library, Colorado Springs, CO. WPAFB Medical Center Library, WPAFB, Dayton, OH. OH.

University of Dayton Library,

Wright State University Library, OH.

Dayton,

B.

Conducted searches for literature through the Defense Technical Information Center (DTIC), DLA, Alexandria, VA and the DIALOG Information Retrieval Service. 1. Requested a search for literature be conducted based on key words and phrases provided by the researches. Based on the technical report summaries, a result of the search, requested the relevant publications.

2.

C.

Conducted an examination of relevant data at the Air Force Historical Research Center, Maxwell AFB, AL. into the following areas:

II.

Arranged the data A. Korean War 1. Army a. b.

Forward aeromedical evacuation Tactical and intratheater evacuation 13

2.

Air Force a. b. c. Forward aeromedical evacuation Tactical and intratheater evacuation Strategic and intertheater evacuation

3.

Navy & Marine Corps a. Forward aeromedical evacuation

B.

Vietnam War 1. Army a. b. 2. Forward aeromedical evacuation Tactical and intratheater evacuation

Air Force a. b. c. Forward aeromedical evacuation Tactical and intratheater evacuation Strategic and intertheater evacuation

3.

Navy & Marine Corps a. Forward aeromedical evacuation

III.

Evaluated the data with emphasis on showing the relation uf the data with the specific problem statement. A. B. Evaluated external Evaluated 1. internal criticism criticism (validity) (validity)

Examined versions of same events by different individuals for similarities and differences. Was the variation in the data explainable? Did the account of the historical events include interpretations of the data presented. What was the basis for the translatinnq of the data?

2.

14

3.

Examined the meaning of particular events and established a meaningful relationship, if there was one, to the specific problem (14:252).

An extensive DTIC search provided qumerous documents concerning Army aeromedical evacuation in the Vietnam War.

There were no documents found through DTIC concerning aeromedical evacuation in the Korean War. A DIALOG search

failed to provide any documents.

Articles and books con-

taining information from all the services on aeromedical evacuation from both wars were obtained from the libraries previously identified. Most of the information of aerothe records

medical evacuation by the Air Force was found in of the Air Force Historical Research Center.

Unit histories

and commander end of tour reports contained vital information. Presentation This thesis examines aeromedical evacuation in the

Korean War and the Vietnam War in Chapter III. evacuation in

three chapters. aeromedical

This chapter examines

the Korean War during the time period from The military services examined Army, and Navy. aeromedical in this

1950 to 1953.

chapter are the Air Force, Chapter IV. evacuation in

This chapter examines

the Vietnam War during the time period from

15

1965 to 1973.

The military services examined in this Army, and Navy.

chapter are the Air Force, Chapter V. of aeromedical

This chapter compares and contrasts methods evacuation used in each war. The chapter

closes with conclusions based on the comparisons and provides recommendations to improve, aeromedical and prepare for,

evacuation in future wars.

16

III. Introduction In 1950,

Korean War

prior to the outbreak of the Korean War, Chairman of the Armed Forces Medical

Dr. Policy

Richard Meiling, Council said;

As a peacetime operation, the air transportation of patients is steadily improving in efficiency. As a military operation under combat conditions, a lot of improvement is still required. There still . . . is the small minority which is unable or unwilling to recognize the inherent soundness of air evacuation. Though the resistance was difficult reluctance of many to use aeromedical to understand, the

evacuation during the to take some time for

beginning of the Korean War caused it an orderly system of aeromedical lished. Many Army, Navy,

evacuation to be estab-

and some Air Force personnel

believed that ships and ground transportation were the best ways to evacuate the wounded. port facilities reasonable in Inadequate roads, rail, and

Korea made aeromedical option, but it

evacuation a very resisted

and essential The

was still

by many people. medical facilities

lack of infrastructure

an" adequate

helped to establish aeromedical

evacuation as the necessary course to take (64:104). Another proponent of aeromedical Wilford F. Hall, USAF, wrote in 1951; evacuation, General

The indirect advantages of having air evacuation serving the military is not unlike the resultant medical advantages of good country roads and the 17

automobile to the farmer over the horse and buggy days of 30-40 years ago. Today, most people living in rural areas are equipped with fast motor cars and connected to one of several towns with excellent all-weather roads. The sick or injured of these households may be promptly and quickly brought to the doctor in the city, who has all the advantages at hand of his complete office equipment, consultants and professional assistants and hospital facilities. Medical advantages to the patient are obvious. The ability of the doctor to see more patients and do a better work are likewise obvious. With a requirement for the deployment of our military forces on a global scale, the air ambulance is a potent factor and a modern piece of our medical armamentarium for providing better medical care to all by fewer physicians (35:1026). In the early stages of the Korean War aeromedical

evacuation was thought of as an emergency method of transporting the wounded. It was used only in those cases when

the injured could not be transported by means of stretcher bearers, field ambulances, trains, or hospital ships. The

Army's policy was to keep the injured soldier as far forward as possible so he could return to combat as soon as possible. The medical system and it's transportation methods (30:584-

were focused on keeping the injured soldier forward 565). Even though it

was recognized that aircraft offered the from Korea to the

cheapest and fastest way to move patients United States,

neither the Army nor the Air Force had given evacuation of sick The Far East

any thought to the concept of aeromedical

and wounded within the theater of operation. Air Forces (FEAF)

did not provide a regulation governing evacuation until 18 December 1951;

intra-theater

aeromedical

18

18 months after the start little

of the war.

The directive did

more than confirm the policies and practices which in the war. Aeromedical

had evolved through experience

evacuation gained wide-spread acceptance not through the regulations but through it's proven usefulness (30:585).

Types of Injury and Disease Encountered During the Korean War the United Nations suffered 142,000 casualties. people. The Koreans lost at least one million Korea in three

The losses by the United States in less than the losses in

years are narrowly over ten years. in Korea than in

the Vietnam War,

The British lost three times as many people the Falklands. Chinese casualties are un-

certain,

but are into many hundreds of thousands incurred in

(36:9). as well have a

The injuries

a war time situation,

as the kind of diseases

individuals are exposed to,

definite impact on the type of medical used.

evacuation that is 51 percent

of Army evacuation to the United States, 34 percent were disease cases, injuries (61:75).

were wounds,

and 16 percent

were non-battle Table

1 displays that explosives and fragmentation for 59 percent of those U.S. Army perExplomortar,

weapons accounted

sonnel medically evacuated to the U.S. sive projectile and bazooka shells (which

from Korea.

included artillery,

shells,

plus unspecified

explosive projectile

19

shells) were responsible casualties evacuated.

for about 41 percent of the

TABLE 1 (61:78) U.S. ARMY WOUNDED EVACUEES RECEIVED IN THE UNITED STATES BY CAUSATIVE AGENT 2 Sept 1950 - 31 Dec 1953 Injury and Wound

Causative

Agent

___________________________ ______________________________

Number Total all agents Small arms weapons (subtot) Rifle bullet Machinegun bullet Others unspecified bullets Explosive and fragmentation weapons (subtotal) Rifle artillery Specified projectile explosives Unspecified projectile explosives Bombs and other air launched missiles Land mine Grenade Other or unspecified fragments Parachute jump and aircraft accidents Land transport vehicles Incendiaries and other chemical weapons Direct or indirect intended effects of war Self infliction Falls or jumps Machinery, tools, objects Other agents 19,465 (6,460) 934 602 4,924 (11,559) 18 3,357 4,734 19 899 1,232 1,300 29 184 52 341 640 128 35 37

Percent 100.0 (33.2) 4.8 3.1 25.3 (59.3) 0.1 17.2 24.3 0.1 4.6 6.3 6.7 0.1 0.9 0.3 1.8 3.3 0.7 0.2 0.2

20

The proportion of wounds caused by small was higher in the Korean War than in that in in

arms weapons Reister

World War II.

points out the reason is less enemy aerial

the Korean War there was

activity

support of their ground troops

thus making bombs and other air launched explosives not as significant a factor as a cause for casualties Of all of the traumatisms Army evacuees, (61:78).

or injuries of the 19,465 U.S. two main categories:

85 percent were in

Compound fractures

were about 50 percent while wounds of all Table 2 shows the

types accounted for about 35 percent. distribution by type of traumatism. TABLE 2 (61:79)

NUMBER AND PERCENT OF U.S. ARMY WOUNDED EVACUEES BY TYPE OF TRAUMATISM (2 SEPT 1950 - 31 DEC 1953) TYPE OF TRAUMATISM Total Fracture, Compound Fracture,other, or not elsewhere classified Wounds Amputation. traumatic Burns Concussion Other or unspecified NUMBER 19,465 9,687 956 6,868 708 85 77 1,084 PERCENT 100.0 49.8 4.9 35.3 3.6 0.4 0.4 5.6

Chain of Evacuation Aeromedical

in

the Korean War only a part of the overall A general understand-

evacuation was in

evacuation process

the Korean War.

21

ing of the evacuation process is role of aeromedical

necessary to appreciate the This

evacuation played in the process.

section will generally address the chain of evacuation with a more detailed analysis of the aeromedical cussed later. Figure 1 shows the medical evacuation flow chart for the Army in the Korean War. The flow was also similar for Air Force evacuation dis-

the Marine Corps and downed Air Force pilots.

personnel in Korea were usually close to medical facilities therefore this flow did not apply. The injured soldiers

from the front lines were initially brought to battalion aid stations by litter, jeep, or ambulance. There the wounded

received first aid and emergency treatment and were moved by jeep or ambulance to collecting stations. Critically wound-

ed patients were flown by helicopter to a MASH (Mobile Army Surgical Hospital). Other patients went by ambulance to the From the Division Clearing

Division Clearing Stations.

Stations patients were sent by air or train to evacuation hospitals. Some of the patients went from the evacuation In the

hospitals by air to Japan while others went by ship. Japan, most patients went to the hospital at Fukuoka,

point of debarkation, ambulance,

but some were transported by rail, Patients

and air to other hospitals in Japan.

who could be treated and returned to duty remained in Japan. This was usually the case if the patient's hospital stay was The more serious cases

expected to be 120 days or less. 22

ARMY MEDICAL EVACUATION FLOWCHART

SAID STATION
S SMASH DIVISION CLEARI NG STATION REGT COLLECTING STATION

EVACUATION HOSPITAL
KOREAN AIRFIELDS i

118th STA HOSPITAL

iTAZUKE AIRFIELD

HANEDA AIRFIELD

TRIPLER ARMY HOSPITAL

TRAVIS AFB, CA ARMY HOSPITALS ZONE OF INTERIOR

Ground

Air

Sea

FIGURE 1

23

were flown back to the United States. non-serious

In some circumstances

cases were evacuated to the United States bein the hospitals in in the United

cause of the immediate lack of bedspace Japan.

Patients scheduled for hospitalization

States were evacuated as soon as their physical would permit.

condition

The bulk of the patients who were evacuated

to the United States were flown out of Haneda Field near Tokyo. Enroute to the United States, some patients were in Hawaii while

left for treatment at Tripler Army Hospital

the others continued to Travis AFB for treatment and distribution to other hospitals throughout the United States

(11:51).
Aeromedical Evacuation Process in Korea system for moving

The Eighth Army began a traditional

and hospitalizing the sick and wounded when American troops landed in Korea in July, 1950. The policy was for patients

who could return to duty within thirty days to be hospitalized in Korea. Patients who required specialized treatment would be moved to

or more than thirty days hospitalization hospitals in Japan (30:585-586). Lt.

General Stratemeyer, (FEAF),

Commanding General

of the Far Eastern Air Forces

recognized that the speed with which a wounded person received medical died. attention often determined if he lived or limited suron 4

He was also very familiar with Korea's

face transportation.

He informed General MacArthur,

24

July,

1950,

that FEAF was ready to accomplish the aerofrom Korea. During July

medical

evacuation of casualties little

and August of 1950 there was medical evacuation system. 15, 1950,

use made of this aero-

From the beginning of the war to from

September Korea,

13,015 wounded were evacuated percent)

but only 3855 (29.6

were evacuated by air,

even though 36,000 wounded empty cargo planes

could have been flown out on Because of the rough roads the Eighth Army chose

(18:12-13).

between Taegu City and Taegu Airfield, to move its hospital in

wounded south by train to the evacuation Pusan . Most of the patients evacuated from

Pusan to Japan went by ship. to the Pusan Airfield facilities very

Patients were sometimes taken The airfield had no

for evacuation.

for patients and patients often had to wait for was arranged.

long periods before air transportation

The Eighth Army stated it

could not afford to count on this

type of air evacuation and therefore would use more reliable evacuation methods (30:586).

With the creation of the FEAF Combat Cargo Command on August 26, 1950, the commander, General Tunner, directed his Up to

staff to study the aeromedical this point, aeromedical

evacuation situation.

evacuation in

Korea had a very unre-

liable record even though the war was only two months old (18:12-13). creased. As the war went on aeromedical evacuation in-

25

The

aeromedical

evacuation

process

in

the Korean

War

can be divided evacuation; theater tion

into four

categories; aeromedical

forward

aeromedical intertransportaAll was but aerocovered

intratheater

evacuation; aeromedical

aeromedical

evacuation;

and

of the wounded within the United States. transportation research. within the United States Helicopters and other aircraft

medical in this

of the 3d (MATS), and

Air Rescue and

Squadron,

Military Air Transport retrieved front

Service

other similar personnel

units,

and removed lines

injured

wounded ical

from the C-47s,

to MASH or aircraft Air

other medcarrying

facilities. personnel

C-54s,

and other

medical

from the

801st Medical

Evacuation and other locaaircraft Squad-

Squadron, units, tions

315th Air Division (Combat if

Cargo),

transported patients, in Korea and Japan.

required, C-9s,

to further and other

C-54s,

with medical ron, MATS,

personnel

from the

1453d Air Evacuation from Japan

transported patients

to the United them

States. to their

Other elements final destination

of the MATS

system then carried United States

within the

(76:34).

Forward ward

Aeromedical

Evacuation.

Almost

all

of the

for-

aeromedical

evacuation of the w-rdi

Fixed wing aircraft there was no in landing the

wpv-o

ccomplished used beThe primary and

by helicopters. cause generally

couldn't be facility.

mission of the rescue.

helicopter

Korean War was the helicopter's

search

This research

only covered

aero-

26

medical

evacuation mission even though there is

some overlap

between the two missions. tool for medical logistical

Making the helicopter the basic

evacuation was one of the most important of the Korean War (20:93). helicopters in The

innovations

missions assigned the first

Korea were to fly This

high ranking officers from one location to another.

was generally forgotten as the mission was changed to evacuation and rescue work in the first weeks of the war (44:20).

The incident which changed ter in Korea occurred in August,

the mission of the helicop1950. An Air Force heli-

copter detachment was notified of a seriously wounded soldier at a front mountain. line aid station on top of a 3000 foot The

The aid station was cut off from the rear. and evacuate the soldier.

mission was to fly in ation was successfully saved.

The evaculife

accomplished and the soldier's

The following day the primary mission of helicopters (44:20). aeromedical evacuation

was changed to rescue and evacuation The quick adoption of helicopter

was a result of both the nature of the Korean War and the Korean countryside. The broken and rugged terrain separated facilities. The

troops from each other and from mcdical poor infrastructure, by the enemy,

and the guerilla warfare tactics used The few

also contributed to the problem.

roads were rough and crowded through ground movement of wounded traumatic, problems for the injured. In

over-use making the slow, and full of

contrast, 27

the helicopters

flight was fast and generally much

trauma to the already injured patients

smoother causing less

(44:21).

The Air Force accomplished aeromedical evacuations in

most of the helicopter The following is a memo

Korea.

to the Surgeon General Crabb,

from Brigadier General Jarred V. Headquarters FEAF.

Deputy for Operations,

Until 1 January 1951, all helicopter evacuations were performed by the USAF, except within the 1st Marine Division. The Marines handled their own evacuations except in isolated cases where help was needed they called on the Air Force. There have been 1394 personnel picked up from front line and behind the enemy line areas by USAF helicopters. Percentages of USAF versus Marine Corps or Army helicopter pickups are not available. This was discussed with the Eighth Army Surgeon and he stated the Army did not keep a consolidated record of evacuations. It is the opinion of operations personnel, Fifth Air Force, that 85 percent of all evacuations are performed by Air Force helicopters (4:20)." The Marines medical 1951 first regularly used helicopters for aeroJanuary

evacuation in

November 1950 and the Army in

(64:104). In August of 1950 the evacuation F of the 3d Air Rescue of patients was begun

by Detachment

Squadron whose primary This

mission was to retrieve downed pilots (64:104).

detachment was under the command of Captain Oscar N. Tibbets. With the drive into North Korea, the detachment

moved north and then retreated south with the United Nation forces. At the end of 1951 the unit stationed airfield. itself at

Yongdungpo near the Seoul

On 22 June,

1951 the

unit was reorganized as Detachment

1, 3d Air Rescue Squad-

28

ron.

It

was augmented with enough people to run a rescue center. Between 25 June 1950 and 30 June 1952 the of which 4573 (20:94).

control

unit picked up and evacuated 5258 personnel were evacuated by the H-5 helicopter alone

During the fall of 1950 and spring of 1951 the 3d Air Rescue Squadron helicopter crews continued of the front line aeromedical SB-17, SB-29, SA-16, C-47, evacuations. to perform most The squadron had There

H-5,

and L-5 aircraft.

were many maintenance

problems principally caused by trying

to maintain so many different types of aircraft at one time in a small unit. The four SA-16s which arrived on 28 July for

1950 were all down at one time due to lack of parts, example. medical

The H-5 helicopters were used primarily for aeroevacuation because ambulance travel over existing

and hastily made roads was dangerous and slow for the wounded, as earlier stated. The helicopter was able to carry two technician (77:111). The helicopters

patients and a medical were normally

located at a MASH and dispatched to the front charge. There were not enough H-5

lines by the surgeon in

helicopters to meet all evacuation needs so they had to be used discretely thus involving the chie, surgeon. Helicop-

ter evacuation was used when a soldier had a head wound, chest wound, or stomach wound, because the speed with which attention determined

such wounded persons received medical their chances for survival (30:589).

29

With I Corps, Detachment I.

the following procedure was used by

A battalion aid station notified the sur-

geon's office at I Corps of the location of the wounded soldier. Using direct communication with the 8055th MASH,

the I Corps surgeon gave the element commander the exact coordinates, the type of wound, security status of the area The

from enemy attack,

and the type marker to be used.

pilot and the medical technician then made the necessary pickup (77:247-248). Wounded who were evacuated lines were often in by helicopter from the front Al-

surgery within an hour (30:589).

though the helicopters were not equipped for night flying, one pilot responded to a call to a clearing station late one night. He flew using a flashlight to see his instruments in a circle lit by jeep headlights. Helicopter

and landed

pilots also provided aeromedical

evacuation for paratroop Assistance during the

drops north of Pyongyang on 20-22 October 1950. was also provided by other liaison planes and, two days, 47 casualties were evacuated (77:111).

The Eighth Army Surgeon said that half of the 750 critically wounded soldiers evacuated on 20 February, 1951

would have died if tation.

they had been moved by surface transporalso had nothing but praise for He also continued to in-

General Stratemeyer

the Air Rescue helicopter pilots. sist

that air evacuation should be separate from air rescue. 1951 in Tokyo, General 30 Stratemeyer gave

On 16 January,

General

Hoyt S.

Vandenberg,

USAF Chief

of Staff,

a require-

ment for 31 additional

helicopters

for Korea.

Most of these squad-

were to be used to establish a provisional ron.

helicopter

Headquarters USAF was unwilling to take any more H-5s

for the Air Rescue Service and the new H-19s and H-21s would not be available until early 1952. Stratemeyer asked General Force with a authorized responsible On 11 March 1951 General

Vandenberg to equip the Fifth Air He asked it )e

liaison squadron for Korea.

12 H-5s and 12 L-5s.

The squadron would be On 14 July the liaison

for air evacuation missions.

USAF authorized the Fifth Air Force to activate the

squadron with 12 L-5s and also told FEAF the Air Rescue Service would have first from production. request, choice on all helicopters received FEAF made a third

On 24 July 1951,

insisting that they required a squadron of H-19

helicopters assigned to the 315th Air Division for front line aeromedical that no evacuation missions. The USAF told FEAF or even

liaison or helicopter units were available for deployment to FEAF. On 25 July,

programmed

1951 the

Fifth Air Force activated the 10th Liaison Squadron at Seoul Airfield. aeromedical This unit had no helicopters so could not perform It was for

evacuation missions for the Eighth Army.

limited to performing the Air Force

courier and light-transport duties

(30:589-590). concerning Army avia1952 made the

The Army and Air Force Agreements

tion made on 2 October 1951 and 4 November 31

Army responsible

for "battlefield pick-up of casualties, point of treatment, and any

their air transport to initial

subsequent move to hospital facilities zone." The Air Rescue helicopters

within the combat continued to evacuate (30:590).

some of the front-line casualties Colonel Chauncey E. very interested in Dovell,

Eighth Army Surgeon,

was He a

the helicopter

as an evacuation tool. loan for a test. flew with Dovell in Pusan. In

requested an Air Force helicopter on test on 3 August, 1950 the helicopter

from

Taegu to the 8054th Evacuation Hospital started a campaign to have helicopters and received U.S.

Dovell

under his own control In October 1950,

support from his superiors.

Army Surgeon General

Bliss visited the Far East Command

and discussed medical Arthur. General

evacuation problems with General Mac-

Bliss reported to his staff that "MacArthur in the T/O&Es (Tables of

feels that helicopters should be Organization and Equipment)

and should be part of medical is". The Surgeon General

equipment - just as an ambulance requested two helicopter helicopters each.

ambulance companies of twenty-four eight helicopters had to the Far

By 20 October 1950,

been purchased by the Army for immediate airlift East Command (20:95). By March 1951 the Army's

2d Helicopter Detachment had The 3d

four helicopters that flew from the 8055th MASH. Helicopter Detachment with three machines the 8063d MASH,

was attached to

and the 4th Helicopter Detachment had four

32

helicopters which flew from the Ist MASH. problems

One of the major aeromedical

from forward

identified with the Army helicopter

system was communication. Calls

evacuation

units for helicopter

assistance had to go to headquarters systems for approval.

and back through poor communications This caused a delay in been possible (20:165).

the quick response which could have

The Marine Corps used helicopters to evacuate ground casualties casualties ward airstrip One in

Marine The

the Inje area of Eastern Korea.

were brought by the Marine helicopters to a forat Pupyong-ni (30:590). that plagued the helicopter lack of parts. At the begin-

of the major problems

during the Korean War was the ning of the Korean War,

industry was not geared towards the The fine tolerances of many

production of helicopter parts. of the rotating parts potential in

the helicopter and the limited use, made American industry unwill-

for commercial

ing to devote

large amounts of resources and money to such a Once production did increase there of sup-

speculative investment.

was a problem of transporting the large quantities plies to Korea from the United States. were more than 800 helicopters competing for available parts. another problem in an evaluation Korea: (medical Harry S.

By late 1952 there and nonmedical) Pack identified

of the problems of heli-

copter evaluation in

33

The basic concept of the'employment of the helicopter...is its increased speed over other forms of transport currently in use in the movement of personnel and materiel. Therefore, it is only logical that the entire helicopter program, including maintenance and supply procedures, should follow the same philosophy of speed and mobility to ensure receiving maximum value from the helicopter (22:17). Intratheater Aeromedical aeromedical Evacuation. The intratheater of

evacuation of patients was the responsibility services.

FEAF's air transport in June 1950,

When the Korean War started Air Evacuation Squadron had the

the 801st Medical

been stationed at Tachikawa, year.

Japan since earlier in

There were only a few nurses

and a very small workIn July 1950, the Army's

load since there were no wounded. 24th Division soldiers were airlifted were killed and wounded. ment for aeromedical son was responsible evacuation

into Korea and many

This began a much larger require(72:49). Major Charles Peter-

services

for the initial

organization of air at Taegu, Peterson,

out of Korea.

In July 1950,

with a few airman operating out of tents, nize an aeromedical evacuation system.

attempted to orgasome-

Nurses were

times available but often times not.

Pilots bringing in Nurses and sometimes as atten-

cargo took out the wounded who were waiting. medical technicians worked around the clock,

long as 72 hours straight.

Nurses provided medical

tion to the patients and advised pilots on proper altitudes

for flying to accommodate the requirements patients.

for particular but at other

Flying quickly was always important,

34

times flying smoothly was more important Allen D. Smith became

(72:54).

Colonel of the

flight surgeon and commander Squadron in

801st Medical Evacuation (72:49). During the first

the fall of 1950

three months the aeromedical

evacuation process was not well organized because of the lack of personnel; inexperienced personnel and inadequate

suDpl'es and equipment;

and the absence of a theater dir"-evacuation (66:). the 801st

tive or policy on medical

Under the management of the Fifth Air Force, Medical

Air Evacuation Squadron using mostly 374th Troop

Carrier Wing transports flew 1159 patients from Korea to Japan from the beginning of the war to 18 August, 1950.

When the Combat Cargo Command took over FEAF transport activity they said that air evacuation from Korea had "a rather spotty history". The air capability was not being

fully used because the airfield at Taegu was eight miles from town and was joined by a very poor road. Army, its which had a shortage of ambulances, on a train at Taegu, The Eighth

preferred to put and

patients

move them to Pusan,

have them wait patients

for surface transportation.

Some of the

flew from Pusan's

east airfield but often had to (77:108-109). A memorandum

wait for extreme amounts of time

by Colonel Allen D. Smith and Major Charles the hostility Army.

Peterson depicts

apparent at the time between the Air Force and

35

The Army complained that it was short of ambuwere too far from lances and that airstrips hospitals. Also, that aircraft were not scheduled to suit their needs. The Army, however, gave no consideration to locating hospitals where they would be readily accessible to airstrips. An additional factor was the inadequate selling of the advantages of air evacuation to the Army by the Air Force. This was absolutely necessary since the Eighth Army Surgeon was distrustful of air transport and loathe to diverge from old established practices (66:). A more orderly procedure visit by Colonel C. Clyde L. was brought about through a (FEAF Surgeon), Lt.

Brothers

Colonel F.

Kelley

(Fifth Air Force Surgeon),

and Major

George Hewitt (Cargo portation). evacuees

Command's Assistant Director for Transa steady flow of 450

They planned to initiate

out of Korea daily.

Their plan was to have pa-

tients delivered to Pusan by train where they would be moved to waiting planes by ambulance. airlifted the to Itazuke, The patients would then be

Japan for temporary hospitalization at Other aircraft, principally CTo move the

l18th Station Hospital.

46s would move the patients to the Tokyo area. more serious cases a special C-54 airlift directly from Pusan to Tokyo.

was provided

Some patients were also flown (See

directly to Itazuke from Taegu and Pohang (77:108-109) Figure 2).

Care for the patients was provided by the 801st Medical Air Evacuation Squadron, in Japan, which was attached to the Six flight nurses and six

Cargo Command for temporary duty.

medical technicians were assigned to the Korea flights and

36

Riu,,

v~scsijin

MA NC HU R IA
Kongays
016 sn 1

Kopson
ngjirn chaft~onc o-o

Yongdokoscis

JAPA

gangg~o

Koso

FIGUR 2.

AP OFKORE

-3'

hoqyn

I oeon *" 37on

Krnwoin.

twelve of each to the flights to Tokyo.

The number of

patients on each flights was about the same but the flight to Tokyo was about three times as long. Another decision

was to not commit any special transport crews to air evacuation but to brief all The trip crews on the standard procedures.

out of Pusan would use C-46s and C-47s and from The C-119s were not used be(77:110).

Inchon C-54s would be used.

cause their greater capacity was needed for cargo Int-atheater air evacuation was divided parts: within Korea; Korea to Japan

into three An

; and within Japan.

example of the monthly breakdown of the numbers of intratheater patient airlifted 30 1952 is shown in by FEAF from 1 July 1950 to June

Table 3. TABLE 3 (78:241)

MONTHLY MEDICAL AIR EVACUATION Month January February March April May June July August September October November December 1950 ....... ....... ....... ....... ....... ....... 831 800 7,243 5,877 13,880 20,316 1951 10,301 18,137 12,451 10,693 11,051 14,811 5,965 5,556 11,869 12,718 7,023
6,249

IN FEAF 1952 5,541 5,584 5,345 3,847 4,593 4,789 ........ ........ ........ ........ ........ ........

Under the Eighth Army system,

patients who required

more than thirty days hospitalization were flown to Japan. 38

Patients who were scheduled 3or Japan were also screened so that head and chest cases went to the Tokyo area, and hepatitis to the Osaka area, frostbite

and other cases requiring

long hospitalization but with no complications went to the Fukuoka (Kyushu) area. The Division Surgeon tried to get

this screening done at the forward airstrips to permit more direct transportation and reduce the enroute time taken, Eighth Army approval was not received (73:101). A lot of coordination was necessary in order to make this process work smoothly. The Division Surgeon had to An air but

work closely with Transport Movement Control (TMC).

evacuation section was established within the Surgeon's Office. At noon every day the Eighth Army medical evacu-

ation officer at Pusan notified the Division Surgeon of the number of patients to be moved the following day. Other

intormation from the 801st Liaison Officer at Tae-a gave the types and numbers of cases to be moved to Japan and the number of aircraft needed for evacuation from forward airstrips the next day. This information was based ( the

battle situation and the number and status of patients in forward field hospitals. In Japan similar notification was

made by the Hospital Regulating Officer (Japan Logistical Command) ments. of the next day's intra-Japan evacuation requireAll of this information was received by noon and, the Surgeon's Office submitted to pickup point, destination,

based on this information,

TMC a request for aircraft type, 39

and its

loading time. schedule

The TMC then put the requirements

into

for the next day with high priority. further transport

Later in if

the day and evening

requests were made Whenever

required based on new information possible medical equipment, nurses,

(73:101-102).

and technicians were Korea and which Figure 3 shows evacua-

added to aircraft which delivered cargo in might pick up evacuation patients (30:587).

the flow of requests for intertheater aeromedical tion.

This procedure was designed to hold to a minimum requests lift for additional aircraft and to aid in the rapid air-

movement of patients.

Flights

sometimes had to be can-

celed because Eighth Army could not always provide firm patient load figures. Flight requests were sometimes made available pa-

on anticipated patients rather than actual tients.

Some flights were canceled because of bad weather, (73:101-102).

but every effort was made to fly all schedules

At any time during the Korean War the 315th Air Division was able to support the Eighth Army with all the aeromedical airlift it required. The limiting factor was the Squadron

small size of the 801st Medical which was responsible patients.

Air Evacuation

for the care and handling of the days in 1950 and 1951 the

During the critical

nurses and technicians day.

flew as many as three roundtrips a to exhaustion. On maximum

They worked themselves

aeromedical

evacuation days there were not enough medical

40

REQUESTS FOR AIR EVACUATION

-KOREAAir Evacuation
Out of/intra Korea

Coordinating Officers (Army)

IAir Evacuation Medical Army S th Section

TAC GPS

S (Navy)

Coordinating Officers

8o1st MAES 0
Liaison Officer Air Evacuation Coordinating Officers (Air Force) I

OPS
Orders

801st

MAES Ops Sect AD

- A31 5th

'

TMC 31 5th

A/E Ops

Officer Air Lvacuation Coordinating Officers (Army) Meical Section Air Lvacuation (Navy) /Mod JLCOM Reg Officer Air Evacuation Coordinating Officers TAC GPS Intro Japan I OPS Orders

(Air Force)
801st MACS accomplishes liaison and forward requests A/E Ops Officer coordinates, consolidates requests, and
monitors flights

Med Reg Officer regulates the flow of patients out of Korea and Intra Japan

FIGURE 3

41

personnel

to accompany

all the aircraft and the aircrews had (30:593).

to care for the sick and wounded they carried In addition to medical medical

care on flights the 801st had a

service corps officer or senior NCO at each of the

airfields where patients boarded and/or disembarked from the aircraft. These individual; served as a liaison with the

medical units and supervised the lozlang and unloading of patients. The staging and holding facilities were often crude. in where patients In the spring of muddy areas. In

waited for the airlift 1951,

they consisted of sagging tents

many instances

schedules were delayed because the holding ready when the aircraft

detachment did not have the patients arrived. Sometimes airlift

requests were cancelled after

flights had already taken off thus wasting all the schedule and preparation time. Occurrences like these wasted the and medical

time and energy of flight crews,

flight nurses,

technicians as well as the maintenance and ground service people (30:593).

During September and October 1950 the Cargo Command used centralized control and continuous field liaisons in an of

attempt to make aeromedical transporting patients fields were secured, airfield was secured, in

evacuation the normal method (30:587). As air-

the Far East

the plan was modified.

When Kimpo

Cargo Command started an immediate support of the U. S. X Corps.

flight evacuation plan in

This consisted of a minimum of three C-54s spaced throughout 42

the day.

This

lift

was supplemented

when required.

Wnen

the airfield at Wonsan was captured the Cargo Command made the Marine Squadron VMR-152 directly to Osaka, Japan. responsible for evacuation On 17 October, 1951, the airfield

at Sinmark was opened and C-54s began removing patients to Kimpo where they received MASH. medical assistance from the 8055"h

On 21 October evacuation began from the airfield at Here there were difficulties, since one delayed due to the layout

Pyongyang.

of the runway,

Ir-craft cuuld block all

others behind it.

Other than excessive waiting times at evacuatilo process was

Pyongyang and Kimpo the aeromedical generally well managed In November (78:110).

1950 the attack of the Chinese Communists, took a heavy toll on soldiers

along with the frigid weather, and Marines. "Kyushu Gypsy" soldiers Koto-ri In

early December 21st Troop Carrier Squadron or frost-bitten and

C-47s moved 4689 wounded

and Marines from the airstrips of Hagaru-ri (30:589). its casualties

The 21st Squadron evacuated Marine R5Ds carried Marine Force C-54s evacuated

to Yonpo. and Air Due to the

casualties to Itami,

Army soldiers to Fukuoka.

dangerous mission the nurses planes for the aeromedical

of the 801st were only on the to Japan. The evacuations per-

lifts

were accomplished under enemy gunfire and some medical sonnel were injured.

One 801st medic was aboird a Gypsy Clanding in 43 enemy territory

47 which crashed on takeoff,

about three miles from the airstrip.

The technician en-

couraged the wounded men to help each other back to the airstrip. were Immediately on their return to the airstrip loaded on another C-47 and evacuated (72:55-56). they The

medical technicians were responsible the C-47s. Also in November, in

for the patients aboard

the western part of Korea,

nurses and technicians cared for patients from the airfields given up to the communists as the Eighth Army retreated from Sinanju, Pyong-yang, and finally Seoul and Suwon. Flight

nurses and medical technicians of the area,

were on the last planes out In early December

taking care of patients.

1950 the Eighth Army felt the Communists might take over all of Korea and decided to empty all of the combat zone hospitals. patients. On 5 December 1950, 131 flights evacuated 3925 evacu-

This was the largest day of aeromedical In January,

ation during the Korean War.

1951 the ground

fighting was centered around Wonju, be used because of the short airstrips

where only C-47s could at nearby Chungju.

At 0945 on 13 February 1951 the Eighth Army reported a requirement for the evacuation of 600 patients from Wonju. missions and including

Before midnight C-47s diverted from tactical lifted 818 patients 401 from Wonju, from the forward

hospitals,

The number of patients needing evacuation (30:589). At approxi-

from Wonju was slightly exaggerated

mately the same time Eighth Army Transportation Section requested three C-47s to lift Republic 44 of Korea (ROK)

personnel

from Kangnung

(K-18)

to Chungju.

Because of the evacuation and

need for the aircraft for the aeromedical unavailability of any more aircraft, mission.

only one C-47 was This raised the issue of evacuation operations

allocated for the airlift relative priorities (73:104). justified.

for aeromedical

The Far East Command ruled that the diversion was Two days later the hospitals at Pusan were over-

loaded with casualties

and 1325 patients were evacuated. air evacuation days in the

This was another of the busiest Korean War (30:589).

During 1950,

C-47s accomplished most of the aeromedical The C-54s and C-46s carried most

evacuation within Korea. of the patients

from North Korea to Japan and from southern The C-54 had the greatest It capacity

Japan to the Tokyo area.

and was the best for longer distances. able, more stable,

was more comfortThe

and had more room for the patients. large but, having only two instead of

C-46 was almost as four engines, in.

was not as comfortable

or as dependable to fly none of the

The C-47 could fly in

and out of airstrips

other types of aircraft could use and was therefore of particular value in Korea. For example, a C-47 landed on and

took off from a short, ri with wounded

frozen rice-paddy airstrip

at Hagaru-

aboard (72:56).

During the three years of the Korean War the 315th Air Division and its predecessor provided aeromedical evacuation

for 311,673 sick and wounded patients and only six patients 45

were

lost.

The total evacuated exceeds the number of total because it included multiple movements of paand within

casualties,

tients within Korea, Japan (30:593).

between Korea and Japan,

As an example,

one patient could be evacthen from Japan. crews of

uated from one hospital to another within Korea, Korea to Japan,

and from one hospital to another in The medical

This would count as three evacuations. the 801st Medical 12,000 flights, strips,

Air Evacuation Squadron flew more than

operated out of more than 35 Korean air-

and cared for more than 280,000 patients of those

moved by the 315th (76:34). Intertheater Aeromedical Evacuation. The intertheater

evacuation was accomplished by the Military Air Transport Service Medical (MATS). At thp beginning of the war the 1465th was evacuating about

Air Evacuation Squadron (MAES)

350 patients a month from Japan. operation soon used the routes, assigned to the Pacific Airlift.

The MATS evacuation facilities, and aircraft

Aircraft which transported

cargo and personnel to Japan from the United States were aeromedical States. evacuation flights on the return to the United with the regular crew, flight nurses,

The aircraft,

and medical Kwajalein,

technicians normally flew through Guam and or Wake or Midway to Hickam AFB in California. litter Hawaii, and

finally to Travis AFB, first C-97 brought 63

On 29 July,

1950 the

patients from Tokyo to Travis,

46

through Wake and Hickam, because

in

23 hours.

On later flights, it was possible

of the distance the C-97 could fly,

to eliminate the Wake stop and thus eliminate about 500 miles from the trip. With this schedule the wounded (77:110-111). in the

patients knew that home was not far away The 1453d MAES was the first

USAF organization

Korean War to receive a Meritorious Unit Commendation (76:38). The commendation stated that the 1453d MAES had by "exceptionally meritorious conduct

distinguished itself in

the performance of outstanding service from 27 June to 31 During this time the squadron had evacuated over a distance of over 90 million

December 1950".

16,604 battle casualties

patient miles between the Far East and the United States. The mission was accomplished without a single fatality (76:38). The squadron was credited in the commendation constant with

having saved "many thousands of lives" by its innovation and development

of air evacuation techniques. transit, improving medical

This included reducing time in care,

and increasing patient comfort. Table 4 shows aeromedical evacuation became the primary

means of evacuation to the United States during the Korean War. Members of the Army were evacuated to the U.S. more

than any of the other services due to the nature of their duties. Table 5 shows the statistics on the evacuations to

the United States broken down by services. 47

TABLE 4

(61:70)

PERCENTAGE DISTRIBUTION OF EVACUEES RECEIVED IN THE U.S.

(2 SEPT 1950 31 DEC 1953)

Mode
Type of Personnel

of Transportation
Air &

Air
All personnel, All areas Army personnel, All areas Japan-Korea All other areas 93.2 93.2 95.4 88.2

Water
6.6 6.3 4.3 11.7

Water
0.2 0.3 0.3 0.1

TABLE 5 EVACUEES

(61:70) RECEIVED 1953) NAVY AND CIVILIAN 537 %1.36 IN THE U.S.

FROM JAPAN-KOREA (2 SEPT 1950

-

BY SERVICE
31 DEC

TOTAL 39,568 100%

ARMY 38,515 %97.34

AIR FORCE 516 %1.30

Table Korean All each

6 shows the U.S. broken

Army evacuation

figures

for the

War,

down by battle evacuees

and non-battle

injuries. Of

of the wounded

originated

from Japan-Korea. 51 were

100 Army evacuees cases, 34 were

from the Far East Command, disease cases, and 16 were

wounded

nonbattle

injury cases
The flow

(61:75).
of wounded from the area changed with the com-

bat situation.

Figure 4 shows the fluctuation graphically.

48

TABLE 6 (61:75) U.S. AREA ARMY EVACUEES (2 Sep 1950 31 Dec 1953) DISEASE

BATTLE INJURY

NON-BATTLE INJURY

Japan-Korea Other overseas areas Total

19,465 0 19,465

50.5 0.0 37.0

5,974 1,4901 7,464

15.5 10.6 14.2

13,077 12,6071 25,684

34.0' 89.4A 48.8

The greatest and October of the first

number of wounded evacuees 1950 and then again in

was in

September During

December

1950.

two months,

75% of the evacuations

were due to In January

wounds and in

December 50% were due to wounds.

and February of 1951 nonbattle due to more cold weather of the truce talks in evacuated dropped in

injuries exceeded the wounded With the beginning

related cases.

July 1951,

the proportion of wounded but was still 40

August and September, In

percent of all the evacuees. wounded evacuees

October 1951 the number of offensive the first to secure Line 6 months of

rose due to a U.N. front. In

JAMESTOWN on the western

1952 the number of wounded evacuees a low of 94 in Communist proportion June 1952.

decreased each month to of 1952, the Chinese

In October

launched their largest attack of the year and the of wounded evacuated rose to 52 percent in 1952. In the first the

last quarter of percentage

six months of 1953 the

of wounded evacuees

never exceeded 40 percent.

49

Wounded
4000

2000

0 M MJ S NJ S NJ A 00F 0 DF AJ 1951 MMJ A JA i952 JMM J S N SN A 0 0D F AJ 1953

Disease and Nonbattle Injury

4=0

_R

.........................................................................

2000 .........................................................................................................

S NJ M MJ SNJ 0 DrA J A 0D 1951

FIGURE 4.

M MJ FAJA 1952

S NJ M MJ 0D F AJ 1953

S N 0D

U.S. ARMY EVACUEES TO THE UNITED STATES 50

The percentage increased to 48 percent in July and peaked out at 58 percent in August (61:75). Specific Problems Encountered and Lessons Learned Many people had high praise for aeromedical evacuation during the Korean War. General Matthew B. Ridgeway,

Commanding General of the United Nations Forces in Korea, singled out aeromedical evacuation in the Nineteenth Report

of the United Nations Command in Korea to the United Nations Security Council. He said;

High praise must be paid to the elements engaged in evacuation by air of wounded personnel and individuals Countless numbers of soldiers from behind enemy lines. and countless numbers of men who would have become prisoners have been saved by prompt and efficient The action of the air rescue and evacuation units. wounded soldier in Korea had a better chance of reThis was covery than the soldier of any previous was. not only by virtue of improved medical treatments available at all echelons, but also in large measure because of his ready accessibility to major medical installations provided by rapid and evacuation (76:). Oth,praises included Doctor Elmer L. Henderson, after facili-

President of the American Medical Association who,

returning from a visit to Far East Air Force medical ties,

described air evacuation as "the greatest thing that

has come out of this Korean incident as concerns saving lives" (76:). In 1952 the USAF Office of the Surgeon Genofficers at the front

eral said that "responsible medical

line in Korea estimated that without rapid transportation by helicopter and immediate emergency aid including blood

51

transfusions, (76:)."

80 percent

of the wounded

would have died

Another advantage by FEAF was from evacuation morale.

of aeromedical

evacuation

identified

the humanitarian

standpoint. effect

Aeromedical

had an extremely

positive

on a patient's and in as

Knowing that

he would be carried quickly facility, and his

much comfort developed raised a

as possible to a medical "the worst difficult is over" time

the patient spirits were

feeling

at this

(73:106). in a memorandum to the major advantages one agency as: of

The

315th Air Division Surgeon, identified

Commanding General, the aeromedical

the three system under

evacuation

A single a. Better control is effected by one agency. transport movement can follow all aircraft 100 percent of the time. If there is a weather or mechanical failure the sending agency can be notified immediately if is to be late. One evacuan air evacuation aircraft ation agency is easily contacted, resulting in better coordination with using agencies and increased utilization of the available aircraft. b. More transport is available. By having all cargo aircraft under one command more aircraft are immediately available for air evacuation use. During the height of the Chinese North Korean offensive it was possible to place medical evacuation personnel on transports sent out by this command even though request for air evacuation had not been made, since it was known that due to the severity of the Eighting, patients would be available, and many lives were thus Command having available lift. Had there saved by this been many agencies doing the air evacuation such a procedure would have not been possible. C. Critically short medical personnel are being utilized. There is a saving in medical evacuation personnel when only one organization accomplishes the air evacuation mission. If several organizations were doing air evacuation there would of necessity be a duplication of personnel. This is all the more impor52

tant since medical evacuation personnel are not readily available. After more than a year of combat operation the 801st MAES could still profitably utilize additional well trained technicians (73:108). The Surgeon made the point that centralized control a very important factor. He said; was

One medical air evacuation squadron working with one transport agency has accomplished more than several squadrons working with more than one transport command (73:108). Aeromedical fortable evacuation was much faster and more comCivilian consulon his

than evacuation by land or sea.

tants who accompanied the Air Force Surgeon General inspection tour of the Far East in

the spring of 1951 comThey

pared air evacuation with land and sea evacuation. stated that evacuation

from Korea through Japan would take by boat and train, but seriously

from three to four weeks wounded patients from Korea in

could be airlifted

to the United States also said that air method of evacuation personnel

36 hours.

The consultants

evacuation was also the most economical since it enroute, saved time, required

only a few medical

and used space on returning cargo aircraft that (76:). Personnel shortages, inade-

would have been empty quate helicopter

capability,

deficient training,

and the all of

lack of established aeromedical added to the difficulty nurses in

evacuation procedures

of these operations. in

Shortages

July 1950 caused strains

evacuations often made it

and shortnecessary

ages of enlisted medical for them to receive

technicians

their training on the job. 53

The 3d Air

Rescue

Squadron was limited in

1950 to the H-5 helicopter patients (76:). of

which could only carry two litter Allen D. Smith compiled aeromedical following; evacuation in a list

of the advantages His list

Korea.

included the

1. Morale - Patients being evacuating realized that they would receive the best possible medical care in very short time. 2. Economy of time - Patients were aeromedically evacuated in a matter of hours, not days. 3. Economy of personnel - Evacuation by air allowed medical personnel to remain in fixed locations where more cffective medical care could be provided.

4. Economy of material - The use of helicopters and other aircraft reduced the need for forward hospitals. 5. Economy of lives - Patients were transported in relatively smooth conditions, in comparison to the bumpy, dirty surface travel in Korea. 6. Economy of transportation - Moving casualties by air saved ground transportation for use by actual fighting troops. The mobility of the forward unit was also greatly increased by removing the injured from the forward area. 7. Increased range and mobility of air travel surface travel over

8. Economy of the actual dollar - Aircraft were used to transport critical war materiels from the United States to the battlezone. On the return trip, patients were evacuated. During September 1951 the 315th Air Division evacuated 11,869 patients a distance of 3,421,166 miles at a cost of 6.6 cents per mile (65:323-332). There were also problems evacuation. Korea Aeromedical identified with aeromedical in and between Japan and These

evacuation

involved complicated problems of coordination.

54

problems took time to solve and FEAF added to the delay by not issuing directives on the subject until December !951. between Korea and The lack of good re-

To add to the confusion communications Japan were very poor in information, the beginning.

concerning aeromedical Japan made it

evacuation needs, difficult

ceived from Korea in schedule

to properly had to be

outgoing cargo aircraft.

These aircraft

properly configured tients from Korea.

for the return trip with Because of this, patients

incoming paand aircraft Korea, because

often had to wait for long periods of time in

of lack of space for patients or to reconfigure the aircraft. of its For these and other reasons, (76:). the Army sent man%

patients to Japan by Er-

Responsibility for the various phases of aeromedical evacuation was often vague. responsible cilities. It was often unclear who was

for the operation of the casualty staging faIn February, 1951, the commanding a letter officer of the

801st MAES complained to FEAF in waited in of time. the facilities He considered

that patients

often without food for long periods the operation of the facilities Navy, or Air the

responsibility of the sending agency (Army, Force) bility issued, in but as long as there was no directive

the responsiwas

could not be fixed. there were "still

Even after the FEAF directive

many Army and Air Force personnel

wide disagreement

on the concepts of how much Air Evac-

uation should be handled by Army and how much by Air Force 55

and how much within each of the two Armed Services should be done by different sub commands" (76:).

The system developed near the end of the Korean War was an improvement and was described in part as follows:

The using agency - whether Army, Navy, or Air Force has only to furnish its air evacuation requirements to an Air Force AIr Evacuation Liaison Officer who relays the information to the air evacuation operations officer (HSC) of the 315th Air Division. Here coordination is effected with the Army Regulating Officer, and aircraft flying cargo runs are designated to pick up patients on their return trips, at the time and place specified. Thus air evacuation is integrated with operational schedules. Movement of patients now has the highest priority. In emergencies patients may be moved without regard to cargo (76:). Many people had high praise for the performance of the helicopter in Korea and many advantages were pointed out.

Spurgeon Neel points out five. 1. The speed with which casualties can be evacuated by helicopter is greater than with any other method. 2. The helicopter is very flexible in that the controlling surgeon can shift the support from one unit to another unit if necessary. 3. The patient is more comfortable since he moved in the shortest time and in the best condition possible by helicopter. 4. The patient can be moved to the treatment facility which can best service him because of the speed, flexibility, dnd range of the helicopter. 5. The proper use of the helicopter use of medical personnel. Since the bring the casualties to the doctor, can be concentrated in forward areas better surgery can be provided with (53:220-227). permits economy of helicopter will specialized people and more and fewer people

There were also disadvantages evacuation.

of helicopter aeromedical

Ground forces had to learn that the helicopter it had to operate under. Heli-

had certain limitations copters could not fly in type of terrain,

bad weather,

could not land on any Medi-

and could not then operate at night.

cal personnel had to overcome these among many different obstacles. of accurate The marking of landing sites, coordinates, the transmission evacu-

and restricting helicopter cases were just a few of the

ation to only critical solutions (53:220-227).

One of the most useful helicopters evacuation was the Sikorsky H-5. type in use was no longer in

used for aeromedical

A problem was that the

production creating continuing ver', difficult

problems with parts and making maintenance (64:105-106). the cost.

Another disadvantage described by Neel was was much more

Transporting patients by helicopter

costly than using the field ambulance.

Cost cuuld be miniand

mized by assuring the helicopters were used efficiently for severe cases (53:).

The ratio of maintenance time to flying time of helicopters in Korea was about 6 to 1. This had to be (53:).

considered when planning helicopter evacuations FEAF drew the following it's experience in list of lessons

learned from

the Korean War.

1. In every theater of operations there should be a definite air evacuation plan, and this plan should be given to all units in the command. 57

2. The air evacuation squadron should be manned at 100 percent times. equipment at all

assigned to the theater with personnel and

3. All aircraft to be used for the purpose within the theater should be under a single transport headquarters. The air evacuation squadron should be assigned directly to this headquarters. Such centralization would make more aircraft available and would permit critically wounded personnel to be used more effectively. 4. Medical the theater. evacuation should have top priority within

5. All cargo air evacuation assigned to a combat theater should be properly equipped to do aeromedical evacuation at all times. 6. The Air Force should assume and maintain the responsibility for operating patient holding facilities. 7. A portable aspirator, modified for 24-volt current, should be adapted or an item of equipment authorized to air evacuation squadrons. 8. Only school-trained air evacuation technicians should be furnished to air evacuation squadrons as combat crew replacements. These technicians should be especially designated for this operation prior to departure from the Zone of Interior. 9. A field-grade Medical Service Corps Officer, experienced in all phases of troop carrier operations, should be attached to the office of the theater surgeon in a combat theater of operations (76:). There enemy lack in was a large difference in air power in used by the The evac-

the

Korean War from other offensive by the it

wars

the past. aeromedical

of an air a much

enemy made

uation With

easier job than of a few

possibly could have helicopters If in

been.

the

exception free

incidents, air attack.

were in the

relatively Korea had

from enemy

the enemy

committed more

aircraft

to fly

South Korea,

58

success great.

of aeromedical Scheduled

evacuation might not have been as

combat cargo planes although fired upon could have been much easier Helicopters evacuating may have as an

from the ground many times, targets for flying aircraft.

casualties found it example

under the attack of fighter aircraft,

to be an impossible task while using a hoist, (64:107).

59

IV. Overview Aeromedical advances

Vietnam War

evacuation of casualties was one the major service during the Vietnam War. World War II As

of the medical in

previously mentioned, aircraft

when very few tactical from the field the

were used to evacuate casualties In

mortality rate was 4.5 percent. about one out of every seven U.S.

the Korean War when

casualties was evacuated In

by helicopter the mortality rate dropped to 2.5 percent. Vietnam the actual rate dropped even further, evacuation of the majority of U.S. casualties due to the from front

lines by helicopter, tactical airlift

evacuation of the seriously wounded by and out-of-country

fixed wing aircraft,

evacuation by USAF MAC aeromedical (68.5:66).

evacuation aircraft

Some problems were caused by the location of the Vietnam War in relation to the United States. Vietnam War was a

country halfway around the world.

Patients being evacuated

to the United States had to fly over 7800 miles to reach Travis AFB, Andrews California, and almost 9000 miles to reach The nearest off shore U.S.

AFB near Washington D.C.

hospital was located almost 1000 miles away at Clark AFB in the Philippincs. Japan, The nearest complete hospital Within the country, 60 was in

2700 miles away.

the waterways,

jungles,

and lack of infrastructure

obstructed the evacof combat

uation of patients operations

even without the interference

(52:xiii).

South Vietnam was divided into four military zones. The northern zone, or I Corps Zone, ran from the demilitaDinh provinces. The II

rized zone down to i(ontum and Bihr

terrain was almost all high mountains and dense jungles.

Corps Zone ran from I Corps Zone south to the southern foothills of the Central Highlands. It This was about 100 kiloplain,

meters north of Saigon.

included a long coastal Highlands,

the highest part of the Coastal and Darlac Plateaus.

and the Kontum Corps Zone

III Corps Zone ran from II southwest of Saignn. Highlands, a few large,

to an area 40 kilometers foothills of the Central

The southern dry plains, zone. IV

and jungle along the Cambodian border were in

this

Corps included almost all of the delta formed by the mekong River in except the southern part of Vietnam. It had no forests tip

for the dense mangrove swamps at the southernmost

and forested areas just north and to the east of Saigon (19:21). Vietnam. Types of Injuries and Disease Encountered in Vietnam because of either diinjuries and with Figure 5 shows the four Corps zones in South

People were evacuated sease or injury. diseases

To understand the types of

the aeromedical

evacuation process had to deal

61

I CORPS

11CORPS
Dak To BINH DINH

OUAN 0 h ahKontumO Phu Ba V. Do 0

TRIKONTUM 0 HaiVanPas NangPHU PLI PLEIK hoku * Bong Son An Khe 9Phu Cat 41 0 Gui NEhon BON PHU YEN Tuy Hoa

(4Cu Lao Chain 0DARLAC' Ho A

,),H*u Bon Chao Reo)

Ban Me Thuot CLa TamKyReQUNG*U CUAN QUG~ Lai CUANG TIN aiYE g11 Ga OU N G IBao TUYE KHANH HOA
Nha

Trang NEh~a Cam Ranh

ra

Loc 0

Phan Rang

LAM DONG BINH THUAN Phan Thiet

NINH THUAN

soo

75

III

CORPS AND CAPITAL SPECIAL ZONE

IV CORPS
KEENPHONG TUONG KEEN

Phuoc AnLcCHAU PHO

Binh

Chou Phu (Chau Doc).' DOG d84C Ca La oa 0

OGSeven

Mountaina

BINH TUYO LONGuGucPHN

LOBNGa

PUG U

QaLong

BAG LIE

CuCon

Son

Bien

oa

DINH

Phu Vi0

(Bo 'a)~sDiF IGUEN GHI HAU OA

5.a FOUR CORS am Tn

ONES TIN

VIETNAMnhHun (oc Ta62

this section will describe them and touch on other problems, as well. Disease. Disease was the biggest culprit in in Vietnam. As can be seen in the welTable 7,

fare of Americans approximately

69 percent of all hospital

admissions for the Injuries and wounds

Army were due to some kind of disease.

only accounted for one-sixth of the admissions during this time (52:33). TABLE 7 (52:33)

HOSPITAL ADMISSIONS FOR ALL CAUSES, U.S. ARMY (VIETNAM) (Rate expressed as number of admissions per annum per 1000 avg strength) NONALL BATTLE YEAR [CAUSES~ INJURY 1965 1966 1967 1968 11969 484 547 515 523 459 67 76 69 70 63 BATTLE INJURY WOUNDS 62 75 84 120 87 DISEASE AS %OF DISEASE IALL CAUSES 355 396 362 333 309 73 72 70 64 67

The average Army annual Vietnam II (351 per 1000)

disease admission rate for World War

was about one-third that in

(approximately

877 per 1000) Korea

and more than 40 percent per 1000) (52:32). Why

lower than the rate in

(611

was there so much improvement? ment to effective in

Neel attributes

the improveprograms

disease control. in

Disease control

Vietnam were begun

1965 and were maintained through II where

the end of the war.

This was unlike World War

63

disease control and in

was begun

in still

1945,

near the end of the war,

Korea where there (52:32). Lt.

was a delay but of less Leonard D. Heaton, USA, Army

magnitude

General

Surgeon General,

attributed the improvement

to better under-

standing of the different efforts in preventive

types of infections and greater (38:85). types of diseases the Army Table 8 shows hospital days lost from

medicine

There were many different medical services had to fight.

duty by cause and Table 9 shows cause. groups. The diseases

admissions by

could be diviued into two general few people, like hepatitis,

Thoze which affected

but put them out of action for a long time and those which affected many people, like diarrheal and skin diseases, periods.

which affected the person

only for relatively short

Malaria was widespread and put individuals a long time,

out of action for

a combination of the worst of both groups. Vietnam the rates for

Neel points out that as we stayed in diseases taken.

like malaria fell as preventive measures were These statistics encouraged disease control efforts

and permitted disease rates to be accuracy.

forecast with some for the field

This could be very valuable

commander planning combat operations

(52:33-34).

There were problems with the reporting of some of the data depicted in the tables. One of the problems was in Origin (FUO). to include There was a other conthe

category Fever of Undetermined tendency for some medical

personnel 64

ditions, In

such as headache and backache, the statistics

in

this category.

contrast,

on malaria and hepatitis are

more accurate since they could positively and specifically be identified in most cases (52:33-34).

TABLE 8 (52:34) APPROXIMATE NUMBER OF MAN DAYS LOST FROM DUTY BY CAUSE AMONG U.S. ARMY PERSONNEL IN VIETNAM, 1967-1970 CAUSE 1967 1968 215,400 83,181 64,832 106,743 116,981 60,132 289,700 943,809 1969 183,050 63,530 50,790 125,280 86,460 48,980 201,500 762,720 1970 167,950 70,8001 80,1401 175,5101 85,840 45,100 203,500 834,540 1,044,750 309,670

Malaria 228,100 Acute Respiratory 66,800 Infection Skin Diseases (incl 66,400 dermatophysis) Neuropsychiatric 70,100 conditions Viral hepatitis 80,700 Venereal disease 55,500 excl. CRO cases Fever of undeterm 205,700 origin Disease Total Battle injury and wounds Other Injury 780,800 1,505,200 347,100

2,522,820 1,992,580 415,140 374,030

The acclimatization process had a significant the high incidence, General George J. short duration type diseases. Marine Corps,

effect on Brigadier

Hayes,

while speaking at the

1970 Pacific Command Conference said: . . . there is a time reference with respect to diarrheal and upper respiratory disease and fevers of unknown origin . . . The combination of change in circadian rhythm, and early acquired diarrhea, most certainly of viral origin, lead to about a six week acclimatization period for the troops. After this time 65

the incidence of such disorders in decreases to a negligible level

acclimatized troops

(52:37).

The 12-mon t h rotation policy made the rates of these diseases higher because of the continued arrival unacclimatized people (52:36-39). TABLE 9 (52:36) SELECTED CAUSES OF ADMISSIONS TO HOSPITALS AND QUARTERS AMONG ACTIVE-DUTY U.S. ARMY PERSONNEL IN VIETNAM 1965-1970 (Rate expressed as number of admissions per annum per 1000 strength) CAUSE 19651 1966 1967 1968 1969 1970 of

87.6 52.9 74.8 84.1 120.4 61.6 Wounded in Action 59.9 70.0 63.9 67.2 75.7 69.1 Injury (except WIA 20.8 22.1 39.0 30.7 24.7 48.5 Malaria 34.0 31.0 38.8 32.5 33.4 47.1 Acute Respiratory infections 18.9 32.9 28.4 28.3 23.2 33.1 Skin di-eises(incl dermatophytosis) 10.5 13.3 15.8 25.1 11.7 12.3 Neuropsychiatric conditions 7.2 7.0 8.6 6.4 5.7 4.0 Viral hepatitis 277.4 281.5 240.5 195.8 199.5 222.9 Venereal disease (includes CRO) 1.0 1.4 3.8 2.6 2.2 3.6 Venereal disease (excludes CRO) 72.3 56.7 57.7 42.8 57.2 56.2 Fever of undetermined origin

Like the Army,

malaria and fever of undetermined origin

were the major causes of hospitalization for members of the Navy and Marine Corps in Vietnam. The average hospital stay

for a patient with malaria was about 31.5 days. views with the patients, it

From inter-

was suggested that their failure measures, such as taking Chloro-

to follow proper preventive

66

quine-Primaquine (45:278).

tablets,

accounted

for many of the cases

Diseases such as malaria,

hepatitis,

dysentary,

and

others common to Vietnam did not have the same consequences for Air Force personnel. medical The noneffectiveness rates due to Vietnam as in Bohannon

causes were approximately the same in

the United States for Air Force personnel. attributes

General

this to the Air Force's fixed-base

operation

which was in

contrast to the Army and Iarine Corps troops exposed to was more

who roamed throughout the jungles and swamps various diseases. The fixed-base environment

controllable since Air Force personnel over the environment, general sanitation water supply,

had direct control housing, and

food,

(8:24).

The number one cause of disability for Air Force flying personnel in Vietnam was respiratory conditions. infection, followed by such

dermatological

Gastrointestinal

diseases,

as upset stomach and diarrhea, group of diseases.

were the next most common cited as the Nutrition and

The immunization program is Vietnam.

major deterrent to these diseases in emphasis in

on hygiene standards also played an important part (8:24-25). in battle were reshown in

fighting disease Wounds.

Wounds to Army soldiers ways.

ceived in Table 10.

many different

A breakdown is

67

TABLE

10

(52:54)

PERCENT OF DEATHS AND WOUNDS ACCORDING TO AGENT VIETNAM JAN 1965 - JUN 1970

AGENT Small Arms

Fragments

DEATHS 51
36

WOUNDS 16
65

Booby Traps, mines Punji stakes

Other

11 0
2

15 2
2

Weapons than in

used

by the wars

enemy

in

Vietnam were different and

more more type

advanced serious weapons weapons bul-

previous The

and caused rounds

wounds. created

high velocity damage

from M16/AK47

much more wars.

than did the

lower velocity of many of the

of previous lets made

The tumbling action The

larger entry wounds. also created

extensive use medical

of mines Dirt,

and boobytraps

serious

problems.

debris,
This, the

and everything else entered many of the wounds.

along with the the severity of the wounds, complicating

work of Another

surgeons

(52:53). was the punji stake with stick. the tip in The punji

cause

of wounds sharp The

stick

was

a needle

bamboo

smeared in the

with human waste. ground step would the

sticks

were then put victims.

traps

awaiting unsuspecting stick become not and it

When someone the foot

would or leg up

on this soon

entered The

the body, infection

infected. (40:).

would travel

leg if

treated

68

Many Lieutenant the juries. failure

injuries Colonel to He

in

the

Vietnam

War were

preventable. Corps, of contends in-

William M. Hannon, contributed

Marine to

use helmets

many

the

said, we

If our combat troops . . . were to wear a helmet, believe that about one-third fewer significant combat casualties would need to be admitted to a neurosurgical center here in Vietnam (52:55). The fixed troops who stayed in one place, wore found it. such as those flak too

from

operating bases, who were on

usually move

helmets and the

vests. heavy

Soldiers and hot

the

equipment

and usually not to

did not wear

Some

commanders of the reduction casualties

decided in

use the protection and the

because in

mission capability

increase

heat

(52:55).

Aeromedical

Evacuation

Process in

in the

Vietnam Vietnam War, like the (1)

Aeromedical Korean forward theater theater flights War, was

evacuation categorized

into

four separate (2) (3) tactical strategic flights. research

systems: intrainter-

aeromedical aeromedical evacuation, were not be

evacuation, evacuation, and (4)

and and

domestic in is this

Domestic but in a brief under-

covered

description of standing the MAC points nation. of

the process

provided

to he'p

overall

aeromedical

process. from their final destides-

was responsible arrival in

for moving patients States to their

the United of

The responsibility

determining

a patient's

69

tination was with the originating medical

facility

in The first

conjunction with several regulating agencies. agency was the Far East Joint Medical (FEJMRO), pitalized in in Camp Zama, Japan. If

Regulating Office

a patient was to be hos-

the Far East or Southeast Asia the FEJMRO If the patient was to go to Regulating in the When the

determined where he would go. the United States, Office (ASMRO),

the Armed Services Medical

Washington D.C.,

determined where

United States that patient was to be hospitalized. patient arrived at Travis AFB or Andrews AFB,

he was then

moved by trunk and feeder flights to his final destination. Trunk flights flew on a schedule points in Guire, the U.S.; Travis, between seven main transfer Maxwell, M.c-

Buckley,

Kelly,

Andrews,

and Scott AFBs.

At the transfer point flight

nearest his destination hospital he boarded a feeder to the final destination. The 37!th Aeromedical

Airlift

Wing Command Post at Scott AFB monitored feeder flights.

all trunk and in

An aircraft took off or landed somewhere A "hot line"

the U.S.

every 17 minutes.

linked each of the Status

transfer points to the command post at Scott AFB.

boards were maintained at the command post to show how many patients needed to be moved, aircraft availability, patient (59:18-19). where they were to be moved to, each enroute

and the progress of

The mission of the 375th was very compaccess to over 500 airports and of

licated since it

provided

more than 600 medical

facilities. 70

For the transportation

the wounded, (84:98).

fourteen C-131s

and four C-118s were used

Evacuations

from the field were usually by Army or Intratheater flights moved patients hospital bases in Japan,

Marine helicopters.

within the battle area and to U.S. Okinawa, and the Philippines.

These flights were the (PACAF). Strategic cf the

responsibility and

of the Pacific Air Forces

i:iterthcater evacuations

were the responsibility M.S. White, in

Military Airlift Commend illustrated States the breakdown

(MAC).

a study,

of evacuations

to the United

for toe three qervices. of wounded evacuated

The study showed the perto the U.S. as 60 percent

centages Army,

35 percent Navy and Marine Corps, (79:782). This is

and approximately a result in of the

one percent Air Force different missions

performed by the services Evacuation. If

Vietnam. ot

Forward Aeromedical medical logistics '.ere

one element

selected to be responsible lives saved, it

for in-

creasing the numoer of the helicopter

oould certainly be was the term

ambulance units.

"Dust-Off"

given to The aeromedical helicopter evacuation alties were evacuated lances.

evacuations

performed by these casu-

crews. by 1'.S.

Nearly all battlefield

Army UH-1 helicopter ambuoccasionally assisted in Patrick

\ir Force helic-?ters (6:280).

these operatlns H. Brady, Medal

United States Army Major said;

of Honor reclpien,,

71

Dust Off has been one of our greatest assets in Vietnam, not only for the service it provided for our troops but also for the great example it provided for our allies (13:23)." At the peak of combat operations in operated 116 of the air ambulances 1968, the Army These

(6:280;52:70).

helicopters transported from six to nine patients at a time. The medical duration. medical rifle. evacuation flights averaged about 35 n[i,'e copilot,

The crew usually consisted of a pilot, and the crew chief

aidman, In

armed with an automatic left

less dangerous areas, space

the crew chief was for patients seat,

behind to allow additional

(6:281). cockpit stated that painted

heavy armor plates protected the pilot's doors, and cabin floor.

The Geneva Convention

helicopter ambulances on the sides, nose,

should have

large red crosses In Vietnam,

and bottom.

the crews only

painted a small

red cross on the nose.

The other crosses

were painted out because the Viet Cong were thought to use the large red crosses for targets Hopkins, said; We sometimaes felt that VC are aiming particularly at the big red crosses on the side of our chopper, but they're probably shooting at any helicopters they see. At any rate, they do not respect the red cross at all (59:22). The helicopter brought modern medical closer to the battle frontlines provided great flexibility in capabilities It also a pilot in (70:). Captain Ronald F. Company,

the 2d Platoon,

498th Medical

than ever before.

the treatment of patients.

72

The helicopters, made it

working with the communication network, the status of patients while in

possible to evaluate

flight and to direct the helicopter to the nearest hospital best suited to the needs of the patient. developed a backlog of patients, to the helicopter location The (52:70). first helicopter ambulance unit sent to Vietnam was (Helicopter Ambulance), in 1962. later and it If a hospital

notification could be sent

could be redirected to another

the 57th Medical Detachment nicknamed "The Originals",

Its mission was to The detachment

support the 8th Field Hospital

at Nha Trang.

was authorized five HU-lA helicopters, in March 1963 by the Initially, improved

which were replaced

"B" version of that helicopstationed at Qui Nhon the

ter.

two helicopters were

and three at Nha Trang. helicopters time (52:71).

Later as fighting escalated, in order to improve Jr.

changed locations

response

Capt John Temperelli,

was the commander The unit

o" the 57th.

He ran into many supply problems.

was not authorized a cook so a six month supply of C-rations was obtained. There was no survival equipment so the men

made up kits from the local

stores before

leaving the U.S. C-

The typical kit contained a machete, rations, mirror, crisis. lensatic compass,

canned water,

extra ammunition,

signaling in a

and sundry items they thought they would need This kit was stored in a parachute bag

(22:24).

73

The 57th evacuated a U.S. May 1962 Tuy Hoa, captain, for their first

Army Captain advisor on 12 The evacuation was from The

mission.

sixty five kilometers north of Nha Trang. suffering from an extremely high fever, (22:24).

was flown

to the 8th Field Hospital On 8 February mand, Vietnam (MACV)

1962 the U.S.

Military Assistance ComBefore MACV, the

was established.

Military Assistance Advisory Group (XAAG) senior military headquarters Vietnam. sections parts in MAAG was compriscd

acted as the in

for all military units of Army, Air Force,

and Navy

which were responsible the Vietnamese military. U.S.

for advising their counterAs the first COMUSMACV Vietnam),

(Commander,

Military Assistance Command,

Lieutenant General MAAG but kept it support of MACV. Chief, Pacific

Paul D. Harkins did not get rid of the matters in

for advisory and operational

MAAG also responded to the Commander-in(CINCPAC), for the administration The multiple of the com-

Military Assistance Program. munication created Vietnam.

lines of

some confusion within U.S.

units in control of

For example,

since MAAG had operational

Army aviation units,

the Senior Advisor assigned to a VietArmy aviation support. could directly reThe advisor assigned request to the comfor support.

namese Army Corps could request U.S. In

fact the Vietnamese Corps Commander support.

quest helicopter aeromedical

to the corps would formally transmit a manding officer of a U.S.

helicopter company 74

So,

a request for aeromedical individuals;

evacuation consisted of a the Vietnamese Corps Comand the commander of the

minimum of three mander;

the MAAG representative; company.

helicopter

Problems which could not be settled commander were commander had the Vietnamese Captain

between the advisor and the helicopter elevated to General to deal Army, with, Harkins.

The helicopter

and satisfy on a daily basis, and the U.S.

MAAG,

MACV,

Army Support Group.

Temperelli (19:57).

faced a futile bureaucratic

chain of command

Captain Temperelli

alqo ran into many transportation He attempted to

problems as the commander of the 57th. relocate JP-4 storage areas to

locations which would provide Neither He also

better refueling capability for the helicopters. Nha Trang nor Qui Non had refueling capability. tried to get approval to replace unnecessary with auxiliary fuel cells,

cockpit heaters

but never received approval. and excesses identified in the

There were many deficiencies lists

of equipment issued to the 57th as well as other in Vietnam. The unit carried unnecessary

aviation units

heaters and winter clothing with them to Vietnam because they were on standard equipment Early in to the U.S. lists (22:25-27). for parts directly

the war units sent requests

Army supply on Okinawa.

Okinawa often returned to comply with direcAfter several

the paperwork to them for corrections

tives the unit had never even heard of. 75

months (USASGV) Also, depots

of

logistical

chaos

the Army Support the requisitioning

Group,

Vietnam

began to coordinate the first

of parts.

in in

year of operations, could

the Army supply of the was the

the Pacific

only supply 75 percent One in reason for this Vietnam. The

aviation orders unusual role

from Vietnam.

of the helicopter and wore

helicopter

flew more estimates had the

hours had

out quicker then the peacetime Since the 57th Medical it had Detachment no supply from

calculated. in

only UH-ls

Vietnam at It

the time,

for replacement some helicopters during a visit Wheeler, were

parts.

had to cannibalize others Harkins two flying.

parts

to keep the by General of Staff,

For example, Earle G.

in

and General 57th's

Army Chief

of the

helicopters no

on the ramp with no rutor blades (22:25). also began to demand 1962

because

they had

spares

Combat units maining parts. tions This in In

the 57th's received

few reinstruc-

November of its

the 57th

to bring all was to provide man' of

starter for a

generators large scale

to Saigon. combat rotor assault gear

parts

which

the starter

combat UH-ls

had bad tail

boxes took

and faulty

generators.

Temperelli

personally

the genera'ors Joseph W. Vietnam, that

to

Saigon and reported commander lack of the

to Brigadier Army Support on the air fly

General Group,

Stillwell, the would

of the

generators

57th's helicopters evacuation coverage.

leave South Vietnam suggested that

without

Temperelli

the 57th

76

down to support the assault. perelli

Stillwell

said no and Tem-

left without the generators but with a promise that Only one of the

they would be returned after the assault. generators made it back to the 57th.

The unit was totally 1962. It was

grounded from 17 November to 15 December incredible that the only aeromedical unit in

helicopter

evacuation When

the country was shut down for almost a month. the one operational

the one generator was returned,

heli-

copter was shifted back and forth between Nha Trang and Qui Nhon in an attempt to provide coverage at each location

(22:25-27). Another difficult General situation was in September 1962 when

Stillwell contemplated transferring

the 57th from Tem-

the Medical

Service to the Army Transportation Corps. Carl A. Fisher,

perelli accompanied by Lt Colonel

USASGV visited

Surgeon and commander of the 8th Field Hospital, General policy

Stillwell and convinced him to maintain the current (22:27). in the first year

Since the 57th flew very few missions in Vietnam, many people

argued there should not be dedicated evacuation. Some suggested re-

helicopters

for aeromedical

moving the red crosses and assigning support tasks to the idle medical helicopters. The senior MAAG advisor in Qhi

Nhon tried many times to commandeer a :tandby e-.cuation helicopter. rity Each time he was told that he could have prio(22:26).

only 4f he were a casualty 77

Early in South Vietnam)

January

1963 an ARVN

(Army

of the Republic

of

assault in

the Delta convinced many people closer to the fighting. Three

the 57th should be brought

American advisors and sixty-five ARVN soldiers were killed and the 57th Medical Detachments at Nha Trang and Qui Nhon On 16

were too far north to help evacuate the wounded.

January the Support Group ordered the 57th to move to Saigon. The 57th only had one flyable aircraft but TemOn 30 Saigon

perelli was told new UH-lBs would be on the way.

January the 57th arrived at Tan Son Nhut Air Base in (22:25-28). Saigon was much different Qui Nhon and Nha Trang. commissary, and many more for the crews

and pilots than

They had access to a post exchange, luxuries in Saigon. The local

stores sold American spirits cast the

and Armed Forces radio broadThere were swimclubs, and access the In

latest music and sporting events. bowling clubs, rowing, golf and tennis and water-skiing.

ming clubs,

to motor-boating,

Even so,

veterans had very little

time to enjoy all the

luxuries.

late February 1963 Captain Temperelli turned over the command of the unit to Major Lloyd E. Spencer and the veteran arrived.

pilots rotated out of Vietnam and the replacements After his arrival, ral Stillwell. Major Spencer was called in

to see Gene-

He was asked how he was going to cover all in the country with just five aircraft. General

the requirements

All Spencer could say was he would do his best. 78

Stillwell promised the Vietnam to the 57th.

first

five new UH-lBs

in

South

On 11 March 1963 the

last of the

grounded UH-lAs were signed-over for return to the United States. The following day the Support Group issued the five new UH-lLs that were on a ship in 1968, Saigon

detachment harbor.

On 23 March

the 57th was fully operational

again (22:27-28). An initial problem encountered by the 57th was that was

their assigned parking area at the Tan Son Nhut Airport directly behind the Vietnamese Air Force's C-47 Dakotas. The Vietnamese pilots always parked with the tails

of their

aircraft towards the 57th's area. were started, copters copters. park in

When the C-47's engines over the heliof the heli-

they would splatter oil all windows, and windshields

bubbles,

The Vietnamese pilots were asked several times to the other direction, but refused. Spencer's "When

solution to the problem was effective. you fly a helicopter over the tail

He explained, it

of a C-47

really plays got

hell with the pianes rear elevators; the message and mvc~'d the C-47s." 57th's helicopters of Pleiku. U.S. In

so the Vietnamese April

1963 two of the

went in semipermanent

standby to the town support of small In late

Most of their missions were in in

Army Special Forces teams

the highlands.

June 196

one of the helicopters

at Pleiku was assigned to In I Corps

Qui Nhon to continue coverage Zone to the north, U.S.

of that sector.

Marine H-34 helicopters conducted 79

both combat aviation support and medical evacuation.

The

57th's helicopters at Pleiku and Qui Nhon provided support for II Corps Zone, and the three helicopters at Saigon

covered II

and IV Corps Zones.

Even though all the four the evacuation

corps regions

of South Vietnam were covered,

capability was very thinly spread (22:27-29). Up to this time the 57th worked without a tactical sign. They. simply used If "Army" and the tail call

number of the

aircraft.

a pilot were flying a helicopter with a tail his call sign was Army 54321. They also

number of 62-54321, communicated find.

internally on any vacant frequency they could

Major Spencer decided this system was not acceptable.

He went to Saigon and visited the Navy Support Activity (NSA) which controlled all call words used in South Vietnam.

He looked through the Signal Operations Instruction Book which listed all the unused call words. Many entries but one like

"Bandit" were more suitable for assault units, entry, "Dust Off" seemed appropriate

for the 57th's medical

evacuation missions,

since the countryside was dry and dusty blankets, and shelBy

the helicopter pickups often blew dirt,

ter halves all over the people on the ground (22:27-28). giving the 57th some identity,

Spencer by accident had given in the Viet-

a name to one of the most magnificent missions nam War.

Others would later give meaning to the name as the evacuation grew. Late

popularity of helicopter aeromedical in

the summer of 1963 the NSA decided to reassign all of the 80

call

signs in
the

Vietnam.

Dust Off was given to another

Company. Despite call was the sign

aviaurging and

tion unit, of the NSA, the

118th Airmobile

the 57th refused to give to use it. The

up the

118th refused

resistance

successful

and the call

sign remained

with the 57th its

(19:48). sign, it on

Even though the 57th retained still had no formal that mission their U.S.

own call The pilots was civilian to

statement.

worked

the assumption wounded It and

main purpose military evacuation Major and

to evacuate personnel. the Vietnamese Temper-

injured

continued

to provide

service

when elli, to

resources

permitted. receive

Spencer,

like Capt

continued to

pressure

from ground

commanders With on the pasthe

use Dust Oft aircraft Stillwell's mission. on a space

for administrative he kept the 57th

purposes. focused

General medical sengers

support The

57th sometimes basis

accepted healthy condition in

available to

with the

passengers of nowhere the air.

might have if As the pilot

leave

the helicopter a Dust Off

the middle while in

received

request

the year went

on the 57th

flew more the

and more

Dust Off missions. 197 Vietnamese destroyed made flights three

On 10 September Delta,

1963,

57th evacuated

from the large

where the The in

Viet Cong had Dust Off helicopters

settlements. jammed

with Vietnamcse and standing 1964

the

passenger

compartments In crews,

on the

skids third

(22:29-30). group of new pilots, the

Feuruary

the 57th's personnel

and maintenance

arrived and

were under

81

command of Major Charles

L.

Kelly.

On I

March

1964 Support to

Group ordered the aircraft the Delta. Two helicopters 57th Medical

at Pleiku and Qui Thon to move and five pilots, Detachment now called

Detachment A, lance),

(Helicopter AmbuMajor

Provisional,

flew to the base at Soc Trang.

Kelly also moved with Detachment A south, the field to ground duty. in crude huts with sandbags in

since he preferred lived while

At Soc Trang the detachment and bunkers for protection in air conditioned and a bar in

the rest of the 57th

Saigon lived

quarters with private ba'is, living quarters. ferred It

a mess hall,

their

Despite the difference,

most pilots pL-e-

Soc Trang (22:34-35). was at Soc Trang that Major Kelly began the Dust Off and dedicated service. With the time was the pilots

tradition of valorous

buildup of war activity the 57th for the first receiving enough Dust Off requests to keep all busy. General The helicopters were showing signs

of age and use and helicopters for

Stillwell could not find replacement

the detachment. each month in

The pilots were flying more than 100 hours medical evacuations. Some pilots stopped

logging their hours after 140 hours so the flight surgeon would not ground them for going over their munthly ceiling. Even so, the Dust Off mission was once again under attack.

The Support Command began pressuring the 57th to put removable red crosses general on their helicopters and to begin accepting

purpose missions.

Kelly told his men that the 57th 82

must prove

its

worth and helicopters-

"by

implication the value of dedi-

cated medical

beyond any shadow of a doubt". in response to requests, but

The 57th not only flew missions

began to seek missions by flying on a planned kilometers at night.

circuit of 720 from desti-

This plan many times delivered each night to their medical otherwise waited until resulted in

ten to fifteen patients nations who would have During "arch night

the next day. of

1964 this strategy

74 hours of that

flying that evacuated

nearly 25 percent Stillwell

month's 450 evacuees.

General

abandoned

the idea

of having the 57th use removable

red crosses

(22:34-37).

Another problem for Kelly at this time was a lack of pilots. The Surgeon General's Aviation Branch tried to have Service Corps pilots assigned to nonmedical units in Vietnam. They thought the new pilots

new Medical helicopter

would benefit Off

more from the combat training than fr,)m Dust In June 1964 Kelly provided his

flying (22:34-37).

response: As for combat experience, the pilots in this unit are getting as much or more combat-support flying experience than any unit over here. You must understand that everybody wants to get into the Aeromedical Evacuation Business. To send pilots to U.T.T. (a nonmedical unit) or anywhere else is playing right into their hands. I fully realize that I do not know much about the big program, but our job is evacuation of casualties from the battlefield. This we do day and night, without escort aircraft, and with only one ship for each mission. The other (nonmedical) units fly in groups, rarely at night, and always heavily armed (22:37).

83

Kelly thought his unit had a unique mission to do and the only effective training was to be found in helicopter (22:37). On 1 July, 1964, a Dust Off

he was making an

approach to pick up wounded from a particularly dangerous area. The enemy was waiting and opened fire. A U.S. He was readvisor on

peatedly told to withdraw but refused.

the ground gave him a direct ordec to withdraw and Kelly replied, "When I have your wounded." A few moments later
"EDst

Kelly died with a bullet uound through the heart. Off" became the call missions in sign of all Army aeromedical I have your wounded"

evacuition became

Vietnam and "when

the personal

saying of many of the medevac pilots who (51:7-8). became the

followed Kelly

After Kelly's death Captain Paul Bloomquist commander of the 57th Medical Detachment in

Saigon and Cap-

tain Patrick H. Brady went to Soc Trang to take cver Detachment A. Assuming the 57th would now select its missions

more carefully, in

the commander of the 13th Aviation Battalion be made,

the Delta asked Captain Brady what changes would

now that Kelly was gone. continue to fly missions accepting any call In

Brady told him that the 57th would exactly as Kelly had taught them,

for help (22:37-38). office named five

August 1964 the Surgeon General's

more air ambulance The 82d Medical Sam Houston,

units for assignment to Southeast Asia. (Helicopter Ambulance) at Fort

Detachment

Texas,

was given 1 October 84

1964 for its move.

The four other units were put on notice without

ture dates Ambulance) (the Delta) (22:39). The 82d Medical in Detachment 1964 in

firm depar(Helicopter IV CTZ

became operational (52:71).

November

Three of the 57th of

pilots

were transwere transMajor

ferred ferred

to the

82d and three

the 82d pilots aid in

to the 57th. Capozzi H.

This was to in

trai-iing. the 82d The settled

Henry P. Howard call call

was put

command of the 57th.

and Major of the

Huntsman up.

commanded The neA

question

sign came sign and

commanders 82d.

on the 57th's changed 57th

unit emblem in the

for the emblem.

They simply the

the 57th to

an 82d

Some of

former

"pilots objected to the piracy but the policy was practical.

Both units helped (22:39). One drastic pozzi change was the conservative their styles of Caperformed the same mission recognize the and the common symbols helicopters

the ground

forces

ambulance

and Huntsman.

They counseled

pilots with the

to accept ground only in landthe

no missions forces extreme ing old

without direct

communication to

requesting the emergencies, Despite

mission,

fly night fly

missions

and to never these orders into the

into an insecure instilled

zone.

the veterans

"Kelly spirit" in

new pilots.

Capozzi

and Huntsof is

man did succeed searching

the

stopping the Kelly practice They said "Shopping

for patients. This

for business

a waste of time".

was a sound decision

because of the

85

improved

communication network and the increase in (22:39-40). (Air Ambulance)

the

number of Dust Off units The 283d Medical August 1965, Ambulance) in

Detachment

arrived in

followed by the 498th Medical September 1965. arrived in

Company (Air Detachment

The 254th Medical

(Air Ambulance)

Vietnam before the end of the until February 1966 because a of the unit's equip-

year but was not operational

backlog at the port delayed the arrival ment. The four detachments

were authorized six helicopters The 498th Medical and supported II CTZ

each and supported

III and IV CTZ's. 25 helicopters

Company was authorized (52:71). By the beginning proficient.

of 1966 the Dust Off crews were very to learn from,

With four years of experience

the Dust Off sorties had evolved into a very specialized method of aeromedical close knit. evacuation. The crews were extremely

Each member of the four man crew had very well The success of the missions

defined responsibilities.

depended upon everyone knowing what they were supposed to do and doing it. several ties, The typical request would come from one of If an American or Allied unit had casualthey would call Dust Off the

sources.

and a strong enough radio, If

directly. request Dust Off.

Dust Off could not be reached directly,

went to the unit's headquarters

and from there to

Whichever method was used certain information had The necessary information included the exact 86

to be given.

location of the casualties,

landing

zone,

the number

and condition and

of

the types

of wounds, ground,

radio frequency any special

call

sign of the unit whole blood, and weather order terrain

on the

needs such as in the area, in in the

feature,

enemy activity four were

conditions.

The first flown.

critical

for the were

mission to be

Two elements the

request wounded dition

open to interpretation, intensity was

condition of the Often the con-

and the

of enemy fire. exaggerated Landing in in

of patients

order to get them were to often reported a sortie. If the

rapid medical secure

attention.

zones

when they were not a rule of thumb

an effort

assure

Eventually people landing radio the

gained wide

acceptance.

on the ground zone was was

could stand up to becurc. it

load the wounded the was cruciai that

defined as

contact

established (19:101-102).

when the helicopter

approached

landing

zone

A Dust Off on three minutes in the air after

stand-by could be receiving the

in

the air

in

less than Once

evacuation

request.

the pilot

would tune to the Dust Off While frequency the pilot zone. The

frequency the pilot it

and receive would

his mission directions.

enroute

also find the ground unit's on the way. In

and notify collected copilot In

they were vital

addition, landing

information flew while

about the the pilot

usually

worked the

radio.

the rear, (19:103).

the crew chief

and medic

prepared for the wounded

87

In the landing zone the crew chief and medic would quickly sonnel load the wounded or supervise the loading by perWhen the patients were loaded

of the ground unit.

the crew chief would give the pilot the signal to take off. The medic and crew chief would then treat the patients. medic would report the condition of each patient to the pilot who would radio this information to the nearest medical regulating officer (MRO). Based on this information the facility The

MRO would direct Dust Off to the proper medical (19:103-105). Tn March 1966 the 44th Medical Brigade, activated units in in January,

which had been

assumed control of most Army miedical

Vietnam.

During the next two years the Brigade Group (III the

cou-diiiatcd t"e aztivities of the 68th Medical and IV Corps Zone), 55th Group (North Corps Zone) In lished: the 43d Group II Corps Zone), (South II

Corps Zone), (I

and the 67th Group

(22:44).

1965 a new form of air ambulance unit was estab- the air ambulance platoon. These units, unlike

the air ambulance units of the 44th Brigade, the combat assault divisions

depended upon The

for command and supply.

air ambulance platoon usually consisted of twelve UH-l helicopters. After testing the new system the initial Air Ambu-

lance Platoon was deployed to the mountainous lands of South Vietnam in

Central High-

August 1965 as part of the 1st 15th Medical 08 Battalion. In

Cavalry Division (Air Mobile)

addition to providing aeromedical

evacuation the unit also

had the equipment to rescue downed pilots of crashed aircraft. The unit consisted of a medical evacuation section

with eight helicopters helicopters.

and a crash rescue section with four in Vietnam it

After the platoon's arrival problems,

found that maintenance

general aircraft shortages, impossible to keep

and regular evacuation missions made it four of the aircraft available missions. detachments The platoon's

at all times for crash rescue unlike the helicopter used "Medevac" as

pilots,

of the 44th Medical Brigade,

their call sign (22:48). have walrrant officers (19:93)

They were also the first evacuations

unit to in Vietnam

fly aeromedicdl

To protect the platoon's aeromedical

evacuation

helicopters they began keeping gunships on call but the platoon's medevac pilots thought traveling with the slower (22:48). evacuation (air

gunships wasted time In

September 1965 another type of medical - the medical

unit was deployed to Vietnam: ambulance). helicopters

company

These units were authorized and a strength of 28 officers The 498th Medical

four two-patient and a larger group Ambulance), became

of enlisted men.

Company (Air Madrano,

under the command of Lt Colonel Joseph P. operational in

Vietnam on 20 September 1965.

The company 1 1/2 platoons Also at Nha section,

was divided with 1 1/2 platoons at Qui Nhon, at Pleiku,

and the fourth platoon at Nha Trang. maintenance

Trang were the company headquarters, 89

and operations nonimedical to the unit distance

section.

Because

of the officer

lack of pilots pilots were

many sent

commissioned on

and warrant

loan from the

1st Logistical

Command. in

The

of the platoons

from the headquarters Each commander in II

Saigon thought Each of flight Dust

caused a few problems. some or all of the air thought

Corps

ambulances

belonged

to them. a

the commanders

the authority troop sites Though coverage

to dispatch deserved

should be his and their Off or Medevac pany provided it , created coverage. excellent

individual

the dispersion for air

of the comsupport had

ambulance

many

maintenance at three

difficulties. sites by

Maintenance the single

to be

accomplished

maintenance

platoon assigned The next air

to Nha Trang ambulance Company

(22:49-52). established was in Vietnam,

company

the 436th Medical from the old 57th and

(Provisional),

established

and 82nd Detachments, The 43d Medical The company's evacuation in

along with the 254th Group took command to of

283d Detachments.

the provisional supervise The all

company.

mission was III

aeromedical

and IV Corps. to

company

operated 22 helicopters coordination of the air

and was expected ambulance

improve the The own

detachments. retained as just In September its

improvement did not occur. separate identity

Each detachment the company

and regarded in the

another headquarters 1966 the Provisional

chain of command.

Company was renamed the

436th Medical

90

Detachment

(Company

Headquarters)(Air

Ambulance)

and attach-

ed to the 68th Medical

Group (22:49-53). was apparent that rescuing people mission. The Army

As the war went on it

from the dense forests was a difficult

came up with many solutions to the problem.

One of the most North Caro-

interesting was actually tested at Fort Bragg, lina. It

required the ground troops to strap a large box to the upper branches of a large tree. The

collapsible

box was dropped to them from the evacuation helicopter. After strapping the box to the tree, climb down and haul the box. the troops were to

the injured person back up the tree to

They were to wait while the helicopter hovered

over the box and the helicopter crew would extend a four foot ladder down to the box. The wounded would then be since it was

taken aboard.

This concept was ridiculous

difficult to transport the wounded to the top of the tree and the box was difficult to secure (19:105).

Another idea was called the "Jungle Canopy Platform System". This required the helicopter crew to unroll two

large stainless steel nets over the tops of the jungle trees. Then, if the wounded could be moved to the treetops, and the wounded for de-

the helicopter would hover over the nets, could be picked up and evacuated.

This worked well

ploying healthy troops but no commander was willing to test it in combat. This idea, like the box in the tree, soon

faded away

(19:105-106). 91

The previous ideas were not accepted

and instead of the solution a

trying to bring the patient to the helicopter, was to bring the helicopter to the patient. hoist was introduced.

To do this,

Mounted inside the top of the cargo floor behind the copilot's seat,

area and anchored to the

the hoist was swung outside the aircraft pulleys were clear of the skids. tric winch and could lift It

so the cables and

was powered by an elecThe hoist

600 pounds 200 feet.

required the helicopter to hover over the wounded and lower the cable to the ground. a vest. On the lower end of the cable was the vest dnd hoisted

The wounded man was placed in

up to the waiting helicopter. added new capabilities it

The addition of the hoist

but also increased the danger because motionless, above the

required the helicopter to hover,

pick up zone while the operation took place. in a high hover in a combat zone is

A helicopter (19:105-

very vulrerable

107). The first actual rescue mission using a hoist was on 17 1st Platoon, 498th sup-

May 1966 by Captain Donald Retzlaff, Medical Company, Nha Trang.

The mission was flown in

port of the 101st Airborne Division, Be.

12 miles north of Song was the first

The medic rode the cable down since it On the ground,

time the hoist was used.

the medic showed the

the ground troops how to place the man to be rescued in vest. The first

casualty lifted was a lieutenant who had

92

been killed an hour before.

Before that day was over, (19:108-110).

17

wounded had been lifted by the hoist

Continued use of the hoist throughout Vietnam created several improvements. A rigid lifter was added for patients the vest. in

who were too seriously wounded to be put in Neither the vest nor the litter dense jungle areas.

had worked very well

To solve this problem the "Jungle (19:108-112). The penetrator was

Penetrator" was developed a torpedo-like

3 foot projectile

attached to and lowered pulled

from the helicopter.

On the ground the seats were

down from the bottom half of the projectile were strapped on (34:45)%.. Vietnam in training, The first

and the wounded in

penetrators arrived use,

June 1966 and were placed in in October (19:112).

after extensive

The use of the hoist required helicopter crews.

skill and courage by the

The pilot usually communiefted simulta-

neously with the ground unit and the medic and the crew chief in the rear of the helicopter. It was crucial the the

helicopter remain motionless while hovering 200 feet in air. The slightest movement was amplified through the Also, there was considerable

cables to the ground.

anxiety hovering

waiting for the Viet Cong to fire on the helpless, helicopter.

Often there was darkness or strong crosswinds (19:113-114). units

that made Lhe operation even more difficult By the end of 1966, were using hoists.

all the Dust Off and Medevac

As the jungle penetrator became more 93

popular the use of the vest was discontinued. lifter

The rigid

was used for patients who were unconscious or too (19:115).

seriously wounded for the penetrator

In March 1967 General Westmoreland told the Commander in Chief, U.S. Army, Pacific, that his theater needed 120 In April some measures were

air ambulances but only had 64. taken to correct the situation. were taken from nonmedical units (22:55). Medical Company detachments

Many helicopters and pilots

units and assigned to medical September 1967, the 45th

In addition in (Air Ambulance) Vietnam.

and four other air ambulance The units were moved around in response to the battle

arrived in

to provide the Oest area coverage situation. In 1968,

four more detachments were sent to evacuation

Vietnam completing the buildup of aeromedical units. lances

By 1969 there were 116 field army helicopter ambuin Vietnam. These were assigned to two companies Figure 6 (52:71). system of patient Then came the attention withand

11 separate detachments as shown in

Originally there was no standard classification or categories patient classifications in two hours;

of precedence.

of urgent -immediate

priority - attention within 24 hours; and Later, urgent was used priority

routine - attention within 48 hours.

to mean immediate evacuation to save life or limb, was used to mean 4 hours, deterioration for several

and routine meant no expected hours (13:21).

94

KVi Snh

Camp Evans "-37th MDHA xueO Phu Sol

P Eagle 571s14 DHA Y;Da Nang "Eagle Dust Off" 326th Mod Battalion 238th MDHA l0ut Airborne Div

Ce

SbieI CORPS

Chu Lei
54th MDHA 88th MDHA

AIR AMBULANCE UNITS IN VIETNAM

31 December 1969
!59 0 50 10 Miles 100 Kilometers Pleiku o 283d MDHA

Qui Nhon 496th MCHA

II CORPS

N/va rrang'' 254th MDHA~

III CORPS
Air Ambulance Platoon C Sn 15th Mod Battalon Phuoc oVinh lot Cay Div (Alrmoblle) 0
-. 0 Lai Khe ",/--t g='hCu Chi0 57th[ MDHA

5t

PhnangRn 247th MDHA

1591h MRHA SAIGON

Bnh Thuy \Novel Base a d8MDHA0

Long Binh 45th MCHA

ScTrong o

IV CORPS

FIGURE 6.

AIR AMBULANCE UNITS IN VIETNAM

95

One M.ajor the

of

the problems

with this the

system,

identified who

by classified qualithere the in a

Patrick Brady, for so.

was that

individuals

patient

evacuation

were usually

not very well realize

fied to do is

An untrained person a correlation Some as

does not

not necessarily of

between ccldiers urgent

pain and call

seriousness wounded

a wound. priority

would

friend's when

so he

could be

evacuated

immediately

the classification Overclassificition since

should have

been prifor

ority or routine. the Dust Off pilots lous situations

was also a problem themselves into

they pushed for patients but who

periwere in

many times classification

they thought not

the urgent

were actually by Army to 67,910 106,229 completed

(13:21).

The number evacuation 85,804 in rose 1967,

of patients from 13,004 and reached 104,112

evacuated in 1965,

helicopter in in 1966, 1969. to In flying

a high of

1969 more than about

missions were (51:9).

while

78,652 combat

hours

Similar

figures in

are Table Also, 10. a

recorded Each time significant civilians.

by Lieutenant a patient number

General

Joseph was

M. Heiser counted U.S.

was moved he

again.

of the evacuees

were

and Vietnamese

The Dust Off had

crews

who

flew and

the aeromedical lifficult was jobs

missions in Vietnam. Half

one of the most dangerous evacuation of these under

Landing and the members during their

enemy fire Purple (40:).

routine.

crews

earned of duty

Hearts

for wounds eleven

one

year tour

Over the

96

year period, wounded.

207 Dust Off crewmen were killed and many more in Vietnam

There were 199 Dust Off helicopters

(19:153-155). Table 11 (39:214) EVACUATIONS YEAR Prior to 1965 1965 1966 1967 1968 1969 1970 Total BY ARMY AIR AMBULANCES IN VIETNAM

PATIENTS 12,000 11,000 65,000 94,000 208,000 241,000 197,871 828,871

*,

From 1962 to 1973, flown. medical

a total of 496,573 missions were

Over 900,000 patients were evacuated to various facilities, almost half of those Americans. The

average time lapse from wounding to hospitalization was one hour (19:153-154). In an interview by Time magazine, U.S. Army Major Paul

"Big Bear" Eoomquist Vietnam.

was asked why he continued to stay in

Major Bloomquist had flown 750 combat missions, won 27 citations, and rescued more He

been wounded 3 times,

than 800 wounded soldiers at the time of the interview. also volunteered for a second tour of duty and refused to take leave alter the first replied; 15 months he was in Vietnam.

He

97

Because, I like the excitement. And because I think that my crew and I can do this job better than anyone else. It's the job that counts above all, and it's the job that somebody has to do (31:25) This type of dedication was found medical evacuation teams in Vietnam. Until January in many of the

Tactical and

Intratheater Evacuation.

1968 intratheater medical Air Force C-130s, C-123s,

evacuation was performed by U.S. and C-7s. The C-118s of the

6485th Operations Squadron, in Japan,

part of the 315th Air Division technicians from

with flight nurses and medical Evacuation Squadron,

the 9th Aeromedical

were also assigned Committing the Cin medical intra-

to fly in-country evacuation missions. lI1s was one of the great theater support in Vietnam improvements (6:281).

These reciprocating

engine aircraft were slower than the prop-jet C-130s and less suitable permanently expanded for landing at forward sites but they were evacuation. in The 6485th

modified for aeromedical

from four to seven aircraft Philippines, in in early

1966 and moved to It began and crews

Clark Air Base,

1968.

limited operations

January 1968 with aircraft

assigned three day cycles flying to fourteen Vietnamese airfields for evacuations (10:397). (AES) medical

9th Aeromedical personnel

Evacuation Squadron

on C-130s moved patients from Vietnam to Clark Air flights and in May 1962 a weekly schedule flew

Base on regular was established

interc,.;necting with the C-123s which 98

the Nha Trang-Saigon run.

The C-130 aeromedical

route was cen-

extended into Thailand and another aeromedical ter was established at Don Muang, Tan Son Nhut Air Base. in

control

addition to the one at of the 9th AES

in 1963 detachments

were opened at Clark Air Base, Bangkok.

Tan Son Nhut Air Base and 1963 and were

Statistics compiled by the squadron in

1964 statistics

show that roughly two hundred patients Asia.

moved each month within and from Southeast forty percent were battle casualties

Less than

(10:396). between hospitals to pick up

Patients were frequently transferred in Vietnam.

Often the transfer moved individuals

points for flights back to the United States.

By 1966 there three 60 and a

were seven 400 bed field or evacuation hospitals, bed surgical hospitals, convalescent Bay. a Navy hospital in

Da Nang,

center and an Air Force hospital at Cam Rahn

By 1968 the surgical hospitals were expanded to eight hospitals to twelve. All the hospitals. exThey

and evacuation

cept for a few near Saigon,

included Pleiku, Qui Nhon,

were located by airstrips.

Tuy Hoa, Nha Trang, Phu Bai,

Quang Tri, transported

and An Khe.

In June

1967 the 834th Air Division in Vietnam: and two

over 7000 patients between points two thousand by C-123,

three thousand by C-130, thousand by C-7

(10:397-399).

Physicians decided priorities which determined how quickly patients should leave for destination hospitals. Like the Dust Off classifications, 99 cases were categorized as

"urgent",

"priority",

and "routine".

"Urgent"

cases were

those which had to go immediately to save a life or prevent serious medical complications. "Priority" cases were those locally. All other

which needed prompt medical

care not available

These patients were to be moved within 24 hours. patients fell into the "routine" category (2:44).

and had a time "routine" and

limit for movement of 72 hours most "priority" cases scheduled flights. in

All

could be handled

on the regularly cases

Immediate movement of the "urgent" the air be diverted, on a special mission.

required aircraft

or an alert airYore than 65

craft to be launched percent of

all the aeromedical In

evacuation missions within 1966, C-130s accounted for

Vietnam were unscheduled.

more than 36,000 patient moves, tients a day for that year 1967 to January 1968, month.
.

averaging nearly 100 paDuring the period from July averaged 5813 per

patient movements

From February 1968 to June 1968 the average was 9068 (6:281). intratheater flights fell into two cate-

per month

Scheduled gories.

There were aeromedical

evacuation flights which

returned recovered patients outbound

patients back into Vietnam and evacuated on a routine basis. C-118s were usually

used for these flights.

The other type of scheduled flight usually tho C-130. The air-

used backhaul cargo aircraft,

craft was scheduled for a resupply mission and was reconfigured as an aeromedical evacuation 100 flight for the return

trip.

Aircraft

scheduled

for this type of mission sometimes crew on board and at other times (59:22-24).

originated with the medical picked up the medical

crew with the patients

Almost 11 times each day requirements were called in, missions were set up, offloaded, (6:282). medical crews were picked up, and patients cargo

planes reconfigured, Converting the cargo

evacuated con-

or passenger aircraft

sisted of removing cargo pallets or passenger seats and installing the vertical poles to support the litters. The

time to do this depended on the number of seats and litters needed for a specific flight. figured in as little C-141 Starlifters were recon(59:21). I'

as 25 minutes

The unscheduled

flights posed the most problems since for

they were normally diverted cargo missions reconfigured air evacuation.

The efficient use of the unscheduled mis-

sions required a lot of coordination between the aeromedical evacuation control airlift aircraft aircraft brackets patients. medical centers (AECCs), airlift operations or

control centers, crews,

transport squadrons, facilities

the individual All

and the medical

involved.

subject to diversion were equipped with litter and other necessary equipment More than 65 percent for transporting aero-

of all intratheater

evacuation missions were unscheduled

(59:24-25).

On 8 July 1966 the 903d Aeromedical

Evacuation Squadron

was organized at Tan Soon Nhut Air Base under the 9th Aeromedical Evacuation Group. There were detachments 101 located at

Cam Rahn Bay,

Nha Trang,

Qui Nhon,

and Da Nang.

Later, Each

other detachments

were added at P 1 iku

and Vuk Tau.

detachment had two male flight nurses and up to ten aeromedical evacuation technicians. in late 1967. Female nurses were assigned besides providing

beginning medical

The detachments,

flight crews,

also operated the control elements

which coordinated patient and aircraft movements with local hospitals, In airlift control elements, and the AECC (10:399).

February 1967 the 903d Medical

Evacuation Flight was

transferred

to Phu Cat from Pope AFB and assigned to the The 903d Flight was a self contained unit of

903d Squadron.

mobile teams designed to provide medical Vare at forward airstrips. medical The personnel were trained in flight and ground

skills and had enough equipment for four 25 bed Teams were sent to Khe Sahn in and again to Khe Sahn in 1967,

forward facilities. Dong Ha in May 1967,

early 1968.

The 903d Squadron treated and moved over 10,000 patients during the 30 day period after the Tet Offensive 1968 (10:399-400). shuttle began in

C-130s operated a daily round-robin The flight went into and Hue Phu Bai. Occasion-

form 0700 to 1700 hours.

forward sites such as Dong Ha, The aircraft

Quang Tri,

flew the evacuees back to Da Nang.

ally after the second round robin flight, flown to Qui Nhon, Da Nang was full. patients a day. Phu Hiep, Nha Trang,

patients would be

or Cam Rahn Bay when from 125 to 158

The aircraft averaged

Another C-130 operated at night to handle 102

patients

in

the late afternoon and evening. per flight.

This aircraft During February on 330 flights

averaged from 40 to 60 patients

1968 more than 10,770 patients were evacuated (6:283). The unit earned the Presidential (10:399).

Unit Citation for

this activity

During the early part of 1968 fighting around Saigon produced many casualties which required evacuation. accommodate this an aircraft To

began flying seven days a week Stops in between includAfter the

from Tan Son Nhut to Cam Rahn Bay. ed Cu Chi, Bien Hoa, Vung Tau,

and Bihn Thuy.

1968 surge of casualties the number of flight nurses assigned to the Far East was increased from 314 to 409. nurses were transferred from a MAC C-141 McGuire AFB, New Jersey to Yokota AB, Twenty

evacuation unit at This increased

Japan.

the number of flight nurses there to 62.

Twenty MAC nurses After

were also sent to Yokota for 90 days temporary duty. that 90 days, thirty nurses were sent to replace them.

Twenty of these nurses were from the 34th Aeromedical uation Squadron at Kelly AFB, Texas (6:283).

Evac-

After 1969,

the operations were reduced and the personnel were consolidated at Cam Rahn Bay in mid 1970. Two years later the longer

squadron was phased out because its required (10:400).

services were no

To understand the amount

of work being done an example from Vietnam and

of the number of casualties evacuated Thailaiid is found in Table 12. 103

These are from the monthly

reports the

froir

the

9th Aeromedical Another

Evacuation Group,

part of from

315th Ai-- Division.

study of evacuations

1965 to April patient patients

1968 shows that This does

PACAF handled not represent

over 200,000 the number of were moved. in the casualmoves

movements. moved,

but the

number of times patients once battle

Many patients

may have been moved more than The study reported of these that

evacuation process. ties had

grown to forty percent

evacuation

(80:1339).

TABLE PATIENTS

12 (52:400)

EVACUATED BY PACAF AIRCRAFT Month Ending 15 June 1967 7023 2259 175 239 1703 iMonth Ending June 1969 9087 224 176
i9

Month Ending 25 July 1965 Intra-Vietnam From Vietnam Intra-Thailand From Thailand Non-Southeast Asia 190 607 11 41 629

598

By mid-1967 the medical technicians,

number of U.S. and

Air Force

flight

nurses,

administrators

assigned to the This was a

PACAF aeromedical 500 percent

evacuation in three

system reached 300. years. This, was in

increase

along with the for a

twelve-month duty continuing very

cycle in

Vietnam,

responsible most

low experience

levels in

specialties. had previous on the job

Less than half the nurses flight medicine training. basis

arriving Training

Vietnam

was performed

on a one-on-one

within the

squadrons

and detachments.

104

New individuals

flew missions with experienced

people until

they gained the required experience and self confidence. Many medical technicians also arrived untrained. It was

their responsibility to load and unload the patients as well as assist the nurses when necessary. supply shortages very rarely occurred While patients were being airlifted played a very important part in Very few casualties died in In contrast, medical

(10:399). the flight nurses evacuation.

their successful

the air,

a tribute to the flight

nurses since most of evacuation flights did not have doctors onboard. During evacuations, the flight nurses had many
40

responsibilities

often performing jobs usually left to They administered blood transfusions, treated shock victims, performed

qualified physicians. intravenous feedings,

emergency tracheotomies,

and other emergency procedures.

They not only had to deal with the wounded but with the victims of malaria, dysentery, and other diseases. The This

average age for these Air Force nurses was 28 years.

duty was considered the most prestigious assignment by the AF nurses and not one requested a transfer during the entire war. There were 54 PACAF flight nurses flying in the Southfor

east Asian area.

MAC had 67 flight nurses responsible

the flights back to the United States. ficult jobs. wounded men in

Both groups had dif-

The PACAF nurses had to care for the recently short often turbulent missions. The MAC

105

nurses dealt with supporting patients for the long flight over the Pacific Ocean (23:75-79). The PACAF nurses work day averaged 12-14 hours with 8 hours in the air. The MAC nurses put in as many as 105

hours without relief on a roundtrip over the Pacific Ocean. Why did these nurses continue to perform such difficult missions? Senior Flight Nurse Major Jean A. Corrigan says;

The first few flights are toughies. It's scary knowing But somehow even our so many lives depend on just you. youngest nurses mature almost overnight. They seem to grow a sort of shell just thick enough to hide heartache (23:). Senior Flight Nurse Major Lola Ball said;

If the men can make such a sacrifice and still smile, we can do our bit, too. I keep remembering a claymore casualty we flew home. He was just a kid really, and there was nothing much left of him - no arms, legs, eyes, just that big heart beating. Each time I checked to see how he was doing he whispered 'Just fine, Ma'am, thank you kindly.' Sometimes it hurt so much inside you just crawl back to your quarters and have a quiet cry (23:). Through all this it was important for the air evacThey knew

uation nurscs to look attractive

at all times.

the injured men wanted to see an ordinary American girl. The perfume atomizer was just as important an item as the medical kit (23:75-79). Strategic and Intertheater Evacuation. The Military from Vietnam

Airlift Command had responsibility for flights to the United States. flights were used in Early in

the war MAC aeromedical PACAF

conjunction with PACAF flights.

106

would Asia

fly the casualties and MAC In

to various hospitals

in

Southeast

would then move them to the United States May 1966, at the request of the USAF Surgeon the feasibility of

(33:18). General, starting

studies were begun to examine movements from Vietnam combat

zones

to the United

States through Japan and the Philippines. nificantly (18:20). transferred Yokota AB, old system. much better At first, reduce the intransit first time

This would sig-

for the patients flight

On 1 July patients Japan. The

1966 the

MAC aeromedical

from Saigon to Travis AFB, This flight was

through than the was also

15 hours quicker transfers

elimination of aircraft (33:18). were evacuated

for the patients the wounded

to

Clark Air Base. Hospital in or

From there they were Hawaii, to the U.S. In

routed to Tripler Army Hospital in

General

the

Ryuku Islands, of 3.5

to Japan. general were

the summer

of 1966 the equivalent in Japan.

hospitals

was established

These hospitals 60 days

for the

wounded who

could return to duty within

(52:77). On 28 June out of Da Nang 1967 the first MAC aeromedical mission flew

for the United States. Guam,

This mission flew (18:20). By the Cam

through the Philippines, end of 1967 Rahn Bay, Japan scheduled

and Hawaii left in

flights

from Tan Son Nhut, Vietnam

and Da Nang Air Bases These flights

for Yokota AB, six hours. at

(59:18).

took approximately in

Patients assigned

to the hospitals

Japan got off

107

Yokota AB and other patients bound for the United States got on. Patients going to hospitals east of the Mississippi Washington D.C. (18 hours via Elmendorf

flew to Andrews AFB, AFB, Alaska).

Those patients going to hospitals west of the California, by a direct 10 they

Mississippi flew to Travis AFB, hour flight (52:77).

These flights were so successful (18:20).

were ultimately increased to thirteen a week From the experience

gained from moving patients directit was learned that long distance. of aeromedical from and

ly from Vietnam to the United States, many of the patients Beginning in

could not endure the

August of 1968, initiated.

the dual stage

evacuation was

Patients were transported Philippines,

Vietnam to the offshore

islands of Japan,

Okinawa for more hospitalization and stabilization.

When

they were stabilized or ready for further movement they were flown to the United States or returned to duty. mission were flown daily, Rahn Bay, Three Cam

one each from Tan Son Nhut, (18:24).

and Da Nang Air Bases

Thousands of wounded were evacuated during the TET offensive June, 1968, in 1968. During the period of January through moved out of Vietnam.

there were 55,075 patiants

The 1969 Spring Offensive also created a surge for aeromedical evacuation. MAC evacuated 7436 patients This was the out of last time a

Vietnam during the month of March.

large number of injured were evacuated out of Vietnam (33:19). On March 7 1969 a record high (711 patients) 108 was

evacuated separate

out of

Vietnam by MAC.

This required twelve high. During

missions which was of January-August

also an all-time 1969 an average

the period

of almost

11,000 casualties States by MAC The aircraft

per month were evacuated (18:24-25). used by the MAC air

to the United

evacuation

system was

mainly propeller changed to an all

driven at the beginning jet system at the in 1965. end. By

of the war but Overseas movement

was by C-118s and there ing

C-135s

the end of and C-9,

the war accomplish-

were only two aircraft, movements.

the C-141 Both these

overseas

aircraft

were jet

powered

(33:14). C-118s were capacity The one of the aeromedical of 36 litter or 65 slow

The Douglas workhorses. ambulatory The

was a maximum flight

patients.

speed was (33:16).

relatively

cruising at only The C-141s The first November vehicle

307 miles per hour replaced the

C-135s very to MAC

early

in

the war. 1965. airlift perform The three On

C-141 was

delivered

on 23 April the principle

1 the C-141 was designated in the Pacific. evacuations aircraft The C-141 as well was 60

was designed

to

aeromedical capacity

as to carry litter

cargo. in

of the

patients

tiers,
litter

100 ambulatory patients,

and 42 ambulatory patients. pallet

or a combination
To make augmented flights the

of 27
better standard Cpallet was

for the patients 141 latrine and

a comfort

cooking facilities.

The comfort

109

a cubicle with two latrines,

two ovens, refrigeration made it

cooking facilities
and a

including
coffee maker. hot meals

compartments, possible (33:14-15). to serve

This pallet during

the patients

the flight

An aircraft uation Douglas DC-9 and, DC-9 after civil

was

needed

specifically

for medical and analysis, The first first the

evac-

years airliner on

of research was

selected. It

USAF of A

was completed

17 June

1968.

was the

twelve DC-9s Tonne, Wing,

to be delivered. Nurse

Lieutenant

Colonel

Mary Airlift

Chief Flight Scott AFB,

of the gave it

375th Aeromedical the nickname

Illinois was

"Nightto

ingale".

The

interior

configured of litter 18 litter It

for easy conversion ambulatory patients

accommodate The normal

a combination configuration patients

and

patients.

was

and 20 of carrying or

ambulatory 40 litter

(33:16-17). or more than

was

capable

patients

40 ambulatory above

patients,

the combination nurses patient reading and three console light, The with

of the two mentioned aeromedical had a nurse emergency ambulatory a flexion

along with two Each regulator, outlet, and

technicians call system,

(18:26). cold air

oxygen mask, seats were

electrical first class

ash tray.
t

commercial a

ype

seats

back to allow leg out in

a patient with Wide

full aisles

leg cast to put his allowed patients oxygen,

front of him. to pass in the easily. side

on crutches were located

Vacuum,

and therapeutic

wall

110

panels.

Medical of all

crew

seats

were

located

as

to provide

observation Other inclined ment, access

patients of this

(33:17-18). aircraft isolated included special exhaust (68:102). integral compartand

highlights

ramp and stairways, ultraviolet-filter from all

care

germ killing to litters

system,

sides

There

were three operated inches operarAs

entrances stairways. high and

to the aircraft. The 11 third

Two were had an Pccess

hydraulically door 6 feet 9

feet 4

inches and

wide,

with a

hydraulically patients.

ed ramp, the out.

to help load

off-load

stretcher

C-9 became The last

operational aeromedical

the C-131 flights

and C-118

were phased in 1969

for both were

(18:25). MAC's 342 patient 1969. creased in March aeromedical movements evacuation in January workload 1965 to increased 820 in from March in-

13,

The missions

associated in

with those January

movements

from twelve missions 1969 (18:25-26).

1965

to 259 missions

Specific

Problems

Encountered

and Lessons Lt-rned for the American

The Vietnam War Armed Forces. evacuation medical

was a new experience even more The true

This was

for aeromedical with aero-

units

and people. in

experiences

evacuation

the Korean War.

War were only a brief Helicopter flights ambulances in and

introduction intratheater

to the Vietnam and intertheater

evacuation

Korea

ill

rarely not ed

flew

over enemy territory. thick jungles aircraft mobile, in and forests Vietnam.

The terrain which

of often

Korea did obstructin Korea in

have the

aeromedical

Army hospitals troops,

were relatively Vietnam (22:115). Many people bright General asked were, uation

moving with the were in

while

almost all

hospitals

fixed

locations

believe

that deromedical in in

evacuation was War.

the

spot for the Spurgeon

United States responded, lessons

the Vietnam an oral

Major when

Neel

interview,

what the major in respect

gained from the of the

Vietnam War evac-

to the

operation

aeromedical

system;

It (medical care) is not a subsystem of logistics or a subsystem of personnel; it is a system of its own which involves hospitals and supply and maintenance and evacuation and service and management. It reaffirmed in my mind that if you had a system with helicopters, it would be a lot less expensive and a lot more efficient than a system without the helicopters ...... I think that when people look back at what were the significant breakthroughs in Vietnam, they are going to talk about the vascular surgery; they are going to talk about the whole blood distribution, and all like this; but I think the one most important contribution that the Vietnam experience made to the nation is proving the feasibility of using helicopter type evacuation to provide a more efficient medical service. I think we have clearly demonstrated that, and I think that in addition to all of the good surgery that was done and all the other heroic things that were done, that is the one BIG thing that is going to profit the nation (54:32-33). Many problems pilots Initially, and crpwq in were also their encountered to by helicopter casualties. of

attempts

evacuate and

the poor

navigation

equipment

shortage

112

instrument trained pilots made it mountainous often made it terrain of Vietnam.

difficult

to navigate the the weather

Added to that, (22:79).

even more difficult

One problem which continued through the war was the ground unit expectation that the air ambulances would transport the dead. Although there was nothing in the USARV

regulations which authorized this, American soldiers helicopters expected it.

both the ARVN and transport and if the

Nonmedical

often evacuated both dead and wounded

Dust Off helicopters had routinely refused to evacuate dead,

the combat units may have decided to rely exclusively transports for evacuation of both

on their non-medical wounded and dead.

Combat operations might have also suffer-

ed since the ARVN soldiers often would not advance until their dead were evacuated. teams evacuated the dead if of the wounded (22:79-81). The language barrier was also a problem which hindered the work of the helicopter evacuation crew. the wounded evacuated by the crews Almost half of So most helicopter evacuation it did not jeopardize the life

could not speak English

and the crews usually could not speak enough Vietnamese, Korean, or Thai to communicate with the passengers. Even

when an air ambulance unit shared a base with an ARVN unit, the language problem was serious. A former commander of the

254th Detachment recalled an experience: The periodic attacks on the airfield were experiences to behold. Trying to get from our quarters to the 113

airfield was the most dangerous. The Vietnamese soldiers responsible for airfield security didn't speak English and with all the activity in the night vehicles driving wildly about, people on the move. machine gun fire and mortar flares creating wierd lighting and shadows - the guards were confused as to who should be allowed to enter the field and who had no reason to enter. If one could get to the field before the road barriers and automatic weapons were in place all was well. Later than that, one might as well not even try to get on the field. We had several instances of the guards turning our officers back at gunpoint! We tried to get ID cards made but the Vietnamese refused to issue any cards. We sometimes felt we were in more danger trying to get to the airfield during alerts than we were picking up casualties (22:79-81). The pilots and crews present also had to deal with the always More pilots died from

threat of a serious accident.

night and weather The difficulties

induced accidents than from enemy fire. of flying a night mission were many. navigation were not well Roads

and towns used as aids in Terrain,

lighted.

especially the mountains,

became a great danger to instruments. Adequate Many

pilots who lacked adequate navigation

lighting at landing zones was virtually nonexistent. pilots refused to fly night mission while a few, rick Brady, preferred them (22:81-82). danger of being shot was always evacuation crew.

like Pat-

The ever-present

threat for the helicopter aeromedical

Comparing thcir loss rate with the nonmedical crews, the rate was 1.5 times as high. About

helicopter forty

holicopter aviators because of hostile

were killed by hustile fire over the ten years.

fire or crashed Another 180 Hoist

were wounded or injured as a result of hostile fire. 114

missions were always

very dangerous missions.

One out of occur-

every ten hits on aeromedical red on hoist missions.

evacuation helicopters

The standard mission averaged an

enemy hit every 311 trips but hoist missions averaged an enemy hit every 44 missions, dangerous (22:117). approximately seven times as

Another problem for the helicopter pilots was the resentment felt by some of the ground commanders because of evacuations. Even

their inability to control the helicopter

though there was usually a large rank difference pilot and the ground commander,

between the

there were few instancein gettirg direct

when the ground commander succeeded support without first channels (22:120).

going through the proper request

The overclassification cussed earlier, War. This, in

of casualties,

which was dis-

was a continuing problem during the Vietnam conjunction with the lack of proper definipriority, and urgent -

tions of the categories - routine, caused much controversy. the classification, a difficult

Much of the controversy dealt with Most ground commanders had

"priority".

time saying their wounded could wait for 24 which was the time limit for

hours for medical attention, priority patients. lation to read, medical

USARV headquarters

changed the regu-

"Priority:

Patients requiring prompt The precedence will be

care not locally available. is

used when it

anticipated that the patient must be evac115

uated within four hours or else his condition will deteriorate to the degree that he will become an urgent case." such as Major Patrick Brady, thought there He

Some people,

should only be two categories,

urgent and nonurgent.

thought all missions should be flown as urgent, permitting,

resources

and the requestor should be allowed to set his (22:121). of methods

own time limits on nonurgent patients

During evacuations there were two extremes used by the helicopter pilots. paid little

Some like Kelly and Brady

attention to the security of the landing znn. or the time of day. Others were very cautious.

the weather,

The USARV regulation

favored the more cautious approach.

There was much tension between the pilots of the two styles of evacuation. There was no attempt, and it probably would

have done no good, command.

to resolve the tension by any higher

The regulation left the ultimate decision whether aircraft he

to reject or abort a mission up to the individual commander. During, Major Brady's first tour in

Vietnam,

was told that if

he kept taking so many risks he would of Honor, which he did.

either be killed or earn the Medal

Although most pilots did not perform as did Brady or Kelly, thpy did act bravely and honorably and earned widespread respect and gratitude from those who were in Vietnam (22:).

116

V.

Conclusions and Recommendations

The Vietnam War and Korean War were important parts of our country's and military history. played a critical its achievements. role in Aeromedical evacuation

the two wars and can be proud of evac-

This research examined aeromedical played.

uation in

these two wars and the role it

The in-

vestigative questions stated previously were answered in Chapters 3 and 4. This chapter restates those questions

along with brief answers. Investigative 1. war? Both wars divided aeromedical basic categories; forward, evacuation into four and Question Answers evacuation were used in each

What means of aeromedical

intratheater,

intertheater,

domestic aeromedical covered in

evacuation.

Only the first

three were

this research. evacuation in the Korean War was Army and

Forward aeromedical initially

done by Air Force helicopters and crews.

Marine Corps helicopters and crews eventually started aeromedical evacuation missions, also. Helicopter aeromedical was in the Vietnam

evacuation was not done to the extent it War. During the Vietnam War,

Army Dust Off and Medevac

helicopters were the main means of forward aeromedical evacuation. 117

Intratheater aeromedical the Air Force in in

evacuation was accomplished by the Korean War and PACAF

both wars; FEAF in

the Vietnam War. C-46)

The aircraft used by both FEAF (C-54, C-130) were identified and

C-46,

and PACAF (C-118,

described. Intertheater aeromedical lished by the Air Force in and MAC in the Vietnam War. C-141, evacuation was also accompthe Korean War and C-118 used

both wars; MATS in The C-97, C-121,

by MATS and the C-130, discussed. 2.

and C-9A used by MAC were also

What types of injuries were incurred

in

each war? and

Most wounds in

both wars were caused by explosive

fragmentation weapons. explosives, cause grenades,

This category included projectile mines, and bombs. The second highest

for injuries in

both wars was small arms weapons. machine guns, and other

This included bullets from rifles, guns. 3. What types of medical each war?

equipment were used in

air

evacuation in

The medical aeromedical

equipment used by the various stages of The forward aero-

evacuation was different.

medical evacuation medical was absolutely necessary, valuable. fluids, A basic first

equipment consisted of only what since space in the helicopter was intravenous

aid kit, morphine, equipment,

resuscitative

and scalpels and tubes for

tracheotomies were about all that were usually taken. 118

Intratheater and intertheater aeromedical

evacuation

flights had more sophisticated equipment since the flights were longer and it stable condition. facilities was necessary to keep the patients in a

Most aircraft were adapted into medical Others, such as the C-9A, evacuation with

as best they could be.

were designed specifically for aeromedical the latest medical equipment. 4. In each war,

what types of medical personnel were

involved in bilities?

the air evacuation and what were their responsi-

Medical personnel played an important role in successful aeromedical evacuation of casualties in

the both the

Korean War and the Vietnam War. evacuations,

During helicopter forward for loading and unThe medics

medics were responsible

loading the wounded along with the crew chief.

treated the patients often with help from the crew chief. He was also responsible for operating the hoist or giving if the crew chief operated the the medic would who would

directions to the crew chief, hoist.

Once the patients were loaded,

provide the status of the patient to the pilot, pass the information over the radio. In intratheater and intertheater aeromedical in both Korea and Vietnam, were responsible

evacuations

flight nurses and

medical technicians patients.

for the care of since

The flight nurses had many responsibilities

doctors were rarely on the flights. 119

These included caring

for the patients, otomies,

blood transfusions,

emergency trache-

treating shock victims,

and responding to other

emergency conditions.

The medical technicians helped the On many occasions, when

flight nurses perform these tasks.

the load for the medical personnel was too great, crew helped as much as it 5. could.

the flight

What were the organizational structures of the evacuation

agencies given the responsibility of aeromedical in each of the wars? Forward aeromedical

evacuation in both wars was under although during both wars evacu-

the control of medical personnel,

attempts were made to place helicopter aeromedical ation under the auspices of transportation.

This enabled

people with the most knowledge in medicine to make the decisions concerning who should be evacuated and where. Intertheater and intratheater aeromedical was provided by the transportation community, evacuation but care and

determining how evacuees were to be transported was managed by medical personnel. The transportation and medical people

had to and did work together in both wars. 6. How was information necessary for a successful evacuation communicated in each of the wars?

aeromedical

Radios were used for communicating the requirements to the helicopters wars. in forward aeromedical evacuation in both communication to the heliwhich received

During the Korean War,

copters was from the Corps surgeon's office, 120

the information from a MASH unit.

During the Vietnam War,

the unit suffering casualties contacted the helicopter directly if their radio was strong enough. If the radio was

not strong enough, unit's headquarters.

the information came from the requesting

The intertheater and intratheater aeromedical ation in

evacu-

both wars required a good communication system.

Information concerning patient requirements was continually passed between Korea and Japan during the Korean War and Vietnam and Japan during the Vietnam War. personnel, equipment, How much

-and supplies to provide depended upon

this information.

Unscheduled flights presented the biggest evacuation in both

problem for intratheater aeromedical wars.

Over half of the intratheater flights in and were very difficult

both wars

were unscheduled 7.

to plan for. lessons

What were the aeromedical each conflict? in

evacuation

learned in

Demanding situations areas in was first which many

both Korea and Vietnam exposed The helicopter

lessons were learned.

put to medical

evacuation use on a large scale in

the Korean War.

The advantages of using the helicopter over lessons

ground transportation was one of the most valuable learned in expanded in to medical

the Korean War and that lesson was validated and the Vietnam War. The helicopter got the injured a more stable The use of the

care more quickly and in

environment than did ground transportation. 121

helicopter reduced the number of medical medical personnel required,

facilities

and care.

allowing more specialized

Aeromedical

evacuation had an extremely positive effect injured or ill in Korea and care

on those who were wounded, Vietnam.

A feeling of safety existed because medical

would soon be received. Confusion often existed in bilities in both wars as to responsievacuation. To prevent

certain areas of medical responsible

confusion as to who is coordinated theatre bilities

for what,

a thoroughly

plan should identify the responsi-

of each of the military services and the units The plan should be provided to all

within these services.

units so that the responsibilities are well known to all concerned. The great responsibility of aeromedical evacuation

units demands they should be manned and equipped as close to 100 percent of authorization as possible. All aeromedical evacuation units with a similar purpose This would prevent dupli-

should be under a single command. cation of'%fforts,

permit more aircraft to be available, and

prevent confusion and doubt about responsibilities,

allow maximum use of the small numbers of medical personnel available. There is also the need for ground commanders to be

educated so they will realize how important aeromedical evacuation is for them. Although the evacuation 122 of

casualties is

a medical problem,

the ground commander

is For

better off when the casualties have been evacuated. aeromedical

evacuation to be successful the support of the is absolutely necessary. learned in the Korean War applied

ground commanders 8.

Were the lessons in preparing

effectively

for and conducting the Vietnam War? in the Korean War was a the Vietnam War.

The use of the helicopter

lesson that was very effectively applied in

Although the lesson of the helicopters was applied in Vietnam, many details were overlooked. for aeromedical had been in Maintenance and

equipment support Vietnam, just as it

aircraft was lacking in A lack of trained Vietnam, just as as to who

Korea.

medical technicians in Korea.

and nurses existed in

A clear definition of responsibilities, and how, In for aeromedical

could be evacuated exi: ted in Korea.

evacuation units Lessons

Vietnam,

the same was true.

learned from aeromedical

evacuation in

the Korean War were the Vietnam both

for the most part not used as learning tools in War. wars, Although aeromedical it

evacuation was a success in

was through the persistent work and creativity of

people on the scene that the missions were accomplished. Conclusions Aeromedical medical evacuation is a critical part of not only areas of war. aeromedical In

logistics but also the operational

wars similar to the Korean and Vietnam Wars,

123

evacuation is

likely to be the only answer to the problems It should not be thought a

of transportation of casualties.

method of evacuation to be used only when other systems cannot be used. It should be developed and designed as the In addition, the basic

primary method of evacuation.

doctrine should be to move the patient out of the area to a medical facility as soon and quickly as possible rather than facility to the patient. One agency evacuation

to bring the medical should be responsible

for the entire aeromedical

process within the theater.

The advantages to this

organization and responsibility assignment were previously discussed. The Korean War and Vietnam War taught us much about aeromedical evacuation. it In order for that learning to for the future. both the

become lessons If

must be used to prepare

we do not remember and learn from the past,

failures and successes, mistakes that they made. happen.

we are destined for the same We can't afford to permit that to

124

GLOSSARY

AD AECC AES AF AFB ALCC ARVN ASMRO CINCAFPAC

Air Division Aeromedical Evacuation Control Center Aeromedical Evacuation Squadron Air Force Air Force Base Control Center Airlift Army of the Republic of Vietnam Armed Services Medical Regulating Office Commander-in-Chief Army Forces Pacific

CINCFE
CINCPAC

Commander-in-Chief,
Commander-in-Chief,

Far East
Pacific

COMUSNACV
CRO CTZ

Commander,

United States

Military Assistance

Command, Vietnam Carded for Record Only Corps Tactical Zone

DA
EUSAK FEAF

Department of the Army

Eighth United States Army, Far East Air Forces Korea

FEC FEJRY'O JLCOM

JOC KIA LZ MAAG

Far East Command Far East Joint Medical Regulating Office. Japan Logistical
Joint Killed Operations in Action

Command
Center

Landing Zone Military Assistance Military Military Advisory Group

MAAGV
MAC MACV

Military Assistance Advisory Group,

Command Airlift Assistance Command,

Vietnam.

Vietnam

MAES MASH MATS

MES MRO MSC NSA PACAF PACOM

Medical Air Evacuation Squadron Mobile Army Surgical Hospital Military Air Transport Service
Medical Medical Medical Navy Evacuation Squadron Relulating Office(r). SLrvice Corps

Support Activity

Pacific Air Forces Pacific Command 125

ROK RVN RVNAF SEA SG TD TDY USA USAF USARV USASCV USASGV USMACV VC VNAF WIA

Republic of Korea Republic of Vietnam Republic of Vietnam Armed Forces Southeast Asia Surgeon General Table of Distribution Temporary Duty United Stares United States United States United States United States United States Vietnam Army Air Force Army, Vietnam. Army Support Command, Vietnam. Army Support Group, Vietnam. Military Assistance Command,

Viet Cong Vietnamese Air Force Wounded in Action

126

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U.S.

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History Interview

by John

W. Ballard on 3 March 1977, 55. 56. 57. 58.

Brooks AFB TX. Air Force Army Digest,

"New Route Speeds Vietnam Air Evacuation," Times, 26: 7 (10 August 1966). "Lifesaver's Unlimited," Otto, Wayne R. 21: 20-22 (September 1966). Parrish, Vietnam.

12, 20, and 5: A Doctor's Year in John A. New York: E. P. Dutton, 1972.

A History Military Logistics: Peppers, Jerome G. Jr. of United States Military Logistics 1935-1985. Huntsville AL: Logistics Education Foundation Publishing, 1988.

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"Aeromedical Evacuation in Pletcher, Kenneth E. Southeast Asia," Air University Review, 19: 16-29 (March-April 1968). "Praise from UN," (July 1951). USAF Medical Service Digest, 6: 19

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Battle Casualties and Medical Reister, Frank A. Washington DC: Dept of the Army, 1973. Statistics. "Vietnam's Angel of Mercy," Renshaw, Clarence. Infantry, 61: 42-44+ (November-December 1966). Schoeni, A.L. 4-9 (ist 12. "Angels on Pinwheels," Quarter 1953). Sperryscope,

"Air Evacuation - Medical Obligation Smith, Allen D. Air University Quarterly and Military Necessity," Review 6: 98-111 (Summer 1953). ------. "Medical Evacuation and It's Future," The Military Surgeon, 110: 1952). Influence on the 323-332 (May

65.

66.

Memorandum Smith, Allen D. and Charles W. Peterson. on Medical Air Evacuation in a Combat Theater. Operations Branch, Medical Services Plans Division, Office of the Surgeon General, Korea, 20 February 1952. Smith, Arthur M. Proceedings: U.S. (November 88). Stone, Age," 1968). "Safeguarding the Hospital Ships," Naval Institute, 114: 57-65

67.

68.

"Aeromedical Airlift Joins the Jet Irving. 102-105 (March Air Force/Space Digest 51:

70. 71.

Air University "Tactical Air Rescue in Korea," 120-123 (Fall 1953). Quarterly Review, 6: "USAF Hospital Clark and the Tarrow, Arthur B. Air University Review, 18: Vietnam Casualties," (November-December 1966). 85-89

72.

The Story The Greatest Airlift: Thompson, Annis G. Dai-Nippon Printing of Combat Cargo. Tokyo Japan: Company, 1954. History 315th Air DivLiion 315th Air Division. Historical (Combat Cargo) 1 Jan 51 - 30 Jun 51. 315th Air Division (CC) APO 959, 1951. Office. 131

73.

74.

---- . History 315th Air Division (Combat Cargo) I Jul 51 - 31 Dec 51. Historical Office. 315th Air Division (CC) APO 959, 1952. Tilford, Earl H. Search and Rescue in Southeast Asia, 1961-1975. Washington DC: Dept of the Air Force, 1980. U.S. Air Force. The U.S. Air Force Medical Service and the Korean War (1950-1953). Department of the Air Force, Office of the Surgeon General, 22 August 1960. -------. United States Air Force Operations in the Korean Conflict 1 November 1950 - 30 June 1952. Historical Division. Research Studies Institute (AU), Maxwell AFB AL, 1 July 1955. -------. United States Air Force Operations in the Korean Conflict 1 July 1952 - 27 July 1953. Historical Division. Research Studies Institute (AU), Maxwell AFB AL, 1 July 1956. White, M.S., et al. "Results of Early Aero-Medical Evacuation of Vietnam Casualties," Aerospace Medicine, 42: 780-784 (July 1971). ---- . "Medical Aspects of Air Evacuation of Casualties from Southeast Asia," Aerospace Medicine, 39: 1338-1341 (December 1968). Williams, Fenton A. Just Before the Dawn: A Doctor's Experiences in Vietnam. New York: Exposition Press, 1971. Willwerth, James K. (May 1969). Winchester James H. Home from Vietnam,"
1966).

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77.

78.

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"Dust Off! Dust Off!: Lifeline Reader's Digest, 88: 60-66 (May

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132

Vita Captain Fred M. Clingman was born on 2 January 1957 at Tachikawa Wheatland, AFB, Japan. He graduated from high school in

California in

1975 and enlisted in the Air Force. of Professional Florida. He

In 1983 he received the degree of Bachelor Studies from Barry University, Miami

Shores,

received his commission from Officer Training School, Lackland Air Force Base, San Antonio, Texas on 29 February 1984 and was assigned to Minot AFB, officer. While there, North Dakota, as a missile maintenance

he served as the Officer in Charge of

the Scheduling Control Branch, 91st Strategic Missile Wing and the Officer in Charge of the Missile Electrical Branch, Organizational Missile Maintenance Organization. 91st

He earned

a Master of Science in Administration from Central Michigan University in May 1967. Air Force Logistics Institute where he In 1988 he was selected to attend the School the of Systems and

of Technology's was enrolled in

Graduate

Logistics

Management Program. Permanent Address: 5755 Oakwood Drive Marysville, CA 95901

133

UNCLASSIFIED SECURITY CLASSIFICATION OF THIS PAGE Form Approved

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la. REPORT SECURITY CLASSIFICATION UNCLASSIFIED 2a. SECURITY CLASSIFICATION AUTHORITY 2b. DECLASSIFICATION/DOWNGRADING SCHEDULE 4. PERFORMING ORGANIZATION REPORT NUMBER(S) lb. RESTRICTIVE MARKINGS 3. DISTRIBUTION I AVAILABILITY OF REPORT

OMB No. 0704-0188

Approved
distribution

for public
inlimited

release;

S. MONITORING ORGANIZATiON REPORT NUMBER(S)

AFIT/GLM/LS/89S-9
6a. NAME OF PERFORMING ORGANIZATION School of Systems 6b. OFFICE SYMBOL (If applicable) 7a. NAME OF MONITORING ORGANIZATION

and Logisitics
6c. ADDRESS (City, State, and ZIP Code)

AFIT/LSM
7b. ADDRESS (City, State, and ZIP Code)

Air Force Institute of Tecinology Wright-Patterson AFB OH 45433-6583

Ba. NAME OF FUNDING/SPONSORING ORGANIZATION Bc. ADDRESS (City, State, and ZIP Code) 8b. OFFICE SYMBOL (If applicable) 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER

10. SOURCE OF FUNDING NUMBERS PROGRAM ELEMENT NO. PROJECT NO. TASK NO. WORK UNIT ACCESSION NO.

11. TITLE (Include Security Classification)

ANALYSIS

OF AEROMEDICAL

EVACUATION IN THE KOREAN WAR AND VIETNAM WAR Capt, USAF

114. DATE OF REPORT (Year, Month, Day) 15. PAGE COUNT

12. PERSONAL AUTHOR(S)

Fred M.

Clingman,

M.S.,
-Pb.

13a. TYPE OF REPORT

TIME COVERED

MS Thesis
16. SUPPLEMENTARY NOTATION

FROM

TO

1989

September

7146

17.

COSATI CODES -7 CO AI CODE

-S-Rt

_"8. SUBJECT TERMS (Continue on reverse if necessary and identify by block number)

FIELD
15

GROUP

SUB-GROUP

F-Aeromedical Korean War

.-

Evacuation,

Evacuation, Medical,

05

Vietnam War,
19. ABSTRACT (Continue on reverse if necessary and identify by block number) '

Helicopter
?.,f'_

Evacuation
.

Thesis Advisor:

Jerome G. Peppers, Professor Emeritus

Jr.

Appr ved for.ubllc .elease:

IAW AFR 190-1.

LARRY W. EMM LHAIiLt 41, USAF 14 Oct 89 Director of Research and Consultation Air Force Institute of Technology (AU) Wright-Patterson AFB OH 45433-6583
20. DISTRIBUTION/AVAILABILITY OF ABSTRACT EM UNCLASSIFIED/UNLIMITED r:1 SAME AS RPT. 22a. NAME OF RESPONSIBLE INDIVIDUAL 21. ABSTRACT SECURITY CLASSIFICATION r DTIC USERS

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Jerome G. Peppers, DD Form 1473, JUN 86

Jr.

(513)
Previous editionsare obsolete.

878-7068

AFIT/LS

SECURITY CLASSIFICATION OF THIS PAGE

UNCLASSIFIED

UNCLASSIFIED This study examined aeromedical evacuation during the Korean War and the Vietnam War. The two wars, the Korean and the Vietnam, are the most recent in our country's history, and will most likely be the type of conflict we as a nation will be committed to in the future. The purpose of this research was to identify and describe the major logistics and operational factors of aeromedical evacuation in the Korean War and the Vietnam War. The identification of

successful

logistic activities in aeromedical evacuation in

each of these wars permits a comparison between the wars. The description and identification of factors and the comparison between the wars provides insight to problems that may be encountered in future conflicts. From the study of past experience in these two wars we can learn from the mistakes and successes and avoid the same problems in the future. Chapter III examined aeromedical evacuation in the Korean War. This includes forward aeromedical evacuation, intratheater aeromedical evacuation and intertheater aeromedical evacuation. Chapter IV examined aeromedical evacuation in the Vietnam War. The military services examined in this chapter are the Air Force, Army, and Navy. Chapter V compares and contrasts methods of aeromedical evacuation used in each war. The chapter closes with conclusions based on the comparisons and provides recommendations to improve, and prepare for, aeromedical evacuation in future wars. Z.

UNCLASSIFIED