U.S. Army Medical Department, Office of Medical History
Skip Navigation, go to content

HISTORY OF THE OFFICE OF MEDICAL HISTORY

AMEDD BIOGRAPHIES

AMEDD CORPS HISTORY

BOOKS AND DOCUMENTS

HISTORICAL ART WORK & IMAGES

MEDICAL MEMOIRS

AMEDD MEDAL OF HONOR RECIPIENTS External Link, Opens in New Window

ORGANIZATIONAL HISTORIES

THE SURGEONS GENERAL

ANNUAL REPORTS OF THE SURGEON GENERAL

AMEDD UNIT PATCHES AND LINEAGE

THE AMEDD HISTORIAN NEWSLETTER

Chapter II

Table of Contents

CHAPTER II

Birth Of A Tradition

The lay of the land and the guerrilla nature of Viet Cong warfare in South Vietnam demanded that the American forces stationed there from the early 1960s through March 1973 again use the medical helicopter. In a country of mountains, jungles, and marshy plains, with few passable roads and serviceable railroads, the allied forces waged a frontless war against a seldom seen enemy. Even more than in Korea, helicopter evacuation proved to be both valuable and dangerous.

South Vietnam consists of three major geographic features. A coastal plain, varying in width from fifteen to forty kilometers, extends along most of the 1,400 kilometers of the coast. This plain abuts the second feature-the southeastern edge of the Annamite Mountain Chain, known in South Vietnam as the Central Highlands, which run from the northern border along the old Demilitarized Zone south to within eighty kilometers of Saigon. The Central Highlands are mostly steep-sloped, sharp-crested mountains varying in height from 5,000 to 8,000 feet, covered with tangled jungles and broken by many narrow passes. The southern third of the country consists almost entirely of an arable delta.

These three geographical features helped shape the four military zones of South Vietnam. The northern zone, or I Corps Zone, which ran from the Demilitarized Zone down to Kontum and Binh Dinh provinces, consisted almost entirely of high mountains and dense jungles. At several points the Annamites cut the narrow coastal plain and extend to the South China Sea. II Corps Zone ran from I Corps Zone south to the southern foothills of the Central Highlands, about one hundred kilometers north of Saigon. It consisted of a long stretch of the coastal plain, the highest portion of the Central Highlands, and the Kontum and Darlac Plateaus. III Corps Zone ran from II Corps Zone southwest to a line forty kilometers below the capital, Saigon. This was an intermediate geographic region, containing the southern foothills of the Central Highlands; a few large, dry plains; some thick, triple-canopy jungle along the Cambodian border; and the northern stretches of the delta formed by the Mekong River to the south. IV Corps Zone consisted almost entirely of this delta, which has no forests except for dense mangrove swamps at the southernmost tip and forested areas just north and southeast of Saigon. Seldom more than


22

twenty feet above sea level, the delta is covered with rice fields separated by earthen dikes. During the rainy season the paddies are marshy, making helicopter landings and vehicular troop transport extremely difficult. Hamlets straddle the rivers and canals, and larger villages (up to 10,000 people) and cities lie at tile junctions of the waterways. Bamboo brakes and tropical trees grow around the villages and usually extend from 50 to 300 meters back on either side of the canal or hamlet.

The entire country lies below the Tropic of Cancer, between the 8th and 17th parallels. The climate is generally hot and humid the year round. In winter the country lies under a high pressure system that causes a dry season in the south. In the summer, however, rains fall heavily, varying from torrential downpours to steady mists. The northern region of South Vietnam has the most rain, averaging 128 inches, while the Saigon region averages 80 inches. In the northern region and the Central Highlands, where most of the fighting by U.S. troops during the war occurred, dense fog and low clouds often grounded all aircraft. About ten times a year, usually between July and November, typhoons blow in from the South China Sea, soaking South Vietnam with heavy rains and lashing it with fierce winds.

Although the climate and terrain exacerbated the technical problems of medical evacuation by helicopter in South Vietnam, the air ambulance pilots who worked there worried as much or more about the dangers that stemmed from the enemy's frequent use of guerrilla tactics. The Viet Cong were wily, elusive, and intensely motivated. They usually had no respect for the red crosses on the doors of the air ambulance helicopters. Likely to be annihilated in a large-scale, head-on clash with the immense firepower of American troops', they usually struck only in raids and ambushes of American and South Vietnamese patrols. To perform their missions the air ambulance pilots often had to fly into areas subject to intense enemy small arms fire. Later in the war the pilots encountered more formidable obstacles, such as Russian- and Chinese-made ground-to-air missiles. No air ambulance pilot could depend on a ground commander's assurance that a pickup zone was secure. Mortar and small arms fire often found a zone just as the helicopter touched down. Enemy soldiers were known to patiently hide for hours around an ambushed patrol, looking for the inevitable rescue helicopter.

In these conditions the modern techniques of aeromedical evacuation developed and matured. The obstacles of mountain, jungle, and floodplain could be overcome only by helicopters. The frontless nature of the war also made necessary the helicopter for medical evacuation. Air ambulance units found ever wider employment as the helicopter-used both as a fighting machine and as a transport vehicle-came to dominate many phases of the war.


23

The Struggle Begins

In 1961 President John F. Kennedy took the first of a number of measures that over the next four years drew the United States deep into the stormy politics of Southeast Asia. In May, Kennedy publicly repeated a pledge, first made by President Dwight D. Eisenhower in 1954, of U.S. support for the government of the Republic of Vietnam. Kennedy had the Department of State adopt a less demanding diplomacy in its dealings with the troubled regime of President Ngo Dinh Diem. The department tried to coax Diem into making urgently needed political, economic, and military reforms, but he dallied, and the Viet Cong summer campaign of 1961 further weakened his tenuous hold on the country. U.S. officials knew that he was losing control rapidly when, in September, the rebels captured a provincial capital only ninety kilometers from Saigon.

President Kennedy now believed that he had to decide whether to watch a U.S. ally collapse or to find some way of helping Diem fight the Viet Cong. In October 1961 Gen. Maxwell D. Taylor, the President' s personal military adviser, and Dr. Walt W. Rostow, one of the President's aides, recommended that the United States commit some of its combat troops to Diem's defense. But Kennedy turned down this proposal. Instead he persuaded Diem to agree to a program of broad reforms, in return for the deployment of more U.S. military advisers and military equipment to support the combat operations of the Army of the Republic of Vietnam (ARVN).

On 11 December 1961 Saigon saw the arrival of the first direct U.S. military support for South Vietnam-the 8th Transportation Company from Fort Bragg, North Carolina, and the 57th Transportation Company from Fort Lewis, Washington. Both were light helicopter units. The two companies consisted of 400 pilots, crews, and technicians, with thirty-three U.S. Army H-21 Shawnee helicopters. The aircraft carrier that brought them, the U.S.S. Core, also brought four T-28 single-engine, propeller aircraft en route to the Vietnamese National Air Force (VNAF). With its deck towering over hundreds of nearby junks, the Core edged up the Saigon River to a pier in front of the Majestic Hotel. Thousands of Vietnamese lined the riverbanks and watched the start of a new phase in the war dividing their country.

In January and February 1962 two more helicopter companies, the 93d Transportation and the 18th Aviation, arrived in Saigon. The city struggled to find room for several thousand personnel from helicopter companies, Air Force training groups, engineer detachments, the Seventh Fleet, and sundry advisory units. The South Vietnamese Army, equipped with American armored personnel carriers and backed by the new American helicopters, began to show a


24

more aggressive spirit. Accompanied by U.S. advisers, it attacked previously inviolate Viet Cong strongholds, such as War Zone D north of Saigon, and the U Minh Forest in the southern Mekong Delta.

The First Air Ambulance Unit in Vietnam

Despite their early successes in 1962, both the South Vietnamese and their American advisers suffered growing numbers of casualties. By the end of the year the medical part of the Vietnam troop list had expanded to encompass units able to provide a full range of medical services for a planned eight thousand U.S. military personnel. In Washington, Maj. Gen. James H. Forsee, Chief of Professional Services at Walter Reed, and Col. James T. McGibony, Chief of the Medical Plans and Operations Division, assured the Surgeon General that the medical units assigned to Vietnam would supply fully integrated health care. Forsee and McGibony designated the first Army medical units that would go to Vietnam to support the U.S. buildup: the 8th Field Hospital; medical detachments for dental, thoracic, orthopedic, and neurosurgical care; and the 57th Medical Detachment (Helicopter Ambulance). Arriving in April 1962, the 57th remained there throughout the next eleven years of American military involvement in that country.

This long ordeal began for the air ambulance pilots and crews in late February 1962, when Headquarters of the U.S. Second Army ordered the 57th, stationed at Fort George Meade, Maryland, for a permanent assignment to the U.S. Army, Pacific. A frenzied logistical effort began. Since the 57th was not authorized a cook, the commander, Capt. John Temperelli, Jr., obtained a six months supply of C-rations. Since they had no survival equipment, the unit's men hastily made up their kits from local stores. The typical kit, stored in a parachute bag, contained a machete, canned water, C-rations, a lensatic compass, extra ammunition, a signaling mirror, and sundry items the men thought they might need in a crisis. When they arrived in Vietnam in late April, the pilots had five "Hueys," as their UH-1 helicopters were nicknamed. Along with the 8th Field Hospital and the other medical detachments, the 57th set itself up in the seaside town of Nha Trang, 320 kilometers northeast of overcrowded Saigon. The assignment of U.S. Army medical units to Nha Trang prevented a worsen-ing of the logistics problem in Saigon, but it placed medical support far from most of the U.S. military units in the country.

On its first mission the 57th evacuated a U.S. Army captain advising the ARVN forces. An evacuation request came on 12 May from Tuy Hoa, sixty-five kilometers up the coast from Nha Trang. The captain, suffering from an extremely high fever, was carried to the 8th


25

Field Hospital. Soon after, the 57th began to evacuate ARVN soldiers as well, even from combat. Although the U.S. Military Assistance Advisory Group (MAAG) prohibited the 57th from evacuating Vietnamese soldiers and civilians, Captain Temperelli found this policy to be unrealistic. He had to work closely with local Vietnamese officials to set up designated evacuation sites in secure areas and to improve the communication nets that relayed the 57th's evacuation requests. Forced to use the ARVN radio channels, the 57th was obliged to honor requests for evacuation of Vietnamese casualties. In the years ahead the air ambulances carried the wounded of all nationalities, even those of the enemy.

As yet, however, the 57th was a new unit, little known, and with little to do. It spent most of that summer sitting in Nha Trang, unable to get to the fighting. By the end of June the detachment had evacuated only twelve American and fourteen ARVN personnel. In an attempt to increase his range of action, Temperelli assigned two of his Hueys to Qui Nhon, another coastal town some 160 kilometers to the north. Neither base had refueling sites in its area. The radius of action from each was only 140 kilometers, and most of the fighting was at least 200 kilometers to the south. Hoping to add an extra fifty-five minutes flying time to each helicopter, Temperelli asked for permission to replace the unnecessary cockpit heaters with auxiliary fuel cells; but he never received approval for the change. He also tried to have the helicopters' JP-4 fuel stored in certain critical inland areas, but was only partially successful. He could also obtain no favorable response to his several requests for permission to move the unit to Saigon or the Delta.

Early in July 1962 all commanders of U.S. Army aviation units in South Vietnam met in Saigon to discuss the possibility of the extensive use of Army aviation in support of South Vietnamese counterinsurgency operations. Briefing officers told the commanders that greater American military involvement would probably require Army aviation to assume many duties formerly assigned to armor, ground transport, and the infantry. Captain Temperelli left this conference angered that, in spite of the predicted growth of Army aviation in Vietnam, the Army Medical Service had so far furnished only limited resources to his unit. The reluctance of the Vietnamese Air Force to respond to many evacuation requests convinced him that the burden of medical evacuation in this war would have to fall on U.S. Army helicopter ambulance units. Yet so far the Surgeon General had sent no representative to the 57th to see what its problems were.

In fact, the logistics problems of the 57th were only a small part of the shortages that hindered all Army aviation units in the first years of the war. Deficiencies and excesses in the authorized lists of equipment


26

too often appeared only after units were committed to combat. Many of the aviation units carried unnecessary heaters and winter clothing with them to Vietnam simply because the standard equipment list called for them. Red tape compounded equipment problems. At first the aviation units sent their orders for parts directly to the U.S. Army on Okinawa, but Okinawa often returned the paperwork for corrections to comply with directives that the forces in Vietnam had never heard of. Only after several months of logistical chaos did the Army Support Group, Vietnam (USASGV) begin to coordinate the requisition of parts.

In this first year of operations Army supply depots in the Pacific could fill only three-fourths of the aviation orders from Vietnam. This problem arose partly from the unusual role of the Army aviation units there. Army helicopters used in support of ARVN operations flew far more hours and wore out much faster than peacetime supply estimates provided for. By November 1962 the Army had thirteen aviation units flying 199 aircraft of eight types at ten places in Vietnam. Multiple bases for several units added to the units' supply needs.

Since the 57th Medical Detachment had the only UH-1's in Vietnam so far, it could draw on no pool of replacement parts. Instead, it had to cannibalize one of its own helicopters to keep the others flying. When Gen. Paul D. Harkins, commander of the Military Assistance Command, Vietnam (MACV), and Gen. Earle G. Wheeler, Army Chief of Staff, visited Nha Trang in August 1962, they saw two of the 57th's UH-1's sitting on a ramp, with no rotor blades. The 57th had no spares.

Then combat aviation units began to demand the 57th's few remaining parts. In November, feeling confident after an influx of new infantry equipment from the United States, the South Vietnamese Army planned a large scale combat assault into the "Iron Triangle," a Viet Cong stronghold northwest of Saigon. Armed Huey UH-1's were to cover the CH-21's carrying ARVN troops to the landing zones. Since several of the Hueys had bad tail rotor gear boxes and faulty starter generators, the 57th received instructions to bring all its starter generators to Saigon. Plainly, the unit's craft were about to be cannibalized.

To head off the danger, Temperelli accompanied the generators to Saigon and reported to Brig. Gen. Joseph W. Stilwell, commander of the Army Support Group, Vietnam. Noting that the absence of the generators on the 57th's aircraft would leave South Vietnam without air evacuation coverage, Temperelli suggested that the 57th might fly down to support the ARVN assault. But Stilwell said no. Temperelli handed over the generators and left, taking with him a promise that they would be returned after the operation. Only one ever made it


27

back, and the 57th was totally grounded from 17 November to 15 December. When he recovered the one generator, Temperelli shifted the 57th's one flying aircraft back and forth between Nha Trang and Qui Nhon to provide some coverage at each location.

A graver danger to the 57th's independence developed out of its medical mission. For most of the Korean War, Army ambulance helicopters had served under the aegis of the Army Medical Service, attached to the hospitals behind the corps areas. But in September 1962 General Stilwell considered ending this policy in Vietnam by transferring the 57th from the Medical Service to the Army Transportation Corps, which then controlled all other Army helicopters in Vietnam. Temperelli, accompanied by Lt. Col. Carl A. Fischer, USASGV Surgeon and commander of the 8th Field Hospital, again went to Saigon. This time he was more successful, convincing Stilwell to maintain the old policy.

Temperelli also deflected other attacks on the 57th's integrity. Because of the relatively few hours flown by the pilots in their first year in Vietnam, other Army aviators there argued against dedicating any helicopters to medical evacuation. Some suggested removing the red crosses from medical helicopters and assigning general support tasks to any idle medical aircraft. In another attempt to coopt the 57th's resources, the senior MAAG advisor in Qui Nhon tried several times to commandeer a standby evacuation ship; but each time the 57th told him that he could have priority on the craft only if he were a casualty. All in all, 1962 was not a good year for the air ambulance unit and its pilots.

Early in January 1963, however, an ARVN assault in the Delta convinced many skeptics that the 57th ought to be brought closer to the scene of battle. South Vietnamese intelligence had heard of an enemy radio station operating near the village of Ap Bac in the Plain of Reeds. Fifty U.S. advisers and 400 men of the ARVN 7th Infantry Division flew ten CH-21 Shawnee helicopters to the area. Five armed UH-l's that would serve as close air cover escorted the convoy.

The first three waves of helicopters dropped their troops into the landing zone without difficulty. But just as the fourth wave was touching down, Viet Cong opened fire with automatic weapons and shot down four of the CH-21's. A U.S: Army UH-1B moved into the face of the enemy fire to try to rescue one of the downed crews. It too crashed-the first UH-1B destroyed by the enemy in the Vietnam War. The other four UH-1's suppressed the Viet Cong fire, allowing the remaining Shawnees to leave the hotly contested area without further loss.

Other than for the unusually large number of forces involved, the battle was. typical for this period: in the ground fight that followed, the South Vietnamese infantry failed to surround the Viet Cong, who


28

escaped under cover of night. Three American advisers and sixty-five ARVN soldiers were killed. The 57th Medical Detachment, still stationed at Nha Trang and Qui Nhon, far to the north, could not help evacuate the wounded.

The losses suffered at Ap Bac impressed on Army commanders that the air ambulances might be best employed near the fighting. On 16 January the Support Group ordered the 57th to move to Saigon. By this time the 57th had only one flyable aircraft, at Qui Nhon. But Support Group told Captain Temperelli that new UH-1B's were on the way. On 30 January the 57th arrived at Tan Son Nhut Air Base in Saigon.

Dust Off Takes Form

The pilots and crews found Saigon much different from Qui Nhon and Nha Trang. Here they enjoyed access to a large, fully stocked post exchange and commissary. Local Vietnamese stores sold French wines, liqueurs, and champagnes, and the post exchange sold popular American spirits. The Armed Forces Radio Station broadcast the latest American music and reported ball game scores. The officers had clubs in the Brink and Rex Hotels, and the Five Oceans Club in the Cholon Officers' Open Mess. The French-sponsored Cercle Sportif provided the officers swimming and tennis, and the Club Nautique offered water-skiing, rowing, and motorboating. Also available were the Saigon Tennis Club, the Saigon Golf Club, and the Cercle Hippique for horseback riding. The city even boasted a six-lane bowling alley. Some of the pilots frequented cafes like the Riverboat Restaurant, and one even sang for a while in a downtown nightclub.

The veterans had little time to enjoy such amenities. In late February 1963 Captain Temperelli passed the reins of the 57th to a new commander, Maj. Lloyd E. Spencer. The veteran pilots rotated out of Vietnam and their replacements arrived. Shortly after Spencer arrived in Saigon, General Stilwell called him in for an interview. Slapping at a map of South Vietnam, Stilwell asked Spencer how he proposed to cover all the country with only five aircraft. All that Spencer could say was that the 57th would do its best. After a lengthy discussion of problems, Stilwell again promised the 57th the first five new UH-1B's in South Vietnam. On 11 March the unit signed over the last of its grounded UH-1A's for return to the States. The next day Support Group issued the detachment five new UH-1B's that were still on a ship in the Saigon Harbor. On 23 March the 57th declared itself fully operational again.

But Saigon brought its own problems. The 57th's assigned parking area at Tan Son Nhut Airport was directly behind the area where the Vietnamese Air Force pilots parked their C-47 Dakotas. When


29

the VNAF pilots started their planes, always parked with the tails towards the 57th's area, the engines spattered oil all over the bubbles, windows, and windshields of the Hueys. Several times the 57th's crews asked the Vietnamese to park the C-47's facing another direction, but the pilots refused. The 57th's solution to the problem, while it did not foster allied harmony, was effective. Spencer explained: "When you fly a helicopter over the tail of a C-47 it really plays hell with the plane's rear elevators; so the Vietnamese got the message and moved the C-47's."

In April, part of the 57th's pilots and crews bade farewell to the comforts of Saigon when two of the aircraft went on a semipermanent standby to the town of Pleiku, some 120 kilometers northwest of the 57th's old base at Qui Nhon. Pleiku lies in Vietnam's Annamite mountain chain. That month a 57th helicopter at Pleiku joined a search and rescue mission for a B-26 that had crashed while covering a combat assault. The crew found the B-26 lying on a pinnacle, but could not land because of the stunted trees and other growth that covered the peak. While the pilot hovered as low as possible, the crew chief and the medical corpsman leaped from the Huey to the ground, where they cut out a landing area. The Huey landed and the men removed the B-26's .50-caliber machine guns and the bodies of its three Air Force crewmen.

The 57th's two units in the north stood duty round the clock, until their operational commanders canceled night missions after a transport aircraft went down on a flight in darkness over the South China Sea. Most of their missions were to small U.S. Army Special Forces teams scattered among the Montagnard villages in the wild highlands. The Viet Cong there had none of the sophisticated weapons used by their compatriots in the south. The air ambulances at Pleiku contended with only homemade guns, crossbows, and a few firearms the Viet Cong had captured from ARVN troops.

In late June, one of the Hueys at Pleiku moved to Qui Nhon to resume coverage of that sector. In I Corps Zone to the north, U.S. Marine H-34 helicopters furnished both combat aviation support and medical evacuation. The 57th's aircraft at Pleiku and Qui Nhon covered II Corps Zone, and the three in Saigon covered III and IV Corps Zones. Although all the four corps regions of South Vietnam had some form of medical evacuation, it was thinly spread.

For the past year the 57th had worked without a tactical call sign, simply using "Army" and the tail number of the aircraft. For example, if a pilot were flying a helicopter with the serial number 62-12345, his call sign would be "Army 12345." The 57th communicated internally on any vacant frequency it could find. Major Spencer decided that this slapdash system had to go. In Saigon he visited Navy Support Activity, which controlled all the call words in South Vietnam. He


30

received a Signal Operations Instructions book that listed all the unused call words. Most, like "Bandit," were more suitable for assault units than for medical evacuation units. But one entry, "Dust Off," epitomized the 57th's medical evacuation missions. Since the countryside then was dry and dusty, helicopter pickups in the fields often blew dust, dirt, blankets, and shelter halves all over the men on the ground. By adopting "Dust Off," Spencer found for Army aeromedical evacuation in Vietnam a name that lasted the rest of the war.

Even though distinguished by its own name, the 57th still had no formal mission statement. Its pilots worked on the assumption that their main purpose was to evacuate wounded and injured U.S. civilians and military personnel. It continued to provide this service to the Vietnamese as well when resources permitted. Like Captain Temperelli, Major Spencer also felt pressure to allow ground commanders to use Dust Off aircraft for routine administrative flights, but with General Stilwell's support he kept the 57th focused on its medical mission. If the 57th had already scheduled one of its aircraft for a routine flight, it sometimes accepted healthy passengers on a space-available basis, with the proviso that the passengers might have to leave the ship in the middle of nowhere if the pilot received a Dust Off request while in the air.

As the year went on, the 57th flew Dust Off missions more often. On one day alone, 10 September 1963, it evacuated 197 Vietnamese from the Delta, where large Viet Cong forces had virtually destroyed three settlements. That day Dust Off helicopters made flights with Vietnamese jammed into the passenger compartment and standing on the skids. The last flight out took place at night, and the three aircraft flew near a firefight on the ground. After a few tracer rounds arced up toward their helicopters, the pilots blacked out their ships and flew on to Saigon.

The first nine months of the year had brought important changes. Dust Off had a name, solid support from above, a mission-though no mission statement-and a great deal more business. Its problems reflected its new-found popularity.

Relations with the South Vietnamese

Although the number of Vietnamese casualties rose in 1963, the South Vietnamese military refused to set up its own aeromedical evacuation unit. The VNAF response to requests for medical evacuation depended on aircraft availability, the security of the landing zone, and the mood and temperament of the VNAF pilots. If the South Vietnamese had no on-duty or standby aircraft ready to fly a medical evacuation mission they passed the request on to the 57th.


31

Even when they accepted the mission themselves, their response usually suffered from a lack of leadership and poor organization. Since South Vietnamese air mission commanders rarely flew with their flights, the persons responsible for deciding whether to abort a mission often lacked the requisite experience. As a MACV summary said: "Usually the decision was made to abort, and the air mission commander could do nothing about it. When an aggressive pilot was in the lead ship, the aircraft came through despite the firing. American advisers reported that on two occasions only the first one or two helicopters landed; the rest hovered out of reach of the wounded who needed to get aboard."

An example of the poor quality of VNAF medical evacuation occurred in late October 1963, when the ARVN 2d Battalion, 14th Regiment, conducted Operation LONG HUU II near O Lac in the Delta. At dawn the battalion began its advance. Shortly after they moved out, the Viet Cong ambushed them, opening fire from three sides with automatic weapons and 81 -mm. mortars. At 0700 casualty reports started coming into the battalion command post. The battalion commander sent his first casualty report to the regimental headquarters at 0800: one ARVN soldier dead and twelve wounded, with more casualties in the paddies. He then requested medical evacuation helicopters. By 0845 the casualty count had risen to seventeen lightly wounded, fourteen seriously wounded, and four dead. He sent out another urgent call for helicopters. The battalion executive officer and the American adviser prepared two landing zones, one marked by green smoke for the seriously wounded and a second by yellow smoke for the less seriously wounded. Not until 1215 did three VNAF H-34's arrive over O Lac to carry out the wounded and dead. During the delay the ARVN battalion stayed in place to protect their casualties rather than pursue the retreating enemy. The American adviser wrote later: "It is common that, when casualties are sustained, the advance halts while awaiting evacuation. Either the reaction time for helicopter evacuation must be improved, or some plan must be made for troops in the battalion rear to provide security for the evacuation and care of casualties."

The ARVN medical services also proved inadequate to handle the large numbers of casualties. In the Delta, ARVN patients were usually taken to the Vietnamese Provincial Hospital at Can Tho. As the main treatment center for the Delta, it often had a backlog of patients. At night only one doctor was on duty, for the ARVN medical service lacked physicians. If Dust Off flew in a large number of casualties, that doctor normally treated as many as he could; but he rarely called in any of his fellow doctors to help. In return they would not call him on his night off. Many times at night Dust Off pilots would have to make several flights into Can Tho. On return flights the pilots often


32

found loads of injured ARVN soldiers lying on the landing pad where they had been left some hours earlier. After several such flights few pilots could sustain any enthusiasm for night missions.

Another problem was that the ARVN officers sometimes bowed to the sentiments of their soldiers, many of whom believed that the soul lingers between this world and the next if the body is not properly buried. They insisted that Dust Off ships fly out dead bodies, especially if there were no seriously wounded waiting for treatment. Once, after landing at a pickup site north of Saigon, a Dust Off crew saw many ARVN wounded lying on the ground. But the other ARVN soldiers brought bodies to the helicopter to be evacuated first. As the soldiers loaded the dead in one side of the ship, a Dust Off medical corpsman pulled the bodies out the other side. The pilot stepped out of the helicopter to explain in halting French to the ARVN commander that his orders were to carry out only the wounded. But an ARVN soldier manning a .50-caliber machine gun on a nearby armored personnel carrier suddenly pointed his weapon at the Huey. This convinced the Dust Off crew to fly out the bodies. They carried out one load but did not return for another.

Kelly and the Dust Off Mystique

Early in 1964 the growing burden of aeromedical evacuation fell on the 57th's third group of new pilots, crews, and maintenance personnel. The helicopters were still the 1963 UH-1B models, but most of the new pilots were fresh from flight school. The new commander, Maj. Charles L. Kelly, from Georgia, was a gruff, stubborn, dedicated soldier who let few obstacles prevent him from finishing a task. Within six months he set an example of courage and hard work that Dust Off pilots emulated for the rest of the war.

Kelly quickly took advantage of the 57th's belated move to the fighting in the south. On 1 March 1964 Support Group ordered the aircraft at Pleiku and Qui Nhon to move to the Delta. Two helicopters and five pilots, now called Detachment A, 57th Medical Detachment (Helicopter Ambulance), Provisional, flew to the U.S. base at Soc Trang. Once a fighter base for both the French and the Japanese, Soc Trang was a compound roughly 1,000 by 3,000 feet, surrounded by rice paddies.

Unit statistics soon proved the wisdom of the move south: the number of evacuees climbed from 193 in February to 416 in March. Detachment A continued its coverage of combat in the Delta until October 1964, when another helicopter ambulance detachment from the States took over that area. Major Kelly, who had taken command of the 57th on 11 January, moved south with Detachment A, preferring the field and flying to ground duty in Saigon.


33

Detachment A in Soc Trang lived in crude "Southeast Asia" huts with sandbags and bunkers for protection against enemy mortar and ground attack. The rest of the 57th in Saigon struggled along with air conditioning, private baths, a mess hall, and a bar in their living quarters. In spite of the contrast, most pilots preferred Soc Trang. It was there that Major Kelly and his pilots forged the Dust Off tradition of valorous and dedicated service.

Major Kelly and his teams also benefited from two years of growing American involvement in Vietnam. By the spring of 1964 the United States had 16,000 military personnel in South Vietnam (3,700 officers and 12,300 enlisted men). The Army, which accounted for 10, 100 of these, had increased its aircraft in South Vietnam from 40 in December 1961 to 370 in December 1963. For the first time since its arrival two years ago the 57th was receiving enough Dust Off requests to keep all its pilots busy.

But Major Kelly faced one big problem when he arrived: the helicopters that the 57th had received the year before were showing signs of age and use, and General Stilwell, the Support Group commander, could find no new aircraft for the detachment. Average flight time on the old UH-1B's was 800 hours. But this did not deter the new pilots from each flying more than 100 hours a month in medical evacuations. Some of them stopped logging their flight time at 140 hours, so that the flight surgeon would not ground them for exceeding the monthly ceiling.

The new team continued and even stepped up night operations. In April 1963 the detachment flew 110 hours at night while evacuating ninety-nine patients. To aid their night missions in the Delta the pilots made a few special plotting flights, during which they sketched charts of the possible landing zones, outlined any readily identifiable terrain features, and noted whether radio navigational aid could be received. During one such flight Major Kelly and his copilot heard on their radio that a VNAF T-28, a fixed-wing plane, had gone down. After joining the search, Kelly soon located the plane. While he and his crew circled the area trying to decide how to approach the landing zone, the Viet Cong below opened fire on the helicopter. One round passed up through the open cargo door and slammed into the ceiling. Unfazed, Kelly shot a landing to the T-28, taking fire from all sides. Once down, he, his crew chief, and his medical corpsman jumped out and sprayed submachine gun fire at the Viet Cong while helping the VNAF pilot destroy his radios and pull the M60 machine guns from his plane. Kelly left the area without further damage and returned the VNAF pilot to his unit. Kelly and his Dust Off crew flew more than 500 miles that day.

On 2 April one of the Detachment A crews flying to Saigon from Soc Trang received a radio call that a village northwest of them had


34

been overrun. Flying up to the area where the Mekong River flows into South Vietnam from Cambodia, they landed at the village of Cai Cai, where during the night Viet Cong had killed or wounded all the people. Soldiers lay at their battle stations where they had fallen, women and children where they had been shot. The Dust Off teams worked the rest of the day flying out the dead and wounded, putting two or three children on each litter.

One night that spring Detachment A pilots Capt. Patrick H. Brady and 2d Lt. Ernest J. Sylvester were on duty when a call came in that an A1-E Skyraider, a fixed-wing plane, had gone down near the town of Rach Gia. Flying west to the site, they radioed the Air Force radar controller, who guided them to the landing zone and warned them of Viet Cong antiaircraft guns. As the Dust Off ship drew near the landing zone, which was plainly marked by the burning A1-E, the pilot of another nearby Al-E radioed that he had already knocked out the Viet Cong machine guns. But when Brady and Sylvester approached the zone the Viet Cong opened fire. Bullets crashed into the cockpit and the pilots lost control of the aircraft. Neither was seriously wounded and they managed to regain control and hurry out of the area. Viet Cong fire then brought down the second Al-E. A third arrived shortly and finally suppressed the enemy fire, allowing a second Dust Off ship from Soc Trang to land in the zone. The crew chief and medical corpsman found what they guessed was the dead pilot of the downed aircraft, then found the pilot of the second, who had bailed out, and flew him back to Soc Trang.

A short time later Brady accompanied an ARVN combat assault mission near Phan Thiet, northeast of Saigon. While Brady's Dust Off ship circled out of range of enemy ground fire, the transport helicopters landed and the troops moved out into a wooded area heavily defended by the Viet Cong. The ARVN soldiers immediately suffered several casualties and called for Dust Off. Brady's aircraft took hits going into and leaving the landing zone, but he managed to fly out the wounded. In Phan Thiet, while he was assessing the damage to his aircraft, an American adviser asked him if he would take ammunition back to the embattled ARVN unit when he returned for the next load of wounded. After discussing the propriety of carrying ammunition in an aircraft marked with red crosses, Brady and his pilots decided to consider the ammunition as "preventive medicine" and fly it in to the ARVN troops. Back at the landing zone Brady found that Viet Cong fire had downed an L-19 observation plane. Brady ran to the crash site but both the American pilot and the observer had been killed. The medical corpsman and crew chief pulled the bodies from the wreckage and loaded them on the helicopter. Brady left the ammunition and flew out with the dead.

By the time the helicopter had finished its mission and returned to


35

Tan Son Nhut, most of the 57th were waiting. News of an American death traveled quickly in those early days of the war. Later, reflecting on the incident, Kelly praised his pilots for bringing the bodies back even though the 57th's mission statement said nothing about moving the dead. But he voiced renewed doubts about the ferrying of ammunition.

In fact, the Dust Off mission was again under attack. When Support Command began to pressure the 57th to place removable red crosses on the aircraft and begin accepting general purpose missions, Kelly stepped up unit operations. Knowing that removable red crosses had already been placed on transport and assault helicopters in the north, Kelly told his men that the 57th must prove its worth-and by implication the value of dedicated medical helicopters-beyond any shadow of doubt.

Whereas the 57th before had flown missions only in response to a request, it now began to seek missions. Kelly himself flew almost every night. As dusk came, he and his crew would depart Soc Trang and head southwest for the marshes and Bac Lieu, home of a team from the 73d Aviation Company and detachments from two signal units, then further south to Ca Mau, an old haunt of the Viet Minh, whom the French had never been able to dislodge from its forested swamps. Next they would fly south almost to the tip of Ca Mau Peninsula, then at Nam Can reverse their course toward the Seven Canals area. After a check for casualties there at Vi Thanh, they turned northwest up to Rach Gia on the Gulf of Siam, then on to the Seven Mountains region on the Cambodian border. From there they came back to Can Tho, the home of fourteen small American units, then up to Vinh Long on the Mekong River, home of the 114th Airmobile Company. Next they flew due east to Truc Giang, south to the few American advisers at Phu Vinh, then home to Soc Trang. The entire circuit was 720 kilometers.

If any of the stops had patients to be evacuated, Kelly's crew loaded them on the aircraft and continued on course, unless a patient's condition warranted returning immediately to Soc Trang. After delivering the patients, they would sometimes resume the circuit. Many nights they carried ten to fifteen patients who otherwise would have had to wait until daylight to receive the care they needed. In March this flying from outpost to outpost, known as "scarfing," resulted in seventy-four hours of night flying that evacuated nearly one-fourth of that month's 450 evacuees. The strategem worked; General Stilwell dropped the idea of having the 57th use removable red crosses.

Although most of Dust Off's work in the Delta was over flat, marshy land, Detachment A sometimes had to work the difficult mountainous areas near the Cambodian border. Late on the after-


36

noon of 11 April Kelly received a mission request to evacuate two wounded ARVN soldiers from Phnom Kto Mountain of the Seven Mountains of An Giang Province. When he arrived he found that the only landing zone near the ground troops was a small area surrounded by high trees below some higher ground held by the Viet Cong. Despite the updrafts common to mountain flying, the mists, and the approaching darkness, Kelly shot an approach to the area The enemy opened fire and kept firing until Kelly's ship dropped below the treetops into the landing zone. Kelly could set the aircraft down on only one skid; the slope was too steep. Since only one of the wounded was at the landing zone, Kelly and his crew had to balance the ship precariously while waiting for the ARVN troops to carry the other casualty up the mountain. With both patients finally on board, Kelly took off and again flew through enemy fire. The medical corpsman promptly began working on the Vietnamese, one of whom had been wounded in five places. Both casualties survived.

When Kelly flew such a mission he rarely let bad weather darkness, or the enemy stop him from completing it. He fought his way to the casualties and brought them out. On one mission the enemy forced him away from the landing zone before he could place the patients on board. An hour later he tried to land exactly the same way, through enemy fire, and this time he managed to load the patients safely. The Viet Cong showed their indifference to the red crosses on the aircraft by trying to destroy it with small arms, automatic weapons, and mortars, even while the medical corpsman and crew chief loaded the patients. One round hit the main fuel drain valve and JP-4 fuel started spewing. Kelly elected to fly out anyway, practicing what he had preached since he arrived in Vietnam by putting the patients above all else and hurrying them off the battlefield. He radioed the Soc Trang tower that his ship was leaking fuel and did not have much left, and that he wanted priority on landing. The tower operator answered that Kelly had priority and asked whether he needed anything else. Kelly said, "Yes, bring me some ice cream." just after he landed on the runway the engine quit, fuel tanks empty. Crash trucks surrounded the helicopter. The base commander drove up, walked over to Kelly, and handed him a quart of ice cream.

Apart from the Viet Cong, the 57th's greatest problem at that time was a lack of pilots. After Kelly reached Vietnam he succeeded in having the other nine Medical Service Corps pilots who followed him assigned to the 57th. He needed more, but the Surgeon General's Aviation Branch seemed to have little understanding of the rigors of Dust Off flying. In the spring of 1964 the Aviation Branch tried to have new Medical Service Corps pilots assigned to nonmedical helicopter units in Vietnam, assuming that they would benefit more from combat training than from Dust Off flying. In late June Kelly


37

gave his response:

As for combat experience, the pilots in this unit are getting as much or more combat-support flying experience than any unit over here. You must understand that everybody wants to get into the Aeromedical Evacuation Business. To send pilots to U.T.T. [a nonmedical unit] or anywhere else is playing right into their hands. I fully realize that I do not know much about the big program, but our job is evacuation of casualties from the battlefield. This we are doing day and night, without escort aircraft, and with only one ship for each mission. The other [nonmedical] units fly in groups, rarely at night, and always heavily armed.

In other words, Kelly thought that his unit had a unique job to do and that the only effective training for it could be found in the cockpit of a Dust Off helicopter.

With more and more fighting occurring in the Delta and around Saigon, the 57th could not always honor every evacuation request. U.S. Army helicopter assault companies were forced to keep some of their aircraft on evacuation standby, but without a medical corpsman or medical equipment. Because of the shortage of Army aviators and the priority of armed combat support, the Medical Service Corps did not have enough pilots to staff another Dust Off unit in Vietnam. Most Army aeromedical evacuation units elsewhere already worked with less than their permitted number of pilots. Although Army aviation in Vietnam had grown considerably since 1961, by the summer of 1964 its resources fell short of what it needed to perform its missions, especially medical evacuation.

Army commanders, however, seldom have all the men and material they can use, and Major Kelly knew that he had to do his best with what he had. On the morning of 1 July 1964 Kelly received a mission request from an ARVN unit in combat near Vinh Long. An American sergeant, the adviser, had been hit in the leg by shrapnel from a mortar round. Several of the ARVN infantry were also wounded. Kelly and his crew flew to the area. The Viet Cong were close in to the ARVN soldiers and the fighting continued as Kelly's helicopter came in to a hover. Kelly floated his ship back and forth, trying to spot the casualties. The Viet Cong opened fire on his ship. The ARVN soldiers and their American advisers were staying low. One adviser radioed Kelly to get out of the area. He answered, "When I have your wounded." Many rounds hit his aircraft before one of them passed through the open side door and pierced his heart. He murmured "My God," and died. His ship pitched up, nosed to the right, rolled over, and crashed.

The rest of the crew, shaken but not seriously injured, crawled from the wreck and dragged Kelly's body behind a mound of dirt. Dust Off aircraft later evacuated Kelly's crew and the other casualties.

The United States awarded him the Distinguished Service Cross


38

posthumously. South Vietnam conferred the Military Order Medal of Vietnam, National Order, Fifth Class, and the Cross of Gallantry with Palm. Far more important than the medals he earned was his legacy to the hundreds of Dust Off pilots who followed him. His death saddened all who had known him, for he had given so much of himself so selflessly. The men of the 57th heard that General Stilwell, Kelly's commander for the last six months, wept when he heard of his death.

Capt. Paul A. Bloomquist took command of the 57th Medical Detachment in Saigon and Capt. Patrick H. Brady moved to Soc Trang to take over Detachment A. Assuming that the 57th would now select its missions more carefully, the commander of the 13th Aviation Battalion in the Delta called Brady into his office. He asked what changes would be made now that Kelly was gone. Brady told him that the 57th would continue flying missions exactly as Kelly had taught them, accepting any call for help.

A New Buildup

Kelly's death coincided with an important turning point in U.S. relations with North and South Vietnam. In the first half of 1964 the new administration of President Lyndon B. Johnson concluded that the growing political and military disturbances in South Vietnam required a commitment of larger U.S. economic and military resources in the area. In March 1964, after visiting South Vietnam, Secretary of Defense Robert McNamara recommended that the United States increase its aid to the Republic of Vietnam. President Johnson immediately increased U.S. aid to South Vietnam by $60 million. He also promised to obtain new equipment for the South Vietnamese Army, to finance a 50,000-man increase in South Vietnamese forces, and to provide funds for the modernization of the country's government. At his request the Joint Chiefs of Staff began to draft plans for the retaliatory bombing of North Vietnam. Over the next few months the South Vietnamese government of Maj. Gen. Nguyen Khanh was unable to make good use of the increased U.S. aid; American advisers in the countryside reported that Khanh's political power was still crumbling. General Khanh and Air Commodore Nguyen Cao Ky, commander of the South Vietnamese Air Force, began a public campaign to place all blame for the deteriorating conditions on North Vietnam and draw the United States even further into the conflict.

The United States was already more deeply involved than most Americans knew. For some time United States forces had taken part in clandestine amphibious raids on the North Vietnamese coast to gather intelligence. In the spring of 1964 the Johnson administration publicly stated that the United States was stockpiling for the possible deployment of large numbers of American troops in Southeast Asia.


39

The administration also surrounded with great publicity the dedication of the new U.S.-built airbase at Da Nang, on the northernmost part of South Vietnam's coast. These American threats had no effect on the Viet Cong or the North Vietnamese, who continued to bring supplies south through trails in Laos and to stage daring terrorist raids even in the center of Saigon. The North Vietnamese Navy openly challenged the United States in early August 1964 when its torpedo patrol boats attacked two U.S. destroyers sailing in the Gulf of Tonkin. Congress, outraged by this seemingly unprovoked attack in international waters, quickly gave President Johnson nearly unanimous approval to take whatever measures he thought necessary to protect U.S. forces in the area.

As U.S. involvement mounted, the requests made by Kelly and Stilwell for another air ambulance unit at last took effect. In August the Surgeon General's Office named five more helicopter ambulance detachments for assignment to Southeast Asia. The 82d Medical Detachment (Helicopter Ambulance) at Fort Sam Houston, Texas, was alerted for a 1 October move. The other four detachments were put on notice without firm departure dates and told to bring their units to full strength.

The advance party of the 82d arrived in Saigon on 5 October, and the next day Support Group, Vietnam, gave the detachment five new UH-1B's. The rest of the detachment arrived two weeks later. The officers and enlisted men of the 82d spent their first nights in Saigon billeted with their counterparts in the 57th. There they heard disturbing war stories from the veterans, then left for their new home in Soc Trang. Most of the detachment traveled by convoy, down Route 4 through the alien Delta countryside. Their first sight of Soc Trang-a small airstrip with a tiny village at one end, lying in the middle of rice paddies, with only a triple-stranded concertina wire to protect the perimeter-added to their concern.

To stagger personnel departure dates and help train the new 82d pilots and crews in Dust Off flying, three of the 57th pilots transferred to the 82d, and three from the 82d transferred to the 57th. Mai Henry P. Capozzi commanded the 82d; Maj. Howard H. Huntsman, the 57th. The 82d used the 57th's Hueys until it had its own in place and declared itself operational on 7 November 1964.

The new unit retraced the steps of their predecessors. Soon after they started flying evacuation missions the pilots of the 82d had their first taste of Viet Cong resistance. On a mission near Bac Lieu on 27 October, one of their new helicopters took three hits during a takeoff with casualties aboard. The crew flew back to Soc Trang and found one bullet hole through the red cross on one of the cargo doors. One of the ARVN evacuees lay dead from an enemy round that had penetrated the aircraft.


40

The old question of a call sign soon came up. After considering various signs, including those used by helicopter ambulance units in Korea, the new commanders settled on the 57th's sign, "Dust Off." When the 82d also adopted the 57th's unit emblem, merely changing the "57th" to "82d," some of the former 57th pilots objected to this piracy. But the policy made sense, since both units performed the same mission and the common symbols helped the ground forces recognize the ambulance helicopters.

One radical change was the conservative style of Capozzi and Huntsman. Both felt that the "wild and wooly days" ought to end and that the pilots of the 57th and 82d ought to temper their flying with cool judgment. They counseled their pilots to accept no missions without direct communication with the ground forces requesting the mission, to fly night missions only for extreme emergencies, and never to fly into an insecure landing zone. Despite these orders, the veterans of the 57th at Soc Trang quietly instilled the old élan in the new pilots, ensuring that the Kelly spirit stayed with Dust Off until the end of the war.

In one area, however, Capozzi and Huntsman succeeded in ending a Kelly practice. They refused to allow their pilots to fly the Delta looking for patients. "Shopping for business," they said, "is a waste of time." They reasoned that the communication net was now secure enough to ensure speedy response to any call. The decision was sound. With five new helicopters, Dust Off no longer had to cover 31,000 square kilometers with only two flyable aircraft. U.S. advisers could call or relay their mission requests directly to the air ambulance units via FM radio; ARVN units in the Delta routed their calls through the joint U.S.-ARVN Combat Operations Center at the 13th Aviation Battalion (U.S.). The aircraft pilots decided on missions Air Force radar control at Can Tho provided its customary invaluable service; the rapport of USAF radar controllers with pilots of the 82d was as excellent as it was with those of the 57th.

In other respects, Kelly's teachings lived. As casualties mounted in the first months of 1965, the pilots of the 82d, despite their commander's caution, flew many night missions. Since the Viet Cong usually attacked outposts and villages at night, and both sides patrolled and set ambushes at night, the Dust Off pilots too had to be abroad, seeking the wounded where they lay.

The Crisis Deepens

Late in 1964, the 271st and 272d Viet Cong Regiments merged and equipped themselves with new Chinese and Soviet weapons, forming the 9th Viet Cong Division. The 9th Division showed the value of this change in a battle for Binh Gia, a small Catholic village on Inter-


41

provincial Route 2, sixty-five kilometers southeast of Saigon. On 28 December and over the next three days the Viet Cong ambushed and nearly destroyed the South Vietnamese 33d Ranger Battalion and 4th Marine Battalion, and inflicted heavy casualties on the armored and mechanized forces that came to their rescue. The reorganized and reequipped Viet Cong were so confident that they stood and fought a four-day pitched battle rather than employ their usual hit-and-run tactics. The South Vietnamese suffered over 400 casualties and lost more than 200 weapons. Nearly eighty helicopters, including those from the 57th Medical Detachment, took part in the relief operations of this battle. During the fighting, Dust Off rescued nine crewmen from their downed helicopters and evacuated scores of South Vietnamese troops.

Assistant Secretary of State William P. Bundy urged President Johnson to retaliate against North Vietnam. He was seconded by the new commander of the Military Assistance Command in Vietnam, Gen. William C. Westmoreland, and the U.S. ambassador to South Vietnam, Gen. Maxwell D. Taylor. Westmoreland thought that the Viet Cong seemed to be preparing to move from guerrilla tactics to a more conventional war. But President Johnson, ignoring his advisers, refused to allow an immediate bombing campaign against North Vietnam.

Shortly afterward, however, Johnson himself lost confidence in current U.S. and South Vietnamese policy. On the morning of 7 February the Viet Cong attacked the U.S. advisers' base and airstrip at Camp Holloway near Pleiku. Mortar fire and demolitions killed several Americans, wounded more than a hundred, and destroyed five aircraft. Within hours forty-nine U.S. Navy fighter-bombers struck back at a North Vietnamese barracks just above the Demilitarized Zone. In his memoirs General Westmoreland called this strike a vital juncture in the history of American involvement in Southeast Asia. Within two days President Johnson approved a policy of "sustained reprisal" against the North.

Along with the rest of the U.S. Army in Vietnam, Dust Off quickly felt the new surge of America's war effort. From 1962 to early 1965 the Dust Off pilots and their crewmen had been at school in Vietnam. Now they would have to show what they had learned, applying on a large scale the tradition of courage and unhesitating service that they had forged in the early years.