Armed MEDEVAC versus the Geneva Convention

[Bushranger 71]

The realities of casualty evacuation

A bit of military history might help crystallize issues here.

During 5.5 years (2,000 days) of Vietnam operations, No. 9 Squadron RAAF effected 4,357 casevacs/medevacs of Australian, New Zealand, US and Vietnamese military and civilians. Considering 500 plus Australians killed and beyond 3,000 wounded/injured, the balance was much more toward combat casualties than routine medical evacuations. Official records also often reveal multiple night missions during a week of activities.

9SQN operated Iroquois helicopters all armed with M60 7.62mm doorguns which were not just defensive weaponry as presumed by some. I personally forced sizeable enemy groups besieging friendly forces to break off engagements due to suffering casualties from air to ground doorgun suppression by a single aircraft – nobody likes being attacked from the air without overhead protection.

Squadron aircraft were not adorned with big red crosses for casevac/medevac requirements. Majority of casualty evacuations were usually performed by the nearest utility Huey and mostly unescorted, aiming to get casualties to medical care with minimal delay. The US Army also provided an unarmed Huey with big red crosses and a medic on board at the 1 Australian Task Force base, but that aircraft was often engaged by the enemy and whether the medic could do any more for the badly wounded than crewmen/gunners was very debatable. Arresting bleeding and keeping casualties breathing was about the best that could be achieved while getting them to hospital, usually within about 15 minutes.

9SQN normally had 2 crews on standby for casevac/medevac requirements during hours of darkness and RAAF or Army medical orderlies were included in the crew. Ultimately, a Squadron aircraft so crewed was also assigned for the role in daylight hours, but I personally viewed this as a waste of resources given that the unit averaged 13 of 16 aircraft on line daily and all were often required for trooping and gunship functions. The Australian Army was somewhat enamoured by US Army practices so it was trendy (or politically correct) to follow American modus operandi regarding dedicated aircraft for casevac/medevac requirements.

There seems to be a warm and fuzzy notion in some circles that helo casevac in military operations is sort of comparable with civil air ambulance practices. Far from it. Recovering battle casualties during the middle of a brawl often means winching them up in litters while doorguns are chattering with dead and wounded being parked on the cabin floor, sometimes among body fluids and people parts. Getting those who can be saved to medical care as quickly as possible has to be paramount and there is virtually no scope for niceties where flight times to battlefield adjacent hospitalisation are short. However, trained medical personnel aboard suitably-equipped helos like the 'Pedros' may be able to do a bit more to sustain life in cases where ferry to medical facilities is of extended duration.

Re the bits concerning the Geneva Convention. I omitted to mention that 9SQN aircraft in Vietnam all had doorguns loaded with 100 percent tracer for quick aim correction and psychological effect, as many engagements were within cricket pitch proximity. A colleague from that era (40 odd years back) mentioned to me recently over beers that it was contrary to the GC. Me being the one responsible for that initiative as the Squadron Air Weapons Officer, I told him to bugger off (almost politely!).