A Pilot's Perspective on Michael Yon's Medevac Debate

Connectivity, lack thereof, being what it is over here in Afghanistan, I was aware of the latest brouhaha Mike Yon has started about medevacs having target markers — ummm — big red crosses painted on them so we’d be in compliance with the Geneva Accords. I figured the controversy, which appears to be more flame and smoke than actual light, would have died down by now, but it appears that The American Thinker and SOF. Both chimed in while I’ve been admiring the scenery here in Kabul.

I thought this quote from Dalton Fury’s SOF article was worthwhile enough to steal:

As a commander, I wouldn’t consider asking a helicopter to fly in to accept a casualty until, in my best judgment, the threat to the helicopter was mitigated.

Even dedicated ISR and gunship support can’t be 100 percent sure that there is not a threat. A single AK round or RPG rocket can take out a helo inbound and miles away from the urgent casualty.

Urban sprawls and rocky mountain ridges along the typically long flight path provide numerous hiding spots for enemy gunners just waiting for the sound of an incoming helo.

An Apache escort might be able to ruin the enemy gunner’s day, but that is reactive, and the damage to the Army MEDEVAC they are escorting might already be done.

My radio transmission might sound like this.

‘You this is Me, request CASEVAC ASAP, location marked by IR strobe, over.’

‘Um, uh, negative Me, please specify exactly which type of helicopter do you need. Do you need an Army MEDEVAC, or an Air Force Pedro, or a DUSTOFF, or a Marine asset, over.’

‘You this is Me, whichever one can get here the fastest to save this brave American’s life, over.’

The point here is that warriors rely on speed to survive, both on the assault and after they’ve been hit. If Army policy in Afghanistan is to wait for an armed escort before the red cross-marked MEDEVAC can fly, then the answer is obvious. Remove the identifying red crosses to appease the Geneva Convention and arm the aircraft for self-defense. The enemy doesn’t care about the Geneva Conventions or any laws of land warfare.

Something struck me, after reading both sides of the argument; both in posts and comments, nobody has asked us pilots what we think.

Geez, I gotta do everything around here — “So, Bill, what do the pilots think about it?”

First off, I’ll establish my bona fides for those of you who don’t know me. I flew with an assault helicopter company in Vietnam, and everybody who flew slicks knew that his secondary mission was medevac. I honestly can’t count the number of times I flew wounded troops from a hot LZ to the hospital pad at Binh Thuy.

Dirty Little Secret: most of the casualties who got treated within the Golden Hour in Vietnam were transported in Hueys that were not dedicated medevac ships. Just one example: long-time Castle ARGGHHH! readers will be familiar with the story (and so will those who read the article in Flightfax, Approach, and Propos de vol, the Canadian aviation safety mag, back when the tale was originally published).

Yup. I once flew a medevac in a friggin’ gunship. And the reason why is because the medevac guys already at Moc Hoa with me were forbidden to go into a hot LZ without Cobra escort. Not “gunship” escort, “Cobra” escort.

And the nearest Cobras were back at Can Tho, about a 40-minute flight away. And by the time the LZ in Cambodia had gone cold, so would the wounded we were scrambled for.

Don’t take that as a slam on the medevac pilots; their CO would have fried them if they’d violated their SOP.

Just to forestall the purists who are ready to point out that what I flew was actually “casevac” rather than true “medevac,” there was no such term as “casevac” in Vietnam. That distinction evolved in the late ’80s, twenty-odd years after I flew whatever-you-want-to-call-it. But when I was flying them, they were called “medevacs.”

The lesson we learned in Vietnam was that it was speed of treatment that saved so many guys. If you were doing cross-border Sneaky Pete stuff, you knew where the LURPS or Green Beanies or SEALs who were calling for help were, because you were the one who put them there, and a goodly portion of the time out in the hinterlands, a lift ship or a slick flying an ash ‘n’ trash mission was able to transport the casualty to a hospital pad before the dedicated medevac ship was halfway to the site. But then, that was yet another “Lesson from Vietnam” the Army was eager to write off as being “irrelevant to the warfight.”

Here’s a news flash for the REMFs — errr — J-types. We paid for those lessons in blood, and they’re as valid today as they were when we learned them.

Fast forward to today. We don’t have the helicopter assets in Afghanistan that we had in Vietnam, let alone the dedicated medevac assets. It makes no sense to me, as a pilot, to let a casualty lie bleeding in a hot LZ when there’s speed of transportation available in the form of a non-medevac ship, without the restrictions placed on the Red Cross crews. And don’t get me started on the length of time it takes to crank an Apache and go through all the weapons checks before it can depart on an escort mission.

A lot of the commenters I’ve read talked about the consequences of violating the Convention by either scrubbing off the Red Cross or by carrying weapons – herewith are those consequences:

“Violation of these Conventions can result in the loss of protection afforded by them.

“Medical personnel (Medical Platoon Leader’s[sic], Platoon Sergeant’s[sic], Senior Line Medic’s[sic]) should inform the tactical commander of the consequences of violating the provisions of these conventions. The consequences can include the following:

“(1) Medical evacuation assets subjected to attack and destruction by the enemy. [As if that hasn’t been the case all along]

“(2) Combat health support capability degraded. [How? Seriously, how? Will the dirtbags start shooting at medics?]

“(3) Captured medical personnel becoming prisoners of war rather than retained persons. They may not be permitted to treat fellow prisoners. [News flash — the dirtbags don’t treat anyone as a POW, they treat them as hostages]

“(4) Loss of protected status for medical unit, personnel, or evacuation platforms (to include aircraft on the ground). [Loss of what protective status? The dirtbags specifically target medical personnel and vehicles]”

Source: http://www.medtrng.com/blackboard/geneva_conventions.htm

So, what’s the difference between what’s happening *now* — in the real world, when we *are* abiding by the Accords — and what would happen if we painted over the target markers? Has the Army even *asked* the lawyers?

I’ll close with two final bits of bloviation, then I’ll shut up.

1. Nothing in either the Geneva Accords or the Hague Conventions prohibits medical evacuation personnel from carrying weapons to defend themselves or the casualties they’re transporting — the prohibition is on offensive weapons. Personal weapons are okay, crew-served weapons are not. I know several grunt-types who were issued the M249 as a personal weapon, however…

2. That Red Cross on an aircraft means it no longer belongs to the parent service of the crew. Anybody, including the enemy, can flag down a dedicated medical transportation vehicle (including a helicopter) and demand his wounded be transported to a medical treatment facility – even if it’s the enemy’s facility.

And that last tidbit came from a medevac crew I know, who said that’s what they were taught in Medevac School…


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