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The Risk and the Rescue - Medical evacuation mission in Afghanistan challenges helicopter crew

During infiltration training at Baghdad International Airport, Iraq -- Staff Sgt. Gabriel Ruff uses a hoist to raise a "patient" to safety  Ruff is a pararescueman deployed from Moody Air Force Base, Ga.  (U.S. Air Force photo by Staff Sgt. Stacy L. Pearsall)

During infiltration training at Baghdad International Airport, Iraq -- Staff Sgt. Gabriel Ruff uses a hoist to raise a "patient" to safety Ruff is a pararescueman deployed from Moody Air Force Base, Ga. (U.S. Air Force photo by Staff Sgt. Stacy L. Pearsall)

Joint-service combat search and rescue training in these HH-60G Pave Hawks from Moody Air Force Base, Ga.  simulates rescuing aircrews behind enemy lines.  Training such as this came in handy for a 41st Rescue Squadron crew deployed to Afghanistan. (Photo by Staff. Sgt. Aaron D. Allmon II)

Joint-service combat search and rescue training in these HH-60G Pave Hawks from Moody Air Force Base, Ga. simulates rescuing aircrews behind enemy lines. Training such as this came in handy for a 41st Rescue Squadron crew deployed to Afghanistan. (Photo by Staff. Sgt. Aaron D. Allmon II)

Before a night training mission, 1st Lt. Mike Kingry, an HH-60G Pave Hawk co-pilot assigned to Moody's  41st Rescue Squadron, programs his navigational instruments, as Capt.  Jason Rodgers, the HH-60G's aircraft commander, prepares his night vision goggles. The 41st RQS Jolly Green Giants" routinely fly night missions to maintain proficiency in their primary mission combat search and rescue. (Photo by Tech. Sgt. Parker Gyokeres)

Before a night training mission, 1st Lt. Mike Kingry, an HH-60G Pave Hawk co-pilot assigned to Moody's 41st Rescue Squadron, programs his navigational instruments, as Capt. Jason Rodgers, the HH-60G's aircraft commander, prepares his night vision goggles. The 41st RQS Jolly Green Giants" routinely fly night missions to maintain proficiency in their primary mission combat search and rescue. (Photo by Tech. Sgt. Parker Gyokeres)

MOODY AIR FORCE BASE, Ga. -- Since the beginning of the global war on terrorism, the 347th Rescue Wing at Moody Air Force Base, Ga., has lost three helicopters in Afghanistan and one in Iraq. Seven crew members gave their lives in the process.

All seven deaths took place in Afghanistan, and the biggest killers of that desolate country are the mountains and the weather. In Iraq, helicopter pilots face a greater prospect of being shot at by ground fire.

In Afghanistan, the greatest threat is the terrain.

After swapping stories with other pilots, I felt flying in Afghanistan seemed sort of "graduate" level. Before leaving, many of us compared notes with Afghan vets. It didn't take long to feel the perils of mountainous flying in Afghanistan. Between Iraq and Afghanistan, most helicopter pilots I've spoken to consider Afghanistan the more dangerous place to fly.

Preparing for this, our flight (the 41st Rescue Squadron's A-Flight) spent two weeks flying in the mountains of Asheville, N.C. While Asheville's altitude doesn't compare to Afghanistan's, the foggy weather synonymous with the Smoky Mountains provided perfect training.

The lessons we learned were worth their weight in gold by the time we were called upon for a medical evacuation mission Dec. 23.

On this night, our crew consisted of Capt. Craig Burks and me, both HH-60G Pave Hawk pilots; Staff Sgt. Grady Galvin, a flight engineer; and Staff Sgt. Rick Castro, an aerial gunner. Other than Castro, all crew members had significant combat experience flying in Iraq.

Flying in Afghanistan, however, was new to all of us.

My crew sat scattered throughout Kandahar Air Base, Afghanistan, as our handheld radios chirped with the news of a possible medical evacuation mission. We soon learned our mission was to pick up a member of NATO's International Security Assistance Force approximately 60 miles north of Kandahar.

When word came we were directing a launch, our crew sprinted into action and expected to be off the ground in 30 minutes. As my crew prepared the helicopter for engine start, I reviewed the route, weather and enemy threats, and developed a game plan.

The weather at Kandahar was still "clear and a million," meaning unrestricted visibility. That gave our crew a false sense of comfort.

About 20 minutes into the flight, Galvin noticed the upcoming mountains looked bigger than those seen during previous trips to the north.

From our experiences in Asheville, our crew began communicating our options. The objective was now only 20 miles away, and the cloud deck peaked at 9,000 feet. We had three options: fly under, fly over or turn around.

Flying under meant circumnavigating clouds, canyons, peaks and ridges -- not something any of us were comfortable with. Flying over meant we might not find a "sucker hole" large enough to get down and make the pick up. Turning around meant one of our allies was going to die.

Turning around isn't an option many of us like to consider as our first.

We knew running out of gas wasn't an issue, so giving it a shot by flying over the top of the clouds looked like the best option. All of us are family men with children, and we were aware of the risks. As a crew, we chose to take the high road and fly above the clouds, hoping for a clearing. We decided to fly to the point in space where the victim lay below.

If we couldn't get through the thick clouds, we'd have to acknowledge the mission couldn't be performed at an acceptable risk level.

With more than 10 miles to the objective, the weather didn't look good. All of us were beginning to think it was a fool's errand. The best news came when the joint terminal attack controller announced "skies clear," and much to our pleasure, the assessment proved true.

We crested one final ridge poking out of the clouds, and it was clear the cloud blanket ended. We were able to make a rapid descent to successfully retrieve our patient.

Out of Moody's four accidents, not one was from enemy fire. All shared one thing -- they were flown by crew members trained in the ability to assess risk using operational risk management and were trained in the use of crew resource management. For us, what could have been an unsuccessful or even fatal rescue attempt turned into a success because we had a team of experienced aviators able to assess a dynamic environment and make the right decisions.

We have lost airplanes and people. I don't pass judgment, but I am determined not to repeat the mistakes of the past.

As the war in Afghanistan continues into its sixth year, the U.S. Army and Air Force have entered into an agreement that allows the Army to use combat search and rescue crews to augment their medical evacuation capability. As the requirements of a medical evacuation essentially mirror those of the combat search and rescue mission, our crews stand ready to fly either mission at a moment's notice.

We will always follow our credo, "These things we do ... that others may live," but we do not venture beyond our capabilities and what we are trained to do. For aviators, it's important to be realistic with your capabilities. If you're uncomfortable, it is your responsibility to speak up. Chances are, someone else is uncomfortable too.

I am happy to say, at least for now, we are all home. After four months deployed to Afghanistan in support of Operation Enduring Freedom, the members of the 41st Rescue Squadron A-Flight fulfilled the final half of an eight-month commitment supporting our combat search and rescue mission. And the use of crew resource management translated into mission success.