‘Taliban shoot at us one minute, we fly them to hospital the next’ … Life with the US airborne medics
Terrorism analyst and former SAS member ALEX GARDINER has just spent a week in Afghanistan with America’s Dust Offs – the helicopter teams who bring the wounded and dying out of battle. Here, he relives the terror of his trip and the heroism of the crews who risk everything to save friend and foe alike.
It’s 43C (109F) in the shade at Afghanistan’s Bagram Air Base when the nine-liner, the military equivalent of 999, comes in. Within three minutes the airborne medics of 31 Delta, Charlie Company, 6th Aviation Battalion are loaded into their Black Hawk helicopter.
Fifty yards away is our armed escort, the Black Hawk Chase Bird, call sign Grim Six. It has a picture of the Grim Reaper, cloak flowing and scythe aloft, painted on its fuselage.
Innocent victim: The 31 Delta crew help a civilian whose child has been wounded
As it rises in formation behind us, I recall the brief given by our crew chief as he waved at the medical equipment bolted to every square inch of the cabin in which I am travelling: ‘Hey, Alex, if we crash, in the unlikely but happy event of any of us being alive, feel free to help out.’
We land in a blizzard of dust and the flight surgeon and his Emergency Medical Technician (EMT) leap from the helicopter and jog towards a knot of uniforms clustered around a figure on a stretcher.
I see our patient, a Taliban fighter, covered by a space blanket complete with matching silver bonnet.
He is manhandled on board, one of the escorts climbs in, the other two escorts hop on the Chase Bird and the reception party exchange fist salutes with our crew. The rotors that never stopped turning hoist us into the sky.
‘So, let me get this straight,’ Graham the co-pilot says over the intercom. ‘We’re up here getting shot at. We have some guy on board who has spent a morning trying to kill US soldiers, whose very desire is to die in battle. We are spending $4,000 per hour per bird. We’re shipping his ass to Bagram to give him the best medical care available in Afghanistan.’
He pauses for effect. ‘Just so he can get better and come after us all over again.’ Another pause. ‘Everyone OK with that?’
There is no reply; the two medics are busy with a person they see as a patient, not an enemy. I see a well fed young man in his early 30s, with a dark curly beard. He is spattered with blood and has tubes up his nose and in his chest and arms. His hands are covered in blood.
Help for all: Back at Bagram Air Base, an injured enemy fighter is carried towards the hospital
His face is peaceful and his eyes are closed. Suddenly they flick open and he stares with a remarkable expression of awareness. The EMT yells: ‘Whoa, he just woke up!’ Everyone hears, even the escort who is not wearing headphones.
He is classed as ‘urgent surgical’, so there will be a full medical team waiting for him. We land at Bagram and taxi to the Craig Joint Theatre Hospital, named after Army Staff Sergeant Heathe Craig, a 28-year-old helicopter medic whose line snapped mid-rescue, plunging him 295ft to the ground in Naray, Afghanistan, on June 21, 2006.
Our jihadist is whisked away, where he will be operated on, nursed back to health by infidels, female infidels at that, and cared for by people he has sworn to destroy.
But bound by a sort of aviators’ Hippocratic oath, the helicopter crew accept it is their duty to lift anyone – irrespective of race, religion or politics – whose life, limbs or eyesight are in danger.
So, satisfied by another job well done, they return to the hangar where they play basketball and gossip until the next nine-liner of their 12-hour shift.
This is the modern face of America’s Dust Offs, the helicopters that evacuate the wounded and dying from the world’s war zones. You’ve seen them in the opening shots of M*A*S*H.
Now they are back again, in a new century, here in Afghanistan with their motto ‘Burning Gas To Save Your Ass’ and their racy platoon T-shirts that bear an image – reminiscent of the drawings popular on Second World War bombers – of a scantily clad nurse dangling from a helicopter. The caption reads: ‘Hanging Out There To Pick You Up.’
Today I am flying with call sign 31 Delta, piloted by Mark and Graham – I’m told first names, but surnames are withheld for security reasons. It is crewed by flight surgeon Jeremy, 29, who has two young sons at home waiting for him to finish a 13-month tour.
The Dust Off platoon’s irreverent logo
His medical technician is Kevin, also a father of two, and their crew chief is Brandon, who celebrates his Irish heritage with a leprechaun tattoo. He is both mechanic and medic, tending to both chopper and patients.
‘Who have we got?’ the co-pilot asks. ‘Afghan EPW, enemy prisoner of war,’ says Jeremy. ‘Four gunshots, unconscious but stable.’
‘He’s taken four rounds, he’s unconscious and he still needs three US soldiers to guard him?’ says Graham. ‘Must be a maniac.’
We ascend. The shadows of our two Black Hawks dance across a breathtaking landscape. We streak over canyons and ravines marbled with water running down from the Hindu Kush mountain range.
The idyll is broken when I notice Kevin commenting on a vehicle he has seen. His prudence is timely. ‘Muzzle Flash! Left. Four o’clock, quarter of a mile!’ he barks.
Instantly, the pilot heaves the Black Hawk over to the right and drops the nose to increase airspeed. G-force pins me as we swoop away from the threat. The co-pilot warns Grim Six, which accelerates to place itself between the medics and the threat.
We have been shot at from a pick-up truck. In a minute we are well past, but Grim Six is hanging back, circling the spot to pick up the vehicle that opened fire.
They find it but have not been fired at, thus, according to the ROE (rules of engagement), are prevented from tackling it.
‘That’s nice,’ Graham says. ‘They’re shooting at us one minute and we’re patching them up and flying them to hospital the next.’
It’s a little-known fact that 80 per cent of the casualties airlifted by the Dust Offs are Afghan nationals. Not all are enemy fighters, some are civilians. The medics, despite their black humour, are professionally non-partisan.
The men of 31 Delta and Grim Six are part of a fleet of 12 Black Hawks with a radius of about 250 miles. They are six months into a year-long tour during which they expect to fly around 1,300 sorties.
The pressure on them, physical and mental, is extraordinary. As we repair to the waiting area after another nine-liner, I fall in step with a distinguished-looking captain who sports Ranger and Airborne insignia, and a small cloth cross.
Emmitt is chaplain to 6th Aviation Battalion. His presence in the hangar has been demanded by the officers of Charlie Company because of the strain the job can have on the men.
‘I have been with Charlie Company for six months,’ he says. ‘I know them individually, I know the signs; can tell by their demeanour when something’s not right.’
‘Give me an example,’ I say.
‘When we pick up dead soldiers, you know, a Fallen Hero mission. Or when we pick up dead Afghan kids, boys and girls, maybe several scooped up into one body bag. That can be bad for some of the boys: especially with men who have kids of their own.’
Eyewitness: Alex Gardiner joins the medics in their Black Hawk helicopter
I ask him about the so-called Fallen Hero missions.
‘I ride in the Chase Bird. All the dead ride in there. The living go in the Dust Off. The wounded don’t need to wake up and see a bodybag.’
I am struck by the vision of a Dust Off burning through the air pursued by a chaplain riding in a Black Hawk painted with the Grim Reaper. I mention the incongruity of it, but Emmitt just laughs.
‘The gallows humour is important and is a good sign,’ he says. But then he turns more serious. ‘I carry the Stars and Stripes because often we pick up from the point of injury where they simply don’t carry the flag or have time to render honour. So I begin that process on board the Chase Bird. I drape the flag over the bodybag and I pray.
‘When we land at Bagram the process of honour and respect for the fallen is continuous. I ensure the flag stays in position until the body is taken to mortuary affairs.’
My mind dwells on the American capacity for sentiment – the predilection for the mawkish that can make a cold-blooded Brit sneer.
Bagram Air Base, home to about 13,000 American servicemen and women, is ripe for a good British sneer, with its signs exhorting attendance at classes ranging from self-development and sexual and racial discrimination awareness to salsa.
If you are American you can get career advice, study for a degree, obtain discounts on pick-up trucks (free hunting rack thrown in) and even pay your bills back in the US.
But somehow Emmitt’s work doesn’t seem sentimental, and I walk away from him trying to comprehend the strength it takes to show unyielding faith and kindness when the going gets tough.
My emotions are reaching an unfamiliar limit. I have been on three missions in one day and I am emotionally and physically battered.
And I am doing this for just a week. The men and women I am working with get 18 days’ home leave in 13 months. They face daily danger from an enemy who will accept mercy but never grant it. If there is a plus side, it is hard to see.
Two days later I am at the end of my stay but still hoping to fly my tenth mission. In nine so far I have a tally of 11 Afghan soldiers, one Afghan child, two jihadists and two Americans soldiers – proof that the Dust Offs do collect mainly Afghans.
Half an hour later, with two hours of daylight left, my wish is granted. The nine-liner is dropped.
Something feels wrong as I strap in. Triggering my queasiness to full-blown nausea might not take much; the smell of blood mixed with the reek of fuel would do the trick.
Through my headset I catch the abbreviation POI, and know we are going to the point of injury – where the incident happened – so there might still be enemy in the area.
I hear the casualty is an EPW, a Talib or Al Qaeda fighter with two gunshot wounds.
It is confirmed there has been an actual firefight as opposed to a more random IED (Improvised Explosive Device, a powerful landmine). The enemy may be lying in wait, having baited a trap for us.
I know why I am feeling uneasy: I don’t want to go. I am ashamed as I wonder what it must be like to have to do this, to risk your life, on the last sortie of a 12-month tour.
Thirty minutes later we are down on the ground. The EMT and the crew chief are out in a flash. The pilot and co-pilot give a running commentary on the state of security of this small Coalition firebase: they are not impressed.
A group of American GIs come forward carrying the patient, another brown-skinned, blood-spattered body shrouded in a space blanket.
His face is grey with pain and he rolls in his stretcher, revealing bloody buttocks and a soggy dressing. One GI hops on board as escort; the remainder, dust-covered and haggard, will soldier on.
The Dust Off lifts and I glimpse Grim Six about half a mile away, circling while we were on the ground but now turning to fall in behind.
The man on the stretcher is causing the medics concern. The flight surgeon observes his vital signs on the monitor and reports the deterioration is serious. More intravenous liquid is pumped in under pressure, saturating the victim’s system.
After five minutes the vital signs of pulse, heart rate and breathing look better. ‘He’ll make it,’ the EMT concludes with satisfaction. And he does.
A kaleidoscope of images flood back to me as I trudge away from the Dust Off hangar for the last time.
I see bewilderment on the face of an Afghan as he takes his first flight, then a grimace of pain on a child’s face, a comatose jihadist on his way to life in prison – having faced the Afghan courts following treatment – after failing to achieve martyrdom.
But my most recurring image is the disoriented Afghan man, his face screwed up in pain, reaching for comfort from a fellow human. The EMT read his wordless plea and, for a few seconds, two men who had never met clasped hands.
I keep asking myself why they do it. It cannot be money or simply patriotism.
I found my answer, perhaps, in a conversation with a father who told me that as long as Coalition forces keep Al Qaeda and the Taliban in Afghanistan, we’re winning. ‘No buildings have fallen down in the States since 2001, have they?’ he said. ‘My kids are growing up safe.’
But they know, as I do, that our humanitarian efforts are ultimately futile. They patch up the Taliban so they can fight on.
There is indeed a grim irony in the fact that we are so civilised we see it as our duty to restore our enemy to health. But at what cost?