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HISTORY OF AEROMEDICAL EVACUATION IN THE KOREAN 
WAR AND VIETNAM WAR 


A thesis presented to the Faculty of the U.S. Army 
Command and General Staff College in partial 
fulfillment of the requirements for the 
degree 

MASTER OF MILITARY ART AND SCIENCE 
Military History 


by 

WILLIAM G. HOWARD, MAJ, USA 
B.A., Edinboro University, Edinboro, Pennsylvania, 1991 


Fort Leavenworth, Kansas 
2003 


Approved for public release; distribution is unlimited. 



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4. TITLE AND SUBTITLE 

HISTORY OF AEROMEDICAL EVACUATION IN THE KOREAN WAR AND 
VIETNAM WAR 

Unclassified 

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6. AUTHOR(S) 

Howard, William, G 

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US Army Command and General Staff College 

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US Army Command and General Staff College 
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13. SUPPLEMENTARY NOTES 

14. ABSTRACT 

Modern US Army rotary wing aeromedical evacuation operations and doctrinal concepts can be traced back to the Korean and Vietnam Wars. 
These early concepts have formed the foundation for the current doctrine, structure, and employment of aeromedical evacuation assets on the 
battlefields of today. Aeromedical evacuation operations performed during the Korean and Vietnam Wars were executed in an exceptional 
manner. The medical personnel, hospital system, medical evacuation, and many other medical functions all contributed to the overall success 
of medical operations. The overall purpose of this research is to identify and describe the major historical operational factors of US Army 
rotary wing aeromedical evacuation system in the Korean and Vietnam Wars. The successful operations of US Army rotary wing aeromedical 
evacuation system in each of these wars permit a historical comparison between them. 

15. SUBJECT TERMS 


|Aeromedical evacuation; Army; Doctrine; Battlefield; Korean War; Vietnam Conflict, 1961-1975; Medical operations; Operational art 


116. SECURITY CLASSIFICATION OF: 


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99 


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Buker, Kathy 
kathy.buker@us.army.mil 


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MASTER OF MILITARY ART AND SCIENCE 


THESIS APPROVAL PAGE 


Name of Candidate: Major William G. Howard 

Thesis Title: History of Aeromedical Evacuation in the Korean War and Vietnam War 


Approved by: 


Major David A. Christensen, M.A. 


Thesis Committee Chairman 


Lieutenant Colonel Daniel J. Jones, M.A. 


, Member 


Colonel Judith A. Bowers, Ph.D. 


, Member, Consulting Faculty 


Accepted this 6th day of June 2003 by: 


Philip J. Brookes, Ph.D. 


, Director, Graduate Degree Programs 


The opinions and conclusions expressed herein are those of the student author and do not 
necessarily represent the views of the U.S. Army Command and General Staff College or 
any other governmental agency. (References to this study should include the foregoing 
statement.) 


n 



ABSTRACT 


HISTORY OF AEROMEDICAL EVACUATION IN THE KOREAN WAR AND 
VIETNAM WAR, by Major William G. Howard, 85 pages. 

Modem US Army rotary wing aeromedical evacuation operations and doctrinal concepts 
can be traced back to the Korean and Vietnam Wars. These early concepts have formed 
the foundation for the current doctrine, structure, and employment of aeromedical 
evacuation assets on the battlefields of today. Aeromedical evacuation operations 
performed during the Korean and Vietnam Wars were executed in an exceptional 
manner. The medical personnel, hospital system, medical evacuation, and many other 
medical functions all contributed to the overall success of medical operations. The overall 
purpose of this research is to identify and describe the major historical operational factors 
of US Army rotary wing aeromedical evacuation system in the Korean and Vietnam 
Wars. The successful operations of US Army rotary wing aeromedical evacuation system 
in each of these wars permit a historical comparison between them. 



TABLE OF CONTENTS 


Page 

THESIS APPROVAL PAGE.ii 

ABSTRACT.iii 

ACRONYMS.v 

ILLUSTRATIONS.vi 

CHAPTER 1. INTRODUCTION AND BACKGROUND.1 

Introduction.1 

The Research Question.2 

Assumptions.3 

Definitions of Terms.3 

Limitations.4 

Scope and Delimitation.5 

Background.5 

CHAPTER 2. KOREAN WAR.14 

Introduction.14 

Aeromedical Evacuation Organizational Structures.17 

Aeromedical Evacuation Utilization.23 

Aeromedical Evacuation Employment.28 

Aeromedical Evacuation Lessons Learned.31 

CHAPTER 3. VIETNAM WAR.37 

Introduction.37 

Dustoff.40 

Aeromedical Evacuation Organizational Structures.41 

Aeromedical Evacuation Utilization.48 

Aeromedical Evacuation Employment.58 

Aeromedical Evacuation Lessons Learned.62 

CHAPTER 4. CONCLUSION AND RECOMMENDATIONS.69 

Subordinate Investigtive Questions.69 

Further Research..74 

Conclusions.75 

Recommendations.76 

APPENDIX A. KOREAN WAR VIGNETTES.79 

APPENDIX B. VIETNAM WAR VIGNETTES.81 

BIBLIOGRAPHY.88 

CERTIFICATION FOR MMAS DISTRIBUTION STATEMENT.92 


IV 





































ACRONYMS 


AFB 

Air Force Base 

ARVN 

Army Republic of South Vietnam 

ASR 

Air Sea Rescue 

CASEVAC 

Casualty Evacuation / Transport 

CSAR 

Combat Search And Rescue 

FEAF 

Far Eastern Air Force 

MAAG 

Military Assistant Advisory Group 

MAC 

Military Airlift Command 

MACV 

Military Assistant Command Vietnam 

MASH 

Mobile Army Surgical Hospital 

MAST 

Military Assistance to Safety and Traffic 

MRO 

Medical Regulating Officer 

NSA 

Navy Support Activity 

OTSG 

Office of the Surgeon General 

PACAF 

Pacific Air Forces 

TO&E 

Tables of Organization and Equipment 

UN 

United Nations 

USAF 

United States Air Force 

VC 

Viet Cong 


v 



ILLUSTRATIONS 


Page 

1. Korea Map. 22 

2. Air Ambulance Units in Vietnam. 44 

3. US Corps Locations Vietnam. 53 






CHAPTER 1 


INTRODUCTION AND BACKGROUND 

Introduction 

History has provided answers to future military questions. One just has to review 
the details and research for the answers, so the same mistakes will not be made 
repeatedly. For example, Napoleon’s campaign in Russia during the early 1800s resulted 
in long supply lines that were unable to sustain his forces. Since the campaign was not 
over before winter, his forces were not prepared, were short of supplies, and forced to 
withdraw to France. During their long march, Napoleon lost 75 percent of his forces due 
to disease or nonbattle injuries and the cold weather. The Germans, however, did not 
review the problems and failures of Napoleon’s campaign before their Russian offensive 
on 22 June 1941, during World War II; otherewise, they might not of had the same 
problems and failures that Napoleon had in the early 1800s. 

Modern US Army rotary wing aeromedical evacuation operations and doctrinal 
concepts can be traced back to the Korean and Vietnam Wars. These early concepts have 
formed the foundation for the current doctrine, structure, and employment of aeromedical 
evacuation assets on the battlefields of today. The overall purpose of this research is to 
identify and describe the major historical operational factors of US Army rotary wing 
aeromedical evacuation system in the Korean and Vietnam Wars. The successful 
operations of US Army rotary wing aeromedical evacuation system in each of these wars 
permit a historical comparison between them. 

The author will describe and discuss the general background of medical 

evacuation in chapters 1 and 2 and will address the primary and subordinate research 

1 



questions as they relate to the US Army aeromedical evacuation system utilized in the 
Korean War. During chapter 3, the author will address the research questions as they 
relate to the US Army aeromedical evacuation system utilized in the Vietnam War, to 
conclude with chapter 4, summarize the findings, draw conclusions, and make 
recommendations for action and further study. 

The Research Question 

This research study focused on the primary question: How did the US Army 
rotary wing aeromedical evacuation system, utilized during the Korean and Vietnam 
Wars, contribute to and shape today’s US Army rotary wing aeromedical evacuation 
system? The following seconardy investigative questions were developed and analyzed in 
order to evaluate and answer the basic research question: What were the organizational 
structures of US Army rotary wing aeromedical evacuation system during each of the 
wars? This question will cover the initial history, structure, and how the US Army rotary 
wing aeromedical evacuation system evolved to include numbers and types of helicopters 
and unit size. In addition, it will include the geographic locations of these units. How 
were US Army rotary wing aeromedical evacuation assets utilized during each war? This 
question will cover how the units and helicopters were generally utilized and what were 
some of the challenges facing the unit commander. How were US Army rotary wing 
aeromedical evacuation assets employed during each war? This question will cover in 
more detail the tactical employment of the units, actual specific missions flown, and 
specific accounts of exemplary service. What rotary wing aeromedical evacuation lessons 
did the US Army learn in each war? How were US Army rotary wing aeromedical 


2 



evacuation lessons learned from the Korean War applied by the US Army during the 


Vietnam War? 


Assumptions 

The author assumes that the historical contributions of the US Army rotary wing 
aeromedical evacuation system can be evaluated, that both primary and secondary 
sources will be valid and reliable means in reaching a conclusion, and that the Combined 
Arms Research Library will have enough primary and secondary sources to provide 
historical data to complete the thesis. 

Definitions of Terms 

There are common key terms and definitions used in the thesis. While sometimes 
used in different context, the following list of definitions is used: 

Aeromedical Evacuation . The movement of patients under medical supervision to 
and between medical treatment facilities by air transportation. 1 

Casualty . Any person who is lost to the organization by having been declared 
dead, duty status—whereabouts unknown, missing, ill, or injured.” 

Casualty Evacuation/Transport (CASEYAC) . The movement of casualties by 

3 

nonmedical transportation assets without provisions of en route medical care.” 

Died of Wounds (DOW) . A hostile or battle casualty who dies after having 
reached a medical treatment facility. 4 

Disease and Nonbattle Injury . A person who is not a battle casualty but is lost to 
his organization by reason of disease or injury or by reason of being missing where the 
absence does not appear to be voluntary due to enemy action or to being interned. 5 


3 



Dustoff . A tactical call sign or code name given to Army rotary wing medical 
evacuation helicopters performing aeromedical evacuation or medical evacuation 
(MEDEVAC) during the Vietnam War 6 

Mass Casualty . Any large number of casualties produced in a relatively short time 
period, usually as the result of a single incident, such as a military aircraft accident, 
hurricane, flood, earthquake, or armed attack. 7 

Medical Evacuation (MEDEVAC) . The timely and efficient movement of patients 

8 

while providing en route medical care to and between medical treatment facilities. 

Medical Treatment Facility . A facility established for the purpose of furnishing 
medical and or dental care to eligible individuals. 9 

Patient . A sick, injured, wounded, or other person requiring medical or dental care 
or treatment. 10 


Limitations 

The author lacked experience in conducting independent, original research, 
sufficient time during the ten-month Command and General Staff Officer Course, and 
access to outside funds to conduct face-to-face interviews. Moreover, the primary 
limitation for this research project was the reliance upon secondary sources for the 
majority of the information, even though the author utilized several primary sources. 
Keeping this in mind, an overwhelming amount of written material pertaining to the 
subject resulted in a limited focus to Army rotary wing aeromedical evacuation during 
these two wars. The limited time allotted, the seventy-five-page limit, and lack of 
opportunity to travel will constrain the amount of primary source information that will be 
available. 

4 



Scope and Delimitation 

The scope of the thesis will be limited to US Army rotary wing aeromedical 


evacuation during the Korean and Vietnam Wars. The US Navy (USN) and US Air 
Force (USAF) neither during this time nor now have dedicated rotary wing aeromedical 
evacuation helicopters, even though the USAF made the widespread use of the term 
aeromedical evacuation. This term aeromedical evacuation utilized by the USAF actually 
refers to the evacuation at the operational and strategic levels through the means of 
transporting casualties by fixed wing aircraft from theater to theater and theater to 
continental US. The thesis will only briefly cover the contributions of the USAF tactical 
combat search and rescue (CSAR) rotary wing casualty evacuation and transport 
(CASEVAC) until Army aeromedical units were established. The medical personnel, 
hospital systems, and supply of all three branches of Army, Air Force, and Navy 
contributed to the overall success of medical operations in the Korean and Vietnam Wars. 
These areas were a very important part of the accomplishments of the medical services, 
but were not included in this research. In addition, the thesis did not focus in on the 
training, detailed command and control network, and the interwar periods. 

Several other modes of casualty ground medical evacuation to nonstandard 
evacuation were utilized during the Korean and Vietnam Wars. The other modes were by 
ships, combat and civilian vehicles, animals, and foot. Even though these were an integral 
part of the evacuation system, they were not included in this research. 

Background 

Aeromedical evacuation operations performed during the Korean and Vietnam 

Wars were executed in an exceptional manner. The medical personnel, hospital system, 

5 



medical evacuation, and many other medical functions all contributed to the overall 
success of medical operations. 

To fully appreciate and understand the impact and importance of the US Army 
rotary wing aeromedical evacuation during the Korean and Vietnam Wars, it is important 
to have an understanding of how casualties and patients were evacuated in earlier times. 
The author will briefly cover casualty and patient evacuation from the American Civil 
War, Spanish American War, World War I, and World War II. With this understanding 
and evolution of earlier US military casualty and patient evacuation, one will understand 
the significant impact and importance of the United States Army rotary wing aeromedical 
evacuation during the Korean and Vietnam Wars. 

The American Civil War was the last great conflict waged before germ theory 
warfare entered the battlefield. Hospitals were unsanitary places, where, as the surgeon 
W. W. Keen later described it: 

We operated in old blood-stained and often pus-stained coats, the veterans of a 
hundred fights. We operated with clean hands in the social sense, but they were 
undisinfected hands. We used undisinfected instruments from undisinfected 
plush-lined cases. If a sponge or instrument fell on the floor it was washed and 
squeezed in a basin of tap water and used as if it were clean. 11 

A British surgeon by the name of Joseph Lister published his work on antisepsis two 

years after the end of the American Civil War. His effort would lay the groundwork for 

accelerated progress in the Spanish-American War, World War I, World War II, Korean 

War, and Vietnam War. 

At the beginning of the American Civil War, the Union Army Medical 
Department was unprepared to treat and evacuate the number of casualties and patients 
this war produced. The experienced veterans of the Mexican War had no idea of the 


6 



magnitude of the difficulties that would be involved in dealing with casualty evacuation 
on the scale of those seen during the Civil War. ~ As a result, the Union Army surgeons 
were called upon, for the first time, to develop plans for evacuating and hospitalizing a 
great number of casualties. This was a huge new undertaking with no developed methods 
of transportation for the wounded; a formal ambulance service did not exist. Each 
regiment theoretically had two ambulances that did not belong to the Medical 
Department; the Quartermaster Corps was the Army’s executive agent for patient 
evacuation. When ambulances were available they were driven by civilian drivers. These 
civilian drivers often fled at the first sound of shooting. The ambulances during this time 
came in two forms: the four wheeled and the two-wheeled version. The latter was issued 
in larger numbers in the beginning of the war and was very uncomfortable for the 
wounded. Near the end of the war, only the four-wheeled version remained in service. 

In the first years of the war, medical ambulances were in such short supply that 
three days after the First Battle of Bull Run on 21 July 1861, some three thousand 
wounded men still lay on the field. Washington hospitals would find themselves so over¬ 
crowded with casualties that cots had to be set up in the halls of Congress in order to 
facilitate the care of many of the wounded soldiers. There were even reports that 
wounded soldiers were forced to walk unaided back to Washington due to a lack of a 
coordinated evacuation system. A few key individuals quickly identified a desperate need 
for improving or reforming casualty care and evacuation. 

During the early months of 1862, the medical director of the Army of the 
Potomac Jonathan Letterman, a surgeon, took the first steps toward developing a system 
of evacuating casualties and patients from the front lines. His plan called for the 


7 



development of the first ambulance companies with permanently detailed soldiers from 
the ranks for ambulance work. Major General McClellan, commander of the Army of the 
Potomac, was so impressed with Letterman’s plan that he approved and issued on 2 
August 1862 a general order to the Army of the Potomac. This general order was 
executed before the Chief of Staff General Halleck or the Secretary of War Mr. Stanton 
approved it. Letterman’s plan was initially rejected by Secretary Stanton, but was finally 
pushed through Congress and sanctioned by law on 11 March 1864. 

Letterman’s initial plan was first tested on 17 September 1862 at the Battle of 
Antietam, which employed field stations and ambulances. After the USArmy officially 
adopted Letterman’s plan, it was finally standardized during the Spanish-American War 
in 1898. Letterman’s plan is the cornerstone for modern-day casualty evacuation. 

During the Spanish American War, the Army fully implemented Letterman’s 
plan. His plan was based upon a “chain of evacuation,” where the casualties were carried 
or assisted from the battle area to aid stations. Finally, field ambulances carried them to 
clearing stations and transferred them to field hospitals for further treatment. ~ Casualties 
were evacuated by rail and water transportation back to the bases or general hospitals. 
Letterman’s chain of evacuation forms the basis of today’s evacuation doctrine including 
the evolution of modern aeromedical evacuation doctrine. 

A soldier lies in a tent hospital in Siboney, Cuba, in July 1898, a victim of yellow 
fever. That month, senior US Army officers fresh from victories at San Juan Hill and 
Santiago proposed immediate evacuation: “The army is disabled by malarial fever to such 
an extent . . . that is in a condition to be practically entirely destroyed by the epidemic of 
yellow fever sure to come.” 14 The country of Spain actually surrendered before the 



president had time to weigh his options. Even though, the US had used the new 
evacuation doctrine for clearing the battlefield. The real enemy of the Spanish American 
War of 1898 would prove to be of another nature. The US suffered fourteen times as 
many deaths from tropical diseases than from enemy action. Malaria and yellow fever 
would be the new enemy during this war. 

World War I, like other wars before it, saw many new medical improvements to 
meet the ever-changing threats. The introduction of mustard gas and the increased 
efficiency of conventional weapons meant larger numbers of combat casualties. The 
initial use of mustard gas resulted in too many casualties to be cared for in the nearby 
field hospitals. The result would be dramatic improvements in the total number of 
hospitals and in triage. In addition, the first motorized ambulances replaced the horse or 
mule-drawn wagons of early wars. The doctors observed that the casualties’ recovery 
rates were increased when the wounded soldiers could be evacuated from the front lines 
before infection had set in. 

The first evacuation of wounded military personnel by an airplane occurred 
during World War I at Flanders, France, on 18 April 1918. A French medical officer Dr. 
Chaissang had drawn plans for the modification of two French planes. He supervised the 
modifications 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 evacuation of the wounded was used to a minor extent in World War I 
because of the practical availability of the airplane for this type mission. The fuselages of 
the converted military tactical types were too narrow to accommodate stretchers, and the 
patients were not helped by exposure to the cold air. 15 


9 



The first successful air ambulance in the United States was created by Captain 
William C. Oaker and Major William E. Driver in 1918. They converted a biplane so a 
standard army stretcher would fit into the rear area. This airplane was used in giving 
assistance to mail-carrying pilots who experienced a high rate of crash landings during 
this period. Oaker and Drivers’ plane could land near the remote crash sites and evacuate 
the injured pilots. The use of the air ambulance plane allowed a doctor to fly to the 
injured pilot, treat him on the spot, and then fly him to a hospital if required. 16 

Some 80 percent of all World War II injuries were from bombs, mortars, and 
shellfire—not bullets. The result was more severe wounds accompanied by shock. World 
War II would be the first war that plasma was introduced. When required, the plasma was 
mixed with sterile water and injected into the blood stream to sustain life until surgery 
could take place. 

Even though during World War I the air ambulance made significant 
advancement, at the beginning of World War II many military authorities believed air 
evacuation of patients was not only dangerous, but also, medically unsound and militarily 
impossible. General David Grant’s, the first air surgeon of the Army air forces’, proposal 
for an air evacuation service was met with much opposition in the upper levels of the 
Army. However, Grant continued to push for an air evacuation system, and in June 1942 
he succeeded. 17 

The first large-scale combat aeromedical evacuation of the war took place in New 
Guinea in August 1942. The Fifth Army air force evacuated more that 13,000 patients 
over 700 miles to Australia in a period of seven days because of an Allied 
counteroffensive against the Japanese. 18 


10 



By 1943, the Army Air Evacuation service had moved significant numbers of 
wounded soldiers by air transport. That year alone, over 173,500 casualties were air 
evacuated back to the United States. During the following year 1944, over 545,000 
casualties were air evacuated, and in 1945 at the wars end, over 454,000 more soldiers 
were evacuated with a thre- year total of over one million. The new air evacuation 
doctrine showed that aeromedical evacuation was a new alternative. One key leader who 
was convinced of the importance of aeromedical evacuation was General Dwight D. 
Eisenhower, Supreme Allied Commander in Europe. Weeks after D day, General 
Eisenhower stated, “We evacuated almost everyone from our forward hospitals by air, 

JO 

and it has unquestionably saved hundreds of lives—thousand of lives.’ 

Helicopters were rarely used during World War II. The first aeromedical 
evacuation test flight was the Sikorsky R-6 in November of 1943. The Sikorsky R-6 
helicopter carried one pilot, one medical attendant, and two simulated litter casualties that 
were attached to the outside of the helicopter to facilitate loading and unloading. The 
casualties could be seen by the pilot and attendant during flight. On 23 April 1944 the 
first actual US Army helicopter aeromedical evacuation rescue mission took place by 
Lieutenant Carter Harman. Lieutenant Harman rescued casualties from stranded forces 
about twenty-five kilometers west of Mawlu, Burma. 

Air evacuation of military patients continued after the end of World War II. On 7 
September 1949 the Secretary of Defense directed that evacuation of all sick and 
wounded, in peace and war, would be accomplished by air as the method of choice. 
Hospital ships and other means would only be used in unusual circumstances. An era of 
aeromedical evacuation had finally emerged. 


11 



*US Army, Field Manual (FM) 101-5-1 and Marine Corps Reference Publication 
(MCRP) 5-2A, Operational Terms and Graphics (Washington, DC: Headquarters, 
Department of the Army, United States Marine Corps, 30 September 1997), 1-3. 

2 Ibid„ 1-24. 

3 Ibid., 1-24. 

4 Ibid., 1-52. 

5 Peter Dorland and James Nanney, Dustoff: Army Aeromedical Evacuation in 
Vietnam (Washington, DC: Department of the Army, 1982): 29-30. 

6 US Army, FM 101-5-1/MCRP5-2A, 1-54. 

7 Ibid., 1-98. 

S Ibid., 1-99. 

9 Ibid., 1-99. 

1 °Ibid., 1-119. 

1 ^‘Military Medicine,” American Heritage 35 (June 1984): 65. 

12 Mary C. Gillet, The Medical Department, 1865-1917 (Washington, DC: Center 
of Military History United States Army, 1995): 153. 

13 

Eloise Engle, Medic: America’s Medical Soldiers, Sailors, and Airmen in Peace 
and War (New York: John Day, 1967), 29. 

14 “Military Medicine,” 69. 

15 A Concise History of the USAF Aeromedical Evacuation System (Washington, 
DC: Department of the Surgeon General, United States Government Printing Office, 
1976): 2-3. 

16 Ibid. 

17 Ibid, 8. 

18 

‘Allen D. Smith, “Air Evacuation—Medical Obligation and Military Necessity,” 
Air University Quarterly Review 6 (summer 1953): 103. 

19 A Concise History of the USAF Aeromedical Evacuation System, 11. 


12 



°Smith, 102. 


13 



CHAPTER 2 


KOREAN WAR 


A specialized vehicle of high cost and limited effectiveness, the 
medevac chopper won its fame as an evacuation vehicle under 
conditions that were unique to the Korean War. As a wealthy 
nation that admired technical innovation and placed a high value 
on individual life, the United States was well fitted to finance such 
a pioneering effort. Preexisting medical skills of a high order were 
necessary to make the trial a success, for only a medical service of 
great sophistication could have dealt competently with the massive 
and near-fatal injuries that were the helicopter’s specialty. The 
endeavor was not militarily significant, but it boosted morale by 
demonstrating that, against all purely material considerations, the 
nation intended to save every possible life. The typically high-cost, 
low-yield experimental period during the Korean War proved the 
potential of a vehicle whose future impact on all emergency 
medicine, both military and civilian, would be great indeed. 1 

“Seeking the Roots of Dustoff—Helicopter Proves 
Self as Life Saver in Korean War, Part Two” 


Introduction 

The research for this chapter focused on the first portion of the primary question: 
How did the US Army rotary wing aeromedical evacuation system, utilized during the 
Korean War, contribute to and shape today’s US Army rotary wing aeromedical 
evacuation system? The author developed the following subordinate investigative 
questions in order to evaluate and answer the basic research question: What were the 
organizational structures of US Army rotary wing aeromedical evacuation during the 
Korean War? How were US Army rotary wing aeromedical evacuation assets utilized 
during the KoreanWar? How were US Army rotary wing aeromedical evacuation assets 
employed during the Korean War? What rotary wing aeromedical evacuation lessons did 
the US Army learn during the Korean War? 



Dr. Richard Meiling, Chairman of the Armed Forces Medical Policy Council, 
stated with conviction before the outbreak of the Korean War in 1950: 

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 

2 

unwilling to recognize the inherent soundness of air evacuation. 

Many senior officers from the Army, Navy, and Air Force still believed that ships 
and ground transportation were the most efficient and best ways to evacuate casualties. 
The resistance and reluctance to utilize rotary wing aeromedical evacuation at the 
beginning of the Korean War impeded the development of a sound detailed system of 
aeromedical evacuation. The primitive state of the road network in Korea attributed to the 
significant transportation difficulties (see figure 1). The scarcity of hard-surface roads, 
the lack of lateral links between the few main highways, and the harsh climate often 
made it extremely difficult to transport casualties from forward units. This lack of both 
infrastructure and adequate US medical facilities in Korea helped to establish Army 
rotary wing aeromedical evacuation as the reasonable and necessary course to follow. 

Flelicopters appeared in significant numbers for the first time during the Korean 
War. They were utilized primarily in a support role, performing logistic resupply to 
ground forces, transporting soldiers, as well as reconnaissance missions; however, 
planners failed to realize the importance of the helicopter as an essential option for 
casualty evacuation. 

During the early months of the Korean War, rotary wing aeromedical evacuation 
was thought of as a last resort method of transporting the wounded, as it was only utilized 
in those extreme cases when the casualties could not be evacuated by means of stretcher 


15 



bearers, field ambulances, trains, or hospital ships. The US Army’s policy and doctrine at 
this time was to keep the casualties as far forward as possible, so they could be returned 
to combat; the Army’s medical evacuation system was designed to be in line with the 
Army’s policy. 



Figure 1. Korean Map. Source : Frank A. Reister, Battle Casualties and Medical Statistics 


(Washington, DC: Department of the Army, 1973), 25. 


16 











Senior officers recognized at the strategic level that USAF fixed wing aircraft 
offered the cheapest and fastest means to evacuate casualties from Korea to the US. Even 
though this was recognized early on, it still would take approximately eighteen months 
after the beginning of the war to see fixed wing and rotary wing aeromedical evacuation 
aircraft gain widespread acceptance—not through policies or doctrine but through its 
proven usefulness and effectiveness. 3 

Aeromedical Evacuation Organizational Structures 
The initial history of the organization starts with the USAF, and later Army 
aviators, employing the equipment available to them, developed a rotary wing 
aeromedical evacuation doctrine that would become a sophisticated part of the Army’s 
medical evacuation and treatment system during the war. However, the Army 
aeromedical evacuation “MEDEVAC,” as it became known, concept was created and 
developed by the soldiers and officers in Korea, such as the Eighth Army surgeon, with 
little backing from the Army Medical Service establishment back in the US. 

Nevertheless, as the concept proved itself, the Surgeon General recognized the need to 
create a formal MEDEVAC structure in the Army Medical Service and to staff 
MEDEVAC units with true medical aviators, rather than pilots borrowed from other 
branches. During the war, pilots from other branches flew the lifesaving helicopters and 
became de facto Army Medical Service members; others would actually transfer to the 
Army Medical Service Corps. While these pilots from other branches flew the 
MEDEVAC missions, no true Medical Service Corps pilots existed in Korea until after 
the 1953 armistice. 


17 




In the Korean War Air Force units actually provided the first rotary wing 
CASEVAC—not aeromedical evacuation, even though the term “aeromedical evacuation” 
was used out of context throughout the war describing USAF rotary wing casualty 
evacuation. The Air Force unit 3rd Air-Sea Rescue (ASR) Squadron arrived in Korea in 
July 1950 under the command and control of Captain Oscar N. Tibbetts and was the first 
helicopter unit utilized during the Korean War for this mission. It is important to know 
that this unit actually was not an aeromedical evacuation unit by the true definition of the 
word, since the USAF did not have dedicated rotary wing aeromedical evacuation 
helicopters. The USAF was able to dedicate helicopters to the CASEVAC mission since 
there was little air opposition in Korea. Consequently, one of the squadron’s detachments 
began responding to evacuation requests for Army casualties. Recognizing the 
effectiveness of rotary wing evacuation, Captain Feonard A. Crosby, Army Medical 
Service Corps, set up a demonstration in the courtyard of Taegu Teacher’s College on 3 
August 1950. Captain Crosby demonstrated how to employ MEDEVAC helicopters for 
tactical frontline evacuations with great success, and one week later, the Fifth Air Force 
commander authorized the use of helicopters for tactical frontline evacuation of Army 
soldiers. 4 

After hearing of the success of Captain Crosby’s demonstration, Major General 
Raymond W. Bliss, US Army Surgeon General, became convinced that the Medical 
Department needed its own air ambulance helicopters. During a visit to Korea in October 
1950, General Bliss discussed medical evacuation problems with General MacArthur and 
upon his return reported to his staff that: ‘MacArthur feels that helicopters should be in 
the Tables of Orgainization and Equipment (TO&E) and should be part of medical 


18 



equipment—just as an ambulance is.’ 0 The Surgeon General requested two helicopter 
ambulance companies of twenty-four helicopters each. By 20 October 1950, the Army for 
immediate airlift had purchased eight helicopters for the Far East Command. Major 
General George E. Armstrong, deputy surgeon general, successfully carried the fight to 
the Army staff and would succeed Bliss later in 1951. At this point, the USAF and Army 
agreed that Army units would provide tactical frontline rotary wing aeromedical 
evacuation, and USAF units would provide strategic fixed wing aeromedical evacuation 
outside the combat zone. 

The first four Army aeromedical evacuation helicopter detachments arrived in 
Korea and were assigned to the operational control of the Eighth Army, but supervised by 
the Eighth Army Surgeon beginning in January 1951. Each of these detachments was 
broken down into two sections, a pilot or commissioned officer section that included the 
commander and an enlisted mechanic section. The sections were authorized four 
personnel each, one pilot and mechanic per helicopter. In addition to the personnel 
sections, the detachments were authorized two Bell ET-13s and two ETiller FI-23s 
helicopters, equipped with two exterior pods for litter casualties; one ambulatory casualty 
could also be carried at the same time under ideal conditions in the cockpit if required. 

The 1st Flelicopter Detachment never became operational, because its helicopters 
were diverted to other units immediately upon arrival to Korea, but the remaining three 
detachments were each attached to a forward-deployed Mobile Army Surgical Flospital 
(MASFI) for command and control, rations, quarters, and administrative matters, since 
the detachments did not have internal support capabilities 6 The Army’s 2nd Flelicopter 
Detachment had four helicopters that flew from the 8055th MASFI located at ASCOM 


19 


city, south of Kimpo Airfield (K-16) outside Seoul. The 3rd Helicopter Detachment with 
four helicopters was attached to the 8063rd MASH located at Changhowon-ni, Yojo, and 
Chongpyong-ni. The 4th Helicopter Detachment had four helicopters which flew from 
the 8076th MASH located at Chunchon. 

There were four mobilie Army surgical hospitals (MASHs) in Korea at this time. 
One MASH was assigned to each of the three Corps, I, IX, and X, and one was held in 
reserve. As the hospitals rotated forward, one of the MEDEVAC helicopter detachments 
was attached to each of the active MASHs, which resulted in the detachments moving 
from hospital to hospital, as they rotated. 

The 2nd Helicopter Detachment was the first actual MEDEVAC helicopter 
detachment to arrive in Korea at Kimpo Airfield (K-16) in January 1951. The detachment 
was organized from assets of the 82nd Airborne Division that had been activated at Fort 
Bragg in October 1950 before its deployment to Korea. The detachment shipped its four 
H-13C models from San Francisco to Korea but never saw them again. To fix the loss, 
the Army airlifted eight H-13Ds to Korea directly from the Bell factory in Niagara Falls, 
New York. However, mishandling of the helicopters at the airfield in Korea damaged 
four of them and the 2nd Helicopter Detachment could only salvage four airworthy 
helicopters. Eventually, the 3rd and 4th Helicopter Detachments came on line and 
provided Army rotary wing MEDEVAC support to the United Nations’ (UN) forces 
throughout the war from their rotating MASH attachments. The 2nd, 3rd, and 4th 
Helicopter Detachments were originally considered general aviation units and not 
medical units since they did not have an official medical TO&E. 


20 



On 20 August 1952, the Army published the first official TO&E 8-500A for an air 
ambulance detachment with seven officers, twenty-one enlisted soldiers, and five 
helicopters. The first 8-500A Detachment was the 53rd Medical Detachment (Helicopter 
Ambulance), activated at Brooke Army Medical Center, Fort Sam Houston, Texas, on 15 
October 1952. Three more official MEDEVAC units with the 8-500A TO&E—the 49th, 
50th, and 52nd Medical Detachments (Helicopter Ambulance—were organized to replace 
the existing more or less ad hoc detachments in Korea during December 1952. During the 
early part of 1953, these units plus three others—the 37th, 54th, and 56th (the latter two 
existed only on paper)—were combined to form the 1st Helicopter Ambulance Company 
(Provisional) that combined all MEDEVAC detachments under a unified command for 
the first time. The official sources differ on whether this took place in February or June 
1953. 

In November 1952, the 49th Medical Detachment (Helicopter Ambulance), 
commanded by Captain John W. Hammett, was organized as the first purely medical 
aviation detachment with the new 8-500A TO&E in Korea, which evolved from the 2nd 
Helicopter Detachment. Hammett, a World War II artillery liaison pilot, later actually 
transferred to the Medical Service Corps. The helicopter and personnel authorization for 
the new 49th Medical Detachment (Helicopter Ambulance) remained the same as the 2nd 
Helicopter Detachment. 

When the Army decided branch chiefs should have their own aviation staff 
sections, the Office of the Surgeon General (OTSG) received an aviation section to 
coordinate planning, operations, staffing, and supply for medical helicopter units. That 
strengthened medical control over MEDEVAC. The OTSG also pushed for training 


21 



Medical Service Corps officers as helicopter ambulance pilots. The push began in early 
1951, but it took a year to amend regulations to allow it, which resulted in the Army 
creating a quota for twenty-five Medical Service Corps officers, mainly new lieutenants, 
to take flight training in October 1952. Eight Medical Service Corps officers started the 
first flight training class, and seven completed it successfully in February 1953. 7 By the 
summer of 1953, the Medical Service Corps received a standing quota for ten Medical 
Service Corps officers to enter the Army Aviation Achool each month; and by 1 October, 
the Army Medical Service Corps had twenty-four qualified pilots and had five additional 
pilots transfer over from other branches. 

Shortly after the end of the Korean War, the OTSG persuaded the Army to 
consider litter capacity in all future helicopter purchases whatever the primary mission. 
This was a factor in the selection of the Bell UH-1 Iroquois (Huey), which carried 
MEDEVAC to new levels during the Vietnam War. 

Now one can understand the initial history and evolution of the Army’s rotary 
wing MEDEVAC detachments in Korea to include, the first more or less ad hoc 
detachments of the 2nd, 3rd, and 4th without actual official TO&Es evolve into the new 
49th, 50th, and 52th Medical Detachments (Helicopter Ambulance) with an official new 
8-500A TO&E. Also, covered were the troop strengths, numbers of helicopters and their 
geographic locations of the detachments. The detachments were required out of necessity 
to evolve to meet the new challenges of the war in Korea, and these changes in 
organization would be the initial framework leading to the Helicopter detachments that 
later would be called upon to serve in the Vietnam War. 


22 



Aeromedical Evacuation Utilization 


Quick adoption and utilization of the Army helicopter, as an aeromedical 
evacuation platform was the result of both the nature of the Korean War and the Korean 
countryside. The broken and rugged terrain separated troops from each other and from 
medical facilities while the poor infrastructure and guerrilla warfare tactics used by the 
enemy initially, also contributed to the problem. Roads were rough and crowded making 
the ground evacuation of casualties traumatic, slow, and full of problems. In contrast, the 
MEDEVAC helicopter flight was fast and generally much smoother causing fewer 
traumas to the already injured casualties. 

Army rotary wing MEDEVAC was only a subdivision of the overall evacuation 
procedure in the Korean War. A basic understanding of the tactical frontline rotary wing 
MEDEVAC utilization process is necessary to fully understand the mission and the 
process. 

Injured soldiers from the front lines were initially brought to battalion aid stations 
by the means of litter teams, jeeps, trucks, and ambulances. At the aid stations, the 
casualties would receive first aid and emergency treatment as needed, and once 
stabilized, they were transported by ground to collection stations, where the more 
critically wounded casualties were flown by Army MEDEVAC helicopters to a MASH. 
Other casualties went by ground ambulance to division clearing stations. From the 
division clearing stations, casualties were then evacuated by Army MEDEVAC 
helicopters or ground to evacuation hospitals. 8 

During the Korean War the utilization of the rotary wing aeromedical evacuation 
system developed into a more routine procedure. At the beginning of the war before 


23 




Army MEDEVAC detachments arrived in Korea and became operational, the 3rd ASR 
Squadron utilized the H-5 and the H-19 helicopters and was given the task of evacuating 
tactical frontline casualties to MASH units located further to the rear. During the late 
summer of 1950, General Stratemeyer, Commanding General of the Far East Air Force 
(FEAF), wanted to expand his unit to develop a new squadron with more helicopters and 
trained medical personnel, but the USAF refused Stratemeyer’s request. Meanwhile, the 
Army authorized more helicopters for its units and started organizing helicopter 
ambulance detachments for utilization in Korea. In essence, these decisions meant that 
the Army would be responsible for the majority of the tactical frontline rotary wing 
MEDEVAC, while the USAF would provide strategic fixed wing aeromedical evacuation 
farther to the rear. 

During MEDEVAC missions, the Army helicopter detachments flew the H-13D 
and the Hiller H-23B, both of which were equipped with external pods. The casualties 
were originally placed in the open litters for evacuation, but the detachment soldiers 
modified the litters into pods to provide casualties with a protected environment. Then 
eventually the pods were modified again to allow casualties to receive transfusions while 
in flight. The rapid evacuation of these seriously wounded soldiers directly from the front 
lines to the appropriate level of the medical treatment significantly enhanced the 
survivability of the soldiers. The fatality rate from seriously wounded soldiers, which had 
stood at 4.5 percent during World War II, fell to 2.5 percent during the Korean War. 
MEDEVAC pilots evacuated more than 20,000 casualties of all nationalities during the 
Korean War. For example, First Lieutenant Joseph Bowler of the 2nd Helicopter 
Detachment evacuated 824 casualties between 10 January and 2 November 1951. 10 


24 



The new Army Medical Detachment (Helicopter Ambulance) commanders had 
many challenges facing them, their personnel, and most of all their equipment during 
their general utilization of the detachments. “There were conditions the weak, fragile 
Korean War helicopters could not work in, and things they could not do. Both machines 
and pilots were too scarce to be lightly risked.” 11 The pilots and ground mechanics had to 
learn by trial and error how to get the most out of the MEDEVAC helicopters under these 
conditions. 

Almost any damage from enemy fire was fatal to the helicopters. Therefore, the 
commander’s rules for their use were strict and tightly monitored by the Eighth Army 
Surgeon’s Office. Missions were restricted to serious injuries, and the pilots had a right to 
refuse any mission that would damage the helicopters. Pickups were supposed to occur 
only at medical treatment facilities and only in daylight hours. Nevertheless, the pilots 
often ignored the rules when there were emergencies. As one officer put it, they would go 

19 

to “any spot that was big enough to get the blades into.’ “ MEDEVAC helicopters were 
supposed to avoid fire, because any hit could be fatal to the helicopter and pilot. 
Helicopters could not fly high or fast enough to evade fire, and if hit they could not glide 
to safe landing areas; on a few occasions, it was even reported that MEDEVAC 
helicopters were shot at by Chinese jet fighters. These helicopter pilots, if shot down, 
could not even use parachutes due to low altitudes and rotors. 

MEDEVAC helicopters were not supposed to even fly at night because the Bell 
H-13 helicopter had no radios, instrument lights, or cockpit lights. Still, pilots often flew 
to aid wounded soldiers in enemy territory day or night, and there were several reports 


25 



where pilots held flashlights between their legs to read the instrument panel to get back to 
the airfield or MASH. 

Additional challenges were the training of the ground troops to guide helicopters 
in, provide coordinates, utilize marker panels, and utilize colored smoke grenades, to 
name just a few since the early MEDEVAC helicopters did not normally have radios. 
Sometimes the lack a of radio was a blessing, making the language largely irrelevant. 
MEDEVAC helicopter detachments supported all the polyglot UN troops. Attempts to 
communicate with the helicopters arriving into a Turkish or Greek landing zone might 
have been more dangerous than helpful, but the panels, smoke and sign language worked 
regardless of the language. For example, in September 1951, a pilot trying to evacuate 
two wounded Turks could not find them until a Turkish spotter plane buzzed him to get 
his attention and led him to the wooded summit where the casualties waited. The pilot 
descended just far enough to clip the treetops with his rotors, thereby alerting watching 
Turkish soldiers that the trees were too high. Quickly, the Turks chopped enough trees 
down for a landing, and the pilot flew the casualties to the MASH without ever talking to 
the ground forces. 13 

The range of the helicopters was limited. A MEDEVAC helicopter could fly only 
two hours unless the pilot carried along five-gallon jerry cans of gasoline in the cockpit 
or on the empty litter pods and refueled while the patients were loaded. Even the batteries 
in the helicopters were also very weak, to the point that some of these helicopters could 
not be restarted sometimes without external power. To avoid being stranded, pilots often 
kept the engines running during refueling. 


26 



Maintenance was always a commander’s nightmare during this time because parts 
shortages were common due to a slow procurement that the Army could not control. 

These helicopters required six hours of maintenance for each hour airborne and averaged 
only a little over an hour of flying a day, carrying an average of perhaps 1.5 casualties per 
day. 

One of the major challenges for detachment commanders was identified with the 
Army helicopter aeromedical evacuation system communication network. Requests from 
forward units for helicopter assistance went to headquarters and back through poor 
communication systems for approval. This caused a delay in the quick response, which 
could have been possible. 

With the reasons stated above, one could clearly see all the initial challenges for 
the detachment commanders and the reluctant reasoning of the senior generals on the 
utilization of the MEDEVAC helicopter. Even though the Eighth Army specifically 
ordered that Army MEDEVAC helicopters not be utilized or jeopardized in missions 
likely to encounter enemy action, MEDEVAC pilots often took risks that higher authority 
would have not granted to save lives and justify the use of the helicopter. 

With the knowledge of general utilization of these detachments, flying from 
MASH location to tactical frontline collection stations and division clearing station to 
MEDEVAC wounded soldiers, at sometimes great risk to themselves; one will 
understand the general utilization of these detachments. Along with this knowledge and 
knowing all the challenges of the detachment commanders, helicopter maintenance, lack 
of radios and cockpit lighting, rules for utilization, and range restrictions; one will have 


27 



the background knowledge that will compel changes in these detachments after the 
Korean War to be implemented before and during the Vietnam War. 

Aeromedical Evacuation Employment 

Army helicopters accomplished almost all of the forward tactical MEDEVAC of 
casualties, and the USAF strategic fixed wing aircraft were not used generally because 
there were no landing facilities forward. The initial primary employment mission of the 
helicopter during the Korean War was CSAR, but this research only covered the Army 
helicopter’s aeromedical evacuation missions and employment, due to the focused 
question and thesis restrictions. Developing the helicopter as the basic tool for medical 
evacuation employment was one of the most important logistical innovations of the 
Korean War. 14 The initial missions or employments assigned to the first helicopters in 
Korea were to fly high-ranking officers from one location to another. This was generally 
forgotten as the missions were changed to MEDEVAC and rescue missions in the first 
weeks of the war. 

The incident that changed the employment of the helicopter in Korea occurred in 
August 1950. The Air Force CSAR helicopter squadron was notified of a seriously 
wounded soldier at a frontline aid station on top of a 3,000-foot mountain with the aid 
station cut off from the rear area. The mission was to fly in and evacuate the soldiers; this 
was successfully accomplished with the soldier’s life saved. The following day the 
primary mission of helicopters changed to aeromedical evacuation and rescue. 15 

The Air Force accomplished most of the initial helicopter CASEVAC in Korea, 
until the Army Helicopter Detachments arrived for employment. The following is a 


28 




memo to the Surgeon General from Brigadier General Jarred V. Grabb, Deputy for 


Operations, Headquarters FEAF. 

Until 1 January 1951, the USAF performed all helicopter evacuation, 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 Eightt 
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. 16 

The Army regularly employed helicopters for MEDEVAC missions in the early 

part of January 1951. On 3 January 1951 First Fieutenants Willis G. Strawn and Joseph 

F. Bowler flew the first MEDEVAC mission. Bowler went on to set a record of 824 

medical evacuations in ten months. 

The British author and Korea veteran George Forty credits the MEDEVAC 
helicopters with evacuating 10,000 casualties including himself. Others give higher 
figures though. The official Army history notes 5,040 casualties in 1951, then 7,923 in 
1952, and 4,735 during the half year of fighting in 1953. The figures do not include 
casualties evacuated by Air Force and Marine helicopters and non-MEDEVAC Army 
helicopters. This was 10 to 20 percent of total battle casualties, which is directly in line 
with the memo, quoted above, to the Surgeon General from Brigadier General Jarred V. 
Crabb, Deputy for Operations, Headquarters FEAF. 

Helicopter Detachments were doctrinally and tactically attached and located at a 
MASH and employed to the front lines by the surgeon in charge. Initially, there were not 
enough MEDEVAC helicopters to meet all evacuation needs, so they had to be used 
discretely thus involving the chief surgeon. Helicopter evacuation was tactically 


29 



employed, when a soldier had a head wound, chest wound, or stomach wound, because 
the speed with which such wounded received medical attention determined the chance for 
survival. Wounded soldiers who were evacuated by helicopter from the front lines were 
often in surgery within an hour. 18 

With I Corps, the following procedure for tactical employment was used by 
Detachment I. A battalion aid station notified the surgeon’s office at I Corps of the 
location of the wounded soldiers; and 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, and the type marker used. The pilot and the medical 
technician then made the necessary pickup. 

The Eighth Army Surgeon said that half of the 750 critically wounded soldiers, 
evacuated on 20 February 1951, would have died if they had been moved by surface 
transportation—not by Army MEDEVAC helicopters. General Stratemeyer also had 
nothing but praise for the Army MEDEVAC pilots. He also continued to insist that Army 
MEDEVAC should continue to be separate from air rescue. On 16 January 1951 in 
Tokyo, General Stratemeyer gave General Hoyt S. Vandenberg, USAF Chief of Staff, a 
requirement for thirty-one additional helicopters for Korea. 19 

Army and Air Force agreements concerning Army MEDEVAC employment 
operations made on 2 October 1951 and 4 November 1951 made the Army responsible 
for tactical employment to pick up battle field casualties, their air transport to initial 
points of treatment, and any subsequent move to hospital facilities within the combat 
zone. 


30 



It is important to answer the question: How was US Army rotary wing 
aeromedical evacuation assets employed? The tactical employment of these MEDEVAC 
helicopters would lay the initial doctrine groundwork for the tactical employment of 
MEDEVAC helicopters in the early months of the Vietnam War. Furthermore, it is 
important to know who some of the heroes were and the specific missions flown during 
the Korean War because this mind-set of the MEDEVAC detachment commanders and 
pilots will lead to even more heroes flying even more complicated, specific, and 
dangerous mission during the Vietnam War to save soldiers’ lives. 


Aeromedical Evacuation Lessons Learned 
Many people had high praise for Army MEDEVAC during the Korean War. 
General Matthew B. Ridgeway, Commanding General of the United Nations Forces in 
Korea, singled out Army MEDEVAC in the Nineteenth Report of the UN Command in 
Korea to the UN Security Council. 

High praise must be paid to the elements engaged in evacuation by air of 
wounded personnel and individuals from behind enemy lines. Countless numbers 
of soldiers and countless numbers of men who would have become prisoners have 
been saved by prompt and efficient action of the air rescue and evacuation units. 
The wounded soldiers in Korea had a better chance of recovery than the soldier of 
any previous was. This 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." 0 

Other praises included Doctor Elmer L. Henderson, President of the American 

Medical Association, who, after returning from a visit to FEAF medical facilities, 

described air evacuation as “the greatest thing that has come out of this Korean incident 

as concerns saving lives.’ In 1952, the USAF Office of the Surgeon General stated, 

“Responsible medical officers at the front lines in Korea estimated that without rapid 


31 



transportation by helicopter and immediate emergency aid including blood transfusion, 

22 

80 percent of the wounded would have died.’ v 

Another advantage of Army MEDEVAC identified by the FEAF was from the 
humanitarian standpoint. Army MEDEVAC had an extremely positive effect on 
casualty’s morale. Knowing that they would be transported quickly and in as much 

comfort as possible to a medical facility, the casualties developed a “the worst is over” 

.23 

feeling, and their spirits were raised at this difficult time." 

Allen D. Smith compiled a list of the advantages of Army MEDEVAC in Korea. 
His list included the following: 

1. Morale—Casualties being evacuated realized that they would receive the best 
possible medical care in a very short time. 

2. Economy of time—Casualties 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 effective 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 over surface travel." 4 

Many people had high praise for just the performance of the newly introduced 
MEDEVAC helicopter during the Korean War. 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 conditions possible by helicopter. 

4. The patient can be moved to the treatment facility, which can best service him 
because of the speed, flexibility, and range of the helicopter. 


32 



5. The proper use of the helicopter permits economy of use of medical personnel. 
Since the helicopter will bring the casualties to the doctor, specialized people can 

be concentrated in forward areas and more and better surgery can be provided 

25 

with fewer people. 

There were also disadvantages of Army medevac operations. Ground forces had 
to learn that the helicopter had certain operating limitations. Helicopter could not fly in 
bad weather, could not land on any type of terrain, and could not then operate at night. 
Medical personnel had to overcome these among many different obstacles. The marking 
of landing sites, the transmission of accurate coordinates, and restricting helicopter 
evacuation to only critical cases were just a few of the solutions. 

The most useful helicopters used for MEDEVAC operations were the Bell H-13 
and Sikorsky H-5. A problem with the later was the type in use was no longer in 
production creating continuing problems with parts and making maintenance very 
difficult. Another disadvantage described by Neel was the cost. Transporting patients by 
helicopter was much more costly than using the field ambulance. Assuring the helicopters 
were used efficiently and for severe cases could minimize this cost. 

The ratio of maintenance time versus flying time of helicopters in Korea was 
about six to one. This had to be considered when planning helicopter evacuation. 

The following list is the top seven combined MEDEVAC lessons learned from 
both the Army and Air Force’s experience in the Korean War. 

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

2. The air evacuation detachments and squadrons assigned to the theater should be 
manned at 100 percent with personnel and equipment at all times. 

3. All aeromedical aircraft is used for the purpose within the theater should be 
under a single transport headquarters. The air evacuation detachments and 
squadron should be assigned directly to this headquarters. Such centralization 


33 



would make more aircraft available and would permit critically wounded 
personnel to be used more effectively. 

4. Medical evacuation should have top priority within the theater. 

5. The Air Force should assume and maintain the responsibility for operating 
patient holding facilities. 

6. Only school-trained air evacuation technicians should be furnished to air 
evacuation detachments and squadrons as combat crew replacements. These 
technicians should be 

7. 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 or operation. -6 

There was a large difference in airpower used by the enemy during the Korean 
War from other wars in the past. The lack of an air offensive by the enemy made Army 
MEDEVAC operations a much easier job than it possibly could have been. With the 
exception of a few incidents, helicopters were relatively free from enemy air attacks. If 
the enemy in Korea had committed more aircraft to fly in South Korea, the success of 
Army MEDEVAC might not have been as great. Helicopters evacuating casualties under 
the attack of fighter aircraft may have found it to be an impossible task. The use of the 
Army MEDEVAC helicopters during the Korean War fundamentally changed the 
Army’s medical-evacuation doctrine, existing organizational structure, utilization, and 
employment of these Medical Helicopter Detachments, which will lead the Army into the 
Vietnam War. The initial success of the air-evacuation system in Korea led to further 
refinements in medical and aviation doctrine during the Vietnam War and into the present 
day. These refinements are: better performing and reliable helicopters, helicopters that 
could transport more casualties, helicopters that could transport casualties inside the 
aircraft, and most of all a helicopter that could provide medical treatment en route by a 


34 



medic. In addition, the Army realized the further forward the MEDEVAC helicopter 
could go, the better chances of soldiers’ lives being saved. This along with the helicopter 
evolution changed the Army Medical Department’s evacuation doctrine going into the 
Vietnam War. These early pioneer MEDEVAC pilots, despite having no medical 
training, pushed the envelope and broke the mold on MEDEVAC methods. Despite the 
limited capabilities of their equipment, the MEDEVAC helicopter pilots of the Korean 
War established procedures and doctrine that laid the foundation of the modern Army 
MEDEVAC pilots. 



2Allen D. Smith. “Air Evacuation—Medical Obligation and Military Necessity,” 
Air University Quarterly Review 6 (summer 1953): 104. 

3 Ibid„ 585. 

4 Warner F. Bowers, “Evacuating Wounded From Korea,” Army Information 
Digest 5 (December 1950): 51. 

5 Rober F. Futrell, The United States Air Force in Korea, 1950-1953 (Washington, 
DC: Office of Air Force History, 1983), 589. 

6 “Aeromedical Evac,” Air Power History 14 (summer 2000): 38. 



S Albert E. Cowdrey, The Medic’s War (Washington, DC: United States 
Government Printing Office, 1987), 93. 

9 

M. T. Martin, “Medical Aspects of Helicopter Air Evacuation,” Journal of 
Aviation Medicine 23 (February 1952): 20. 

10 Harry G. Armstrong, Theater Aeromedical Evacuation System, (Washington, 
DC: Department of the Air Force, 1957), 20. 

1 'Cowdrey, 95. 


35 



12 

“Kenn Finlayson, “Helicopters in Combat: Korea,” Special Warfare 14 (summer 
2001): 39. 


13 

Richard V. N. Ginn, The History of the United States Army Medical Service 
Corps (Washington, DC: Office of the Surgeon General and Center of Military History 
United States Army, 1997), 244. 



15 Ibid. 


16 United States Air Force, The United States Air Force Medical Sendee and the 
Korean War (1950-1953), (Location: Department of the Air Force, Office of the Surgeon 
General, 22 August 1960), 14. 



18 Ginn, 244. 



90 

United States Air Force, 76. 


21 Ibid. 


22 


Ibid. 


23 

315th Air D ivision. H istory 315th Air Division (Combat Cargo), 1 January 
1951—30 June 1951 Historical Office, 315th Air Division (CC) APO 959, 

1951), 106. 

24 Smith, 323-332. 

25 

' Spurgeon Neel, “Medical Considerations in Helicopter Evacuation,” United 
States Armed Forces Medical Journal 5 (February 1954): 220-227. 

26 United States Air Force, The United States Air Force Medical Service and the 
Korean War (1950-1953), 76. 


36 


CHAPTER 3 


VIETNAM WAR 


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. 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, thank you kindly.” 
Sometimes it hurt so much inside you just crawl back to your 
quarters and have a quiet cry. 1 


Katerine Drake 


Introduction 

The research study for this chapter focused on the second portion of the primary 
question: How did the US Army rotary wing aeromedical evacuation system, utilized 
during the Vietnam War, contribute to and shape today’s US Army rotary wing 
aeromedical evacuation system? The intent of the following subordinate investigative 
questions is to evaluate and answer the basic research question above. What were the 
organizational structures of US Army rotary wing aeromedical evacuation during the 
Vietnam War? How were US Army rotary wing aeromedical evacuation assets utilized 
during the Vietnam War? How were US Army rotary wing aeromedical evacuation assets 
employed during the Vietnam War? What rotary wing aeromedical evacuation lessons 
did the US Army learn during the Vietnam War? 

Helicopter aeromedical evacuation officially began during the Korean War, but in 
that war, land-based ambulances still transported 80 percent of the wounded. In Vietnam, 
“dustoff ’ helicopters touched down forward of the aid stations on the battlefield itself and 
evacuated the wounded to air-conditioned fixed hospital facilities as sophisticated as 
those in the US. Army rotary wing aeromedical evacuation of casualties was one of the 



major advances of the Army Medical Department during the Vietnam War. In the 
previous chapter, during World War II when very few tactical aircraft were utilized to 
evacuate casualties from the field, the died of wounds rate was 4.5 percent; but during the 
Korean War, about one out of every seven US casualties was evacuated by helicopter, as 
a result the died-of-wounds rate dropped to 2.5 percent. During the Vietnam War, the 
actual rate dropped even further, due to the evacuation of the majority of US casualties 
from the front lines by Army dustoff helicopters, while the USAF Military Airlift 

Command (MAC) evacuated the seriously wounded from theater by strategic fixed wing 

2 

aircraft back to Japan and to the US. 

Location of the Vietnam War in relation to the US created some problems since 
Vietnam was a country halfway around the world, which resulted in US casualties being 
flown over 7,800 miles to reach Travis Air Force Base (AFB), California, and almost 
9,000 miles to reach Andrews AFB near Washington, DC. The nearest offshore US 
hospital was located almost 1,000 miles away at Clark AFB in the Philippines, but the 
nearest complete hospital was in Japan, 2,700 miles away. Within country, the 
waterways, jungles, and lack of infrastructure obstructed the tactical frontline evacuation 

3 

of casualties even without the interference of combat operations. 

South Vietnam was divided into four military zones as displayed in figure 2. The 
northern zone, or I Corps Zone, ran from the demilitarized zone down to Kontum and 
Bihn Dinh provinces with most of the terrain located in the high mountains and dense 
jungles. The II Corps Zone ran from I Corps Zone south to the southern foothills of the 
Central Highlands and was about 100 kilometers north of Saigon, which included a long 
coastal plain, the highest part of the Coastal Highlands, and the Kontum and Darlac 


38 



Plateaus. The III Corps Zone ran from the II Corps Zone to an area forty kilometers 
southwest of Saigon, which included the southern foothills of the Central Highlands, a 
few large dry plains, and jungles along the Cambodian border. Finally, IV Corps Zone 
included almost the entire delta formed by the Mekong River in the southern part of 
Vietnam that had no forests, except for the dense mangrove swamps at the southernmost 
tip and forested areas just north and to the east of Saigon. 4 



Figure 2. Source: Peter Dorland and James Nanney, Dustoff: Army Aeromedical 
Evacuation in Vietnam (Washington, DC: Department of the Army, 1982), 2. 

39 











Army rotary wing aeromedical evacuation became a routine part of the Army 
Medical Department’s evacuation system in Vietnam, which was universally referred to 
as “dustoff,” a radio call sign adopted in 1963. Medical Service Corps commissioned 
officer and warrant officer pilots who utilized this call sign and the enlisted members of 
the dustoff crews were the heirs to the Letterman legacy mentioned in chapter 1. The 
measures of their devotion glean from their statistics as the Medical Department lost 199 
helicopters in Vietnam, and one-third of the 1,400 dustoff pilots were killed or wounded. 
The memorial book of the Dustoff Association recorded 90 commissioned and warrant 
officers killed in Vietnam, and another 380 pilots were wounded or injured as a result of 
hostile fire or crashes. Casualties among crew chiefs and flight medics included 121 
killed and 545 wounded or injured. 5 

By 1967 there were over 94,000 injured soldiers transported by dustoff 
helicopters that led to the establishment of Air Force Regulation 164-1 that denounced 
earlier Department of Defense findings that air transport was unsafe. From April 1962 to 
the end of the Vietnam War, Army dustoff helicopters transported nearly one million 
military and civilian casualties. The success of the Army dustoff helicopters was largely 
attributed to the actual helicopter’s system design and flight crew. 

Dustoff 

Our kind of flying ain’t no fun 
Dustoff choppers ain’t got no guns. 

But now and then a medic will say 
A machine gun would just get in the way. 6 


40 



Aeromedical Evacuation Organizational Structures 
Major changes in the Army rotary wing aeromedical evacuation of battlefield 


casualties and its organization structure were witnessed during the Vietnam War. While 
some of the same dustoff helicopters that saw service in Korea were used initially, larger 
helicopters performed most aeromedical evacuations. One of the primary Army dustoff 
helicopters used for rescue, medical stabilization, and evacuation was the UH-1 “Huey” 
helicopter. These larger helicopters were a great improvement over their predecessors 
that were flown during the Korean War, since they carried the wounded inside the actual 
helicopter verses outside and provided a medic for en route patient treatment. In addition, 
these helicopters were much more reliable, required less maintenance, had longer range, 
were equipped with radios, and had inside lighting. 

To understand the organizational structure and how it evolved, one needs to 
understand the brief history behind the unit’s primary helicopter UH-1, its capabilities, 
and employment. The ability to carry the casualties inside the helicopter and to provide 
en route treatment was instrumental to the battlefield mortality rate since casualties en 
route to the field hospital could receive definitive medical treatment from helicopter 
medics. This was paramount in reducing the mortality rate of casualties during Vietnam, 
along with the initiation of specialty hospitals for the treatment of certain types of 
injuries. Dustoff helicopters brought modern medical capabilities closer to the tactical 
front lines than ever before, and they provided great flexibility in the treatment of 
casualties. The dustoff helicopters, working with the communication network on board, 
made it possible to evaluate the status of casualties while in flight and possessed the 
ability to be direct to the nearest hospital best suited to the needs of the casualty. If a 


41 



hospital developed a backlog of casualties, notification could be sent to the helicopter, 
and it could be redirected to another location. During the Korean War, this would have 
never been possible, since the those helicopters did not even have radios. 

The first helicopter ambulance unit sent to Vietnam was the 57th Medical 
Detachment (Helicopter Ambulance), later nicknamed “The Originals.” This would not 
only be the first Medical Detachment (Helicopter Ambulance), but also the first aviation 
unit to deploy the UH-1 helicopter in Vietnam. The detachment was authorized, by 
TO&E, five UH-1A helicopters. The personnel organization consisted of two sections: 

(1) pilot or commissioned officer section of seven that included the commander, 
maintenance officer, and operations officer and (2) enlisted soldier section of twenty-one 
that included mechanics, medics, flight operations, and supply. Armydustoff helicopters 
utilized a crew of four: aircraft commander (pilot), copilot, medic, and crew chief (who 
handled the helicopter’s preventive maintenance) armed with an automatic rifle; unless 
flying into dangerous areas, the crew chief was usually left behind to allow additional 
space for additional casualties, unlike the crew of one during the Korean War. The crew 
flew the UH-1 Huey from the early “A” model to the “I” model in use at the end of the 
war, with an official capacity for six litter casualties, but with eight to thirteen reported as 
transported at once. Pilots and copilots were graduates of a special course fordustoff 
pilots. Although some warrant officers lacked this specialized training, close teamwork 
resulted from the beginning. 7 The unit’s mission was to support the 8th Field Hospital, 
which it was actually attached to for command and control, rations, quarters, and 
administrative matters at Nha Trang. This was the standard doctrinal employment of the 
detachment that actually changed little from the Korean War. Initially, two helicopters 


42 



were stationed at Qui Nhon and three at Nha Trang; but later as fighting escalated, 

Captain John Temperelli Jr., commander of the 57th, changed the helicopters’ locations 
in order to improve response time. 8 

In late February 1963 Captain Temperelli turned over the command of the unit to 
Major Lloyd E. Spencer, the veteran pilots rotated out of Vietnam, and the replacements 
arrived. After his arrival. Major Spencer was requested to see General Stillwell and was 
asked how he was going to cover all the requirements in the country with just five 
helicopters. All Spencer could say was that he would do his best, but General Stillwell 
promised the first five new UH-1 “B” models in South Vietnam to the 57th. On 11 March 
1963, the last of the UH-1 A models were signed over for return to the US, and the 
following day the Support Group issued the detachment five new UH-1B models that 
resulted in the 57th becoming operational again at the end of March 1963. 9 

In August 1964, the Surgeon General’s office named four more air ambulance 
units for assignment to Southeast Asia that included the 82nd Medical Detachment 
(Helicopter Ambulance) at Fort Sam Houston, Texas, being given a 1 October 1964 
move date. The three other units were put on notice without firm departure dates. It is 
important to note at this time that all four of these units identified have the same TO&E 
as the 57th initially. The 82nd Medical Detachment (Helicopter Ambulance) became 
operational in November 1964 in IV Corps Zone (the Delta). 10 Three of the 57th pilots 
were transferred to the 82nd, and three of the 82nd pilots were transferred to the 57th. 
This was to aid in training the crews for the critical dustoff mission. Major Henry P. 
Cappozzi commanded the 82nd, and Major Howard H. Huntsman commanded the 57th at 
this time. The question of the call sign came up, so the new commanders settled on the 


43 



“57th” call sign and unit emblem for the 82nd. The 57th pilots objected to the piracy, but 
the policies were practical. Both units performed the same mission, and the common 
symbols helped the ground forces recognize the ambulance helicopters. 11 

After the Surgeon General announced the actual departure dates for the remaining 
three units in September 1965, the 498th Medical Company (Air Ambulance), another 
type of medical evacuation unit, was deployed to Vietnam. This unit had a TO&E 
different from the other medical detachments (Helicopter Ambulance). It was initially 
authorized twenty-four two-patient helicopters and strength of twenty-eight officers and 
fifty-five enlisted soldiers; but before the unit deployed to Vietnam, they received 
twenty-five new UH-1 “Ds” fresh from the Bell Helicopter Plant to replace the Korean 
War twenty-four two-patient helicopters. The 498th Medical Company (Air Ambulance), 
under the command of Lieutenant Colonel Joseph P. Madrano, became operational in 
Vietnam on 20 September 1965, with the company being divided with one and one-half 
platoons at Qui Nhon, oneand one-half platoons at Pleiku, and the fourth platoon at Nha 
Trang. The company headquarters, maintenance platoon, and operations section was at 
Nha Trang. The distance of the platoons from the headquarters in Saigon created a few 
problems. However, the dispersion of the company provided excellent coverage for 
dustoff support; although it created many maintenance difficulties, maintenance was 

12 

accomplished at three sites by the single maintenance platoon assigned to Nha Trang. 

The 283rd Medical Detachment (Air Ambulance) arrived in Vietnam in August 
1965, followed by the 254th Medical Detachment (Air Ambulance) before the end of the 
year, but the 254th was not operational until February 1966 because of a backlog at the 
port that delayed the arrival of the unit’s equipment. The four detachments 57th, 82nd, 


44 



283rd, and 254th were authorized six helicopters each and supported III and IV Corps 

Zones (this was an increase to the TO&E of one helicopter and crew). However, the 

498th Medical Company (Air Ambulance) was authorized twenty-five helicopters and 

13 

supported II Corps Zone. 

March 1966, the 44th Medical Brigade, which was activated in January, assumed 
operational command and control of most Army medical units in Vietnam. During the 
next two years, the brigade coordinated the activities of the 68th Medical Group (III and 
IV Corps Zones), the 43rd Medical Group (South II Corps Zone), the 55th Medical 
Group (North II Corps Zone), and the 67th Medical Group (I Corps Zone) (see figure 3). 

In 1965, another new form of air ambulance unit was established, the air 
ambulance platoon. These units, unlike the air ambulance units of the 44th Brigade, 
depended upon the combat assault divisions for command and control and supply issues. 
The air ambulance platoon usually consisted of twelve UH-1 helicopters, fourteen 
officers, and forty-four enlisted; after testing this new system, the initial air ambulance 
platoon was deployed to Vietnam in August 1965, as part of the 15th Medical Battalion, 
1st Cavalry Division (Air Mobile). The unit consisted of a medical evacuation section 
with eight helicopters and a crash rescue section with four helicopters, which the 
platoon’s pilots, unlike the helicopter detachments of the 44th Medical Brigade, used 
“MEDEVAC” as their call sign. This was in part to keep the old tradition from the 
Korean War, so that they could be immediately recognized as part of the 1st Cavalry 
Division. 14 To protect the platoon’s aeromedical evacuation helicopters, they began 
requesting gunships on call, but the platoon’s MEDEVAC pilots thought traveling with 
the slower gunships wasted time. 15 


45 




Figure 3. Source: Peter Dorland Peter and James Nanney, Dustoff: Army Aeromedical 
Evacuation in Vietnam (Washington, DC: Department of the Army, 1982), 1. 


46 














The next unit established in Vietnam was the 436th Medical Company (Air 
Ambulance) (Provisional). It was established from the old 57th and 82nd Detachments, 
along with the 254th and 283rd Detachments. The 43rd Medical Group took command of 
the provisional company, and the new group’s mission was to supervise alldustoff 
missions in III and IV Corps Zones. It operated twenty-two helicopters and was expected 
to improve the coordination of the air ambulance detachments, but these improvements 
did not occur. Each detachment retained its own separate identity and regarded the 
company as just another headquarters in the chain of command, and in September 1966, 
the provisional company was renamed the 436th Medical Detachment (Company 
Headquarters)(Air Ambulance) and attached to the 68th Medical Group. 

In March 1967, General Westmoreland told the Commander in Chief, US Army, 
Pacific, that his theater needed 120 dustoff or MEDEVAC helicopters and that he only 
had 64. In April, some measures were taken to correct the situation, and helicopters and 
pilots were taken from nonmedical units and assigned to dustoff units. 16 In addition, in 
September 1967, the 45th Medical Company (Air Ambulance) and four other air 
ambulance detachments arrived in Vietnam, while other units were moved around to 
provide the best area coverage in response to the tactical situation, unlike the days in 
Korea where the medical helicopter detachments rotated to forward MASHs. In 1968, 
four more detachments were sent to Vietnam completing the final buildup of dustoff 
units, totaling 116 Army helicopter ambulances in Vietnam by 1969 assigned into two 
companies and eleven separate detachments for operational command and control 
purposes. 


47 



Understanding the initial history and evolution of the Army’s rotary wingdustoff 
detachments, platoons, and companies during the Vietnam War and how they evolved 
into the new medical companies (Air Ambulance) seen at wars end is vital because the 
changes were required to keep pace with the changing US Army, doctrine, and the nature 
of war itself. This will always be the case, and these changes can be seen in today’s 
current medical company (Air Ambulance) organization. In addition, the troop strengths, 
numbers of helicopters, and their geographic locations of the detachments, platoons, and 
companies covered were. The dustoff units were required out of necessity to evolve to 
meet the new challenges of the war in Vietnam, and these changes in organization would 
be the initial framework and organizational structure leading to the current medical 
company (Air Ambulance) that the US Army currently has with little changes. 

Aeromedical Evacuation Utilization 

General utilization of aeromedical evacuation in the Vietnam War, like the 
Korean War, was broken down into separate systems, but due to the primary focus of the 
research on Army rotary wing aeromedical evacuation, the author will primarily focus on 
the forward tactical Army aeromedical evacuation system. 

Army dustoff helicopters usually flew the evacuation missions from the tactical 
front line and the intratheater flights within the battle area. M.S. White, in a study 
illustrated the breakdown of evacuations for the three services. The study showed the 
percentages of wounded evacuated to the US as 60 percent Army, 35 percent Navy and 
Marine Corps, and approximately 5 percent Air Force. This is a direct result of the 
different missions performed by the services in Vietnam. 


48 




If one element of medical logistics was selected to be responsible for increasing 
the number of lives saved, it would certainly be the utilization of Army dustoff helicopter 
ambulance units. The helicopter evacuation crews utilized the UH-1 helicopter 
ambulances in evacuating nearly all-tactical frontline casualties, while the Air Force 
CSAR helicopters occasionally assisted in these operations as CASEVAC helicopters 
transporting casualties. 

A different utilization was that the 57th sometimes accepted healthy passengers 
on a space-available basis with the condition the passengers might have to leave the 
helicopter in the middle of nowhere if the pilot received a dustoff request while in the air. 
As the year went on, the 57th was utilized more and more to fly dustoff missions. In 
September 1963, the 57th actually evacuated 197 Vietnamese civilians from the Delta, 
where the Viet Cong (VC) had destroyed three large settlements. This led to the dustoff 
helicopter crews making flights with Vietnamese jammed in the passenger compartments 
and standing on the skids. 

As the war went on, it was apparent that rescuing wounded soldiers from the 
dense jungles was a valid requirement, and consequently, the Army would now have to 
devise another utilization for the dustoff helicopters. This jungle extraction would lead to 
a completely new method of utilization. One of these examples was when Captain 
Donald Retzleff, 1st platoon, 498th Medical Company, Nha Trang, performed the first 
actual hoist rescue mission 17 May 1966. The mission was flown in support of the 101st 
Airborne Division, twelve miles north of Song B a. The medic rode the cable down since 
it was the first time the hoist was utilized, and once on the ground, the medic showed the 
ground troops how to place the wounded soldier in the vest. The first casualty lifted was a 


49 



lieutenant who had been killed an hour earlier. Before that day was over, the hoist had 
lifted seventeen soldiers wounded in action to safety. 

The continued use of the hoist throughout Vietnam created several improvements. 

A rigid litter was added for patients who were too seriously wounded to be put in the 

vest. Neither the vest nor the litter worked very well in the dense jungle areas. To solve 

this problem the “Jungle Penetrator” was developed. The penetrator was a torpedolike 

three-foot projectile attached to and lowered from the helicopter. Once on the ground, the 

seats were pulled down from the bottom half of the projectile, and the wounded was 
18 

strapped on. The first jungle penetrators arrived in Vietnam in June 1966 and were 
placed in use after extensive training in October 1966. 

The use of the hoist required great skill, training, and courage by the dustoff 
crews. The pilot usually communicated simultaneously with the ground unit and the 
medic and the crew chief in the rear of the helicopter, since it was crucial the helicopter 
remain motionless while hovering 200 feet in the air. The slightest movement was 
amplified through the hoist cable to the ground. In addition, there was considerable 
anxiety waiting for the VC to fire on the helpless, hovering helicopters. Often there was 
darkness or strong crosswinds that made the operation even more difficult. All dustoff 
and MEDEVAC units operating in Vietnam were using the hoist by the end of 1966. As 
the jungle penetrator became more popular, the use of the vest was eventually 
discontinued. The rigid litter was used for patients who were unconscious or too seriously 
wounded for the jungle penetrator. 

Aeromedical evacuation over time almost became routine in Vietnam as the Army 
dustoff helicopters transported over sixty-four thousand casualties in 1966, and by 1967, 


50 



there were sixty-one helicopters providing dustoff support. Colonel Joseph P. Madrano, 
Medical Service Corps, who had been with the 498th Medical Company (Air 
Ambulance) in Vietnam, later emphasized the important story was not in the glamour of 
air evacuation but in its establishment as a routine part of a larger evacuation and 
treatment system. Certainly, the dustoff crews approached their duties in a 
straightforward way. As one pilot put it, “I’m not the hero type, just pulled a mission 
when called, got the poor guy out, took no chances but never turned one down either.’ 19 

At the peak of combat operations in 1968, the Army utilized 116 air ambulance 
helicopter which transported from six-to-nine casualties at a time. Army dustoff 
helicopter flights averaged about a thirty-five minute duration.^ Heavy armor plates 
protected the pilot’s seat, cockpit doors, and cabin floor as a precaution even though the 
Geneva Convention stated that helicopter ambulances should have large red crosses 
painted on the sides, nose, and bottom. In Vietnam, some crews in certain units only 
painted a small red cross on the nose; because they believed that the VC would use the 
large red crosses on the sides for targets, they painted over the other red crosses. Captain 
Ronald F. Hopkins, a pilot in the 2nd Platoon, 498th Medical Company, said, “We 
sometimes felt that VC are aiming particularly at the big red crosses on the side of our 
choppers, but they’re probably shooting at any helicopters they see. At any rate, they do 
not respect the red crosses at all.’ 

Like the commands during the Korean War, the new Army Medical Detachment 
(Helicopter Ambulance) commanders in Vietnam had many challenges facing them, their 
personnel, equipment utilization and most of their entire immediate command and control 
network. Although the some of the challenges were similar, many were different due to 


51 



the nature of this war, geography, senior leaders, and evolving doctrine. As units arrived 
in Vietnam initially, the largest problem was supply-related issues. For example, since 
the 57th Medical Detachment (Helicopter Ambulance) unit was not authorized a cook, a 
six-month supply of C-rations was obtained before deploying, and since there were no 
survival equipment for the helicopters, the men made up kits from the local stores before 
leaving the US. The typical kit contained a machete, canned water, C-rations, lensatic 

compass, extra ammunition, signaling mirror, and sundry items they thought they would 

22 

need in a crisis: and the kit was stored in a parachute bag." 

Even though the dustoff units were under some form of the Army Medical 
Department command and control network, there was always the bureaucracy of the 
senior headquarters, which created challenges. For example, on 8 February 1962, the US 
Military Assistance Command, Vietnam (MACV) was established which, before MACV, 
the Military Assistance Advisory Group (MAAG) acted as the senior military 
headquarters for all military units in Vietnam. The MAAG was comprised of Army, Air 
Force, and Navy sections, which were responsible for advising their counterparts in the 
Vietnamese military. As the first Commander, US Military Assistance Command, 
Vietnam (COMUSMACV), Lieutenant General Paul D. Harkins did not eliminate the 
MAAG, but kept it for advisory and operational matters in support of MACV. The 
MAAG also responded to the Commander-in-Chief, Pacific (CINCPAC), for the 
administration of the Military Assistant Program. The multiple lines of communication 
created some confusion within US units in Vietnam. For example, since MAAG had 
operational control of Army aviation units, the senior advisor assigned to a Vietnamese 
Army Corps could request US Army aviation support, and in fact, the Vietnamese corps 


52 



commander could directly request dustoff helicopter support. So, a request for 
aeromedical evacuation consisted of a minimum of three individuals; the Vietnamese 
Corps commander; the MAAG representative; and the commander of the helicopter unit. 
Problems that could not be settled between the advisor and the dustoff helicopter 
commander were elevated to General Harkins. The dustoff helicopter commander had to 
deal with and satisfy on a daily basis the Vietnamese Army, MAAG, MACV, and the US 
Army Support Group. Many commanders faced a futile bureaucratic chain of 
command." 3 

Another difficult command challenge arouse in September 1962 when General 
Stillwell, commander of the Army Support Group, Vietnam, contemplated transferring 
the 57th from the Medical Service to the Army Transportation Corps. Captain 
Temperelli, commander 57th at the time, accompanied by Lieutenant Colonel Carl A. 
Fisher, surgeon and commander of the 8th Field Hospital, visited General 

Stillwell and convinced him to maintain the current policy for operational command and 
control." 4 

The early Army rotary wing aeromedical evacuation system and utilization of 
dustoff helicopters in Vietnam went through growing pains, as its doctrine from the 
Korean War era was refined under new and different combat conditions. The 57th 
Medical Detachment arrived with five UH-1A model Hueys, but they were handicapped 
by difficulties in obtaining logistical support, particularly for fuel problems and spare 
parts including main rotor blades. Even the size of the red cross on the helicopter was 
even debated which led to some pilots believing the bigger it was, the better. In some 
reports, nonstandard or CASEVAC helicopters at the battle scene would extract 


53 



casualties rather than call for dustoff, but this entailed the usual “scoop and run” risks for 
the casualties. Some of the soldiers who were evacuated by this means died because they 
did not have somebody to stop the bleeding since they were usually just thrown on. 
However, reliance on the dustoff system was to the advantage of commanders and their 

soldiers. It provided medically trained crews, and a sufficiently large helicopter enabled 

25 

the treatment of these casualties in flight. 

One of the greatest challenges in the early years of the Vietnam War was the 
resolution for the ownership of the dustoff helicopters. Many senior officers challenged 
the doctrine of medical control over these aeromedical evacuation units and their 
helicopters in Vietnam, which was established early on from the Korean War era. The 
57th had to fend off officers with desires to ride on the helicopters. A colonel who 
wanted the detachment to fly him to different sites routinely pestered pilot Captain 
Robert D. McWilliams, Medical Service Corps, repeatedly to the point that McWilliams 
finally told the colonel he would have first priority on a ride by becoming a casualty, 
until then he would not have one. 

Since the 57th had the only UH-ls initially in Vietnam, it had no supply of 
replacement parts for the helicopters, which resulted in many challenges for Captain 
Temperlli. The unit even had to cannibalize parts from its own helicopters to keep the 
others flying. For example, during the visit of General Harkins and General Earle G. 
Wheeler, Army Chief of Staff, two of the 57th’s helicopters were on the ramp with no 
rotor blades because they had no spares. Situations like these and others discussed earlier 
in the thesis initially strained the 57th’s ability to employ their helicopters to the fullest 
potential. 


54 



After more aviation units arrived in Vietnam that also had the UH-ls, more 


problems of a different nature began. Combat units began to demand the 57th’s few 
remaining spare parts. This finally culminated in November 1962, when the 57th actually 
received instructions to bring all of its starter generators to Saigon. This was to provide 
parts for a large-scale combat assault, since many of the combat UH-ls had defective tail 
rotor gearboxes and faulty starter generators. Temperelli personally took the generators to 
Saigon and reported to Brigadier General Joseph W. Stillwell, commander of Army 
Support Group, Vietnam, that the lack of the generators on the 57th’s helicopters would 
leave South Vietnam without air evacuation coverage. Temperelli suggested that the 57th 
could actually fly in support of the assault, but Stillwell refused. Temperelli left without 
the generators, but with a promise that they would be returned after the assault. Only one 
of the generators made it back to the 57th ironically, which resulted in the unit being 
completely grounded from 17 November to 15 December 1962. It was incredible that the 
only aeromedical evacuation unit in the country was shut down for almost a month. 

When the one generator was returned, the one operational helicopter was shifted back and 
forth between Nha Trang and Qui Nhon in an attempt to provide coverage at each 
location. 26 

Since the 57th flew few missions in the first year in Vietnam, many people argued 
there should not be a dedicated dustoff helicopter unit. Some even suggested removing 
the red crosses and assigning support tasks to the idle medical helicopters. Each time they 
were informed that they could have priority only if there were casualties. 

In 1963, the major disagreement heated up again of the challenges of utilization 
and command and control of the dustoff helicopters. Colonel John Kligenhagen, 


55 



Transportation Corps, commander US Army Support Command, Vietnam, discovered 
that the aeromedical evacuation helicopters of the 57th were not flying as much as some 
of the utility helicopters of Klingenhagon’s command. Colonel Klingenhagen proposed a 
plan that would paint over the red crosses of the dustoff helicopters and utilize them as 
general-purpose helicopters most of the time, which could be called upon for aeromedical 
evacuation mission if required. Newly promoted Major Temperilli’s response was since 
there was a shortage of fuel trucks in Vietnam, that the Army could utilize fire trucks in 
the same manor as a general-purpose trucks. Simply empty out the water and fill with 
aviation fuel. If there was a fire, the truck could drain the aviation fuel and fill with water 
to put out the fire. Colonel Klingenhagen told Major Temperille that was unacceptable 

because the trucks could never respond in time; thus. Major Temperille responded that 

27 

the same was true for his dustoff helicopters. 

Klingenhagen still maintained his philosophy that aeromedcial evacuation was an 
aviation operation that entailed the movement of casualties. Klingenhagen convinced 
Brigadier General Joseph W. Stillwell, commander of the Army Support Group, 

Vietnam, that his thought process was correct. Stillwell attempted to remove the 
operational control of the 57th from the theater surgeon’s control that resulted in 
Temperille having a personal meeting with General Stillwell, at which he able to 
temporarily squash the transfer proposal, but the efforts still did not cease. When General 
Stillwell left Vietnam in June 1964, Major Charles L. Brady Kelly, Medical Service 
Corps, then the commander of the 57th, presented Stillwell with a farewell gift that 
symbolized the struggle. His medics mounted five red crosses and the tail numbers of the 


56 



five dustoff helicopters on a wooden plaque. Kelly remarked; “Here General, you wanted 

no 

my God-damned red crosses, take them.’ 

Dustoff and MEDEVAC crews who flew missions during the Vietnam War had 
one of the most dangerous and difficult jobs that entailed landing and evacuating 
casualties under enemy fire, but was routine for these crews by war’s end. One-half of the 
members of these crews earned Purple Hearts for wounds during their one-year tour of 
duty. Dustoff and MEDEVAC units in Vietnam flew 496,573 missions from 1962 to 
1973, and over 900,000 casualties were evacuated to various medical facilities. 

With the knowledge of general utilization of these detachments, platoons, and 
companies flying to tactical frontline pick-up zones and aid stations to evacuate wounded 
soldiers, at sometimes great risk to themselves, one will understand the general utilization 
of these dustoff units, which has developed the groundwork for the utilization of the 
medical company (Air Ambulance) of today. The utilization of these assets had to change 
as the war changed from transporting civilians, to the other extreme of transporting 
deceased soldiers, and to the development of the hoist to overcome the jungles of 
Vietnam. Along with this knowledge and understanding of all the challenges of these 
dustoff commanders, helicopter maintenance, and most of all, the constant battle for 
command and control; one will have the background knowledge of what compelled 
changes in these units and strengthened the command and control issue of these units to 
remain under the Army Medical Department. This issue has been a constant struggle for 
the Army Medical Department during and after the Vietnam War, but the success during 
this war has ensured the existence of dustoff units and their command and control 
structure into the future. 


57 



Aeromedical Evacuation Employment 
Early in January 1963, an Army of the Republic of South Vietnam (ARVN) 
assault in the Delta convinced many senior officers that the 57th should be tactically 
employed closer to the fighting. Three American advisors and sixty-five ARVN soldiers 
were killed, and the 57th helicopters at Nha Trang and Qui Nhon were too far north to 
help evacuate the wounded. On 16 January, the Support Group ordered the 57th to move 
to Saigon for tactical operational reasons. The 57th only had one flyable helicopter at the 
time, but Temperelli was told again that new UH-1B models would be on the way. On 30 

29 

January, the 57th arrived at Tan Son Nhut Air Base in Saigon. Shortly after the move to 

Saigon, Major Lloyd E. Spencer took command from Temperelli in February 1963- 
In April 1963, two of the 57th’s helicopters went on a semipermanent standby 
mission to the town of Pleiku. Most of their tactical employment missions were in 
support of small US Army Special Forces teams in the highlands. In late June 1963, one 
of the helicopters at Pleiku was assigned back to Qui Nhon to continue coverage of that 
sector again. In I Corps Zone to the north, US Marine H-34 helicopters conducted both 
combat aviation support and CASEVAC missions. The 57th’s helicopters at Pleiku and 
Qui Nhon provided tactical support for II Corps Zone, and the three helicopters at Saigon 
covered II and IV Corps Zones, respectively. Even though all four regions of South 
Vietnam were covered, the evacuation capabilities were thinly employed. 

In February 1964, the 57th’s third group of new pilots, crews, and maintenance 
personnel arrived and were under the command of Major Charles L. Kelly. On 1 March 
1964, the Support Group ordered the helicopters at Pleiku and Qui Nhon to move to the 
Delta. Two helicopters and five pilots, now called Detachment A, 57th Medical 


58 




Detachment (Helicopter Ambulance), Provisional, flew to the base at Soc Trang. Major 
Kelly also moved with Detachment A south, since he preferred the field-to-ground duty. 
At Soc Trang the detachment lived in crude huts with sandbags and bunkers for 

protection, while the rest of the 57th in Saigon lived in air-conditioned quarters. Despite 

30 

the differences, most pilots and crew members preferred Soc Trang. 

It was at Soc Trang that Kelly, the first of many dustoff heroes in Vietnam, began 
the dustoff tradition of valorous and dedicated service. With the buildup of war activity, 
the 57th for the first time was receiving enough tactical dustoff requests to keep all the 
pilots busy, the dustoff helicopters were showing signs of age and use, and General 
Stillwell could not find replacement helicopters for the detachment. The pilots were 
flying more than 100 hours each month in dustoff missions, and some pilots stopped 
actually logging their flight hours after 140 hours, so the flight surgeon would not ground 
them for going over their monthly ceiling. Even so, the dustoff mission was once again 
under attack by the Support Command, which was pressuring the 57th to put removable 
red crosses on their helicopters and to begin accepting general-purpose missions. Kelly 
informed his men that the 57th must prove it is worth and “by implication, the value of 
dedicated medical helicopters—beyond any shadow of a doubt.’ The 57th not only flew 
tactical missions in response to requests, but also began to seek missions by flying on a 
planned circuit of 720 kilometers at night. This plan at many times delivered each night 
from ten-to-fifteen casualties to their medical destinations, otherwise they would have 
waited until the next day. During March 1964, this strategy resulted in 74 hours of night 
flying that evacuated nearly 25 percent of that month’s 450 evacuees. Finally, General 
Stillwell abandoned the idea of having the 57th use removable red crosses and gave them 


59 



unconditional support for the remainder of his tour in Vietnam. He would never again 

32 

support the dustoff units doing anything other than its evacuation role. 

Another problem for Kelly at this time was a lack of pilots. The Surgeon 
General’s Aviation Branch tried to have new Medical Service Corps pilots assigned to 
nonmedical helicopter units in Vietnam. They thought the new pilots would benefit more 
from the combat training than from dustoff flying. In June 1964, Kelly provided his 
response: 

As for combat experience, the pilots in this unit are getting as much or more 
combat-support flying experience that any unit over here. You must understand 
that everybody wants to get into the Aeromedical Evacuation Business. To send 
pilots to 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 

33 

in groups, rarely at night, and always heavily armed. 

By the beginning of 1966, the dustoff crews were very proficient and tactically 
sound. With four years of experience to learn from, the dustoff missions had evolved into 
a very specialized method of aeromedical evacuation. Crews were extremely close knit 
that resulted in each member of the four-man crew having very defined responsibilities. 
The success of the missions depended upon everyone knowing what they were supposed 
to do and doing it. The typical request would come from one of several sources. If an 
American or allied unit had casualties and a strong enough radio, it would call dustoff 
directly. If dustoff could not be reached directly, the request went to the unit’s 
headquarters and from there to dustoff. 

Whichever method was used, certain information had to be given. The necessary 
information included the exact location of the landing zone; the number and condition of 


60 



casualties; the type of wounds; radio frequency and call sign of the requesting unit; any 
special needs, such as hoist; terrain feature; enemy activity; and weather conditions. The 
first four were critical in order for the mission to be flown, but two elements in the 
request were open to interpretation, especially the condition of the wounded and the 
intensity of enemy fire. Often the conditions of the casualties were exaggerated in order 
to get them rapid medical evacuation. The other one was the landing zone being reported 
secure, when it was not, in an effort to assure an aeromedical evacuation mission. 34 

A dustoff crew on standby could be in the air in less than three minutes after 
receiving the tactical evacuation request. Once in the air, the pilot would tune to the 
dustoff frequency and receive his mission directions. While en route the pilot would also 
find the requesting unit’s frequency and notify it the crew was on the way. In addition, 
the pilot collected vital information about the landing zones. The copilot usually flew 
while the pilot worked the radio, and in the rear the crew chief and medic prepared for the 
wounded. 

Once in the landing zone, the crew chief and medic would quickly load the 
wounded or supervise the loading by personnel of the ground unit. When the casualties 
were loaded, the crew chief would give the pilot the signal to take off, and then the medic 
and crew chief would treat the casualties. The medic would report the condition of each 
casualty to the pilot who would radio this information to the nearest medical regulating 

officer (MRO). Based on this information the MRO would direct the dustoff helicopter to 

35 

the proper medical facility. ^ 

The number of casualties evacuated by Army dustoff helicopters rose from 13,004 
in 1965, to 67,910 in 1966, to 85,804 in 1967, and reached a high of 106,229 in 1969. In 


61 



1969, more than 104,112 missions were completed by crews flying about 78,652 combat 
hours. Each time a casualty was moved, he was counted again. In addition, a significant 
number of the evacuees were US and Vietnamese civilians. 

It is important to answer the question: How was the US Army rotary wing 
aeromedical evacuation assets employed during the Vietnam War? Because the tactical 
employment of these dustoff helicopters will be the initial doctrine for the tactical 
employment of dustoff helicopters after Vietnam, which can still be seen in the modern 
medical company (Air Ambulance). Furthermore, it is important to know who some of 
the heroes were and the specific missions flown during the Vietnam War, because this 
mind set of these early dustoff commanders and pilots will build the reputation, refine the 
doctrine, and develop the tactical employment concepts of today’s dustoff companies. 

Aeromedical Evacuation Lessons Learned 

The Vietnam War was new experience for the American Armed Forces. This was 
even truer for the Army dustoff units and soldiers. The experience with aeromedical 
evacuation in the Korean War was only a brief introduction to the Vietnam War. 
MEDEVAC helicopter flights in Korea rarely flew over enemy territory, and the terrain 
of Korea did not have the thick jungles and forests that often obstructed aeromedical 
evacuation helicopters in Vietnam. Army hospitals in Korea were relatively mobile, 
moving with the troops if required, while in Vietnam almost all hospitals were in fixed 
locations. 

Many people believe that aeromedical evacuation was the bright spot for the US 
in the Vietnam War. Major General Spurgeon Neel responded, in an oral interview, when 


62 




asked what the major lessons gained from the Vietnam War were, in respect to the 

operation of the aeromedical evacuation 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. 37 

Helicopter pilots and crews also encountered many problems in their attempts to 
evacuate casualties. Initially, the poor navigation equipment and shortage of instrument- 
trained pilots made it difficult to navigate the mountainous terrain of Vietnam. Added to 
that, the weather often made it even more difficult. 

One problem that continued through the war was the ground unit’s expectation 
that the Army dustoff helicopters would transport the dead. Although there was nothing 
in the regulation that authorized this, both the Army Republic of South Vietnam 

(ARVN) and American soldiers expected it. Nonmedical CASEVAC transport 
helicopters often evacuated both dead and wounded, and if dustoff helicopters had 
routinely refused to evacuate the dead, the combat units may have decided to rely 
exclusively on their nonmedial transports for evacuation of both wounded and dead. 
Combat operations might have also suffered since the ARVN soldiers often would not 

advance until their dead were evacuated. So most dustoff helicopters evacuated the dead 

38 

if it did not jeopardize the life of the wounded/ 


63 



The language barrier was also a problem that hindered the work of the helicopter 
evacuation crews. Almost half of the wounded evacuated by the crews could not speak 
English, and the crews usually could not speak Vietnamese, Korean, or Thai to 
communicate with the casualties. Even when the dustoff units shared bases with ARVN 
units, the language problem was serious. 

Pilots and crews also had to deal with the always-present threat of a serious 
accident. More pilots died from night and weather induced accidents than from enemy 
fire. The difficulties of flying a night mission were many since roads and towns normally 
used as aids in navigation were not well lit . Terrain, especially the mountains, became a 
great danger to pilots who lacked adequate navigation instruments. Adequate lighting at 

landing zones was virtually nonexistent. All these factors together result in many pilots 

39 

refusing to fly night mission while a few, like Major Patrick Brady, preferred them. 

The ever-present danger of being shot was always a threat for the Army dustoff 
helicopter crews. Comparing their loss rate with the nonmedical helicopter crews, the rate 
was 1.5 times as high. About ninety aeromedical evacuation helicopter pilots were killed 
by hostile fire or crashed because of hostile fire over the ten-year period. Another 380 
were wounded or injured because of hostile fire. Hoist missions were very dangerous 
missions; one out of every ten hits on dustoff helicopters occurred during hoist missions. 
The standard mission averaged an enemy hit once every 311 missions, but the hoist 
missions averaged an enemy hit once every 44 missions, approximately seven times as 
dangerous. 40 

Another problem for the helicopter pilots was the resentment felt by some of the 
ground commanders because of their inability to have direct command and control over 


64 



the dustoff helicopters and the evacuation process. Even though there was usually a large 
rank difference between the pilots and the ground commanders, there were few instances 
when the ground commander succeeded in getting direct support without first going 
through the proper request channels. 

The over classification of casualties was a continuing problem during the Vietnam 
War. This in conjunction with the lack of proper definition of the evacuation categories 
caused much controversy. Much of the controversy dealt with the classification. Most 
ground commanders had a difficult time saying their wounded could wait for twenty-four 
hours for medical attention, which was the time limit for priority casualties. USARV 
headquarters changed the regulation to read, “Priority: Casualties requiring prompt 
medical care not locally available. The precedence will be used when it is anticipated that 
the casualty must be evacuated within four hours or else his condition will deteriorate to 
the degree that he will become a urgent case.' 41 Some officers, such as Major Patrick 
Brady, thought there should only be two categories, urgent and nonurgent. He thought all 
missions should be flown as urgent, resources permitting, and the requestor should be 
allowed to set his own time limits on nonurgent casualties. 

During aeromedical evacuation missions, there were two extreme methods used 
by the dustoff pilots. Some like Kelly, Bloomquist, and Brady paid little attention to the 
security of the landing zones, the weather, or the time of day. Others were very cautious. 
The USARV regulation favored the more cautious approach. There was much tension 
between the pilots of these two styles of aeromedical evacuation. There was no attempt, 
and it probably would have done little good, to resolve the tension by any higher 
command. The regulation left the ultimate decision whether to reject or abort a mission 


65 



up to the individual helicopter commander. Major Brady, during his first tour in Vietnam, 
was told that if he kept taking so many risks he would be killed or earn the Medal of 
Honor, which he received during his second tour. Although most pilots did not perform to 
the exact level of Kelly, Bloomquist, and Brady, they did act bravely and honorably and 
earned widespread respect and gratitude from those who served in Vietnam. 

The Army Medical Service Corps aviation officers demonstrated their importance 
during the Vietnam War as a deployable medical asset. Along with these officers, the 
dustoff crews also possessed the same determined spirit as their predecessors in earlier 
wars. Through the persuasiveness of their actions, the courageous dustoff crews had also 
made the point that they were integral to the Army Medical Department, no different 
from their predecessor ambulance crews in the Civil War, Spanish American War, World 
War I, World War II, and the Korean War. The thought and attempts to dislodge them 
from medical control was a constant struggle, but was doomed to failure. Major Patrick 
Brady believed that Major Charles Kelly had introduced a uniquely medical orientation to 
dustoff that made it fundamentally different from general aviation. Kelly’s death sealed a 
tradition of intense pride by dustoff crews in their mission. Aeromedical evacuation was 
firmly established in the day-to-day support of combat operations in Vietnam. Dustoff 
helicopters were doctrinally forward deployed into operational areas throughout 
Vietnam. 42 


'Drake, Katherine. “Our Flying Nightingales in Vietnam,” Reader’s Digest 91 
(December 1967): 73-79. 

2 

Irving Stone, “Aeromedical Airlift Joins the Jet Age,” Air Force/Space Digest 51 
(March 1968): 66. 


66 



3 

Spurgeon Neel, Medical Support of the United States Army in Vietnam, 1965- 
1970 (Washington, DC: Department of the Army, 1973), 13. 

4 John L. Cook, Dustojf: Illustrated History of the Vietnam War (New York: 
Bantam Books, 1988), 21. 

5 Richard V. N. Ginn, The History of the United States Army Medical Service 
Corps (Washington, DC: Office of the Surgeon General and Center of Military History, 
United States Army, 1997), 321. 

6 Ibid„ 320. 

7 Ibid. 

8 

Neel, Medical Support of the United States Army in Vietnam, 1965-1970, 71. 

Q 

Peter Dorland and James Nanney, Dustoff: Army Aeromedical Evacuation in 
Vietnam (Washington, DC: Department of the Army, 1982): 27-28. 

10 Neel, Medical Support of the United States Army in Vietnam, 1965-1970, 71. 

11 Fred M. Cling man, An alysis of Aeromedical Evacuation Logistics in the Korean 
War and Vietnam War (^^^|n: Department of the Air Force, Air University Air Force 
Institute of Technology, 1989), 85. 

12 Dorland, 49-52. 

13 

Neel, Medical Support of the United States Army in Vietnam, 1965-1970, 71. 

14 Dorland, 48. 

15 Cook, 93. 

16 Dorland, 55. 

17 M. S. White, “Medical Aspects of Air Evacuation of Casualties from Southeast 
Asia ,"Aerospace Medicine 39 (December 1968): 782. 

18 

Steve Haldeman, “Jungle Medevac,” Army Digest 24 (August 1969): 45. 

19 Ginn, 321. 

20 

Carl Berger, The United States Air Force in Southeast Asia, 1961-1973 
(Washington, DC: United States Government Printing Office, 1977), 280-281. 

21 

' Kenneth E. Pletcher, “Aeromedical Evacuation in Southeast Asia,” Air 
University Review 19 (March 1968): 22. 


67 


“Dorland, 24. 

23 Cook, 25-27. 

24 Dorland, 27. 

25 Ginn, 321. 

26 Dorland, 25-27. 

27 Ginn, 322. 

28 Ibid. 

29 Clingman, 78. 

30 Ibid„ 82. 

3 ’Dorland, 34. 

32 Clingman, 83. 

33 Dorland, 37. 

34 Cook, 101-102. 

35 Clingman, 88. 

36 Neel, 9. 

37 

Spurgeon Neel, US Air Force Oral History Interview by John W. Ballard on 3 
March 1977, Brook AFB, TX, 32-33. 

38 Dorland, 79-81. 

39 Ibid„ 81-82. 

40 Ibid., 117. 

41 Ibid., 121. 

42 Ginn, 328-329. 


68 



CHAPTER 4 


CONCLUSION AND RECOMMENDATIONS 


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 days of the past. 
None of us can fully and faithfully recall impressions, perceptions, 
or emotions, which led to certain decisions. Particularly this is true 
for the writer who might not have been present at the event or 
place of decision. 1 


Jerome G. Peppers Jr., Military Logistics 
The Korean and Vietnam Wars are significant chapters in the country’s military 
history, and the Army rotary wing aeromedical evacuation played a vital role in both 
wars. The overall purpose of this research was to identify and describe the major 
historical operational factors of the US Army rotary wing aeromedical evacuation system 
in the Korean and Vietnam Wars and to answer the primary question: How did the US 
Army rotary wing aeromedical evacuation system, utilized during the Korean and 
Vietnam Wars, contribute to and shape today’s US Army rotary wing aeromedical 
evacuation system? The subordinate investigative questions were all stated previously in 
chapters 2 and 3 and were answered in these respective chapters. The primary focus of 
this chapter is to restate these questions along with a brief answer. In addition, the author 
will summarize the finding, draw a conclusion, and make recommendations for action 
and further study. 


Subordinate Investigtive Questions 

What were the organizational structures of US Army rotary wing aeromedical 


evacuation during each of the wars? 



It was apparent early on during the Korea War that the senior leaders recognized 
the need to develop an Army aeromedical evacuation unit with an official TO&E to 
support the Army combat troops in Korea in order to relieve the USAF CSAR units from 
the CASEVAC missions. This was finally accomplished in the establishment of the 
medical detachment (Helicopter Ambulance) and realignment of this unit to the 
operational command and control under the Eighth Army Surgeon attached to a 
corresponding MASH, which resulted in a more efficient application of the aeromedical 
evacuation helicopters. Many new organizations, such as the medical detachment 
(Helicopter Ambulance), medical platoon (Air Ambulance), and the medical company 
(Air Ambulance), were conceived as a result of the Vietnam War experience to meet all 
the new and unusually complex demands and challenges of that war. 

The forward Army rotary wing aeromedical evacuations in both wars were 
ultimately under the command and control of some form of the Army Medical 
Department. Although, this was a continuous struggle because of the many attempts to 
uproot the command and control of these helicopter aeromedical evacuation assets and to 
move them under the command and control of the Transportation Corps during the 
Vietnam War. This enabled officers with the most knowledge of aeromedical evacuation 
doctrine and medicine to make the ultimate decisions concerning the utilization, 
employment, who should be evacuated, and which location should be chosen. 

How were US Army rotary wing aeromedical evacuation assets utilized during 
each war? 

Army rotary wing aeromedical evacuation helicopters and crews played an 
essential role in the successful aeromedical evacuation of casualties in both the Korean 


70 



and Vietnam Wars. The aeromedical evacuation helicopter’s utilization changed from a 
rear-area asset during the Korean War move to a forward-deployed asset during the 
Vietnam War. In addition, the helicopters during the Korean War were flying just to fixed 
battalion aid stations; however, during the Vietnam War they transitioned to flying to the 
actual point of injury. During these forward evacuation missions throughout the Korean 
War, there was no en route medical patient care, and the patients were transported outside 
the helicopter. However, during the Vietnam War, the patients received en route patient 
care, and the actual patients were transported inside the helicopter. These changes would 
enable the medic to provide patient status to the pilot, who would pass the information 
over the radio. 

During the Korean and Vietnam Wars, radios were utilized extensively for 
aeromedical evacuation. Radios were used for communicating the requirements to the 
helicopter units in forward aeromedical evacuation locations during both wars. 
Throughout the Korean War, communication to the helicopters was transmitted from the 
corps surgeon’s office to a corresponding MASH. On the other hand, during the Vietnam 
War, the unit suffering the casualties contacted the actual aeromedical evacuation 
helicopters and or units directly if their radio had the ability to transmit the long 
distances. If the radios were unable to transmit the distance, the request was sent directly 
to the requesting unit’s headquarters. 

How were US Army rotary wing aeromedical evacuation assets employed during 
each war? 

During both wars the Army’s rotary wing aeromedical evacuation units were 
primarily tactical employed forward to support aeromedical evacuation missions. Air 


71 



Force CASEVAC helicopters and crews initially completed the tactical employment 
forward supporting the Army aeromedical evacuation system during the Korean War. 
This was due mainly to a lack of official Army aeromedical evacuation units, helicopters, 
and trained pilots. Army helicopters and crews eventually took over the aeromedical 
evacuation forward missions. Army rotary wing aeromedical evacuation was not done 
extensively until the Vietnam War. During the Vietnam War, Army dustoff and 
MEDEVAC helicopters were the primary means of forward aeromedical evacuation of 
casualties. Many medical officers with combat experience in Vietnam agreed that the 
reliance upon the helicopter was not a condition that was limited to the peculiarities of 
the Vietnam War. The Vietnam War era officially ushered in the rotary wing platform as 
a valuable resource for responsive and efficient patient evacuation. 

What rotary wing aeromedical evacuation lessons did the US Army learn in each 

war? 

Demanding situations during the Korean and Vietnam Wars exposed several areas 
in which various lessons were learned. Confusion often existed in both wars as to the 
command and control and utilization of these Army rotary wing aeromedical evacuation 
units. To prevent confusion as to responsibility and accountability, a thoroughly 
coordinated command and control chain of command should be established. This would 
require a thoroughly coordinated forward aeromedical evacuation plan that should 
identify the responsibilities of each key unit. The plan should be provided to all units, so 
that the responsibilities are well known to all concerned. In addition, the enormous 
responsibility of Army rotary wing aeromedical evacuation units demands that they be 
staffed and equipped as close to 100 percent of authorization as feasible. 


72 



The helicopter was first employed as a medical evacuation platform on a large- 
scale basis during the Korean War. The advantages of using the helicopter over ground 
transportation was one of the most valuable lessons learned during the Korean War, and 
that lesson was validated and expanded during the Vietnam War. The Army rotary wing 
aeromedical evacuation units transported the casualties to medical care faster and in a 
more stable environment than did ground transportation. The use of the helicopter 
reduced the number of medical facilities and medical personnel required, allowing care 
that is more specialized. 

The need is for ground commanders to be educated, so they will realize how 
import aeromedical evacuation planning and rehearsal is for them and their troops. 
Although the evacuation of casualties is a medical problem, the ground commanders 
benefit when the casualties have been evacuated in a timely manor. For aeromedical 
evacuation to be successful, the support of the ground commanders is an absolute 
necessity. 

Aeromedical evacuation had an exceedingly positive effect on the soldiers that 
were wounded, injured, or sick in Korea and Vietnam. A great sense of confidence and 
security existed because aeromedical evacuation would soon arrive and evacuate those in 
need to a medical facility to receive care. In addition, there was a requirement for all 
aeromedical evacuation units with a similar purpose and mission to be under a single 
command and control headquarters. This would prevent duplication of efforts, permit 
more helicopters to be available, prevent confusion about responsibilities, and finally 
allow maximum use of the limited medical units and personnel available. 


73 



How were US Army rotary wing aeromedical evacuation lessons learned from the 
Korean War applied by the US Army during the Vietnam War? 

The use of the helicopter as an aeromedical evacuation platform during the 
Korean War was a vital lesson that was very successfully applied during the Vietnam 
War. Although the lessons of the aeromedical evacuation helicopters were applied during 
Vietnam, many details were ignored. Maintenance and equipment support for the Army 
rotary wing aeromedical evacuation helicopters was lacking in Vietnam, just as it had 
been during the Korean War. A lack of trained technicians initially existed in Vietnam, 
just as it did in Korea. An obvious definition of responsibilities, as to command and 
control, who could be evacuated, and how to employ the assets existed during the Korea 
War. In Vietnam, the same was true initially during the early years of the war. The 
overall lessons learned from aeromedical evacuation during the Korean War were for the 
most part not utilized as learning tools in the Vietnam War. Although Army rotary wing 
aeromedical evacuation was an obvious success during both wars, it was through the 
personality of the commanders, unrelenting work, and creativity of officers and soldiers 
during these wars that the missions were accomplished. 

Further Research 

The research discovered significant changes and transitions in the area of Army 
rotary wing aeromedical evacuation during the interwar period between the Korean War 
and the Vietnam War that should be researched. This would actually reveal another 
subordinate question: What significant changes took place in Army rotary wing 
aeromedical evacuation during the interwar period from the Korean War to the Vietnam 


74 



War? The author identified the question for further research, since it could actually be 


another thesis in itself. 


Conclusion 

The conclusion from the analysis of Army rotary wing aeromedical evacuation 
throughout the Korean and Vietnam Wars was that both were interconnected which 
shared a common theme of dedicated casualty evacuation that evolved to meet the new 
specific demands and nature of those wars. During both of these wars, the fundamentally 
new doctrine and organizational structures proved successful as the units evolved. This 
evolvement was instrumental and relevant in the development of the current US Army 
Medical Department’s evacuation doctrine and unit organization. With minor 
modifications (but numerous name changes), the evolution from Korea to Vietnam and 
from Vietnam to present is virtually the same framework for today’s fleet today. The 
current Army Medical Company (Air Ambulance) seen today is a direct result of the 
unit’s organization structure, utilization, employment, and lesson learned from the 
Korean and Vietnam Wars. The concepts and doctrine developed during these wars 
influence the modern-day units of employing aeromedical evacuation helicopters far 
forward on the battlefield, having one medical company (Air Ambulance) in a direct 
support role of one per division and one per corps and the organization structure of the 
fifteen helicopter companies. The requirement evolved out of necessity to develop a 
better helicopter to transport the casualties. During the Korean War the H-13 helicopter 
with one engine, no radios, no lights, and no en route patient care was utilized; it carried 
two litter patients outside and maybe one patient inside the helicopter during flight. 


75 



During the Vietnam War the UH-1 “A” though “I” model helicopters with one 
engine with more power, radios, navigation aids, lights, hoist, and en route patients care 
by a medic were utilized; they carried up to six litters and one ambulatory or a mixed 
combination of patients inside the helicopter during flight. Finally, the modern-day UH- 
60A and UH-60Q helicopters, which have two high-performance engines, greater speed, 
greater lift capabilities, aircraft survivability equipment, complex radios and navigation 
equipment, oxygen, great lift capabilities, and greater patient capabilities. These 
helicopter choices evolved because of certain lessons learned and commander challenges 
from both wars. 

The current doctrine for aeromedical evacuation units is they are under the 
command and control of a medical headquarters; this is the direct result of their 
efficiency, effectiveness, and responsiveness during the Korean and Vietnam Wars. The 
modern-day Army aeromedical evacuation units will always have new challenges in the 
future, but future leaders, like Majors Kelly, Bloomquist, and Brady, will always be 
present to face those challenges. 


Recommendations 

During future conflicts and wars similar to the Korean and Vietnam Wars, Army 
rotary wing aeromedical evacuation is likely to be the only viable solution to the 
problems facing the US military of transportation of the casualties in a timely manor. It 
should not be thought of as the only method of evacuation to be utilized and employed 
when other systems or platforms cannot be used. Army rotary wing aeromedical 
evacuation should be planed, developed, rehearsed, and designed as the primary method 


of evacuation of casualties. One centralized command and control should be established 

76 



with the responsibility for the entire aeromedical evacuation process and system within 
the combat zone. 

The Army rotary wing aeromedical evacuation system set the standard for the 
entire military during both wars for casualty evacuation. The Korean and Vietnam Wars 
were examples of successful development of the casualty evacuation system, which 
taught the US much about Army rotary wing aeromedical evacuation. Since it was so 
successful during this time, it actually was instrumental in transforming the civilian 
emergency care system. The Departments of Defense, Transportation, Health and 
Education, and Welfare joined in a project called Military Assistance to Safety and 
Traffic (MAST) in order to establish a civilian rotary wing evacuation system equal to the 
system utilized by the Army. In one of the program’s early successes, Army helicopters 

piloted by Vietnam veterans flew more than four-hundred missions evacuating families 

2 

from a flooded area after hurricane Agnes in June 1972. 

In order for the lessons learned to become actual lesson practiced, they must be 
required to be studied and trained at the unit level at every opportunity. The US Army 
Medical Department’s rotary wing aeromedical evacuation system must prepare for other 
challenges that may lie ahead. While cognizant that history never repeats itself exactly 
and that no Army ever profited from trying to meet a new challenge in terms of the old 
practices, the Army rotary wing aeromedical evacuation system nevertheless stands to 
benefit immensely from the study of its experiences during the Korean and Vietnam 
Wars. This study should be of value in serving the Army Medical Department to develop 
future operational concepts, while at the same time contributing to the historical record. 


77 



Jerome G. Peppers Jr., Military Logistics: A History of United States Military 
Logistics, 1935-1985 (Huntsville AL: Logistics Education Foundation Publishing, 1988), 
need a page no. 

““Military Medicine,” American Heritage 35 (June 1984): 77. 


78 



APPENDIX A 


KOREAN WAR VIGNETTES 

An example of one of the Korean War Army MEDEVAC mission occurred 13 
January 1951, when the entire 2nd Helicopter Detachment, commanded by Captain 
Albert C. Sebourn, flew to help a battalion-sized unit surrounded by Chinese troops at a 
school near Choksongni. Taking along a MASH doctor who had asked for a helicopter 
ride, Sebourn flew to the site, landed in the schoolyard, and shut down his aircraft, only 
to see it damaged almost immediately by a mortar round. In the school, the unit 
commander asked them to take his wounded and bring back ammunition. However, no 
one went anywhere that day because the aircraft’s battery was dead, and Sebourn and the 
doctor slept under siege that night. 

When Captain Joseph W. Hely learned what had happened, he decided to go after 
Sebourn. At the request of the Eighth Army, he tried to fly to the school with ammo in 
both litter pods. Nevertheless, a snowstorm prevented his departure. However, the next 
day, he made it. Taking machinegun fire on landing, he delivered the ammunition, loaded 
two casualties, and jump-started Sebourn’s helicopter. The two helicopters made it out 
safely. 

That same day, Hely returned with two other 2nd Helicopter Detachment’s 
aircraft, bringing in food and ammo while taking out casualties; each flight in and out 
was shot at. On his last departure, Hely reportedly marked the perimeter with smoke and 
radioed attack instructions to an Air Force fighter. It is not explained what he used for a 
radio, since the H-13 did not normally have one. 



Another evacuation was made the next morning before the surrounded unit 


withdrew. Sebourn and Hely earned the Distinguished Flying Crosses for their actions. 

A specific tactical Army MEDEVAC mission of a different nature took place in 
the Iron Triangle; the 4th Helicopter Detachment based at 8076th MASH was notified to 
pick up two 7th Division casualties. Within three minutes of receiving the request, the 
helicopter with a CBS news reporter onboard by special permission was on its way. As 
aid and litter teams brought the casualties down from the hill, other soldiers laid out 
marker panels on a paddy field. The helicopter landed thirty minutes after the request and 
just as the litters arrived along with Chinese mortar fire. One shell landed just thirty feet 
from the helicopter. After US artillery was called in on the mortars, the wounded were 
loaded, and the pilot and reporter jumped into the smoke-filled cockpit without even 

checking for damage. Using a flashlight borrowed from an infantryman to read the 

2 

instruments, the pilot flew his casualties back to the MASH at 21:20. 



2 Robert F. Futrell, The United States Air Force in Korea, 1950-1953. 
(Washington, DC: Office of Air Force History, 1983), 589-590. 


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APPENDIX B 


VIETNAM WAR VIGNETTES 

One of the most interesting helicopter jungle extraction methods was actually 
tested at Fort Bragg, North Carolina. It required the ground troops to strap a large 
collapsible box to the upper branches of a large tree. The box was dropped to them from 
the evacuation helicopter, and after strapping the box to the tree, the troops were to climb 
down and haul the injured or wounded soldier back up the tree to the box. They were to 
wait while the helicopter hovered over the box and the helicopter crew extended a four- 
foot ladder down to the box. The injured or wounded soldier would then be taken aboard, 
but this concept was ridiculous and too difficult to execute. 1 

The previous idea along with many others was not acceptable. The initial idea of 
trying to bring the casualty to the helicopter just was not practicable and led to the final 
solution: bring the helicopter to the patient. To accomplish this, a hoist was introduced as 
it was mounted inside the cargo area and anchored to the floor and ceiling behind the 
copilot’s seat. This enabled the hoist to swing outside the helicopter, so the cables and 
equipment were clear of the skids. It was powered by an electric winch and could lift 600 
pounds 200 feet. The hoist missions required the helicopter to hover over the wounded 
and lower the cable to the ground. On the lower end of the cable was a vest. The 
wounded soldier was placed in the vest and hoisted up to the waiting helicopter. The 
addition of the hoist added new capabilities, but also increased the danger because it 
required the helicopter to hover, motionless, above the pickup site, while the operation 
took place in a combat zone.” 



In November 1966 Captain James E. Lombard, Medical Service Corps, and First 
Lieutenant Melvin J. Ruiz, Medical Service Corps, while evacuating casualties near 
Saigon, became the first crew to be shot down on a hoist mission. As Lombard hovered 
and began lowering the cable, they came under fire, and he broke off the hover. With 
hydraulics gone and the transmission growling, they headed to a clear zone just a few 
minutes away. The helicopter traveled 150 meters before the engine quite, forcing 
Lombard to autorotate the burning helicopter to the ground. Fortunately, the crew 

survived and was met by friendly forces. Only two days later Lombard was again shot up 

3 

on another hoist mission. 

Up to this point, the 57th Medical Company (Helicopter Ambulance), the first 
helicopter ambulance unit in Vietnam, worked without a tactical call sign. They simply 
used Army and the tail number of the helicopter. If a pilot was flying a helicopter with a 
tail number of 63-12345, his call sign was Army 12345 as an example. They also 
communicated internally on any vacant frequency they could find. Major Spencer, 
commander of the 57th, decided this system was not acceptable for the tactical 
employment of his unit. He went to Saigon and visited the Navy Support Activity (NSA), 
which controlled the Signal Operations Instruction Book that listed all the unused call 
words. Many entries “bandit” were more suitable for assault units, but one entry, 
“dustoff” seemed appropriate for the 57th’s aeromedical evacuation missions, since the 
countryside was dry and dusty the helicopter pickups often blew dirt, blankets, and 
shelter halves all over the people on the ground. 4 By giving the 57th some identity, 
Spencer by accident had given a name to one of the most magnificent missions in the 
Vietnam War that others would later give meaning to the name as the popularity of 


82 



helicopter aeromedical evacuation grew. Late in the summer of 1963, the NSA decided to 
reassign all of the call signs in Vietnam. Dustoff was given to another aviation unit, the 
118th Airmobile Company. Despite the urging of the NSA, the 57th refused to give up 

the call sign and the 118th refused to use it. The resistance was successful and the call 

5 

sign remained with the 57th. 

Even though the 57th retained its own call sign, it still had no formal mission 
statement. The pilots worked on the assumption that their main purpose was to evacuate 
wounded and injured US military and civilian personnel. It continued to provide 
evacuation service to the Vietnamese when resources permitted. Major Spencer, like 
Major Temperelli, continued to receive pressure from ground commanders to use dustoff 
helicopters for administrative purposes, but finally with General Stillwell’s support, he 
kept the 57th focused on the medical mission. 

On 1 July 1964, Kelly was making an approach to pick up wounded soldiers from 
a particularly dangerous area when the enemy opened fired. Kelly was repeatedly told to 
withdraw but he refused. A US advisor on the ground gave him a direct order “get out, 
dustoff, get out.” Kelly replied, “When I have your wounded.’ 6 A few moments later 
Kelly died with a bullet wound through his heart. Dustoff became the call sign for all 
Army aeromedical evacuation missions in Vietnam and “when I have your wounded” 
became the personal saying of many of the dustoff pilots who followed Kelly. 

Kelly became a legend, revered for his aggressive leadership and fearlessness in 
evacuating casualties. Ironically, his loss ensured that the Army’s aeromedical evacuation 
operations would use his mold, one characterized by unarmed, single-ship operations 
without escort helicopters by aviators who, like Kelly, were experienced in night flying. 


83 



In fact, the flying skills of dustoff crews were such that some general aviation pilots 
believed there was a special school to teach their fling techniques. Kelly was 

7 

posthumously awarded the Distinguished Service Cross. 

After Kelly’s death, Captain Paul Bloomquist, another dustoff hero, became the 
commander of the 57th in Saigon. Captain Patrick H. Brady went to SocTrang to take 
over Detachment A as the detachment commander. Assuming the 57th would now select 
its missions more carefully, the commander of the 13th Aviation Battalion in the Delta 
asked Captain Brady what changes would be made, now that Kelly was gone. Brady told 

him that the 57th would continue to fly missions exactly as Kelly had taught them, 

8 

accepting any call for help. 

In an interview by Time Magazine, US Army Major Paul “Big Ugly Bear” 
Bloomquist was asked why he continued to stay in Vietnam. Major Bloomquist had 
flown 750 combat missions, been wounded three times, won twenty-seven citations, and 
rescued more than 800 wounded soldiers at the time of the interview. He also volunteered 
for a second tour of duty and refused to take leave after the first fifteen months he was in 
Vietnam. He replied: 

Because, I like the excitement. And because I think that my crew and I can do this 
job better than anyone else. It is the job that counts above all, and it is the job that 
somebody has to do. 9 

On 6 January 1968, Major Patrick H. Brady, probably the best-known dustoff 
hero of the Vietnam War, Medical Service Corps, second tour in Vietnam, launched on 
his first mission of that day to evacuate two wounded South Vietnamese soldiers while 
under fire in a heavily fogged-in valley. This was after an attempt by another dustoff 
crew had failed. Brady tipped the helicopter over at an angle so that the rotor would blow 


84 



the fog away in front of the helicopter enough so his crew could make out the trail. 
Meanwhile he flew sideways so he could see more clearly out the open side window. On 
the second mission that same day, Brady responded to a call from a company of the 23d 
(Americal) Division that was trapped in a minefield in the Hiep Due Valley where the 
soldiers were pinned down by six North Vietnamese companies supported from the 
surrounding hills by mortars, rockets, and antiaircraft weapons. Again, a previous dustoff 
attempt had failed. Brady required four flights to extract the casualties, which were 
within fifty meters of enemy soldiers at a site where two helicopters had already been 
shot down. The brigade commander had tried to dissuade Brady from returning after he 
had delivered the first load of casualties to the fire support base overlooking the valley. 
Soldiers there had witnessed the entire panorama. They cheered as Brady landed, while 
the division surgeon, who met the ship, Lieutenant Colonel William S. Augerson, 

Medical Corps, saluted. 10 

On Brady’s third mission, he picked up casualties from an American unit 
surrounded southeast of Chu Lai. He approached the pickup zone by flying backwards to 
protect the cockpit from enemy fire, but the helicopter was badly damaged by gunfire that 
resulted in the controls being partially shot away and in the need for another helicopter. 
For the fourth mission that day he volunteered to pick up casualties in another minefield. 
A mine exploded during the pickup, wounding two of his crew and damaging yet another 
helicopter, but six casualties were successfully evacuated. He changed helicopters again 
and completed two more urgent missions before the day was over. Brady evacuated fifty- 
one casualties on this day. For his incredible actions, President Nixon presented the 
Medal of Honor in October 1969 to Major Patrick H. Brady, Medical Service Corps, the 


85 



first Medical Service Corps officer to receive the nation’s highest honor and the only 
Medical Department officer to win the award in Vietnam. 11 

Officers, such as Chief Warrant Officer Four (CW4) Michael J. Novosel, were 

representative heroes of the warrant officer dustoff pilots. Novosel had originally enlisted 

in 1941, completed flight school, and as an Army Air Corps Captain commanding a 

squadron in the Marianas, had flown in the covering force for General MacArthur’s plane 

as it landed in Japan. He was recalled to active duty as an Air Force major in Korea and 

again returned to civilian life when that war ended. At the time of the early buildup in 

Vietnam, he was flying for Southern Airways and held an Air Force Reserve Commission 

as a lieutenant colonel. Prevented by age from returning to active duty in the Air Force, 

12 

Novosel came into the Army in 1964 as a warrant officer dustoff pilot. 

By 1969, the forty-eight-year-old aviator was on his second tour in Vietnam and 
on the afternoon of 2 October 1969, CW4 Novosel and his crew responded to a dustoff 
request from ARVN units pinned down in an enemy training camp west of Saigon near 
the Cambodian border. Novosel was forced out of the area by enemy action six times and 
each time came back on another approach. After several such pickups and eleven hours 
of flying, Novosel himself wounded at point-blank range by an enemy soldier managed to 
evacuate twenty-nine wounded soldiers. President Nixon presented the Medal of Honor 
to Novosel in 1971 while his son, Michael Novosel Jr., also a dustoff warrant officer, 
looked on. The younger Novosel had joined his father in the same unit at the end of 1969, 

13 

and from January to April 1970, they flew together. This overall level of dedication was 
found in many of the dustoff units in Vietnam. 


86 



'John L. Cook, Dustoff: Illustrated History of the Vietnam War (New York: 
Bantam Books, 1988), 105. 

2 

“Fred M. Cling man, Analy sis of Aeromedical Evacuation Logistics in the Korean 
War and Vietnam War Department of the Air Force, Air University Air Force 

Institute of Technology, 1989), 92. 

3 

Richard V. N. Ginn, The History of the United States Army Medical Service 
Corps (Washington, DC: Office of the Surgeon General and Center of Military History, 
United States Army, 1997), 325. 

4 Peter Dorland and James Nanney, Dustoff: Army Aeromedical Evacuation in 
Vietnam (Washington, DC: Department of the Army, 1982), 27-28. 

5 Cook, 48. 

6 Spurgeon Neel, ‘Dustoff-When I Have Your Wounded,” United States Army 
Aviation Digest 20 (May 1974): 7-8. 

7 Ginn, 322. 

8 Dorland, 37-38. 

9 

“Gamest Bastards of All: The Medical Evacuation Team,” Time Magazine 80 (2 
July 1965): 25. 

10 Ginn, 327. 

n Ibid„ 326-327. 

12 Ibid„ 324-325. 

13 Ibid„ 324. 


87 



BIBLIOGRAPHY 


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