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Saturday, November 1, 2008

Medevac Heroism in Afghanistan

Steve "Elroy" Colby

As the crew neared the landing zone, the number of injured soilders rose. The amazing story of how a night-mission crew, under enemy fire, saved the men they were sent to rescue.

For most Rotor & Wing readers, the daunting efforts expended by this year’s Helicopter Heroism nominees would make your eyes water and heart pound. Standing out from those remarkable nominations was one mission in particular in which SFC Peter Rohrs (then SSgt Rohrs), flight medic with Company C, "DUSTOFF" (Dedicated Unhesitating Service To Our Fighting Forces) 3rd General Support Aviation Battalion 82nd Combat Aviation Brigade provided life saving triage, initial, and follow-on medical treatment to several ambushed infantry platoon members near Asadabad, Afghanistan. This mission, punctuated by gunfire, rocket propelled grenades, mortar fire, close air support (CAS) coordination and refueling delays was accomplished in horrendous terrain, horrible visibility conditions and near utter chaos. Throughout, SFC Rohrs maintained his focus on treating and packaging his patients, coordinating supporting fires, and building and sharing situational awareness on the unfolding mission. In all fairness, SFC Rohrs attributes the mission success to each and every one of the crew members in his flight. His crew was comprised of pilot, CW3 Christopher Ryan (above third from left); co-pilot CW2 Christopher "Shake and Bake" Carson (above second from left); and crew chief SPC Timothy Johns from Co. C, 3-82nd GSAB (above first from left).

The mission started with notification for a mass casualty evacuation (which, by their definition, was more than three casualties). A platoon, on a night movement through high rocky terrain enroute back to their forward operating base (FOB) in northeast Afghanistan (see Figure 1), was ambushed and scattered in groups between a ridgeline and a valley and had a few casualties. Crews from the DUSTOFF group were scrambled to help recover and treat five urgent litter patients. Rough grid coordinates were passed to the medevac team. A two-ship of DUSTOFF medevac helicopters was scrambled due to the number of patients. Because of the hostiles in the area, the UH-60L helicopters were escorted by two AH-64 Apaches into the objective area. As the mission progressed the casualty count ratcheted up from four initially to five prior to takeoff and seven as they rounded high terrain near the site. Then partway through the flight, the count jumped to six urgent litter and three priority litter patients and most of the patients would require hoist recoveries.

The medevac helicopters loitered at a safe FOB while the Apaches scoured the recovery zone for hostiles, contacted a ground element and after determining minimum threats, called the DUSTOFFs back into the zone. The flight medics decided to pick up two more medical specialists from a FOB to receive the patients inside each helicopter while they sent up the patients from the ground. They departed the FOB and upon arrival at the ambush site, the aircraft were directed by the ground forces to a valley at the base of the ridgeline where they believed the most critical patients were located. Because SFC Rohrs was the senior medic in the flight, their aircraft was directed to get him on the ground, assess the situation and propose a recovery plan after building a picture of the battlespace from the recovery zone. The helicopters departed to a safe valley loiter area and orbited in a racetrack pattern in which one leg was dark and the other was a featureless abyss while the Apaches orbited in a wheel above them.

The patients in the primary infil zone had been shot and plummeted from the ridgeline down 70-80 degree sloped terrain, suffering further injuries from the fall. The crew was equipped only with night vision goggles (NVGs) and an infrared searchlight to covertly light up the zero-illumination landing zone (LZ) located in an eastern fork of a major north/south valley at about 6,300 ft MSL. After being lowered by hoist into the site, SFC Rohrs discovered that there were actually six critically wounded patients and one KIA. While triaging, treating and packaging the surviving casualties, an armed, suspected enemy approached the zone. A request for CAS from the Apaches was made but determined that the enemy location was inside "danger close" criteria; too close for safe, effective fire. During this engagement SFC Rohrs returned to the patients while his eastern security sentry covered their flank. The assailant retreated. The clock was ticking away and the DUSTOFF helicopter’s fuel was dwindling down into precious reserves required for the recovery back to the field hospital. SFC Rohrs decided to package the most critical patient whose injuries included gunshot, shrapnel wounds and a broken pelvis. He was hoisted to the DUSTOFF helicopter prior to their return for fuel and ammunition. SFC Rohrs remained on the ground with the remaining patients until the aircraft returned from their forward aiming and refueling point (FARP).

The second DUSTOFF helicopter moved in to assist and SFC Rohrs attempted to vector him to the additional patients that were located on a ledge vertically 300 meters above the valley LZ. The only common reference point usable for radio vectors was literally and figuratively speaking, a burning bush. That aircraft was unable to locate the additional survivors and had to recover to the FOB for fuel.

SFC Rohrs continued to treat the remaining five patients and was notified by his eastern security soldier that the unknown assailant was yet again approaching the casualty collection point. Even after a warning shot, the armed, suspected enemy continued to approach. Under rules of engagement for hostile intent, the security soldier then shot the approaching armed enemy to eliminate the threat to the treatment area. SFC Rohrs then administered treatment to this now disabled enemy and directed security to maintain vigilance on this assailant. He returned to the other wounded soldiers to continue treating them and a rocket propelled grenade slammed into the valley wall above his group. Rocks and debris rained down on the five survivors and the assailant. During this time an AC-130 gunship arrived overhead giving the ground teams renewed hope for effective cover during the treatment and extractions.

The Apaches departed for fuel after the AC-130 arrived. Then a mortar round exploded against the high terrain above them again raining debris and hot metal onto the wounded. While checking the patients yet again, ineffective gunfire rang out from a ridgeline position above and across the valley. SFC Rohrs dragged two of the patients to a better cover and concealment position. When SFC Rohrs picked up one of the team’s weapons that was equipped with a PAQ-4 night aiming device, he found that the barrel was bent and another PAQ-4 was broken.

One hour and 40 min of agonizing wait passed while the helos were at their FARP. During that time SFC Rohrs went about looking for other sensitive equipment and came across another KIA whom he moved to recovery location on a goat path between the first and the second higher LZ. When the helicopters retuned, SFC Rohrs directed the second ship to drop their medic off at the patients above his position to which earlier attempts had failed. Radio communication had been established with that team and collectively they determined that that higher group had more critically wounded patients than did SFC Rohrs lower group and he was unable to make it up the vertical terrain to the higher location. After they located the higher team, the second ship established a hover for their hoist recoveries. SFC Rohrs continued to search for casualties and located several Afganistani National Army KIAs, marking their positions for recovery. Meanwhile, SFC Rohrs’ aircraft returned (a side anecdote was that this particular pilot had on several occasions left SFC Rohrs on the ground often to be recovered by their platoon commander) and established a hover over his position to effect the hoist pickups of the remaining patients.

As the high ship was inserting his medic, SFC Rohrs’ aircraft returned to accomplish their hoist recoveries. They were so close to the other aircraft (which was stacked above them) that they were actually in the rotor wash of the high aircraft, but in the interest of time and fuel they had to accomplish the simultaneous recoveries. CW3 Ryan, the pilot in command (flying this mission on his birthday) made an incremental approach to the "stacked" position to ensure that he could safely control the aircraft while positioned this way relative to their wingman. While rough, it was controllable. The workload was so high though that the pilots continuously swapped controls.

One of the wounded soldiers on the ground, who was effectively helping as a security team member, actually had unknowingly sustained gunshot wounds to his shoulders through the muscle above the collar bone on both sides of his neck. They recovered five wounded including the assailant, one fallen comrade, sensitive gear and lastly SFC Rohrs and the security soldier. Adrenaline was finally wearing off and the reality of the situation was settling in and taking its toll on the crew. The crew was again tasked to go back to the site to recover more KIAs. They recovered two more KIAs. At this point the recovery team had been on an operational NVG mission for eight hours, following a one-and-a-half hour day mission and was collectively "smoked". After repatriating the KIAs, the crew was tasked for yet another recovery mission but in the interest of safety, respectfully declined; at which time another crew was sent to affect those recoveries.

In retrospect, this mission displayed the characteristics of excellent crew, interflight, and CAS coordination. The level of performance reflected a high-level of proficiency and crew dynamic efficiencies. The mission may have approached, but never exceeded, any members’ comfort level. It was conducted in extraordinarily taxing and complex conditions with environmental conditions that would challenge the most experienced crews. It was completed safely and saved lives. The crew collectively related that their small unit cohesiveness was the single most important factor in the professionalism, performance and post-mission support that made extended Afghanistan operations possible. Crews often had remote academics, standards quizzes, post-mission debrief, lessons-learned sessions, and informal study groups. They believe that any combination of crew members of this medevac organization would have resulted in similar results. The crew closeness was still apparent nearly a year after the mission. I asked this crew if they were "king for a day" what system they would want to make their job better. They all agreed that the external hoist would be a great aircraft improvement for the medevac mission to allow safer hoist ops while bringing patients in at the top of the hoist operation. They also agreed that a contingency power switch that would allow short-term operations at higher temperature limits for power critical situations would help provide an extra measure of safety during extreme temperature and altitude envelope missions.

Instructor Pilot CW3 Chris Ryan was a military dependent who grew up all around the world. He graduated from high school in Germany and entered the USAF as a computer maintenance technician. He separated from the USAF and applied to Warrant Officer Candidate School, was accepted, and completed WOC School and flight school in 2000. He has two tours in Afghanistan, and one in Bosnia. His total time is approximately 2,500 hr. Pilot CW2 Chris "Shake and Bake" Carson was born and raised in Frederick, Maryland and enlisted in the Army in 1995 as a Blackhawk crew chief. He attended WOC and graduated from flight school in 2004. He has one tour in Iraq, one in Afghanistan, one in Bosnia, and has 700 hr total time. SPC Tim Johns was born and raised in Mitchell, South Dakota. He entered the Army as a mechanic in 2002 and has one tour in Afghanistan, and one in Iraq, and has a little less than 1,000 hr total time. SFC Rohrs was born in Toledo, Ohio. He was also an Air Force dependent who entered the Army as a medic in 1997. He has two tours in Iraq and one in Afghanistan. He has 1,200 hr total time. He was promoted on September 1 to SFC. President George W. Bush personally pinned the Silver Star on SFC Rohrs for this mission in 2007. Hearty congratulations to SFC Rohrs and this talented heroic crew.

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