The real reason why Army MEDEVAC helicopters fly unarmed
Since the Vietnam War era, there has been a tension between the MEDEVAC force and the Army’s combat arms force. At the time MEDEVAC operated with functional autonomy on the battlefield as a Army Corps level unit. During that war when a request for MEDEVAC was received a helicopter was dispatched from the MEDEVAC fleet – often at the discretion of a sergeant. Many casualties were also picked up by the armed troop carrying UH-1 Huey helicopters. The rule of the day was if a call for a Dustoff was sent somebody went in to get the wounded.
The commanders of the newly formed helicopter airborne units openly sought control of the MEDEVAC helicopters. This was staunchly resisted by the MEDEVAC units.
In When I Have Your Wounded, (Army Magazine, June 1989) a first person account of those days, Major General Patrick Brady, recipient of the Medal of Honor, recalls:
“I was joining the 57th Medical Detachment (Helicopter Ambulance), which had arrived in Vietnam in April of 1962. Since then, they had struggled for operational definition, recognition and permanence. There were those who coveted their brand-new helicopters and many who felt that the medevac (medical evacuation) mission should be a part-time mission. Their primary mission was American casualties, and since there were few of them at this time, these folks believed that the medevac birds should be fitted with convertible red crosses and used for other missions when there were no casualties to carry. The unit was holding its own and had become known as Dust Off. This radio call sign had no particular significance. It had been picked from a list of call signs and kept to avoid confusion. When someone called for Dust Off, everyone knew it was for a casualty. Maj. Charles L. Kelly was the commander.”
“Kelly’s great adversary, and boss, was Brig. Gen. Joe (Joseph W.) Stilwell. He was Vinegar Joe’s (Gen. Joseph W. Stilwell of World War II China-Burma fame) boy, and we called him Cider Joe. This guy was a genuine character. He was not an aviator, but he flew; and when he wasn’t flying, he rode as door gunner. The man was combat hungry and tough as hell. I was told he once survived a jump after his parachute malfunctioned. The last I heard about him was that his plane ditched at sea, and he was never found. Some folks waited a long time for him to walk up off the ocean floor.
His meetings with Kelly were always colorful, occasionally comical and even violent. Kelly was not intimidated by anything, let alone rank. Stilwell resurrected the issue of convertible red crosses and the cannibalization of Dust Off. He told Kelly that it was only a matter of time until he gained control of Dust Off and noted that the surgeon general was a personal friend of his. Kelly allowed that the surgeon general might be his friend, but he wasn’t a damn fool.
Kelly called us together after his first meeting with Stilwell and warned that those “folks in headquarters” did not wish us well. If Dust Off is to survive, he said, we had better prove that no one else could do what we did as well as we did. Performance was the key to our survival, and although he never set any rules for us, he certainly set the example.
The key was patients-saving lives no matter the circumstances; get them out during the battle, at night, in weather, whatever. Get those patients, the more the better; and don’t let anyone else carry our patients.”
“I never again heard another word about convertible Dust Offs. In fact, they began to bring in more Dust Off units. There is no telling how many lives were saved because of Kelly, probably because of his death, and the preservation of the dedicated Dust Off as opposed to some part-time, ad hoc system.”
The Army Medical Department (AMEDD) and MEDEVAC leadership felt passionately that keeping MEDEVAC separate from the combat units granted it the ability to focus solely on its mission: retrieving the wounded from the battlefield and administering medical aid to them. Anything that diminished its ability to maintain a fleet of dedicated evacuation helicopters was to be fought.
In the early 2000’s the Army began restructuring itself into modular, self-standing units. The process included significant changes in how individual units were commanded and where they fit in the new modular Army structure. In a move that evoked loud protests and resistance from the Army Medical Department, the “Aviation Transformation Initiative” permanently embedded MEDEVAC units in the Combat Aviation Brigades within the Army’s aviation arm. AMEDD would retain responsibility for training the pilots and flight medics, but the crews and helicopters became the Charlie Company of the General Support Aviation Battalions within the various Combat Aviation Brigades and subject to the command and control of CAB commanders.
During the many meetings that worked out how the new structure would be implemented, some of the officers supporting the new structure voiced their opinions of the MEDEVAC mission and its pilots:
“My position on it was that it needed to be up under the aviation brigade… Arguments can be given for both sides of it. My personal view of it is that we hold that aviation brigade commander responsible for everything that flies. Therefore, if that’s the case, and they are looked at and he is responsible for that, what does the MEDEVAC do that is so special that that aviation brigade commander cannot oversee? And really, it is nothing. If you look at what a MEDEVAC pilot does, and what a lift pilot does, there is no difference. They transport items from point A to point B. What makes the MEDEVAC different is that mission equipment package that is in the back of the aircraft. And it is that medic and the equipment that is on board that aircraft that makes it special.
Otherwise, the pilots up there are no different. We put warrant officers in the front of the aircraft and go off single ship and perform that mission and they have no additional training other than their flight training. That’s no different than a lift unit can do.”
You can sense the frustration of the Colonel representing AMEDD in the planning sessions:
“I think it has been a theme. If you go back in time with Tom Scofield, all the way back to when they wanted us to be in aviation branch, there has always been a certain intent by the aviation community that MEDEVAC needs to belong to aviation. Some people will say they agree with it and some will say “No, don’t.” But I will say the current leadership that we had during the current transformation process versus the leadership that we had during the ’80s had a different opinion and the current leadership felt strongly that MEDEVAC should be part of aviation, and that aviation branch guys can command a MEDEVAC company. MEDEVAC should just be one of the many missions associated with aviation. Just like picking up bullets and supplies and milk and water. And that they can manage it; they can operate it; they can send it out where they need to; they can command and control it. …In some people’s minds, they think that this would be more efficient—to have MEDEVAC under aviation. …It looks great on Power Point slides.”
Having lost the argument about functional independence, AMEDD drew the line at allowing its helicopters to be available for alternate tasks like utility flights or, if armed, participating in assault operations.
The sole remaining limit on the use of the helicopters for non-MEDEVAC purposes was the prominent Red Cross symbols on every flat surface and the fact that the AMEDD could point to the Geneva Convention as an absolute barrier to arming the aircraft. Under the terms of that treaty the MEDEVAC fleet would remain dedicated to the MEDEVAC mission as long as it displayed the Red Crosses and flew unarmed.
AMEDD is pursuing a public relations campaign to stop the movement to arm the MEDEVAC helicopters as reported by this email to Michael Yon site in early February 2012:
02 February 2012
An Army officer writes:
The Army is not resisting Dustoff policy change because our leadership honestly believes the current policy is superior, but rather because of AMEDD’s (Army Medical Department) protectionist attitude toward “their” Dustoff MEDEVAC helicopters. I’m an active duty infantry officer, and I’ve been following the Dustoff issue since you first brought attention to it. More importantly, I have a lot of contacts within the Medical Service branch. While we have discussed this issue “around the watercooler” at work, Medical Service officers have been receiving briefings from senior members of their branch about a selectively edited account of SPC Clark’s MEDEVAC mission, and what their message should be if anyone asks about it.
My contacts have highlighted that AMEDD’s number one priority is protecting their “ownership” of the helicopters in question. They are concerned that removing the Red Cross from AMEDD’s birds will result in those helicopters being assigned general purpose tasks, outside of the Medical Service Corp’s control. In other words, their top priority is NOT providing the best possible care for our Soldiers and partners, but rather protecting their own fiefdoms. AMEDD is choosing to put Soldiers’ lives in danger rather than chance losing “their” birds. Never mind that our sister services, special operations forces and allies are all able to field armed, dedicated CASEVAC/MEDEVAC helicopters! Somehow, despite all the evidence to the contrary, this is still the irrational argument AMEDD is sticking to, and directing its officers to spread. I’m concerned that in the dust-up over policy recommendations, comparisons with Pedro, and rebutting the JCS letter that we may be losing sight of the real obstacle in our path to reform. Sincere thanks for all you do, and keep up the fire!
So it all comes down to a turf battle over control of the helicopters. AMEDD says only it can perform the MEDEVAC duties with professionalism, while the aviation team says that the complexities of the modern battlefield and airspace requires an integrated approach to handling all the aviation needs.
The MEDEVAC leadership refuses to remove the red crosses and arm their helicopters even though doing so would allow faster responses to some requests for evacuation of wounded troops. The Aviation branch has imposed on the MEDEVAC fleet mission approval procedures that can take the sign-off of a general and locating armed escorts before a MEDEVAC helicopter can launch to rush to save a life. Neither side appears willing to budge off their policies. Meanwhile missions are being delayed and men are dying unnecessarily.
Major General Brady summed up his thoughts in a 2005 response to an article in the January 2005 Army Aviation magazine defending the integration of the MEDEVAC units:
“The most serious ‘rash action’ that can occur during patient evacuation is when anything or anyone interferes with the patient’s needs and the swiftness of evacuation. In his entire dissertation of bureaucratic changes, Col. Forrester does not mention patient needs once. And that is the question that should be at the foundation of any changes to the method of Dustoff…
Col. Forrester opines that the aviation battalion is the answer to Dustoff missions, mission understanding, maintenance, and operational awareness. I never met a non-Dustoff aviator who understood my mission better than I did. But more importantly, what does assigning Dustoff to the aviation battalion do for patient’s needs? I would bet that it will not add to the swiftness of launch, essential in life saving…Is Dustoff not performing? Have patient needs changed?
If Col. Forrester represents current attitude, I sense the beginning of the end of Dustoff and I fear the patient will be the worse for it.”
How prophetic were these words “and I fear the patient will be the worse for it.”
The Army Medical Department and the Aviation branch have not been focused together on doing the right thing for the patient. Both branches bear the responsibility for the dysfunctional policies and procedures that result in the unnecessary deaths of wounded American soldiers.
THIS MUST STOP