Afghan air force improves casualty evacuation capability

  • Published
  • By Capt. Anastasia Wasem
  • 438th Air Expeditionary Wing
While the Afghan air force continues to take the lead and ownership of combat operations, they have also rapidly risen to the challenge of improving casualty evacuation, or CASEVAC, procedures by using both the Mi-17 helicopter and Cessna 208 aircraft.

Between December 2012 and April 2013, CASEVAC patient movement increased by 34 percent with the transportation of 192 patients. Also, with the newly formed concept of operations and emphasis on command and control, response time has been reduced from 72-hours to an average of just three hours.

"My goal is to be a pilot," said Afghan air force 2nd Lt. Awal Khan Safi, a pilot trainee at Shindand Air Base, Afghanistan. "I want to be able to provide the best air support possible, especially casualty evacuation, to soldiers on the ground."

As a former platoon commander with the Afghan National Army for five years, Safi understands that air support and CASEVAC are vital assets that must continue to grow as the AAF matures.

"Before, we relied on (International Security Assistance Force, or ISAF) for CASEVAC support. But now, with the steps that the Afghan air force has taken, we've been able to continuously improve our own CASEVAC procedures," said Col Abdul Rasoul Mayel Laghmani, the AAF surgeon general. "We are beginning to be able to rely on ourselves more and more."

This critical capability is not specific to one location however, but stretching across the country as various AAF units receive the necessary equipment and training to conduct CASEVAC missions. Between the C-208 and Mi-17 aircraft, CASEVAC missions are currently being conducted by the AAF at Kabul, Shindand, Kandahar, Herat, Jalalabad and Mazar-e-Sharif.

In the three months since the AAF conducted its first casualty evacuation on a C-208 from Kabul International Airport, the capability has rapidly increased in the volume of missions as well as spread to both Kandahar Airfield and Shindand Air Base.

On May 14, the Kandahar Air Wing conducted its first C-208 CASEVAC mission, transporting two critical-care patients from Kandahar to Kabul. Both patients successfully arrived in Kabul under the care of AAF medics. Only a week after that mission was completed, May 20, the KAW again conducted a CASEVAC mission to transport two ANA gunshot victims to Kabul for more advanced medical treatment.

"I'm particularly proud in this case; partly because of the coordination piece," said Lt. Col. Michael McBeth, the 738th Air Expeditionary Advisory Group surgeon general and adviser. "Communication is one of the biggest obstacles. The coordination that happened between the KAW flight surgeon, the ICU doctor and the flight physician at the Air Command and Control Center was a huge step in making CASEVAC work and be safe and successful. I was really pleased with how everything went."

The most critical patient that was moved during the May 14 mission was suffering from both kidney and liver failure. He was comatose, jaundiced, had poor respirations and low oxygen saturation. The AAF medics loaded the patient, strapped him in and monitored his vital signs during the flight while also constantly providing oxygen.

"This is dangerous for the patient, to take him up to near 10,000 feet, but sometimes it's worth the risk to get them to a better facility," McBeth said. "The Afghan air force medics really stepped up."

Thus far in May 2013, AAF medics and aircrew have conducted 33 CASEVAC missions and moved 76 patients from battlefields, forward operating bases and clinics to more sophisticated medical hospitals. Three of these missions were conducted on May 8 alone, saving the lives of nine ANA soldiers from the 203rd Corps, 201st Corps and 209th Corps. AAF CASEVAC response to each of these missions was under a record three hours.

Even more lives were saved May 21, as two AAF Mi-17 helicopter crews conducted successful CASEVAC missions while under fire. Despite taking fire, the crews and medics continued the mission to support ground units in Paktiya Province to save the lives of ANA soldiers in the 203rd Corps.

"CASEVAC is still a fairly new capability and has a long ways to go, but the progress that I have seen in my 10 months working with the Afghan air force is inspiring," said Col. Michael Paston, the 438th Air Expeditionary Wing surgeon general and adviser to the AAF. "As the Afghan air force continues to grow and mature in all areas, CASEVAC will continue to expand as well. Soldiers on the battlefield should know that every day Afghan air force members are training hard to be able to better support their needs in the future."

On April 22, the AAF graduated 17 medics from around the country in the first-ever certified flight medic course in Kabul. The AAF medical community spent nearly three months gaining certification from the Armed Forces Academy of Medical Science, planning and executing the rigorous Afghan-taught 10-day class.

The recent graduates have gained a higher level of training in order to conduct in-flight medical procedures in both the Mi-17 and C-208, a skill that will prove vital as fighting season and CASEVAC missions continue.

"It was also a wakeup call for us. This is a capability that has, until recently, been missing," said McBeth about the CASEVAC successes at KAF. "I think that even if the coalition moved out of Afghanistan tomorrow the AAF would still continue to progress with CASEVAC capabilities and move patients to bigger medical facilities without coalition support."