‘ON THE USS BOXER IN THE ARABIAN SEA, 31 March 2003 — Casevacs,” for “Casualty Evacuations,” are medical personnel flown to the battlefield by the Marines. The unit has four teams, eight men to a team. Thirty-two men and women are here on the USS Boxer to cover the Marines fighting in Iraq. Three are physicians; the others are search and rescue paramedics, or corpsmen with some medical training assigned to squadrons.
As assistant wing surgeon and the most senior person in the Casevac program, a Navy captain told Arab News that the program is designed to try to reduce the number of people dying between the battlefield and operating room.
“Two-thirds of casualties die from loss of blood, and one-third die of chest injuries.”
The teams are usually out on the battlefront for 2-4 days, and don’t carry blood with them because it needs to be refrigerated. Casevacs are only able to clamp and stop blood loss on the battlefield.
To reduce the time spent without medical assistance, Marines have put medical personnel on helicopters.
“In Vietnam, the average time for a patient from the battlefield to the operating room was 30 minutes,” said the Navy captain.
“In Afghanistan, the long distances meant the average time to get an injured soldier out was as much as 20 hours. The wounded had to be flown from Khandahar to various bases, then put on an aircraft, which had to perform midair refueling before finally arriving at the medical ship.
“Now, as the battlefield moves forward faster than the medical fields, it’s causing us real difficulties,” said the medical officer.
“So far, this makes Afghanistan look very easy.”
Another problem they are facing is communications: “So much of the radio transmissions on the ground are constantly being stepped on (garbled by other transmissions).”
A Marine captain and pilot, part of MAG-16, told Arab News the USS Boxer is an amphibious ship designed to bring the Marines, equipment and helicopters to the AO (area of operations, or battlefield).
The pilot said he has already flown several times into Iraq: “We were moving Marines along our line of advance to Baghdad. We help move the Marines where they need to go.”
“Our units have flown missions every day, flying 6 hours at a time.”
Using FOBs (forward operating bases) established by the MEF (Marine Expeditionary Forces) all the way up the lines of advance, they supply fuel, food, and other materials. “The logistics train is extensive,” he said.
“We also fly Casevac missions for one of the units out there and have moved both injured EPWs (enemy prisoners of war), as well as our own US troops,” the Marine captain said.
“One of our most important missions is Casevac. Usually our Casevac launches are at night and timing is critical. It is stressful because when we’re flying we have to try to figure out where the care-giving places are, and what level of care is available at the health care units.”
Asked about reports of enemy fire at the Casevac helicopters flying in to airlift the wounded, he only said: “No comment.”
The pilot said this is his first experience in a war and he finds it “remarkably similar to the training we’ve had, as far as our missions and order assignments go. But the pace of it is much faster than we ever anticipated.
“We are keeping up with the march, but it’s just very fast.”
When asked about his concerns about the current dust storm that has taken over the region, he said: “I’m worried that we won’t be able to provide as much as support to the guys up on the front line, whether it be a helicopter of supplies, or an F-18.”
The pilot said his unit of helicopters will eventually be leaving the ship and phase ashore. He said it “is unknown” whether they will eventually return to the ship.
Unlike many Marines Arab News has encountered to date, this pilot has first-hand knowledge of Arabs. Two years ago he was on a joint training session here with the Kuwaitis and met some of the Bedouin tribesmen in the desert.
(The pilot was reading “The Peace to End all Peace,” by David Fromkin, subtitled: “The Fall of the Ottoman Empire and the Creation of the Modern Middle East,” when this correspondent spoke with him.)
“We were astonished by the Bedouin’s hospitality. They would invite us, the aircrew, into their tents and share with us. “We drank a lot of tea and camel’s milk. Their hospitality and friendliness was phenomenal. We were able to communicate through our interpreter, said the pilot. “I have never forgotten, and it is helpful today.”
Col. Knoll spoke to Arab News about the medical evacuations of wounded Iraqi soldiers.
“The biggest problem I’ve heard from my crews is that we’re taking the Iraqis out for medical care, and the helicopter rides scare them because none of the crew speaks Arabic, so no one can reassure them what’s happening is good for them. All they know is what the regime has told them, so why should they trust us? Some originally struggled but they have not been restrained. We dropped them off at the medical ship, the USS Comfort.
“The problem I see is that there is a lot of disinformation and rumors out there and it often appears that the communication flow is inaccurate,” said Col. Knoll.
“I have transportation squadrons,” the colonel said. “Twenty percent of my work will be done during the fight. But 80 percent will be done after the fight, when the Red Cross and the NGOs come in to assist the Iraqi people and to help them rebuild. We will also bring in food in for the refugees and the POWs.
“We do a lot of humanitarian work,” said Col. Knoll. “I’m not here to see how many people my aircraft can kill, but rather to see how many we can help.”
“I would rather be part of nation building than nation destruction. That’s what were here for, and that’s in our best interest.”
Another captain and pilot said he had flown several flights into Iraq. “In my last Casevac missions, the only people I flew out were Iraqis. They were badly wounded.”
“Casevacs have been set up in the helicopters, and have first aid kits. But the Casevac guys are basically paramedics, like in an ambulance. Our vests have flares and radios for survival, and their vests are purely medical with bandages and morphine, etc.”
“We flew the wounded Iraqis to our hospital ship in the region, where there are people on board who speak Arabic.”
Asked how he felt about transporting men viewed as “the enemy,” the pilot said: “I don’t care. They are wounded men, and I feel pretty good about helping them survive.
“I know Casevac is part of our mission,” said the pilot, “and I know the way we train is the triage method, which means whoever is the most wounded is the first one attended to and flown out.
“So, if you’re an Iraqi and badly wounded, you would be evacuated before a less seriously wounded US soldier. That’s the way the medical personnel are trained, I just fly them.”
This pilot said he had traveled to several countries in the Gulf before, and met people who “were always very nice and hospitable, and I love Arab food. That experience was good, as it helps me understand a lot now.”
“I think the Iraqis deserve a better lifestyle,” said the pilot. “I read up about them, their history, and the history of the region before I came over, and I know their living conditions are really bad. I’m glad I’m here to help change it.”
