By Rick Jolly Last Updated: 12:01am BST 01/07/2007
'I have not asked for dedicated helicopters, nor do I want them," says the Surgeon General, Lt Gen Louis Lillywhite. In 1974, like the Surgeon General, I was serving as a regimental medical officer in Belfast. His red-bereted medics and my "green-lidded" boys co-operated to good effect. Eight years later, while he was at Army Staff College, I commanded the field hospital at Ajax Bay, during the land battles of the Falklands campaign. Part of my team came from the Airborne medics of the Royal Army Medical Corps.
We soon became known as the "Red and Green Life Machine" because word spread that every wounded soldier who reached us alive, despite often terrible injuries, made it out alive to the hospital ship Uganda. Only three of our 580 WIA (Wounded in Action) casualties subsequently became DOW (Died of Wounds). The newest generation of medics can call us "old dinosaurs" if they like, but the 580-to-3 ratio is the standard they must beat first.
My boys and I had but a single purpose: to make sure no wounded marine, paratrooper, guardsman or Gurkha succumbed to his injuries. Nearly 200 enemy wounded were also treated with the same considerations, inspired by the "humanity in victory" that Nelson had prayed for on the morning of his death off Cape Trafalgar. The primitive conditions of dirt and poor lighting, and the danger from two unexploded bombs, were our constant companions, but these were of little importance to us. We were there for our friends in the front line, chums who all had a real chance of surviving if they became battlefield casualties. That wasn't solely down to us, of course. The unstinting efforts of our support helicopter force and the hospital ship were also critically important. It was a team effort.
While I don't believe that the superb personal qualities of our combat medics have changed at all since then, I'm delighted to see the way that their professional knowledge and expertise have increased. A recent 25th anniversary visit to my old unit revealed all sorts of minaturised diagnostic and specialist monitoring kit - but still in a tent.
While it was a thrill to meet these confident young men and women and hear about their experiences in Afghanistan, I could not help worrying about one unchanging problem: getting the casualty from the point of wounding and back to definitive surgical care. The story of Corporal Mark Wright GC, as reported in this newspaper, filled me with dismay. To hear that when the casevac helicopter eventually arrived, it lacked the winching gear to lift the terribly wounded Para from the minefield he was lying in, was heartbreaking. My anguish is personal. I have looked down from a helicopter at two of HMS Ardent's crew who would have drowned had they not been winched up, as if by the Archangel Gabriel as one of them put it, in a rescue so movingly described at the Falklands commemoration on Horseguards a fortnight ago.
At the end of the Second World War, the four key factors in battlefield casualty treatment were: surgeons close to the front line; blood transfusion; rapid rearward evacuation by air; and (with absolutely no apologies to the PC polizei) female nurses. Just one of those factors has changed significantly.
In Korea, light helicopters became available in sufficient numbers to make a difference to extraction times over difficult terrain. Who can forget the haunting images that opened all those brilliant M*A*S*H episodes? Vietnam then brought the dedicated Hueys that saved countless lives. Today's battlefield medical support helicopters have improved further, but only in quality, not quantity. My Army friends tell me that there are two "medical" CH-47 Chinooks allocated to the main hospital at Camp Bastion, but that they are not under direct command as mine were. In theatre, delay can be significant. The two Chinooks are at immediate notice to launch, but an authorisation request must first be passed up, and then returned down a variety of command chains.
Both aircraft then deploy, in mutual support, with a varied equipment and skill mix embarked. This is all splendidly tailored stuff, but only when casualty numbers are as small as they have been so far, thank goodness. What would happen if the present system was suddenly faced with the consequences of a full-on firefight like 2 Para's battle for Goose Green: 48 wounded "Toms", some almost ex-sanguinated? Could mass casualties like those from the disaster at Fitzroy on June 8, 1982 be coped with? Then, 160 mainly burns cases arrived in Ajax Bay over the space of two hours, and had to be transported out to the hospital ship the following morning. Officially, no helicopters were available, but my Fleet Air Arm friends managed to achieve the task for me without compromising their other duties.
Who knows what lies around the corner? If we really are going to be in Afghanistan for the long run, then the Surgeon General's apparent complacency over his lack of helicopters is baffling. He needs more "lift and shift" capability to cope with the potential loads. He is on record as saying that the politicians have promised the resources required. If he takes his responsibilities seriously, then he should be asking for more dedicated helicopters - now.
• Dr Rick Jolly is a retired Royal Navy medical officer. His diary of the Falklands field hospital, The Red and Green Life Machine, has just been expanded and republished and is available through www.redandgreen.co.uk
