Bringing home critically wounded troops: "They're very young, very stoic"

The interior of a C-17 aeromedical evacuation flight back to the U.S. from Germany. Photo: USN&WR
Great story from US News & World Report about one Soldier's medical evacuation from Afghanistan via Germany, and the chain of care that saves nearly 99% of critically wounded troops.

RAMSTEIN AIR BASE, Germany -- Barry and Lorria Welch sit solemnly in the jump seats of the massive C-17 cargo plane. Their son, who joined the Army three years ago to pay off thousands of dollars in student debt from getting his associates degree, is strapped to a stretcher a few feet in front of them. He is in a medically induced coma with a ventilator tube regulating his breathing.

This most grievously wounded soldier involved in a fatal attack outside Kabul in late July returned to the U.S. this week, following two failed attempts to transport the blast victim for fear the flight would kill him.

The military flew his parents from their home in Salem, Ore., to this medical facility after he was wounded by an insurgent fighter who detonated an explosive-laden donkey next to a U.S. Army patrol. The Welches then accompanied their son for his return journey to Walter Reed Army hospital in Washington, his body riddled with shrapnel from the attack.

The blast killed three of his fellow troops based at Combat Outpost Soltan Kheyl in Wardak Province, and blinded and likely paralyzed this soldier. The unit's translator and four other Afghans were also killed in the attack.

This journey for the Welches would not have been an option 30 or 40 years ago, at a time before the military put a top priority on sending wounded troops home quickly, and allowing families to reunite with their grievously injured loved ones.

This system of aerial medical evacuation from the war zone saves nearly 99 percent of the critically wounded troops. It employs 21st century medical techniques that allow a soldier injured deep in enemy territory abroad to get the critical care he needs within hours. Medical technicians who spoke with U.S. News say the remainder are usually those who will likely succumb to their wounds but can be stabilized long enough for a reunion with family members in Germany or the U.S.

"It means the world to us," says Lorria Welch, from the deck of the C-17 carrying her son. This traumatic but important journey for her marks the second ever time she's been on an airplane, after first flying to Kentucky to witness their son's graduation from his basic training. "As a parent we say we'd beg, steal, or rob a bank to get here."

A medic from the 86th Aeromedical Evacuation Squadron tends to a wounded Marine being flown back to the U.S. from the Ramstein Air Base in Germany.

Most of the military's medical treatment was exported to the war zone in Vietnam, says Air Force Col. William Rogers, a doctor at Georgetown University and Vietnam veteran. This included advanced therapies, such as fitting for prosthetics as well as rehabilitation. Wounded soldiers could spend months at these facilities before returning home.

By contrast, troops in Operation Enduring Freedom are subject to a long train of medical experts, from the corpsmen who treats their wounds in the mountains or deserts of Afghanistan, to the medevac operators who rescue them by helicopter, to the field hospitals dotted throughout the country. All are able to incrementally treat and stabilize the complicated kinds of wounds from the ever-present improvised explosive devices that have defined the wars in Iraq and Afghanistan.

At each stage, these experts work solely to stabilize a patient long enough to move them onward to more advanced care.

More than 90,000 patients have been transported back to Ramstein since 2003 from the wars in Iraq or Afghanistan, says Air Force Capt. Denise Covert, who oversees the medical facility at Ramstein where troops receive treatment. Of those, more than 51,000 have been sent back to the United States, while the rest of the wounded received the necessary treatment to rejoin their unit back in the war zone.

In total, the medevac service under the Air Force's Air Mobility Command moves roughly 17,000 patients per year, according to an AMC spokesman.

"What helps the warfighter most is they know they'll be able to get out of the [war zone]" if they're hurt, says Air Force Maj. Mike Lucore, a 17-year veteran of air medical evacuations.

An HH-60 Pavehawk helicopter hovers over the air strip at Bagram Air Field in eastern Afghanistan.
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