SCOTT AIR FORCE BASE, Ill. (Oct. 1, 2021) – Thirty-two injured U.S. service members and Afghan civilians were aeromedically evacuated from Hamid Karzai International Airport (HKIA) in Kabul, Afghanistan, following an Aug. 26 bombing there. The attack occurred during the largest noncombatant evacuation operation (NEO) airlift in history, which moved approximately 124,000 persons to safe havens.
The aeromedical evacuation (AE) missions were planned and coordinated by U.S. Transportation Command’s (USTRANSCOM) Office of the Command Surgeon (TCSG).
TCSG provides global patient movement for the Department of Defense (DOD) through the Defense Transportation System, acting as DOD’s single manager for policy and standardization of procedures and information support systems for global patient movement.
“We were intricately involved with U.S. Central Command (CENTCOM) in planning to provide health-service support for patient movement requirements as U.S. forces and equipment withdrew from Afghanistan,” said U.S. Air Force Col. Rudy Cachuela, USTRANSCOM command surgeon and director of Global Patient Movement Operations.
As the pace of the operation increased, he said the requirements did not shift but became more acute.
“We didn’t have the luxury of time as we switched from deliberate planning to crisis action planning,” said Cachuela. “We concentrated on what support would be needed for forces on the ground and for U.S., coalition, and Afghan evacuees.”
For the retrograde then the NEO, Cachuela said they accelerated planning and brought in more AE and critical care air transport teams (CCATT) from the U.S., deploying them to Ramstein Air Base, Germany, to plus up existing crews there due to expected patient volume.
According to U.S. Air Force Lt. Col. Shaun Westphal, division chief, Global Patient Movement Integration Cell (GPMIC) here, AE provides time-sensitive, en-route care of casualties to and between medical treatment facilities, using organic and/or contracted aircraft with specially trained medical aircrew. CCATTs assist AE as a rapidly deployable resource by treating critically ill and injured patients who require continuous stabilization and advanced care.
As credible threats of an attack at Kabul emerged, the TCSG team relocated patient movement resources to be as prepared as possible.
“We moved crews from Ramstein to Al Udeid Air Base, Qatar, placing them closer to HKIA to respond more quickly,” said Cachuela.
The AE flights standing by were swiftly inserted into the NEO airlift flow Aug. 26 when a suicide bomb, assessed to have been Islamic State Khorasan (ISIS-K) fighters, detonated in the vicinity of HKIA’s Abbey Gate. The attack was followed by several ISIS-K gunmen opening fire on civilians and military forces.
“When HKIA became a mass casualty scene, the AE liaisons there input patient movement requirements for the AE/CCATT teams at both Ramstein and Al Udeid,” said Cachuela.
He said CENTCOM had surgical teams and operating rooms at HKIA, where U.S. service member and Afghan civilian patients were treated and initially stabilized. Once stable, they were picked up by three separate U.S. Air Force C-17 aircraft carrying AE/CCATT teams and moved to the next level of care at Ramstein and Al Udeid.
“The AE flights were purposely spaced out to accommodate the flow of patients being treated on the ground, including those needing surgery before being transported,” said Cachuela.
According to Cachuela, the first AE aircraft launched only minutes after the bombing occurred at HKIA, and all patients were successfully evacuated within a 24-hour period.
Participating units included the GPMIC, TRANSCOM Patient Movement Requirements Center (TPMRC)-America, and 375th Aeromedical Evacuation Squadron (AES) here; the TPMRC-East, 10th AES and 86th AES at Ramstein Air Base, Germany; and the 379th Expeditionary AES at Al Udeid Air Base, Qatar.
“Our AE, CCATT and ground teams all performed heroically -- they were able to literally save lives by being ready, well trained, and able to immediately adapt to a large-scale mass casualty event,” said Cachuela.
USTRANSCOM exists as a warfighting combatant command to project and sustain military power at a time and place of the nation’s choosing. Powered by dedicated men and women, TRANSCOM underwrites the lethality of the Joint Force, advances American interests around the globe, and provides our nation's leaders with strategic flexibility to select from multiple options, while creating multiple dilemmas for our adversaries.