Dust Off Army Aeromedical Evacuation in Vietnam

8/9/2019 Dust Off Army Aeromedical Evacuation in Vietnam

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O


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DUST

OFF

RMY AEROMEDICAL

EVACUATION

IN

VIETN M

y

Peter Dorland

and

Jam es Nanney

MIUTAR r INSTRVCTICtII

CENTER OF M ILIT RY HISTORY

UN ITED ST TES

RMY

WASHINGTON D c. 2008


4/148

Library

of

Congress Catalo

ging in Publicati

on

Data

Dorland , Peter, 1946-

Dust Ofr.

Bibliography: p.

I ncludes index.

1. Vietnamese Con fli ct 196 1- 197 - Medical and sa nitary affairs. 2

V iemamese Con

fli

ct 196 1- 197 - Ae rial opera

ti

ons American. I Nan ney.

J a mes, 1945-

II.

Ce

nter

of

Military

Hi

story

U.S.)

III.

Titl

e.

OS559.44.067 1982 959.704 37 82-8858

AACR

First Prin«d 1982-

CM

H Pub 90- 28- 1

For sale by e

Superintendent

of Docwnents

U.S. Government

Printing Office

Interne

t:

bookstoce.gpo.gov Phone: toll fcee (866) 512-1800; De area (202) 512-1800

Fax: (202) 512-2104 Mail: Stop

IDee

Washington. De 20402-000 1

ISBN 978-0-16 -075478-4


5/148

Foreword

From

th

e whealfields of the Civil

War

lo

the

jung l

es

and paddi

es

of

Vielman

,

th

e Uniled

Slales

Army has led

the world

in adapling mod ern

transport tec

hnology

to the humanilar

-ian

goa l o f saving

the liv

es o f th e

sick

and wounded. Drawing on

its first experiments

wi th

heli

co pt

e rs in

Korea , the Army in

Vietnam came

to rely al

most

entire ly

on

the

he licopler for medical evacualion, The Dusl OIT and Medevac helicop

t

er

ambu

l

ance

units

tested

and

pe

rfected for

medical u

se the

Army's

ne w hc licopler, the

UH-

I ( Huey

Iroquois)

, and developed

severa

l

new

devi

ces, especially the hoist that helped

save

tho usands of

American

and allied lives belween 1962 and 1973, The pilolS of lh

ese

heli

copter

ambu lances

disp

l

ayed

a

co

urage

and

devotion to dUly tha t

earned them

widespread

re

spect

from so

ldi

ers

in

Vi

e

tnam.

T his book c

hroni

cles th e

ea

rl y

probl

ems

of

medica l evacuatio n in

Vie tnam , recounts the valor of

seve

ral of the Du st OfT crews, and

describes th e procedures and equipment used to sp

ee

d the moveme lll

of

patient

s LO

in-theat

e r Arm y hospi tal s. Il a lso shows the effect that

lhe helico

pl

cr

had

on lradiliona l Army pro

ce

dur

es dalin

g back lO lhe

Civil War. t sho

uld

inte r

es

t anyone

co

n

cern

ed with Army medical

hi sLO ry th e Vie tnam \tV a

I

, or the problem of adm iniste ring medical

ca re in war o r in tim

es

of civilian

disasters. The

widespread

use of th

e

helico pter for rnedica l evacuation in America since the Vietnam War

testifies

O

th e

broad

er iss ues raised by this s

tud

y and of the relevance

of Arm y his tory to the civilian

commu

nity. t is grat ifying thal the

d

emand

f

or

thi s work

justifies

thi s

new

reprint.

vV as hing to n , D.C.

22 May 1984

DOUGLAS KINNARD

Brigadier Genera l, U,S,A , (ReL)

Chief of

Mi

li lary HiSlory


6/148


7/148

Preface

During a tour wit h

The Histor

ica l Un it ,

U.S. Army

Medical

Depart

-

ment

, ForI Detr ick,

Maryland,

from 1974 101977, Pe

terG.

Do rla n

d,

then a

ca

ptain

a nd a former Dust Ofr pilot in Viet nam,

comp

l

eted

the basic

r

esearch fo

r thi s book a nd drafted a len gth y manu script. In th e li rsl seve n

months of 198 1, as a n ed itor a t the U.S. A

rm

y

Cente

r

of

Military

Hi

story

CM

H ), Washingto n,

D.C

., I co nductcd furt her resea rch o n Du st

O

,

r

eo

r

gan

ized a nd r

cd

r

artcd

ponions

or

the

orig

ina l

manu

script ,

and

added

C hapter 4 a nd the Ep ilogue.

T he

au t

ho rs

accumu

lated a store of debt s, bOlh a t Fort De trick and

Washingto n . Albert E Cowd rey, ch ie f

0

1 the

Medi

ca l Hi slO ry Branch

eM

H , supervised the project , improv ing the manusc

ri

pt s prose

and

organ

i

zation

in many places,

and saw

th at

the

revisio n received a review by

othe r

hi

sto

rian

s

at

the

Center:

Stanley L. Falk ,

George L. Mac

Garrig le, and

Jeffrey G reenhut. Col. James W . Dun n s cr iti

ca

l eye a lso

impr

oved

the

substance

of

the book . T he final ed it ing a nd prepa ration of the book for

pub lication was the work of Edith M. Boldan . Arthur S. Hard yman helped

design the cove r a nd the map.

Others

at the

Center

who respond ed

to

frequent pleas for assistance were

Charles

S impson,

Co l Ma

ry

Van Ham

,

Charles

E

ll

sworth ,

Geraldine

Ju

dk ins,

Mary

Gillett, Dwight

Oland,

Graham Cosmas, V in

cen

t Demma,

J e ffrey C la rke,

and

my coworke rs in the Ed

it

oria l Bra nch .

Without

the

help of

the

se man y peop le, Peter Dorland and I could no t

h

ave

produced this book. T he autho rs, of co urse, accept sole responsibil ity

for any e

rror

s.

Wash ington , D.C.

1

a

nu a ry 1982

J

AMES NANNEY

v


8/148

The Authors

Peter G. Do

rl

a nd received a bachelo r s degree in biology from Amherst

College. From Apri l 197 1 to Apri l 1972 he served in V ietnam as an Army

lie ut

ena

nt flying helicopte r ambulance miss ions for Eagle Dust r of the

101s1

Airborn

e Division (Ai rm obile) . From 1974 to 1977 he worked on thi s

manu

script at Fort De tri ck, Maryla nd , f r the

Arm

y M

ed

ica l Depa rtm ent.

He then returned to

fl

ying duties, and is c

urr

ently com m

and

ing .

as

a majo r,

the 247t h Med ical De tachment

at

Fo

ri

Ir win , Ca liforn ia .

Jam es

S

Na nn ey rece ived

hi

s B.A ., M .A ., and Ph .D. degrees from

Vanderbilt U niversi ty.

Hi

s fields were Ame

ri ca

n diploma tic history

and

Ru s-

sia n histo ry. From 1974 to 1980 he worked as a research associate for the

George C. M a rsha ll R esearch

Foundat

io n, helpin g Dr . For res t C. Pogue ex

am ine the postwa r ca ree l- of Ge neral Marsha ll as Secrc tary o f S ta te and

Secr

eta

ry of

Def

ense. In 1977 -78, he took a year s leave of absence from the

Foundat

io n

10

teach Ru ssian and rece nt U.S. history at Mu

rray

Stale U nive r

s

it

y.

Mu rr

a y, Ke

ntuck

y. Si nce

Novem

be r

1980

he has b

ec

n a me

mb

er

of

the

staff o f the Ce nte r of Military

Hi

s t

ory.

He is c

urr

entl y work ing o n the up

dating

of Ameri

can l

ita

ry

lis

to

ry

VI


9/148

hapteT

I.

II.

III.

IV .

Contents

THE EARLY YEARS

Early Medical Evacuation

Early Aeromedica l Evacuation

The Korean War .

BIRTH

OF A TRADITION

The

Struggle

Be

gins. . . . . . .

The

First Air Ambulance Unit in Vietnam . . .

Dust OffTakes

Form .

R elations with the

South Viet namese .

Ke

ll

y a nd the

Dust Off

Mystique .

A New Buildup . . . . . . . . . . . . . .. .

. . . . . .

The

Cr

isis Deepens . . . • . . .

. .

THE SYSTEM MATURES

.

age

3

4

6

1

2 1

23

24

28

30

32

38

4

43

Origins of the Air Ambulance Pla

to

on . . . . . . . . . . 44

The

Air Ambu lance Platoon Goes to W

or

k . . . 46

The

Med ica l

Company

(Air

Ambu

la nce). .

49

The 436th

Medi

ca l Company (Provisional) . 52

ATTL E

BORO

. . . . . . • .

53

The 45th Medica l

Company

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

55

The

Buildup

of

1967 . . . . . . . . . . . . . . . . . . . . . . 56

Ri verin e

Operations

. '

57

l l i k h .

..

The

54th and the Kelly Tradition. . . . . . . . . . . . .

. .

61

Dust

Off

Win

s It s First M

eda

l

of

H

onor.

. . . . . . . 63

Dust Off

in the

Saddle

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

..

66

THE

PILOT

AT

WORK . . . . . . .

The

UH 1 Iroquois ( Huey ) . . .

The

Hoist .

.

Evacuation ssions

Evacuat ion Problems

.

Enemy Fire . . . . . . . . . . . .

A Turn ing Point . .

•

. .

67

67

7

74

79

84

88

VII


10/148

hapttr

v FROM TET TO STAND DO

W N

TET 1968 . . . . . .

The Drawdown Be

gin

s.

A Second Medal or Honor .

VNAF Du

st O

fr

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

Cambodia . . . . . .

. . . .

A Medevac in Per il

. .

Laos.

Papa

Whi

skey . . . .

Stand

Down and

Ship Out

EP ILOGUE .

Sta

stics

Doctrine and Lessons Learned

. .

A Hi storica l Perspective . . .

BIBLIOGRAP

HICAL NOTE

. . . .

INDEX . .

MAP

. . . .

VIII

Articles

Books and St udies . . . . . . . . . . . . .

. . .

. .

. . . . . .

. . .

89

89

94

96

98

1 1

1 2

106

11 0

3

11 5

11 5

11

7

121

1

25

1

25

1

27

129

2


11/148

DUST

OFF

ARMY

AEROMEDICAL

EVACUATION

IN VIETNAM


12/148

~ Camp Evans

Kh. S nh

o

~ MDHA

Of}

HU

0;:;

PhU

8a;

~ p

Eagle

571d

·

lHA

Eag le

DUlt

Off

r D

Nlmg

326th Med Battalion

236th

MOHA

10lst Airborne Dlv \

(Alrm bile)

c

k

I CORPS Chu o f

54th MDHA

68th MDHA

AIR AMBULANCE UNITS

IN VIETNAM

3 December 1969

?

o

6 0

1yO

Miles

50 1 Kilometers

PlfJ iku

0

283d MOHA

Qui Nhon

498th MCHA

[[ CORPS

Air

Ambulunce

Platoon

15th Mod

Buttalion Phuoc

tat Cuv Dlv

(Airmobile)

Vinh

0

LO

;

Khfl

Cu

hi

o

7th

MDHA

lS9th ~ H

® a long Binh

Binh Thuy

Naval

Base

0

8 d

MDHA

S IGON

45th

MCHA

Soc

Trtm9

~

IV CORPS

Phan Rang

247th

MDHA


13/148

CHAPTER I

The Early Years

The sma ll outpost in the Vietna mese delta stood a vigilan t watch.

For the past tw ent y-four hours guerr illa soldiers had ha rassed its

defe

nder

s with occas ional mortar rounds a nd small arms fire. A rad io

ca

ll

for help h

ad

brought

ghter

-bombe

rs a nd a spotte r plane to

tr

y to

dis l

odge

the

enemy

from foxholes a

nd

bunkers they

had

built

during

the night. But neither the

ae

rial

obse

rver n

or

the

men

in the outpost

cou ld detect the Commu nist soldiers in their concealed positions. At

dawn

the outpost

comma

nder

ca

lled off his a lert a nd reduced the

number

of

perimeter gua rd s. Then he led a patrol out to su rvey the

a rea.

No

soone r had they le ft their defenses than the enemy opened

fire . Two of the soldiers fell bad ly wounded a nd the rest scrambled

back to the sa fety of their perimeter dragging their casualties wit h

them.

While

the medical corp

sme

n tr

eated

the wou nded a radio

telephone operator

ca

lled their headq u

arte

rs to the east at C ia Lam.

There

w h

en

the request for m

ed

ica l

evacuatio

n came

in

th e

duty

pilot ran to hi s

wa

itin g he

li

co pter and in

minutes was

a irbo

rn

e. Hi s

opera tions officer had told him that the

pickup

zone was insecure a nd

th at gunship s

wou

ld cover

him

.

Sin

ce there were f

ew

hel ico pter am-

bu lances in the thea ter this

fli

ght wou ld be a lon g on

e:

forty- ve

minutes eac

h way. After

taking

o

ff

the pilots r

ad

ioed the gu nships

and

confirmed the time

and

place of rendezvous.

On

his

map

he trac

ed his route

out

across the

paddied

l

andscape

broken

on

ly by a n oc

casio nal v ill

age

h

am

le t o r barbed wire

camp.

Five m i

nut

es from the beseiged o

utp

ost the flight l

ea

der of the

gun ship team radioed the air ambu lance that they had him in sight

a nd were closing on him . Wh ile the

ambu

la nce pilot pla nn ed his ap

proach the gunships

made

strafing runs over the outpost to keep the

enemy

dow n.

The

outpost

commande

r

marked

his pickup zone with a

smoke gre nade

and

the a

mbulance

pilot circl

ed

down

to it fr

om

high

overh

ead

. As soon as he

landed

he shou t

ed

at the grou nd troops to

load the wounded before a mortar hit him .

Once

the patients were

secured the pilot sped out of the

area

a nd h

ea

ded towa rd Lanessan

Ho

spita l radioin g

ahead

to report his est imated time of arr iva

l

Litter

bearers from the hospital wai ted to ru sh the casua lties in to the

emergency room as soon as the helicopter touched down.


14/148

4 D UST O FF ARM Y A ERO M EDI

CA

L EVACUAT ION I N V I ET NAM

The a rea where this mi

ss

ion took pl ace was the R ed Ri ver Delt a

in

no rthern

Vi

e tnam . Cia Lam

wa

s the airfie ld serv in g Hanoi from

across the Doumer Bridge s

pann

ing the Red

Riv

e

r.

The de lCnd ers o f

the

outpo

st we re the French in the early

19

50s

.

By the end of 1953

th

e French in Ind

oc hina we

re us

ing

e ight

ee

n medica l

evac

ua tio n

helicopters .

From

April 1950 through ea rly 1954 French a ll

ambulances evacuated about fi ve

th

ousand cas ua lti es.

In these same years the V .S. Arm y whi ch had used a few

he licopters for medical evac

uation

a t the end of World W ar II ,

empl

oye

d helicopter ambu lances

on

a large r sca le, transpo rtin g so me

17, 700 V.S. casualties of the

Kor

ean War. Several y

ear

s later in the

Vietnam War it used helicopter

ambu

lan ces to move a lmost 900 ,000

V .S.

and

a

lli

ed sick a

nd

w

ound

ed.

The

ae

rom

edica l evacua

ti

on

techniques deve lo ped

in th

ese wars opened a new era

in th

e

tr

ea tment

of emergency patients. With their ability to land on almost a ny ter

ra in , heli

co

pters ca n

save

prec ious

minut

es th at o ften m

ea

n the d if

ference betwee n life and de

ath.

T oday ma ny civilia n medical and

d isaster re lief agencies rely on helicopter ambula nces. For the pas t

thirt

y years the

V.

S. Army has played a leadin g role

in

the develop

ment of this new technology.

arly M ed ical v cuation

Although surgeons often accompanied the profe

ss

iona l a rmies of

th e e ightee nth ce ntury, th e la r

ge

c iti

ze

n armies of the

ea

rly nine

teenth century, wh

ose

batt les oftcn produ ced mass ive cas ualties,

dem

anded and received the first effective systems

of

medi

ca

l evacua

tion. Two

of

the officers o f Napoleon Bona parte, the Ba rons Domini

que J

ea

n La

rr

ey and Pie

rr

e Francois Percy, des igned light, we ll

s

prun

g c

arri

ages for swift evacuation of the wo

und

ed .

Na

poleon saw

tha t each of his di visions rece ived a n a mbulance corps of abou t 170

men, headed by a chief s

ur

geon a nd equipped with the new horse

drawn ca rri ages. O ther continenta l po wers quickly adapted the

French system to th e ir own

need

s, but th e Brilish and America n

a rmies lagged a fu

ll

ha lf ce

ntur

y in learning the medical lessons of the

Na poleonic era.

In the Seminole W ar of

18

35-42 in Florida, the

V.S.

A

rm

y

M edical D epartme

nt

ex

perimented with ho rse-draw n ambul ances

and reco

mm

ended their adoption by the A rmy. But the Depa rtment

apparentl y got no res ponse. A f

ew

years later

ex

periments

we

re re

s

um

ed , and a four-wheeled ambulance proved success ful in the West.

But by the outbreak of the C ivil Wa r in April 1861 the Army had ac-

'This incide

nt is rel

atcd by Va ler

ie A n d

a Frcnch Air Force medica l pilot who new in

In dochi na. in her anic le L H sa

ni

ta

ir

e en Indoch ine, I. Officier

de R

tJertlt

\ 0 1 2

pp 30-3 1


15/148

THE E RL Y YE RS 5

quired more two-wheeled th an four-wheeled ambu lances, and even

these were in short

supp

l

y.

In 1862 a nd 1863 scarce ambulances , poorly

trained s

tr

e tch er bearers, and unruly ambu lance d

ri

vers greatly

hind

ered the M edical Department s efforts to care for the wou nded.

Ambulances were so scarce that after the first major battle of the war at

Bull Run (2 1July 186 1) many

of

the 1,000 Union wounded depended

on friends

and

rela

ti

ves to pick them up in a family ca rriage. Man y

more simply str

agg

led the twenty-five mi les

ba

ck to W as hington on

foot. Three days after the battle hundreds of wou nd

ed

st

ill

lay where

they had fa llen. The stretcher bea rers co nsisted almos t

en

tirely of

me

mb

ers of milita ry bands who had been assigned the duty. As one

historia n noted, ... sc

rubbing

blood- soaked noors

and

tables, dis

posing of

dirt

y scabby bandages and carry

in

g bleed

in

g, she

ll

-shocked

soldiers h

ad

nothing to do with music, accordin gly the impressed musi

cians ed

th

e scen

e.

At the second battle of Bull Run (29 August 1862) the large

number

of civ

ili

an drifters hired by the

Quartermaster Co

rps to drive the am

bulances simply ned the scene at the first few shots. T he

Sur

geon

General quickly rounded up about two hundred more vehicles from the

streets of Washington and accepted civi lian volunteer drivers, who proved

to be worse than the first lot. M a ny broke into the med icine cabinets on the

ambu la nces, drank the liquorsupply, then d isappeared.

Those

who made

their way to Bull

Run

were found stealing bl ankets and

ot

her provisions,

and some even took

to

rining the pockets of the d

ea

d and dying.

Over the co

ur

se of the war, however,

th

e Union system ma

rk

e

dl

y

improved, thanks to the e

ff

orts of M aj . Jonat han Letterman, Medical

Director of the Army of the Potoma

c.

Letterma n reco

mm

ended sweep

ing reform s

in th

e ambulance system and the crea

ti

on of an orde

rl

y

group of med ical clear ing stations to the immed iate rear of each bat

tl

e

fr

ont.

The

mi

ss

ion

of

the a

mbulan

ces was to bring a

ll

casualties

to

the

clearing stat ions as rapidly as po

ss

ible. The station would then sort the

casualties, a proce

ss

known

as

triage. As soon as poss

ibl

e

th

e s

ur

geons

we

nt

to

work

on the serious casualties whom

th

ey deemed savable and

se

nt th

em to hospitals

in

the rear.

Th

e most se riously wounded were

often set aside,

many

to die before they reached the operat

in

g table. The

li

ghtly wounded were treated l

ater and

retained ncar the fronl. wo

goals suffu sed Letterman s new system: to reduce the tim e between

wounding a nd lifesav ing (definitive) surgery, and to evacuate a casualty

no farther to the rea r th

an

hi

s wounds demanded. T

hi

s wou ld result in a

hi

erarchy of medical selv ices, a chain

of

evacua

ti

on

that

ca

rried

a patient

to more specia

li

zed care the fa

rther

he moved

fi ln the

front.

On 2 August 1862 Maj.

Gen.

George B. M cC lellan ordered that

Lette

rman

s plan be

placed

into effect in the

Army

of

the Potomac

.

Ambulances were to be used on ly for the

tran

sport of sick or wounded

soldiers . Stretcher-b

ea

rers and hospita l stewards were to

wear

dist inc


16/148

6

DUST OFF ARMY

AEROMED CAL

EVACUAT

ON N V

ETNAM

live insi

gn

ia on their uniforms. Ambulances were to move at

t

e head

of a ll wagon trains, not the rear. On ly medical

cor

psmen were to be

a llowed to remove the wounded from the battlefield . Al

though

a m

bulances horses and harnesses were to be under divi sion con trol all

am

bulanc

e

driver

s were to be

und

er M

ed

ical

Department

control,

trained

for their work,

and

not a llowed to assume other duties such as

ass i

sting

surgeons in the field hospita ls. They were also expect

ed

to be

of

proven

good character. In March 1864

President

Lincoln

approved

a congress ional

act creat

ing a uniform

ed

Ambulance Corps, based on

Letterman s pla n , for the entire Army of the United

States

.

Alth ough the Ambulance Corps was

disbanded

at the end of the

war, it had served

remar

k

ab

ly well when it was needed . The Medical

epartment

during the war had never

overcome

seri

ous

problems in

the supply

of

medicine

and

the cons

tru

ction

of

field hospital

s

But its

numerous horse-drawn ambulances had effectively removed the

wounded from the battlefields, even during the massive conflict

at

Gettysb

urg

In

the

Spanish

-Amer ican War and

Wor

ld War I , the U.S . Army

had to relea rn many of the medical lessons of the C ivi l War. By

World W ar I ground evacuat ion of cas ua lties could be accomplished

by motor-driven ambu lances, but the increased speed was offset to

some degree by limited road access to the widely dispersed front lines

in

France and

the Low

Countr

ies.

World War

s I

and

II show

ed that

automotive transport,

while effect ive for

backhau

ls from

clearing

sta

tions to field hospitals and

evacuation

hosp itals , was of limited value

in

evacuating

cas ualties from the spot where they fell.

Early eromedical Evacuation

The

first aeromedical evacuation occurred in the Franco-Prussian

War

of

1870-71. During

the German seige of Paris, observation

balloons flew out of the city with

many

bags

of

mail, a

few

high

ranking officials, and 160 casualties . Thirty-three years l

ater

at

Kitty

Hawk,

North Carolina,

Wilbur

and Orville Wright proved that

manned, engine-powered flight in heavier-than-air craft was actua lly

possible.

In

1908 the War

Department

awarded a contract to the

Wright

Brothers for the Army s first a irpl

ane,

and in July 1909

accepted their product.

Two

enterprising Army

officers quickly noted the medica l poten

tial of such aircraft.

At

Pensacola, Florida, in the autumn of 1909,

Capt.

George H.

R . Gosman, Medical

Corps, and

Lt. Albert

L

Rhoades, Coast Artillery Corps, used their own

money

to construct a

strange- looking craft in which the pilot, who was also to be a doctor,

sat

beside

the

patient.

On

its first powered flight the plane crashed into

a tree. Lacking the funds to continue the project,

Captain

Gosman


17/148

TH

E I

::A

RLY Y EA RS

7

went

to

W ashington

to se

ek money from the W ar Depa

rtm

ent. H e

told one conference: I clearl y see tha t thousand s of ho

ur

s and

ultima tely thousa nds of patients would be saved

thr

ough use of

a irp lanes in a

ir

evacuatio

n.

But his audience thought the

id

ea im-

pr

ac

ti

ca

l

In

May 19 12 other m

ili

tar

y av ia tors reco

mm

e

nd

ed the use

of a ir a

mbu

lances to the Secreta ry of W a r, but the W a r Dep

art

ment

still thought airplanes

un

suitable for such a mi

ss

ion .

Durin

g W orld

W ar I

Arm

y Avi

at

ion grew st

ea

d ily,

but it

s planes served as air am

bu l

an

ces only sp

ora

dica

ll

y.

As they had with gr

ound ambu

la nces, the French pioneered the

use of a irpla nes as a mbula nces. During maneuvers in 1912 a n

a irp lane helped stretcher pa rt ies on the ground locate simu lated

cas ualties.

Th

e

Fr

ench then des igned a monoplane with a box-like

structure under its fuselage for moving casual

ti

es to

field hospitals In

Octo

ber 1913 a French milita ry officer reported ,

W

e sha ll revolu

ti

onize war s

ur

gery if the aeropla ne ca n be adop ted as a means of

tra nsport f

or

the wo

und

ed .

Du

ring

World

W a r I the French d id

occas iona lly move the wo

und

ed by a irpla ne , especia lly in Nove mb

er

1915

durin

g the r

et

rea t

of

the Serbi a n

Ar

my from a combined

German,

Austrian , a nd Bulga ria n attack in Alba

ni

a. Although the type of a ir

craft used in Alb

an

ia was ad

eq

ua te in t

hi

s isol

ate

d emergency, it was

hardly fit for rout ine use on the W estern Fron t

For the rest of the war the French

Army

gave li ttle atten tion

to

aeromed i

ca

l evacu

at

ion; they had too many cas ualties and too few

air

cra

ft to be concern ed with i

t

B

ut

one F rench military

surgeon,

Dr.

Eugene C hassaing, managed to keep the idea a live.

Wh

en he first

asked f

or

money to build air a

mbu

lances, one officer respo

nd

ed , Are

there not

eno

ugh d ead in Fra nce today without killing the wounded in

airp lanes? espi

te

such cr iticism, C hassai

ng

acquired an old

Do

rl

and

A.

R.

II figh

ter

an

d des igned a side

open

i

ng

th

at

a

ll

owed two

stretchers

to

be carried in the empty space of the

fu

se lage behind

th

e

pilot.

After

several test

fl

ights of the craft, he was perm itted to place six

such aircraft into operation.

In

Apri l 1918 two of these planes helped in

the evacuations from Flanders, but the fighting grew so intense there

that French higher authorities would

not

sanction continued use of the

planes. Late in

19

18

Dr. Chassaing

received permission to convert

sixt y four a irp lanes in Morocco into air ambu lances. and all were

used in that co untry in France's war against Riflian and Berber

tribesmen

in

the At las mountains. The French experimented with a

ir

ambulances throu ghout the interwar pe

ri

od.

By the end of World War I the U.S.

Army

had also begun

to

re

exa

mine its position on a ir ambulances. In 1920 the Army built

and

ew its l

ir

st a ircra ft de signed as

an air

a mbu la nce,

th

e

DeHavi

ll

and

DH-4A, which had space lor a pilot, two litter pat ients, a nd a medica l

a ttendant. In 1924 the

Army

let its lirst contrac ts lo r a ir ambula nces,


18/148

8

DUST O F

F

RMY AERO M EDI

CAL

EVACUATION I N V IETNAM

and

in th

e nex t f

ew

yea rs

it

occas iona lly used its a

ir

ambulances to

p r ~

vide d i

saste

r re lief lO th e civili an community. In April 1927 afte r a tor

nado struck the sma

ll

town of Rocksprings, Texas the Arm y sent eigh

tee n

DH

-4

obse rva tion pl anes, two Douglass transport s and a Cox

Klemin

XA

-I

air

am

bul ance. T hese

pl

anes new in phys icia ns and su

p

plies to trea t 200 injured citize ns, some of whom the Cox- Klem in then

fl

ew ou t to mo rc sop

hi

sticated medical care in Sa n Antoni o.

Th

e decade a

ft

er the wa r a lso saw the development of rotary-wing

a ircra ft.

In

December 1928 the U nited States received

from Fra

nce its

first sampl e of a ro tary-w in g aircraft- the autogiro w

hi

ch used one

mo tor-drive n prope ller for forward mo

ti

on and another wi nd-d riven

pr

opeller for verti cal lift. By 1933 one U.S. manufac tur

er

had des ign

ed an

aU

g

ir

o

ambulance to ca

rr

y a pilo t and thr

ee

pa

ti

e

nt

s t

wo

rec

umb

ent in wire basket (S tokes) litters, a nd one sitt ing.

In

the

Dece

mb

er 1933 issue of the

l t

ary

Surgeon

L

t. Co

l.

G.

P. Lawrence

fo resaw

th

e mili ta ry uses of this air ambulance. S in ce

th

e aut

og

iro

could no t h

ove

r rough terrain fores ts and

swa

mps

wo

uld still re

qui re ground

evac

ua tion o f cas ualties . Bu t autogiros working from

nea rby landing areas could back haul the cas ua lties to medical sta

tions. The adva ntages see med indisputable:

AUlOg

iros not being limi ted by roads wou ld f

i.nd

more

fre

que

nt

op ponunities to open advanced landing posts than wou

ld

motor ambulances.

They could maneuver and dodge behind cover so

as to

make hits by enemy

artillery qu ite improbabl e. At nig

ht

they could potter around in the dark, un

disturbed by a

im

ed enemy fi re until they accura tely loca ted the land ing

place ou tl ined by ordi nal y elec

tri

c flas h

li

ght s in the hands of the co llect i

ng

co m

pa

ny and then land so ge

ntl

y

th

at the exact est imatio n of altitude wo

ul

d

be imm ate

ri

al.

In

1936 the Medical Field Se rvice School a t

Ca

rli

sle Ba

rr

acks, P

en

n

sylva nia tes ted

th

e medica l

evac

ua tion abilities of

th

e aut

og ir

o.

T hough the r

es

ults were pro

mi

sin

g

the Army s budgeta ry problems

pr

eve

nted fundin g a ro tary-w in g medical evacuat ion uni

t.

W orld

War

II broug

ht

the first widespread use

of fix

ed-wing a ir

c

ra

ft for milita ry medical evac

uation

. In M ay 1942 the Army M edical

Service activated the first U .S. ae romedical evacua tion unit, the 38th

Medi

cal

Air

Ambulan

ce Squadron stationed at Fort Benning,

eorgia.

Th

e war also stimulated further research on rota

ry

-wing air-

cra ft , both in Germany and the

United

S ta tes . Although Allied bomb

ing raids destroyed the fac tories that the G ermans inte

nd

ed to use for

helicopter production, research and development in the United Sta tes

pro

ceeded apace. On 20 April 1942 Ig

or

Sikorsky staged a successful

nig

ht

demonstration of his helic

opt

er. By M a rch 1943

th

e Army had

ordered thirt

y-

four Sikorsky helicopters, fifteen for the U .S. Army

Air

Forces , fifteen for the British, and four

fo

r the U .S. Navy. T hese a nd


19/148

T H E RLY Y RS

9

la ter versions of the Sikorsky could be

qui

ckly converted to air

a

mbul

ance use by attaching litters to the sides of the a ircraft

T ests at the

Arm

y M a teriel Ce

nt

er in the s

umm

er of 1943 su

g-

gested that the helicopter could be a n effective

air

ambula nce. O n 13

Augu

st 1943 the Army Surgeon sta ted tha t he intended to fill the need

for a complete a

ir

evacuation service

in

combat zones by employ

in

g

helicopters, regardless of terra in features, as the only means of

evacuation from front lines to advanced airdomes. Further successful

tests of the litter-b

ea

ring he licopter in November 1943 s

upp

orted h is

decision . But he licopters we

re

not yet uundant and

th

e Surgeon s

plan c

ame

to nothin

g

The he

li

copter nevertheless

mana

ged to prove its va lue as a dev

ce

for rescue and medic

al

evacuation from fo

rw

a

rd

combat areas. In late

April 1944, L t Ca rt

er

H arma n, one of the first Army Air Forces

pilots

tr

a ined in helicopters a t the Sikorsky pla nt in Br idgeport, Con

necticut , flew for the 1st Air Comma

nd

o Force, U .S.

Arm

y Air

Forces, in

Indi

a.

On

23 April he took one of his unit s new li tter-

bea ring Sikorskys to pick

up

a stra

nd

ed pa rty with casualties about

twenty-fiv e kilometers west

of

M awlu ,

Burma

.

Wh

en he re

turn

ed

to

Indi

a he

had fl

o

wn

the U .S. Army s first he

li

c

opt

er medi

ca

l evacua

tion

m

ede

va

c) mission . Soon he

li

copters became

an

item in

hi

gh de

mand . M aj . Gen. George E . Stra temeye r , commander of the Eastern

Air Comma nd , re

qu

ested six of them for the rescue of five of his pilots

who had cra shed

in in

accessible areas and for similar rescue missions.

In

the spring of 1945 helicopters evacuated the sick a

nd

wounded of

the 112th R egimental C

omb

a t T eam

and

the 3

8th Inf

antry Division

from remote mounta

in

siles on

th

e island of Luzon

in th

e Philippines.

Mo

st evacuation from the fro

nt

lines in W orld War II, howeve r,

w

as

by conventional g

round ambul

ance. T he

Arm

y M edical Service

did

imp

rove its services, grea tly re

du

cing the mor

ta

lity ra tes from th ose

of W orld W ar 1 New drugs , such as penicillin and the sulfonamides,

a nd the stationing of maj or surgical facilities close to the front line,

saved

hundred

s of thousands of lives. Airplanes evacuated over 1. 5

million casualties , far more

than

in World War I , but this role was

largely limited

to

tra nsporting casualties from frontline hospita ls to

restora tive and recuperative hospitals in

th

e rea

r,

ra ther

th

an from

th

e

site of wo

undin

g to life-saving s

ur

gica l care. At

th

e e

nd

of the war Army

ae

romedical

eva

cuation still lacked a coherent system of regulations

and a standing organ izat i

ona

l base. Before it cou ld acquire th ese, Army

aviation would have to s

ur

vive the upheaval a ttending the

creat

ion of

the United Sta tes

Air

Fo rce .

The National Security Act of 1947 established the Uni ted States

Air Force as a sepa rate military arm a

nd

a t the same

tim

e stripped the

Army of most of its aircraft, l

ea

ving it only abo

ut

two hundred light

pla nes a

nd

helicopters. T he genera l mi

ss

ion of Army av iation was


20/148


21/148

THE EARLY YE RS

11

Teachers College.

On

3

August he and

Capt.

Oscar

N.

Tibbetts,

the

squadron s

commander, met at the college

and examined one of

the

H-5 s. A Stokes litter fit into the compartment of the H-5 very well,

but

the handles

of

the

standard Army

litter

had

to

be cut

off.

With

two

patients and Colonel Dovell on

board,

the H -5 lifted off, easily

cleared the surrounding telephone poles and buildings, and returned

for a perfect landin

g

Colonel Dovell asked to see a long flight, so the

pilot flew

him and the two patients out to the 8054th Evacuation

Hospital

at

Pusan, 100 kilometers away.

On

10 August,

at Co

lonel

Dovell s request, Lt.

Gen.

Earle E .

Partridge,

commander

of

the Fifth

Air Force,

authorized th

e use

of

these ancl.other Air Force helicopters

for frontline evacuations. The Air Force

~

i n u e to evacuate the

Army s frontline casualties until the

end

of

the year, allowing the

Army

time to organize and ship to

Korea

its own helicopter detachments.

Late in the year the Army deployed four helicopter detachments

to

Korea. These

units, each

authorized

four

H-13

Sioux helicopters,

conta

ined

no

medical personnel, but were

under

the operational con-

trol

of

the

EUSAK

Surgeon.

Each

was

attached

to a

separate

mobile

surg

ical hospital, with a

primary

mission

of aeromed

ical evacuation.

The

crewmembers

drew their rations

and quarters

from the MASH,

and

their aircraft

parts

and

service from wherever they cou ld be

found. The

2d

Helicopter Detachment became operational

on

1

January

1951; the

3d,

later in January;

and

the 4th, in

March.

The

1st Helicopter Detachment, which arrived in February,

never

became

operationa

l because

commanders

transferred all

of

its aircraft to

other

nonmedical units. At the height

of

the Korean conflict the three

operational helicopter

detachments

controlled only eleven aircraft.

But by the end

of

the war they had

evacuated

about 17,700 casualties,

supplemented

by a considerable number

of

medevac missions per-

formed by nonmedical helicopters organic to division light

air

sections

and helicopters of

Army

cargo

transportation

companies . Marine and

Air Force helicopters had also made a sizable number

of

frontline

evacuations .

The

independence

and

therefore the value

of

the air

ambulance

units increased after the introduction

of

detailed standard

operating

procedures.

Typical of

those

adopted

by the

detachments

was the list

that

Lt. Col. Carl

T.

Dubuy, commander

of

the 1st Mobile Army

Surgical Hospital,

drew up

in early

February

1951. Evacuation re-

quests were to be made only for

patients

with serious wounds, or

where surface transport would seriously worsen a casualty s injuries.

The helicopters would be used strictly for medical evacuation

and

reconnaissance and would not be used for command administrative

or tactical missions. Each request for a helicopter was to include a

clear

and

careful

reading of

the coordinates

of

the pickup site. The

ground

commander was to try to find the lowest pickup site around,


22/148

2

DUST OFF

ARMY

AEROMEDICAL

EV CU TION IN VIETNAM

to ease the

strain on

the minimally

powered

H -13 helicopters

that

performed the

bulk of

medical evacuations in Korea. A request was

not

to be

made

for a

landing

zone subject to hostile fire ; if trouble did

develop, the men on the ground were to wave off the helicopter.

Dubuy recommended

the

use of colored panels to form a cross to

mark the pickup site, and he also favored some indicator of wind

direction and velocity, such

as

grass fire. He suggested that if the

helicopter flew past the pickup zone without recognizing it, the

soldiers on the

ground

should fire flares

or

smoke grenades to attract

the pilot s

attention. (The

aircraft h

ad

no radios.)

Co

lonel

Dubuy

sent

these reco

mmended

procedures

to

the

commanding

general

of

the 7th

Inf

antry

Division, which the 1st

Mobi

le

Army

Surgical Hospital then

suppo

rted,

but

the

division afforded the list

on

ly a

haphazard

distribution.

n January 1951 all four pilots of the 2d Helicopter Detachment

took part in a mission that, although it violated the precept that

helicopters would not be flown within

rang

e of enemy weapons, saved

several lives. On the

morning of

3

January, Capt.

Albert

C.

Sebourn

of the 2d

Detachment

received

an urgent

request for

air

evac

uation

from a

unit at

a schoolhouse s

urround

ed by a large

Ch inese

Communist

force near C hoksong-ni. The

unit

was a Special

Activities

Group

(SAG), an elite, battalion-size

organization

of a ir

borne and ranger-qualified soldiers. Their on ly defensive perimeter

was the

border

of the one acre schoolyard. A

MASH doctor

had

been

asking for a ride in a helicopter. Sebourn put him in the right

seat

and

then fl

ew to the coordinates of the request. After l

and

ing in the

schoolyard,

Sebourn shut

down the helicopter. As soon as he and the

doctor

climbed out, a

mortar

round

l

anded near

the right side

of

the

helicopter, damaging it but not injuring anyone. Both men

ran

into

the schoolhouse, where the

commander of

the

SAG unit

explained

that he had numerous casualties and wanted the helicopter to

bring

in

ammunition

on its

return

flights from the hospital. When Sebourn

tried to

restart

his aircraft, he found that the battery was dead; he and

the doctor stayed

at

the school overnight.

When Sebourn

did not

return

to the 2d Detachment s base after

several hours ,

Capt. Joseph

W.

Hely

checked back through Eighth

Army

channels.

The

request

had

been

quite old

when

the 2d Detach

ment

received it : it

had

been

routed

through

Tokyo.

Eighth

Army

asked

Hely wheth

er

he would fly ammunition out to the beleaguered

force, and he assented. With

ammunition

in both his aircraft s litt

er

pods, he tried to

fly

out, but heavy snowfall made him postpone the

flight until the weather improved.

Next

morning, when he reachea

the area, he noticed tracers from enemy machine g

un

s trying to shoot

him down . He spiraled down into the schoolyard,

unloaded

the

am

munition, gave the battery in Sebourn s helicopter a boost,

and

then


23/148


24/148

14 DUST OFF: ARMY AEROMEDICAL EVACUATION IN

VIETNAM

of helicopters to specific combat units for evacuation missions direct

support).

For

instance , the 3d

Infan

try Division, with an indorsement

from I Corps requested its own air ambulance; I Corps wanted to

g

iv

e each division its own a ir ambulance.

But EUSAK

headquarters

denied the

request

because there were not enough he

li

copters to pro-

vide such individualized coverage, and the current area and standby

coverage was working adequate l

y

Many

other

problems in this new system proved intractable.

The

most serious came from the constant need to repair the helicopter.

T he sluggishn ess of the Air Force, the Army s aviat ion procurement

agency, in meeting Army av iat ion s su

pp

ly needs created a backlog of

requests fo r helicopter parts and components. Just as American in-

dustry at

the

start of World

War

II was

unable

to

fill

a

ll

the Army s re-

quests for airplanes, so at the start of the Korean War it was not

geared for he

licopter

production. T he fine tol

erances

required

because

of

the

many

rot

at

ing

and

revolving parts in a helicopter,

and

the limit

ed

commercial potential for the craft, made American aircraft

manufacturers re lu ctant to devote their resources to such a chancy in-

vestment. When production did increase, a serious problem arose in

transporting the vast qu

ant

ities of war materiel from the States to

Korea . All of these problems adversely affected the supply of spare

par

ts, fuel,

and

even a ircraft. By late 1952 the eleven a ir

ambulance

helicopters in

Korea

had

to compete

with

about

635 oth

er

Army

nonmedical helicopters for whatever resources the American aircraft

industry could provide.

Parts shortages in the field accounted for the loss of

much

valuable

flyin g time in all Army aviat ion units in Korea, more so than any

other problem.

In

a three month period in 1952 the 8193d Army Un it

lost

abo

ut one-third of its potential a ircraft days because of parts short-

ages.

This

resulted in

li

ves lost because the

unit

was

un

ab

le to respond

to a

ll

evacuat ion requests.

The

8193d commander

Capt.

Emil R.

Day

requested that a fifth helicopter be assigned to each of the

MASH

helico

pter

detachme

nt

s,

but

thi s was not done.

In

a

ll

ocating

parts the

Air

Force favored its own

fi

g

ht

ers

and

b

ombers

over the

Army helicopters. Supply personnel in the States seemed to have little

awareness of the cost in human life of

returning

supply requests for

editorial changes, ex

pl

anations of excess requirements, and

proper

item descriptions H arry S Pack, in

an eva

lu

at

ion of the

pr

oblems of

helicopter evacuation

in

Korea, aptly criticized

th

e support system:

The

basic concept of the employment

of

the helicopter

in

the Army . is

it

s increased speed over other fo

rm

s of transport currently

in

use

in th

e

mov

eme

nt

of

per

so

nnel and materie

l.

Therefore,

it is

only logical

th

at the en-

tire helicop ter program, including maintenance a

nd

supply procedures,

should follow Ihe same philosophy

of

speed and mobi l

it

y 1 ensure receiv ing

maximum value from the helicopter.


25/148


26/148

6

UST OFF ARMY

AEROMEDICAL EVACUAT

ION I N V I

ETNAM

into the Stokes li tter. Some pat ien ts with cert ain types o f casts splints

and

dressings cou ld no t be

mo

ved by helicoptcr at a ll becau se of the con

fined spa ce

of

the Stokes litter.

Th

e pilots a nd mecha ni

cs

imp rovised

hea ting for the

in

side

of

these li tte rs by fabrica ting manifold shro uds

and

dueling

warm

a ir

ofT

the

man if

o lds i

nto

the litte rs.

Ev

en so

th

e patie

nt

s

had to be covered with mount a in slee ping bags

or

plas

ti

c bags. If the

manifold h

ea

l

were

used

on

o nc li

tt

er o

nl

y,

exc

ess

wa

rm a ir esca ped ncar

th e hose conn

ec

tion; but

i heat

were tu rned o n both litters

th

ere was not

enou gh lo r ei ther.

The

problem pa rt ly stemmed from the plast ic cover; it

lay direc tly on the pat ient and did not a llow the hea t to circul

ate

properl y

So the de

ta

chment s worked with a maintenance

com

pany and a Bell A ir

craft technical rep resentat ive constructing a three quarte r le ng th cover

of

la b ric-covered

tub

ing tha t could bejoined to the

or

igin al h

ea

d cover.

t

served

as

a windbreak a

nd

gave spa ce

for th

e heat to cir

7

ulatc over

th

e

patient s low

er

body.

InJuly

19

51 a new litter mount , manufac

tur

ed by Bell Aircraft for

the H - 13, reached Korea . These greatly improved mounts accom

moda ted a sta nda rd Arm y field litter ,

elimin

a ting the need to tra nsfe r

a pa tient to a Stokes li tter be l

or

e placing him in the pod. Un fortunately

the cov

ers

that Be ll man uf

ac

tured for the new mount we re usua lly

torn up by the slipstrea m a fter j ust

thirt

y days

of

use . T he

d

etachm

e

nt

s i

mprovi

se

d a

ca

n

vas

cover

from

pup

te nt she lter halves;

when used with the zipp

er

a nd s

nap

s

fr

om the Be ll cover , it

pr

oved rar

s

uper

i

or

to the original in that it had a long service li fe a nd kept water

from see pin g throu gh onto the patient. T he men

of

the detachment s

used their own money a nd

Kor

ean labo r to pr

od

uce a n ample supply

of cove rs.

Even with the improved pods, the ex ternal mounting a nd the

abse nce of a med ica l corpsman o n the a ircraft produced ano ther di

f-

fi

cult

y

P

il

ots b

ega

n to notice

that

many

of

the casualties needed

tra nsfusion s before being moved to a m

ob

ile surgi

ca

l hos pi ta

l

n cold

weathe r an in-

fli

ght transfusio n with the flu ids stored

outs

ide the a ir

cra ft risked deepenin g the pa

ti

ent s shock as the fluid tempe ra

tur

e

dropped. At lirst the pilots would wait the th irt y or forty-five

minut

es

necessary ror a trans

fu

sion before depa rting with a patient. T hen L t

Col J a mes

M. Brown,

commander of

the 8063d

Mob ile Surgical

Hospita

l, dev ised a method for en route tran sfu sions of plas ma 01

whole blood. A bott le of blood or plasma was a ttached to the inside

wall

of

the cockpit with in reach

of

the pilot. Needles a nd plas ma

would be a rra nged before

departure

,

an

d

during fli

g

ht

the pilot could

mon

itor the fluid

flo

w

thr

ough the

tub

es extending to the litter

pod

s .

A rubber bu lb could be used to regula te

pr

essure to the bottle. T

hi

s

modifi

cat

ion was a

ppro

ved for a ll medica l helicopters in the thea ter,

a nd Bell Aircrart also i

ncorporat

ed it in a ll its D-model

air

craft.

Since the E ighth A rmy possessed on ly thirty-two H -13 s by

May


27/148

THE EARLY Y EA RS

17

195 1, use

of

the valuable cra ft had

to

be closely monitored a nd

res tricted . A

re

curring probl em was that ground

co

mmand ers

sometimes reques ted helicopters morc as a co nveni ence than as a

necess

it

y To preve nt thi s, the EUSAK Surge on on 23 June 195 1

dissemin ated a stateme

nt

th

at

th

e role

of

hel icopter evacuat ion was

onl y

to

prov ide immediate evacuation of nontranspo

rt

able and

critica ll y ill or

injur

ed pa tient s who needed surgica l or medical care

not ava

il

abl e a t forwa

rd

medica l facilities .

Thi

s statement was given

wider distribution

than

had Colonel Dubuy s in Februa ry and it

noticeabl y reduced the

numb

er of unnecessary mi ss ions.

T he detac hments o Tered their service to a

ll

of the fi ghting units in

volved in the United Na tions effon in Korea . At first glance it seemed

tha t the language

ba

rrier would make ma ny of these mi

ss

ions

ft

r

em

el

y

difficult. But the lack of air-ground communica tions helpe8 in thi s

respec t for it precluded any a

tt

empt whatsoever at oral o ~ m u n

tion betwee n pilots and ground commanders.

Mo

st pilots found tha t

universal sign

lan

guage us

ua ll

y sufficed to

tr

ansmit any informa tion

necessary to complete

an

evacuation.

In

Septe

mb

er 195 1 one of the

pilots received a request to pick up two

wound

ed men from a T

urki

sh

brigade.

Th

e pilot recalled :

When I

got

to the spot des ignated I couldn t find anybody. I was c

ircl in

g around

when

a

Turkish observa tion

pl

ane buzzed me. He led me to a wooded area

on a moullla in top where

th

e T urks had dug in . T he

tr

ees were too high to

perm it a landing.

t

looked pretty hopeless because couldn t communicate

with them. Fina

ll

y, we ill in close until

th

e roto r blades of

th

e he

li

copter

bru shed the tops of the trees. T he T urks go t the

pi

tch. They chop ped down

enough of the trees so that co uld land on a

rid

ge. sa l down a

nd

the

C hinese began tossi ng mortar shells

a t

me. But go t the two wounded

Tur

ks

out.

Enemy ground res istance to a

ir

ambul ances in Korea never

became a severe problem , as it did later in V ietnam. Few landing

zones

we

re subj ect to enemy sma

ll

a

rm

s fire but many we re within

ra nge

of

enemy anille.

·y

and morta r

s

Although the pilots genera

ll

y

stayed out of landing zones under enemy fire, several had more

th

an

one encounter with C

ommuni

st weapons. At on po

in

t

ea

rly

in

th e

war a compa ny of the 7th Infa ntry Division was

fi

ghting in the area

known as the Iron Tria ngle. In assaulting an enemy-held slope, two ori ts

soldiers were seriously wo

und

ed by the C hinese. A requ es t for an a ir

ambu lance quic

kl

y made its way to the 4th Helicopter Detachment ,

stationed with the 8076th M obile Surgical H ospital a t C hunchon.

C BS correspond ent

Rob

ert Pierpoint was there and had rece ived per

mi

ss

ion to ny with the detachm ent. Three minutes a fter the ca ll came

in , a pilot and Pie rpoint new north toward the pic

kup

site. T he m

en

on the g

round

put out col

ored

panels

to

ma rk a land ing zone on a


28/148

8

UST OFF

ARMY AER

OMED

ICAL

EVACUATI

ON I N V I

ETNAM

n

earby padd

y, whil e others tried to bring the cas ualties down from the

hill. Thirty minutes after the ca ll went out , the helicopter landed at

the marked pos ition. T he pilot and Pierpoint got out. Ju st as the litter

bearers made it down the hill , C hinese

mortar

s from across the va lley

opened up on the

padd

y

A

mortar

r

ound

came

in, hit

about

thirty

fe

et

from the helicop t

er

tail, and sen t the Americans scra mblin g up the hill.

T he company co

mmander

ca lled an arti

ll

ery ba ttalion 6,000 yards to the

r

ea

r and had

th

em knock out

th

e C hinese mortar pos

iti

ons.

T he pilots, Pierpoint,

and

the Iill

er bearers

re

turn

ed to

th

e

helicopter and

lo

aded the cas ualties. Not waiting to check for damage

the pilot climbed int o the

smo

ke-filled cockpit. H e cou ld hardl y see

the

in

struments but as soon as Pierpoint jumped in they made a

max

imum

power

takeoff. T hey l

anded at

the hospital

at

2120, r

eading

their a ircraft instruments with a flashlight one of the men

at

the paddy

had g

iven

them.

In another respec

t

Korea was worse than Vietnam: the am-

bulan

ce crews

some

times

had

to contend with

enemy

aircraft.

Although

the

U.S.

Air

For

ce destroyed most

of th

e

North Korean

air

craf

t ea

rl

y in the con

fli

ct, the entrance of the Chinese Communists into

the war in December 1950 brought fast and powerful enemy jet

fighters to Korea. A few medical helicopters did encount

er

fire from

North Korean

Yak fighters,

but

the

Americans outmaneuvered

the

faster jets and escaped damage.

Apa rt

fr

om

frontline

evacuat

ions a ir

amb

ulan

ce

de tachments

also flew a few

other

medica l

support

missions. By the second year

of

the

war

they routinely

transported

whole blood to the mobile surgical

hospitals. This proved valuable because the whole blood tend

ed

to

break

down

pr

ema

turely or clot when

carr

i

ed

by surface vehicles over

the rough

Korean

roads. The faster means of transport also allowed

blood storage

and

refrigeration to be

centra

li

zed

rather than

dispersed

close to the front.

The

helicopters backhauled some critical patients

from the mobile surgi

ca

l hospitals to a ir

str

ips for

further

evacuation to

one of the general hospitals

inJapan.

Sometimes they even backhauled

patients to hospita l ships

along

the coast,

such

as

th

e Navy s hospital

ship onso

lation

a

nd th

e Danish

Jutlandia

which were

equ ipp

ed for

helicopter landings Since fixed-wing ca rgo pl

anes

ew a ll

casua

lties

bound for Japan , the hospital ships remained anchored as floating

hospitals off Korea rath

er

than act as ferries.

Most

de

tachm

e

nt

pilots also tried to make

th

e life

of

th

e frontline

soldiers as tolerable as they could. Besides medical supplies a

nd

am

munition

the pilots often took beer ice cream and

so

das to the front.

T he sight

of

the helico

pter

coming in for a l

anding

in the blist

ering

Korean

s

ummer

with the pilot wearing only his boots, a red

ba

seba

ll

cap,

a

nd

swimming trunks,

and

then unloading these otherwise unobtainable

luxuries , did mu

ch to boost the morale

of

the co

mbat

soldier

s


29/148

TJ I

RLY YE RS

19

Apart from yielding a great deal

of

practical experience, the

Kor

ean

War

furthered aeromedical evacuation by convincing the Army

that the helicopter ambu lances deserved a permanent organizat ion.

When the war broke out, the Army M edical Service

commanded

neither

helicopters

nor

pilots,

and

its l

eaders

were not

committed

to further-

ing

aeromed

ical evacuation.

In Kor

ea the Eighth Army soon acqu ired

virtually complete operational control

of

the helicopt

er

detachments

charged with a mission

of

medical evacuation.

But

the Surgeon

General

want

ed to have the

detachments made

organic to the Medical

Service, to have an organi za

ti

on within the Office of the Surgeon

General capable

of

dir

ecting and admi niste ring the av ia tion

resources, and to have medical personnel rather than av iators

fr

om

other

branches

of

the

Army

piloting the a ir

cra

ft.

The Surgeon General achieved his first goal with the publi cation

on 20 August 1952

of

TO E 8-500A , which provided for an a ir am

bulance detachment

of

seven officers,

tw

e

nt

y-one dnlisted men, and

five utility h

el

icopters. T he first such u nit was the 53d Medical

Detachment

(He li

cop t

er Ambu

lance),

act

ivated

at

Brooke

Army

Medical en ter, Fort Sam Houston, San Antonio, Texas, on 15

October 1952. In

Kor

ea, mea nwhile, th e a mbulance units were

tra nsfered from the adm ini

strat

ive command

of th

e Eighth

Army

F

li

ght

Detachment

to that of the Eighth

Army

Su

rgeon.

By the end

of

the war the

Su

rgeon Ge neral also succeeded in

achiev

in

g hi s seco

nd

goal of crea

tin

g a special aviat ion section

in

his

office. O n 30

Jun

e 1952 the C hief

of Staff

of the Army directed the

C hairman

of

the Materiel Review Board to eva luate the Army

hel icopter program. In accordance with the Boa rd s recommend ation,

the C

hi

ef of Staff on 17 October 1952 directed the assistant c

hi

efs of

staff a nd the va

ri

ous

Army

branch c

hi

efs to set up their ow n agencies

to

supervise and coordinate aviation within each o

ffi

ce.

The

Surgeon

Gene ra l's Office was charged with coo rdination of a ll

pl

anning

operations, personnel staffin g, and supply

of

Army av iat ion used in

the Medical Service. On 6 November the office estab lished the Army

Aviation Section within

th

e Hospita

li

zation and Operations

Br

anch,

Medical Pl

ans

a nd

Op

erat ions Division .

On

the

adv

ice of the new

sect ion , the S

ur

geon General reco mmended that

...

a

ll

a ircra

li

des igned, developed ,

or

accepted for the

Army (regard

less

of

its in -

tended primary use) be chosen with a view toward potential use as air

ambulances to accommodate a maximum number

of

standard litters .

This advice was followed in 1955 when the Army held a des ign com-

petition for a new multipurpose utility helicopter. The winner of the

competition, the Bell Aircraft Corporation's prototype

of

the U H-1

Iroquois ( Huey ), even tually beca me the Army's standard am-

bulance

helicopter in the Vietnam War.

During

the

Kor

ea n

War

the

Surgeon Genera

l also tried to place


30/148

20

DUST

OFF

ARMY AEROMEDICAL EVACUAT ON N V

ETNAM

M edi

ca

l Service Corps (MSC) pilots in the cockpits of the

Army

s a ir

ambulan

ces,

But he did not succeed until shortly a fter the armistice

in 195 3, From ea rl y 1951 on , the Surgeon Genera l had advocated

tra ining some

MSC

officers as av iators, and in the spring

of

1952 the

regul

at

ions gove

rnin

g

Army

av

iati

on

were

ame

nded to a

ll

ow

MSC

personn el to become pilots, A

qu

ota

of

twenty-

fi

ve

MSC

officers,

most ly second lieutenants, was set for night

tra

ini

ng

in

October.

None

of the current MSC officers h

ad

ever been helicopter pilots,

alth

oug

h a few had had some av iat ion tra in ing, By ea rly July, fifty

three applicat ions f

or

the slots had been received,

but

on ly seve

nteen

applica

nt

s were

qua

li fied, E ight

MSC

officers began night training in

October, a nd one washed out before graduation , The ot her seven

gr

aduat

ed on 28

February

19

53,

In

September

the

Surgeo

n

Genera

l

s

office requested

and

received a standin g

quota of

ten

MSC

officers per

month for attendance

at

the Army Av iat ion Sch901

at Fort

Si ll ,

Ok

la homa, By 1 October the Medica l Service h

ad

twent y-fo

ur

officer

pilots and

soo

n r

ece

i

ved fi

ve more

by

transf

er

from other branches.

No

ne had nown in

Korea

before the a rmi st ice in Jul

y,

After the Korean

War

the Surgeon Genera l s Office app lied itself

to assessing the potent ial of helicopter ambulances in future connicts,

In part icular, Lt.

Col. Sp

urgeon H, Neel,Jr., in a

number of

medical

and av iation

journa

ls, pub

li

cized and promoted the Army s a

ir

am-

bulances. T he Korean expe

rience

he rea

li

zed, cou ld no t serve as an

infa llible guide to the use

of

he

li

copters

in other

types

of

wars and dif

ferent geographica

l regions,

but

it certa inly showed

that

helicopters

h

ad made

possible at l

east

a modificat ion of the first links in Letter

man s chain

of evacua ti

o

n.

A s

up

erior

communi

ca

ti

ons syste m wou ld

a llow a well-equ ipped and well -sta ffed ambu lance to land at or near

the site of the

wounding making

much grou nd evacuat ion un-

necessary,

f

the patient s

cond

ition could

be

stabilized

brien

y,

it

might prove helpful

to

use the speed

of

the he

li

copter

to

evacuate the pa

ti

ent farther to the rear, to more

co

mplete med ical fac ilities

th

an those

provided at a rudimentary div isi

on

clear

in

g station. T

ri

age might be ca r-

ried out belter at a hospital than in the field, But the Korean

War and

the concurrent French struggle in Indochina had afforded on ly

limited , imperfect tests of helicopter medical evacuation, T he poten

tial was obv ious, but not fu lly proven.

2At

th is time the Army Medical

Se

rvice consisted of six cor ps: Medic

al

, De ntal . Veterinary,

A

rm

y Nurse, v\ omen s Medical Specialists. ;md the Mcdical Service Corps,

wh

ich provided iI

va

ri

cty of admini stnll ivc and teehniCil1 services.


31/148

CHAPTER

II

Birth

Of

A Tradition

The

lay

of

the la nd

and

the guerrill a

nature

of

Viet Co

ng

war

f

are

n

South

Vietnam demanded

that th e America n forces stationed th ere

from the

ea rl

y 1960s thr

oug

h

Mar

ch 1973 again use the medical

he

li

copter.

In

a country of mountains,

jungles

and marshy

pl

a

in

s, with

few passa

bl

e roads and servicea

bl

e ra ilroads the a

lli

ed for I s waged a

fro

nt

less wa r against a se

ld

om seen enem

y

Even morc thaT}

in

Korea,

helicopter evacuation

pr

oved to be both va lua

bl

e and

dang

erou

s

South

Vietnam

consists of

thr

ee

major geograph

ic fCatures. A

coastal pla

in

, varying

in

width

fr

om

fift

een to fo rty kil ometers, ex tends

al

ong mo

st of the 1 400 kilom

ete

rs of the coas

t Th

is plain a

but

s the

second fea tur

th e

so

uth easte rn edge of the Annamite Mounta in

Chain,

know n in

South

Vi e

tnam

as the

Central

Hi g

hland

s w

hi

ch

run

from the n

ort

he

rn

border

al

ong

the old Demilitarized Z

on

e so

uth

to

within eighty

ki

l

ometers of

Sa igon .

Th

e

Centra

l

High

lands

are

most ly

steep-sloped sha rp -crested mounta ins vary

in

g in height from 5,000

to

8,000

feet covered with ta ngled jungles a nd

broken

by ma ny na r

row passes. I he

so

uthe

rn

third

of th

e cou ntry co nsists almost entirely

of an

arab

le del ta.

Th

ese three geographica l

fe

a

tur

es helped shape the fo

ur

milita ry

zones of South Vietnam . The northern

zo

ne, or I Corps Zone, w

hi

ch

ra n from the Demilita

ri

zed

Zone

down

to

Ko

ntum

a

nd

Binh

Dinh

prov

in

ces,

co

nsisted almost entirely of high mounta in s and dense

jungle

s

At

seve

ral points th e

Annamit

es cut the narrow coastal pla

in

and exte nd to the South C hina Sea. Il Corps Zone

ran

from I

Co

rps

Zone so

uth

to the so

uth

ern

fo

othills of the Central Hi g

hl

a nds about

one

hundr

ed

kil

ometers north

of

Saigon.

t

consisted

of

a long stretch

of

the coas tal plain the

hi

ghest portion of the

Cen

tra l Hig

hl

and s and

the

Kontum

and D a

rl

ac Plateaus . Corps Zo ne ran from II Co

rp

s

Zone

so

uthwe

st

to

a line fort y kilomete rs below the

ca

pital

Sa

igon.

This was an intermediate geographic reg ion

co

nta in ing the southe rn

fo

o thills o f th e Ce

ntr

a l Hi g

hland

s; a few la rge

dry

pla ins; some thick

triple-ca nopy

jungle

a long the Ca

mb

odia n bo rder; a nd the northe rn

stretches

of

the

delta

fo

rm

ed by the M e

kong Riv

er to the so

uth

.

IV

Corps

Zone cons isted almost entirely

of

thi s delta, which has no forests

exce

pt f

or

den

se

mangrove swa

mp

s at th e

southernmos

t tip and

forested a reas

ju

st north a nd so

uth

east of Saigon. Seld

om

more tha n


32/148

22

D UST OFF RMY EROMEDIC L EV CU T I ON I N V IETN M

twenty

fe

c t ab

ove

sea leve l

th

e de lta is covered wi

th

rice fie lds

sepa ra ted by ea rthen dikes.

Durin

g the rainy season the paddies a re

marshy

making

heli

cop

ter landings and vehicular

troo

p

tr

ansport ex

tr

eme

ly difficult. Hamlets

strad

dle the rivers a

nd

cana

ls,

an

d la rger

villages (up

to

10 ,000 people) and cities lie at the junctions

of

the

waterways. Bamboo brakes and tropica l trees grow a round the

vi llages and usua lly ex tend from 50 to 300 meters back on either side

of the canal or hamlet.

The entire cou ntry lies below the Trop ic

of

Cancer, between the

8th and 17th para

ll

els. T he climate is genera

ll

y hot and humid the

yea r round. In winter the country lies

und

er a high pr

ess

ure system

th at causes a dry season in the south. In the summer however ra in s

fidl heav

il

y,

varying

from

torr

ential

do

w

npour

s to st

eady

mists.

The

no

rth

ern reg ion

of

South Vietnam has the most ~ ave rag ing 128

inches, whi le the Sa igon region averages 80 inci}es.

In

the northern

region a nd the

Centr

al

Hi

ghlands, where most 6rthe ghting by

U.S.

tr

oops

during

the war occurred, dense fog and low clouds often

grounded a

ll

a ir

craf

t About ten times a year, usually between July

a

nd November,

typhoons blow in from the South C hina Sea, soaking

South

Vietnam

with heavy rains and las hing

it

with fierce wind

s

Although the climate a nd terrain exacerbated the technical problems

of

medical evacu

at

ion by helicopter in South Vietnam, the a ir am

bulance pilots who worked there worried as much

or

more about the

dangers that stemmed from the enemy s frequent use

of

guerrilla tactics.

T he Viet Cong were w ily, elusive, and intensely motivated.

They

usually had no respect f

or

the red crosses on the doors

of

the a ir am

bula nce helicopter

s

Likely to be a nnihila t

ed

in a la rge-scale, head-o n

clash with the

imm

ense fire

power

of American

tr

oops, they usua

ll

y

struck only in raids a

nd amb

ushes of

American and

Sou th Viet

namese

patrols

To

perform the

ir

missions

the a

ir

ambu

l

ance

pilots

o ften had to ny into areas subjec t to intense

enemy

sma

ll

arms fire.

Later in the war the p ilots en

countered

more formidable obstacles,

such as Russ ian- and Chinese-made ground-la-air missi les.

No air

ambu

lance pilot could depend on a ground commander s assurance

that a pickup zone was secure.

Mortar and sma

ll arms fire often

found a

zone just

as the helicopter touched down. Enemy soldiers

were known to patiently hide for h

ours around an

ambushed patrol,

looking for the inevit

ab

le rescue helicopter.

In these conditions the modern techniques

of

aeromedica l evacua

tion developed a nd matured. T he obstacles

of

mountain, jungle, and

floodplain could be overcome only by helicopters. T he frontless

nature of the war also made necessary the helicopte r for medical

evacua ti

on

A

ir

ambu lance units found

ever

w

i

er employment as the

helicopter- used both as a

fi

ght ing

machine

and as a transport

ve hi le

came

to dominate

many

phases

of

the war.


33/148

BI RTH OF TR D I T ION

23

e Struggle egins

In 1961 President John F. Kennedy took the first of a number of

measures that over the next four years drew the

United

States deep

into the stormy pol

it

i

cs

of

Southeast Asia.

In

May

,

Kennedy

publicly

r

epeated

a pledge, first made by President

Dw

ight D. Eisenhower in

1954,

ofU

.S. support for the

government

of the Republic of Viet

nam

.

Kennedy

had the Department of

State

adopt a less

demandin

g

diplomacy in its deal ings with the troubled r

eg

ime of

President

Ngo

D inh Diem. The

department tr

ied to coax Diem into mak ing urgentl y

nee

ded

politica l, economic,

and

mi

li

tary reforms, but he dallied,

and

the Viet Cong summer campaign of 1961 further weakened his

te

Dust Off Army Aeromedical Evacuation in Vietnam

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