Stricken with severe chest pains recently, a village elder named Shabarat Sageed made his way to a U.S. Special Forces base near this remote settlement in southern Afghanistan.
Soldiers there radioed a U.S. medical helicopter unit at a bigger compound 55 miles south. Within minutes, crews climbed aboard two Black Hawk helicopters for a 38-minute flight to pick up the ailing man. Sageed, hobbling on a hand-carved wooden cane, was then flown to a U.S. military clinic.
The extraordinary effort to treat a single villager is one way the U.S. military is trying to woo Afghans away from the Taliban in parts of southern Afghanistan. A 16-man medical evacuation unit based in Tarin Kowt, capital of Oruzgan province, has airlifted several dozen Afghans since arriving in March.
A 4-year-old girl who tumbled down a well. A boy mauled by a dog. Another boy with fingers blown off by a land mine. All were scooped up and flown to a medical station at the Tarin Kowt base or farther south to a hospital in Kandahar.
The pilots and crews risk their lives every time they take off. The helicopters burn fuel at a cost of about $3,000 an hour. Many of the patients are in remote parts of the mountainous, 12,000-square-mile area covered by the unit.
Marked by a cross, the medevac helicopters fly without weapons, under what crewmen call an “unarmed but unafraid” philosophy. They are tailed by a “chase bird": a Black Hawk armed with two medium machine guns. The Geneva Convention forbids attacks on medical aircraft, but insurgents frequently fire on them with rocket-propelled grenades and assault rifles.
Yet for all the risks and costs, the rescue missions are a significant component of an evolving counterinsurgency strategy. In a nation with abysmal healthcare, delivering high-quality emergency medical treatment to a beleaguered population is a powerful weapon — even though crews can treat only a fraction of those in need.
Lt. Col. Scott Hasken, the task force commander, says medical treatment has been as important as military operations in winning over villagers in areas dominated by the Taliban.
“We run a risk every time, but it’s definitely appreciated,” Hasken said. “It’s making a difference, especially when kids are involved.”
U.S. military policy allows medevac crews to treat civilians when conditions permit, but every case must be approved by commanders at the main U.S. air base in Kandahar.
If fighting is heavy and crews are needed on a regular basis to treat combat casualties, such as in Helmand province, the policy is to treat only those civilians injured by North Atlantic Treaty Organization forces.
But for now, with no conventional combat troops at the Tarin Kowt base, the medevac crews, which are with the 101st Combat Aviation Brigade, have more time and resources to aid civilians. They also treat wounded U.S. or Australian special forces soldiers based there, along with Dutch soldiers and Afghan security forces.
About 70% of the unit’s 130 missions have helped Afghan civilians or security forces; about 10% for U.S. troops and 20%, other NATO forces. Commanders said they could not provide the exact number of civilians treated, though they said that most Afghans treated have been civilians with illnesses or injuries not the result of the fighting.
“Every time we go out, we know we’re helping somebody,” said Capt. John Robichaux, 30, of Louisiana, who commands the brigade’s 1st Platoon, Charlie Co., 6th Battalion.
In addition to commanding the medevac platoon, Hasken is an Apache gunship pilot in a battalion that flies attack helicopters to support troops in battle and Black Hawks to ferry soldiers on air assault missions.
A few air battalion crew members have been uncomfortable with the focus on treating civilians, Hasken said.
“But they understand why we do it and why it’s important,” he said. “They get it.”
In April, elders in Gizab, a village about 20 minutes north of Tarin Kowt, turned several insurgents over to a nearby Special Forces team. Hasken said they also identified several Taliban compounds that were later attacked by battalion gunships. Local Taliban commanders were captured or killed.
Then, this month, 250 residents of another village, backed by U.S. aircraft, helped 10 Afghan police repel a Taliban attack on a checkpoint, according to the U.S. military.
Many factors influence such uprisings against the Taliban, including tribal politics and local power plays. But the goodwill built by medical missions makes villagers more inclined to side with U.S. forces, Hasken said.
“I truly believe treating the locals up there helped turn those people against the Taliban,” said Sgt. Troy Halfhill, 27, a flight medic who has flown on nearly 40 missions.
Crews have even flown into firefights to rescue Afghan police wounded by insurgents with no U.S. forces to protect them, Robichaux said.
“That builds trust, and getting the Afghans to trust us is one more element in the whole hearts and minds thing,” he said.
Insurgents are well aware of the effects of medevac missions on the Taliban’s own strategy, Robichaux said: “That’s why they’re trying so hard to target us.”
On June 9, an Air Force Black Hawk medevac attempting to rescue wounded Marines in Helmand province was shot down by a rocket-propelled grenade. Four crew members died and three were wounded.
Despite their best efforts, the crews at Tarin Kowt have not been able to save all the injured civilians and soldiers they’ve helped. Some crewmen say they are still haunted by the memory of the girl who had fallen down a well. She died en route to a hospital from head injuries.
“It hits you in your bones,” Robichaux said.
Halfhill, the medic, said his toughest mission was to try to save two Australian special forces soldiers wounded by a homemade bomb. One died at the explosion site. The second, who had one leg blown off and the other amputated at an aid station, died later.
“We tried CPR all the way [to the medical station] and after we got there, but we couldn’t save him,” Halfhill said.
The Australians’ bomb-sniffing dog was also killed. Halfhill brought the animal’s remains back to the Tarin Kowt base. “That was a tough day,” he said.
Robichaux said the crews go all out on every mission, whether it’s to treat a fellow American, an Afghan or even an insurgent.
“You don’t want to go to sleep at night with any regrets,” he said.
During a two-day span last week, the platoon received half a dozen “nine lines,” the emergency radio calls that list nine crucial nuggets of information: location, severity of injury, type of patient and so on.
They treated an Afghan soldier who was either clubbed with an assault rifle or stabbed (sometimes the crews never get the full story), a 14-year-old boy paralyzed by a fall, a boy mauled by a dog, a Dutch soldier wounded in a roadside bombing. And they treated Sageed, the elderly man with the heart problem.
Robichaux, a father of four, was especially moved by the anguish of the paralyzed boy’s father.
“He just had that lost, helpless dad look,” he said. “Seeing that just broke my heart.”’
Even less critical cases can leave lasting impressions. The gratitude expressed by Sageed, who thanked the crew profusely, was memorable in its own way, Robichaux said.
“That right there,” he said, “is enough reward to keep me going.”