14 September 2009
Helmand Province, Afghanistan

With the war increasing, Air Force Pararescue has been crisscrossing the skies picking up casualties.

That’s the Green Zone of Helmand Province, the opium capital of the world.  Those fields are the great ATM of our enemies here.  The fertilizer used to make those fields green is the same fertilizer used to make countless bombs.

We are flying in a special U.S. Air Force Blackhawk helicopter to fetch a seriously ill British soldier.

In Iraq, many of the casevacs were done by ground forces.  In other words, if we hit a bomb or got shot, soldiers would load up the dead and wounded and rush them to the CSH (Combat Support Hospital or “cash”).  But in Afghanistan most of the fighting occurs outside the cities and far away from the base hospitals.  Rescue helicopters stationed at places like Bagram, Kandahar Airfield and Camp Bastion have been flying thousands of missions.

Air Force Rescue Helicopters launching on a mission from Camp Bastion.

There are numerous helicopter rescue “services” in Afghanistan.  For instance, the British have MERTs (Medical Emergency Response Teams) that fly in a CH-47, and the U.S. Army uses Blackhawks as does the U.S. Air Force.  Special operations teams normally cover their own evacuations.

This U.S. Army rescue helicopter parked at Camp Bastion (Helmand) flies with the red cross symbol allowing the enemy to get a better aim at the helicopter.  Unfortunately, by displaying the red cross symbol, the helicopters are not allowed to carry miniguns or other large weapons.  This seems a rather questionable decision given that the Taliban and other enemies could not give a hoot about law.  It is unclear why the Army decided that a red cross provides more protection than miniguns.

These Air Force “Pedro” rescue helicopters have two miniguns each (total of four miniguns), and the PJs all carry M-4 rifles.  They do fire those weapons in combat.  In July, a helicopter swooped down during a rescue and picked up some wounded soldiers and then was shot down.  The second Air Force helicopter had to get the U.S. Army patients off the bird that had been shot down.  But there was not enough room in the second bird for the Pedro crew.  (No injuries.)  So the tiny Army OH-58 Kiowa helicopters flew out—Kiowas only seat two people and both seats were full—and some of the Pedro folks had to clip onto the skids and fly out like James Bond.

The damaged helicopter was left behind.  Bullets had hit a fuel line and caused the fuel to leak out, and so the pilot had no trouble landing, but the helicopter was now stuck in the middle of nowhere.  So after the Pedros rescued U.S. soldiers who then rescued Pedros, other soldiers flew out to rescue the Pedro helicopter.  The plan was to cut off the rotors and have a bigger helicopter use a cable to lift out the Blackhawk and fly it back to base.  But when the soldiers started using a saw on the rotors, sparks hit the fuel that had leaked and the Blackhawk burned to the ground.  The Army killed the Air Force’s helicopter.

The helicopters take hits.  On another mission in Helmand, an RPG shot through the tail but luckily it missed the transmission; if the RPG had hit the transmission, the entire crew likely would have been killed.  And so . . . those miniguns come in handy.  The gunners are great shots and can return accurate fire within seconds.

Some readers have gotten upset that I call them “Pedro,” thinking the name is secret.  The concern is welcome but not warranted in this case.  The Pedros don’t care and they even have a Pedro patch.

The Pararescue medics are often called “PJs.”  The SEALs, Delta, Rangers and Green Berets all hold the PJs in high regard.  Firstly, the PJs are among the best medics in the U.S. military (we have incredible medics—so that’s a significant statement).  Secondly, PJs go through just about any combat training available, ranging from HALO to mountaineering to scuba.  They’ve got scuba gear here at Camp Bastion and have had to use it to recover soldiers who were killed after the enemy blew their vehicle into some water.  In a different war, the Pedros would be tasked to rescue pilots who might be shot down hundreds of miles into enemy territory.

As we fly out to pick up a sick soldier, the door gunners and PJs test-fire the miniguns and M-4s.

When we get low, the PJs sit with their feet hanging out the doors so they can return fire, but up high they relax and take in the scenery.  That’s the Helmand River and part of the “Green Zone.”

The Pedro commander, Major Mathew Wenthe, said that Secretary of Defense Robert Gates had issued a directive that all casualties be evacuated and arrive at the hospital within one hour of the call.  Pedros intend to fulfill that directive.

The Pedro crews at Bastion have three helicopters but they only take two on missions.  Major Wenthe gave high credit to the mechanics who are constantly changing out parts, up to and including seven engines in the last few months.  The birds are ready, and that’s the first step.

There are two Pedro shifts who work 12 hours on, 12 hours off, with no days off during the tour.  The first shift starts at 0200 and runs to 1400 and the second shift takes 1400 to 0200.

Inside the TOC (Tactical Operations Center; the HQ), Pedro has a big board where reports from around Helmand Province scroll down.  If a British unit gets into a firefight, for instance, Pedro knows about the firefight within probably a minute because the messages are relayed to TOCs that need to know.  At least one person is always watching that screen, and so you might hear a pilot say, “The Marines are in contact near such and such.”  Or, “The Brits just hit an IED near Sangin.”

The casualties are classified as Category A, Cat B, or Cat C.  Cat A basically means the soldier is probably going to die, lose a limb, or lose his eyesight if not quickly treated.  Cat B is more like someone who’s gotten shot in the foot.  It’s a big deal, but not immediately life-threatening. Cat C might be some kind of non-life-threatening illness or a broken finger.

When the Pedro crews see injuries scroll down, they rush out to the helicopters like Batman and Robin heading to the Batmobile.  Really, you’ve got to get out of the way or they will knock you down.  Within a few minutes the rotors are spinning but the Pedros actually have not yet been tasked to go.  The British-run JHTF (Joint Helicopter Task Force) is watching the same information but they also have other assets that can be sent, such as the U.S. Army or the British MERT (Medical Emergency Response Team) in the CH-47.  The Pedros are always the first who are ready to go, but it might make sense for JHTF to send MERT because MERT is a bigger helicopter and so it flies faster than Blackhawks.  Plus, the doctor on the MERT can actually pump blood into patients, because when the patient gets shot or blown up, medics on the scene radio the blood types, and the MERT crew can actually fly out with the right blood.  Pedros don’t push blood but do start IVs.  However . . . the CH-47 is a big helicopter and is easier to shoot down, and so if the landing zone is going to be tight or under fire, it might be better to send Pedro. Yet much of Afghanistan is high and hot and the CH-47 can fly in thinner air than can Blackhawks.

While the JHTF makes a decision, Pedro is waiting with rotors spinning and all they need to hear is “Go Pedro.”  Thirty seconds later they are gone.  (The British MERT CH-47 flies faster, but it’s slower to start.)

Every day is a “National Geographic” day.  Afghanistan is incredible.

As we approach the LZ, the PJs pull on rubber gloves; the helicopter is subject to getting bloody.

This rotation of Pedros had done just under 400 missions in three months.  Similar crews in Iraq might do half a dozen missions in the same period.

These PJs have treated hundreds of patients and gone into dangerous areas every day.

Typical compound.

Afghan interstate system.

The Afghans call this the Dasht-i-Margo (Desert of Death).

The roads of nowhere.

Lone vehicle in the Desert of Death.

Some compounds are miles from the nearest neighbor, yet they still have walls.  Afghanistan is the land of a million Alamos.

When Afghans build a home, they start by building a wall.  When the wall is finished, they start on the home.

The pilots swoop in for the patient.  There is only one thing that British soldiers love more than mail and that’s Pedro.  When I told British soldiers from 2 Rifles that Pedro was going to take me, many British soldiers asked me to say “thank yous” to the Pedros.  The Pedros are a great morale booster because we know when we take casualties, Pedro is coming with miniguns and incredible medics.  When other helicopters are grounded by bad weather, Pedro goes.  When bullets are flying, Pedro comes in with miniguns blazing.  They also rescue Danish, Americans, and others, including contractors and Afghan civilians sometimes.

We picked up a British patient from 2 Rifles, one of my favorite infantry units.  The British are more sensitive about casualties than Americans (many Americans don’t care about photos if they are wounded, though some do).  Although I was not embedded with the Brits and so do not have to follow British rules, I respect the soldiers.

And so, without the patient’s consent (which was hard to get because he was in pain and the helicopter was loud and the PJs were working), these photos will not show his face.

The problem was apparently appendicitis.  The PJs went to work and at one point a PJ smacked the bottom of the patient’s right boot.  The PJs said that if his appendix is bad, smacking the bottom of his right foot should cause sharp pain in his abdomen.  And true enough, when the medic smacked his boot, the soldier winced in pain.

As we are flying back, vitals and other information are being transmitted back to Camp Bastion so that when we land, the right doctors and nurses will be ready.

The medical evacuation system is excellent.  Our folks work hand in glove with British and Danish back at the hospital.

During the flight, the PJs also put earplugs in the patient so that his head isn’t rattling from this very loud helicopter.  When patients are brought aboard, the PJs slide the doors shut.

This was an easy mission, but at other times there will be multiple amputations and KIAs and so the helicopters can get full.

British fire crews rush to grab patients.

The hospital is about 30 seconds away from the LZ and the PJs usually go inside so that they can do a handoff to the doctors.  Then we fly back to the runway about half a mile away, refuel, and get ready for the next call.

The motto of Pararescue: “That Others May Live.”  And they mean it.

Don’t mess with the miniguns . . .

The next mission took us to a Special Forces base where an ANA soldier had somehow managed to get shot in both feet.  It was lucky for him that he was with Special Forces; the Green Beret medics also are tops.  I’ve seen the Green Beret medics at work on countless occasions.  It’s bad to get shot, but if you must, it’s best to happen in the presence of Green Berets and to get picked up by Pedros.

Some Green Berets helped load the patient and then went back to whatever it is that Green Berets do out here.

The medic(s) on the scene already have prepped the patient, so the PJs don’t have to bandage him up other than plugging his ears, taking vitals and other tasks.

The pilots flew very hard and at times.

On the way back with the ANA soldier who managed to get shot in both feet, another call came so we diverted to get two more patients.

Americans lived down here before the Soviet invasion and built much of the irrigation networks.  The poppy has already been harvested this year and other crops are in the fields.

The other Pedro bird flies in to get the two patients.

We fly low and make hard turns.  The PJ has to crane his neck back just to see the horizon.

In combat, the Pedro can land and get a patient loaded in about thirty seconds.

The patients are loaded and off we go.  One guy had a tooth problem, and the other got bitten by a bat.

The last mission.  Just under 400 on this tour, and I had the honor of going along.  We’ll never know how many lives the Pedro crews saved this year in Afghanistan, but it was a lot.  A book could be written about their tour, but alas, this is likely about all the recognition they will ever get.  The two crews that I did missions with were:

Pedro 35
Maj Mathew Wenthe
1Lt Josh Roberts
CMSgt Rick Nowaski
TSgt Christopher Gabor
Capt Dave Depiazza
TSgt Tom Pearce
SrA Eric Mathieson

Pedro 36
Maj Mitzi Egger
Capt Adam Tucci
MSgt James Patterson
SrA Adrian Jarrin
SSgt Joe Signor
SrA Anthony Daroste
SrA Alejandro Serrano

The crews assembled and asked me to make their photo, but . . .

Just as they were starting to line up for the photo, a call came in and the helicopters flew away.


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