Helicopter Medical Evacuation
By Jon Welte
In April 1944, Japanese forces in occupied Burma shot down a Stinson liaison aircraft that had been carrying three wounded British soldiers to safety. The pilot and all three passengers survived the downing, but their location behind enemy lines in remote and rugged terrain would have permitted little opportunity for their rescue—except for the presence of a new technology at the front. Flying an experimental Sikorsky YR-4B helicopter, pilot Carter Harmon of the US Army’s First Air Commando Group flew to the crash site to rescue the downed pilot and soldiers. The early helicopter’s performance limitations, combined with hot-and-high conditions at the crash site, limited Harmon to carrying only a single passenger at a time. Over two days Harmon, who later received the Distinguished Flying Cross, ferried the men one by one to a nearby landing strip where a larger fixed-wing aircraft flew them out to safety.
These pioneering flights were the first use of a helicopter for medevac, or medical evacuation. Throughout the first half of the 20th century, aviation promised a solution to a vexing problem—transporting injured soldiers and civilians from combat zones and accident sites to medical facilities. Rapid advances in medicine meant that casualties provided with prompt attention were far more likely to survive, but all too often help was a long and difficulty journey away.
Shortly after World War II, Captain Valerie Andre, a doctor serving in the French Army, faced much the same situation in her efforts to treat soldiers in French Indochina (modern day Vietnam, Cambodia and Laos). An experienced airplane pilot, Capt. Andre realized that the helicopter provided a ready solution to the problem of medical evacuation. She returned to France to earn a helicopter rating and arrange for the purchase of two Hiller 360 helicopters, which she had shipped to the front lines. Over a period of 3 years Capt. Andre flew over 100 combat missions, some under enemy fire, to insert herself into areas with wounded soldiers in need of treatment and/or to evacuate casualties to proper medical facilities that might have been hours or even days away by surface transportation. Andre chose the Hiller 360, manufactured at the Menlo Park factory of the Hiller Aircraft Corporation, for its simplicity and reliability. The aircraft was easy to maintain in the field and, crucially, could carry stretchers mounted externally for the transport of seriously wounded patients. Valerie Andre was ultimately promoted to general and received the National Order of Merit among other decorations in recognition of her service to France.
Elsewhere in Asia, the United States further developed the role of helicopters for medevac operations. During the Korean War the US Army and Marine Corps were similarly bedeviled by rugged terrain and poor roads. Helicopters such as the Hiller UH-12 (derived from the Hiller 360) and Bell 47 were tasked with transporting wounded soldiers to medical facilities. These helicopters evacuated an estimated 20,000 wounded servicemen during the war. By the end of the Korean War the fatality rate for casualties wounded in battle had been cut nearly in half compared to World War II due largely to developments in medevac procedures and technology.
Helicopter technology continued to advance, and when the United States joined the Vietnam War some ten years later the mission had been largely taken over by the new Bell UH-1 Iroquois, universally known as the “Huey”. Powered by turbine engines and able to carry heavier loads than earlier piston-powered Hiller, Bell and Sikorsky aircraft, the UH-1 could carry patients internally rather than strapped to the helicopter’s exterior. This made it possible for medical personnel to begin basic treatment while the patient was in the air prior to reaching the medical center. Over one hundred thousand US soldiers were evacuated via medevac during the Vietnam War, and the ability to provide treatment in the air caused the fatality rate to fall in half again compared to the mid-1950s.
By 1969, soldiers wounded in action in Southeast Asia had lower mortality rates than drivers and passengers involved in serious automobile accidents on American highways, suggesting that a medevac program could provide lifesaving support to civilians in peacetime. A pilot effort to evaluate helicopter medical evacuation services was introduced that year in Mississippi. Three Fairchild Hiller FH-1100 helicopters were purchased and operated to transport patients to medical facilities in cases of extreme need. The program was deemed a success, and throughout the 1970s medevac helicopters and helipads at major hospitals grew increasingly common.
Today, modern medevac operators continue the tradition of using helicopters to quickly and safely transport individuals with serious injuries or critical illnesses directly from incident sites to medical centers able to provide life-saving treatment. Stanford Life Flight, a local operator, embodies the best practices in use for civilian medevac helicopter operations. An Airbus Helicopters EC-145 allows operations in all weather conditions. The aircraft’s raised tail boom and rear clamshell doors permit stretcher loading directly into the rear of the aircraft. Specially-trained flight nurses provide in-flight emergency care comparable to or better than what a ground-based emergency medical technician could provide, and medical centers around the San Francisco Bay area train to operate with Life Flight to receive patients requiring urgent and immediate attention. The Bay Area also hosts medevac resources of the uniformed services, with United States Coast Guard Air Station San Francisco operating its Eurocopter HH-65 helicopters from San Francisco International Airport, and the California Air National Guard’s 129th Rescue Wing at Moffett Field in Mountain View flying Sikorsky HH-60s along with fixed-wing Lockheed C-130 tanker aircraft.
The Hiller Aviation Museum’s collection preserves glimpses of the early development of medical evacuation flights, while San Carlos Airport supports medevac operations in the present day. A Hiller 360 similar to those first flown by General Andre is displayed in the main Gallery, and a Hiller H-12 configured as a US Army medevac aircraft is suspended from the Gallery’s ceiling. San Carlos Airport serves as an essential waypoint for modern medevac aircraft, with Stanford Life Flight and the US Coast Guard frequent visitors for both training and operational missions.
The exploits of General Andre feature prominently in the Museum’s new Women in Aviation exhibit, which documents the exploits of female aviators from the early 20th century through the modern day. On Saturday, January 14th the Hiller Aviation Museum will dedicate this new exhibit and open it to the public. Come join the festivities and celebrate an important dimension in the history of aviation.
Resources
Andre, Valerie. Madame le General, 1988.
| Born | 21 April 1922 Strasbourg, France |
|---|---|
| Allegiance |  France |
| Service/ | French Army |
| Years of service | 1948 - 1981 |
| Rank | Médecin Général Inspecteur |
| Awards | Légion d'honneur ordre national du Mérite Croix de guerre 1939-1945 Croix de guerre T.O.E Croix de la Valeur Militaire Médaille commémorative d'Indochine Médaille de l'Aéronautique Croix du Combattant Volontaire Médaille de Vermeil du service de santé |
Valérie André (French pronunciation: [valeʁi ɑ̃dʁe] (
listen); born 21 April 1922, in Strasbourg) is a veteran of the French resistance, a neurosurgeon, an aviator and the first female member of the military to achieve the rank of General Officer, in 1976, as Physician General. In 1981, she was promoted to Inspector General of Medicine. A helicopter pilot, she is the first woman to have piloted a helicopter in a combat zone. She is also a founding member of the Académie de l'air et de l'espace.[1]
As a member of the military, she is not addressed as "Madame la Générale" (a term reserved for spouses of generals) but as "General".[2]
She started as a Medical Captain in Indochina in 1948, already a qualified parachutist and pilot, in addition to being an army surgeon.[3][4] While in Indochina, she realized that the most difficult part of her duties was retrieving the wounded, who were often trapped in the jungle. She returned to France to learn how to pilot a helicopter, then flew one to Indochina. From 1952-1953, she piloted 129 helicopter missions into the jungle, rescuing 165 soldiers, and on two occasions completed parachute jumps to treat wounded soldiers who needed immediate surgery.[5][6]
One typical mission occurred on 11 December 1951, when casualties were in urgent need of evacuation from Tu Vu on the Black River. The only available helicopter, stationed near Saigon, was dismantled, flown to Hanoi by a Bristol Freighter and reassembled. Captain André then flew into Tu Vu despite heavy mist and anti-aircraft fire. There, she triaged the casualties, operated on the most pressing cases and then flew the urgent wounded back to Hanoi, two at a time. Later, she was put in command of a casualty evacuation flight.
She continued in Algeria as a Medical Commander in 1960, where she completed 365 war missions. She rose to the rank of Medical Lieutenant Colonel in 1965 then to Medical Colonel in 1970. She had a total of 3200 flight hours, and received 7 citations of the croix de guerre.
She has written two collections of memoirs : Ici, Ventilateur! Extraits d'un carnet de vol. (Calmann-Lévy, 1954) and Madame le général (Perrin, 1988).
She is one of eight women to hold the Grand-croix (Great Cross) rank in the Legion of Honour, with Germaine Tillion, Geneviève de Gaulle-Anthonioz, Jacqueline de Romilly, Simone Rozès, Christiane Desroches Noblecourt, Yvette Farnoux et Gilberte Champion. She is the aunt of politician André Santini.
Decorations
- French
- Grand-croix of the Legion of Honour (19 December 1999); previously Chevalier on 25 February 1953
- Grand-croix of the Ordre National du Mérite in 1987, the first woman to receive this distinction.
- Croix de guerre 1939-1945 with 7 citations.
- Croix de guerre des Théâtres d'opérations extérieures
- Médaille de la Valeur Militaire
- Médaille commémorative d'Indochine,
- Médaille de l'Aéronautique
- Médaille du Combattant Volontaire (1944),
- Médaille de Vermeil du service de santé.
- Grande Médaille d'or du l'Aéro-club de France
- Foreign decorations
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