Red Air: America’s Medevac Failure

Luigi59

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Thought provoking article.

About Michael Yon

Michael Yon is a former Green Beret, native of Winter Haven, Fl. who has been reporting from Iraq and Afghanistan since December 2004. No other reporter has spent as much time with combat troops in these two wars. Michael’s dispatches from the frontlines have earned him the reputation as the premier independent combat journalist of his generation.


12 October 2011
Afghanistan

.....The problem was that this was an Army Dustoff medevac, and Army medevacs don’t carry machine guns because they have red crosses emblazoned on the sides and front. When our helicopters sport the red crosses, they can’t carry offensive weapons. This is meaningless anyway because they are accompanied by an Apache attack helicopter, which is fully loaded with a cannon and missiles.

And so while Chazray was dying, his Dustoff medevac was sitting idly on the runway down at Kandahar Airfield. Since there was no available Apache, the Dustoff was not cleared to depart. The Air Force Pedros have no red crosses marking their helicopters. Instead, they have .50-caliber machine guns. The Pedro helicopter teams are parked right there on the same runway and they could have been dispatched, but for some extremely sorry reason the Pedros are not allowed to come into 4-4 Cav battlespace unless there is “red air.” Red air means the weather is too bad for Army helicopters to come. From my experience Dustoffs are not averse to extreme danger, but there are conditions during which they are not allowed to fly during which Pedros will go.

And so the armed Pedros, which could have flown to us in about 13 minutes, sat on the runaway twenty-five miles away, doing nothing. I know first-hand the skill of the Pedros having flown with them in 2009.

Specialist Chazray Clark was dying due to politics, and the Army and Air Force pilots are very angry about this. Chazray’s is not the only such case. Army medevac helicopters fall under the Medical Services Corps, who mark medevacs with red crosses. Officers will tell you face-to-face that the Medical Corps does not want to give up its helicopters because senior officers want their own helicopters to shuttle them from here to there.

It is important to be absolutely clear--this is not about the Dustoff pilots and crews, who are incredibly courageous. They have earned enormous respect. They’ll fly into hell to get one of our wounded troopers. This is about politics getting in the way of saving lives.

Yet despite everyone here knowing we are perpetually short on helicopters in Afghanistan, and while Pedros would have had Chazray to the hospital less than 35 minutes after the blast, Chazray lay dying. There is no doubt in my mind—after seeing Pedros in action many times—that Chazray would have been at the trauma center in less than 35 minutes if the Pedros team had been scrambled. Instead, it took 65 minutes for Chazray to get to the hospital. Chazray was fully conscious when he was finally put on the bird. But he died at Kandahar Airfield. The General in charge of this fiasco needs to be fired.

Unarmed Army medevac helicopters are not even allowed to go into certain combat areas because they may get shot up and have no way of defending themselves. And so if the air is too dangerous due to bullets or bad weather, Air Force Pedros are sent because they fly in all weather and they shoot back with .50-caliber machine guns.

I asked Colonel Patrick Frank, the 4-4 Cav brigade commander, and Lieutenant Colonel Mike Katona, the squadron commander, if they have any discretion about which birds are called. Can we request Pedros instead of Army Dustoff? No. The answer is simple, clear and ultimately disastrous: There is no discretion.

Red Air: America’s Medevac Failure

Michael Yon bio

Army Spc. Chazray C. Clark
 
I don't know the details about what caused these types of delays.

It seems to me (semi-uninformed) that a big potential hold-up to Medevac is the fact that the UH-60s are unarmed. It seems to me that they would have a better chance of getting into and out of locations if they were armed. If they did arm them, of course they would have to remove the Red Cross, and they would lose most their Geneva Convention protections (although that doesn't seem like it would make a big difference in today's world).

Thoughts on changing the Medevac mission to armed personnel recovery?
 
I don't know the details about what caused these types of delays.

It seems to me (semi-uninformed) that a big potential hold-up to Medevac is the fact that the UH-60s are unarmed. It seems to me that they would have a better chance of getting into and out of locations if they were armed. If they did arm them, of course they would have to remove the Red Cross, and they would lose most their Geneva Convention protections (although that doesn't seem like it would make a big difference in today's world).

Thoughts on changing the Medevac mission to armed personnel recovery?

How difficult is it to arm and disarm the UH-60? As in, when we are fighting in places like where we are where the enemy doesn't really give a crap about the Geneva Convention can we easily arm all the UH-60s and if we engage with a major power can we easily disarm them and stick the red cross on it? Just thinking aloud.
 
Yon's story points a direct finger at a bureaucracy as the cause of the delays of the rescue flight - which cost this young soldier his life.

Indeed, Yon wrote about this problem over 2 years ago.

http://www.military.com/forums/0,15240,201013,00.html

Seems like an easy problem to solve - send in the AF Pedros or arm the Army rescue helicopters. It's not as if the enemy is paying any attention to the "law" of not firing on the red cross anyway, are they?

I'm interested to hear scoutpilot expound on a little more why this is or is not feasible (or in our best interests at least).
 
AF CSAR is very good, but not very numerous. They are already beating the HH-60Gs into the ground with the ops tempo. CSAR is a different mission than Medevac, but clearly the Pedros/Jolly crews can get that job done, when asked. The AF CSAR team doesn't get many traditional calls, since the Taliban don't exactly have the worlds greatest integrated air defense system!
So, you can't always say, "send in the Pedros," since they aren't available in sufficient numbers.

As to arming UH-60s, clearly that is doable. To actually make the change, it is more than simply adding guns. You need trained gunners, and pilots that know how and when to utilize them. I don't know if Army Medevac pilots have already had that training or not. I would imagine finding more door gunners wouldn't be terribly difficult. Changing the unit manning, training, and tactics might be a bit of work.
 
As to arming UH-60s, clearly that is doable. To actually make the change, it is more than simply adding guns. You need trained gunners, and pilots that know how and when to utilize them. I don't know if Army Medevac pilots have already had that training or not. I would imagine finding more door gunners wouldn't be terribly difficult. Changing the unit manning, training, and tactics might be a bit of work.

Training issues aren't a huge problem I don't think. Takes some foresight to get people in the pipes, but would an armed medivac pilot have difficulty flying a non-armed mission profile? I was concerned on the capital side. If the UH-60s can play both roles without major costs, wouldn't that be effective potentially?
 
Training issues aren't a huge problem I don't think. Takes some foresight to get people in the pipes, but would an armed medivac pilot have difficulty flying a non-armed mission profile? I was concerned on the capital side. If the UH-60s can play both roles without major costs, wouldn't that be effective potentially?

There a couple of issues at play here. I'll caveat my response with the fact that much of what I will say is tempered and at times truncated by operational security concerns. I won't stray anywhere close to discussing things which are not for public consumption.

It's important to discuss what MEDEVAC (that's how it's spelled, not "medivac" which is a pet peeve of mine) is and what it is not. MEDEVAC is the tactical transport of a patient from the point of injury to a medical facility with enroute care. The enroute care is the key part. UH-60 and the new HH-60L crews provide stabilizing care during the flight to an aid station or CSH. That's obviously the first choice in these situations. The second choice, and one that does happen, is CASEVAC. CASEVAC is the use of any available asset to transport a patient from the point of injury to medical care. CASEVAC is a role that virtually any UH or CH aircrew can perform. Generally, in a CASEVAC situation, the unit medic will travel with the patient to provide a minimum of stabilizing care.

Obviously, MEDEVAC is the preferred method. The aircraft are configured to give the flight medics the best access to the patient and provide a variety of support capabilities (oxygen, IV support, etc.).

So, the notion that only the Pedros could have gone in to rescue this wounded soldier gives me pause. It seems to me that the whole story hasn't been fleshed out here. There are so many moving parts in how airspace is controlled and how assets are allocated, that I hesitate to fully buy Yon's account of how it all played out.

Don't get me wrong, Yon is a good writer. But I do wonder about his credentials sometimes. A former Green Beret would know that the miniguns on a PaveHawk (which he has written about more than once) are chambered in 7.62 NATO and not .50 caliber. It's one of those errors that makes me scratch my head and ask myself how close he really is to this situation, or whether he's relying on extraneous sources and supposition. His article seems to relying on him having knowledge of what a lot of far-flung people and assets were thinking and doing at one discrete point in time. While I will readily admit that it's possible to piece things together in large part, I am still a bit mystified at some of his glaring errors and outright supposition about who could fly where and when.

Getting back to the notion of arming MEDEVAC aircraft, it's not something we do. First and foremost, there is only so much room on an aircraft. People have a notion that aircraft are huge inside. They're not. The flight medics and the crew chief take up a lot of room. Plus you need space for equipment and litter patients. Moreover, depending on the model of UH-60 used, there may be only one side available for a CE weapons station.

Even if we assume we're going to cram two gunners on there, and assume we can find enough bodies to fill the seats AND get them trained, the real issue is this: Yon assumes that door gunners are WAY more effective than they are. UH-60s don't carry miniguns. They carry M240s. That weapon is nowhere near as effective as a minigun. Frankly speaking, even the minigun isn't that great. Door gunners can only do so much to defend an aircraft. Yon makes the assumption that simply arming an aircraft will make it capable of swooping in to save the day. That's not the case.

This brings us back to the concept of arming our medevac or escorting them. The reality is that arming a MEDEVAC aircraft would do little to increase its survivability. In an urgent medevac situation, where the POI is still hot, the best chance that bird has is to be escorted by an armed aircraft.

So, there is little reason to arm a MEDEVAC aircraft in practical terms. As far as using the Pedros, we have to be very careful about how we view their capabilities. They are still highly vulnerable aircraft, though they do offer special capacity to a commander. They are an extremely limited resource, and to get into the practice of using SOF aircraft for MEDEVAC support is a terrible way to do business. It's like relying on Superman to do all our crimefighting. He may be good, but there's only one of him. The Pedros are a search and rescue asset, NOT a MEDEVAC asset.

In reality, if an armed aircraft was REALLY what a commander wanted, a regular UH-60 could provide CASEVAC with organic weapons for defense. They are more plentiful, more familiar with the mission, and with a medic traveling alongside the patient, the care would be similar to what the Pedros would give.
 
Yon probably got the .50cal vs. 7.62 minigun thing from the fact that HH-60Gs carry both, although I don't know when and why they decide to use one over the other.
 
Yon probably got the .50cal vs. 7.62 minigun thing from the fact that HH-60Gs carry both, although I don't know when and why they decide to use one over the other.

I'll give him a pass on that. It is a minor detail, in reality. I'm more concerned with how he knows what exactly each asset was doing and why over a span of an hour or two.

Regardless, the point remains that MEDEVAC is a distinct and separate capability from CSAR or PR. If we want an armed aircraft to pick up a casualty, we have that capability already.
 
In an urgent medevac situation, where the POI is still hot, the best chance that bird has is to be escorted by an armed aircraft.

Agreed, but when the armed escort is unavailable and the MEDEVAC sits on the tarmac waiting (based on the information in the article) the soldier died because he couldn't get to the hospital in time.

There is no doubt in my mind—after seeing Pedros in action many times—that Chazray would have been at the trauma center in less than 35 minutes if the Pedros team had been scrambled. Instead, it took 65 minutes for Chazray to get to the hospital. Chazray was fully conscious when he was finally put on the bird. But he died at Kandahar Airfield.
 
Agreed, but when the armed escort is unavailable and the MEDEVAC sits on the tarmac waiting (based on the information in the article) the soldier died because he couldn't get to the hospital in time.

See, that's not necessarily clear. Yon makes the supposition that the Soldier died because it took an hour to get to a medical facility. He doesn't make any sort of factual case for it. It may have been (as is often the sad reality) that this young man's death was a foregone conclusion based on his injuries.

65 minutes is not at all an outrageous amount of time from injury to aid. In general, the MEDEVAC standard has been 90 minutes maximum from the request to wheels-down at the CSH. That standard is based on medical necessity and developed with guidance from trauma surgeons, and balanced with the size of the battlespace and the resources available. Even in the civilian trauma world, an hour is the accepted standard. The amount of time it took for Chazray to make it to a medical center was not outrageous. Moreover, while on that bird, he had life-sustaining care.

The thing that Yon doesn't talk about, and what makes me wonder, is what conversations were going on. It may well have been that an AH-64 was expected to be available within minutes but was delayed due to a TIC response or a maintenance issue. I find it hard to believe, ludicrous even, that this was a case of a simple decision to not launch a MEDEVAC aircraft. MEDEVAC crews don't accept that. A battle captain won't accept that. A battlespace owner won't accept that.

In short, I don't believe Yon's account. That may make me a heretic here, but I have too many hours in the air, too many MEDEVAC security missions under my belt, and too much experience as a battle captain to believe his simple theory that some big bad officer made one decision about airspace and that not a single aviator questioned it, all of which resulted in Chazray's death.

There are too many variables, and he talked about too few of them.
 
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