Casualty Evacuation in Korea, 1950-53: The British Experience

The Korean War was the first conflict in which helicopters were used extensively for casualty evacuation but their contribution to medical evacuation at that time is disputed. On the one hand, many cases undoubtedly survived because of helicopter transportation; on the other, the proportion of casualties evacuated appears to have been small and difficult to determine precisely. Taking the British army as a case study, this article looks more closely at arrangements for casualty evacuation in Korea, assessing the role of helicopters in relation to other elements of the evacuation system and its operation as a whole. The article is divided into several sections. The first examines the command structure of the medical system in Korea, which extended as far back as hospitals in Japan. It shows how medical support for British forces was closely integrated with that of other Commonwealth forces. It notes that rapid and effective integration was a major factor in the success of medical evacuation because it allowed ideas and equipment to be shared easily and because it fostered a spirit of cooperation. This section also highlights the Second World service of all senior Commonwealth medical officers as a factor conducive to integration. The second section provides an overview of the chain of evacuation from the frontline to hospitals in Japan. It describes the functions of the different medical institutions along the chain and how they were connected. Among other things, it shows how the chain for British and Commonwealth troops intersected with medical units of the United States such as Mobile Army Surgical Hospitals and hospital trains. In the third section of the article, there is a detail examination of evacuation by helicopter, describing how it was arranged, what its limitations were, and what types of casualty were evacuated. It estimates the proportion of casualties that were evacuated by this means. The fourth and fifth sections highlight the importance of command decisions in the effective working of the evacuation system. The fourth concentrates on the evolution of a system of forward treatment of minor cases, looking at the challenge posed by disease and other non-battle casualties. The fifth and final section of the article describes how the system of evacuation functioned as a whole, including the different means used to carry the sick and wounded in addition to helicopters. It stresses the importance of coordination between these different elements and places particular emphasis on the value of wireless communications. The article concludes that the success of casualty evacuation in Korea depended less on any single method of transportation than on effective command and control. In this respect, communication between constituent units of the evacuation chain and cooperation between British and other UN forces was crucial. Of equal and perhaps even greater importance was the decision to implement a policy of forward treatment of sickness and minor injuries. Without such a policy, the lines of evacuation would inevitably have become congested, having a detrimental effect on casualty survival rates. This policy drew on the lessons of the two world wars which were still relatively fresh in the minds of medical commanders. Although far less striking than the advent of the helicopter, prior knowledge of coalition warfare and the handling of mass casualties was crucial to medical success. If there is a lesson to be learned from the Korean War for own times, it is probably this.