Air Force Medicine during the Vietnam War Published Jan. 25, 2018 By Peter Holstein Air Force Surgeon General Public Affairs FALLS CHURCH, Va. -- By the height of the Vietnam War in the late 1960’s, the U.S. Air Force had 1,900 medics conducting medical operations in Southeast Asia. The steady aeromedical evacuation and in-theater care performed by the Air Force Medical Service (AFMS) in Southeast Asia drove innovation and evolution in flight medicine and aeromedical evacuation. At first, the Air Force did not have adequate fixed medical facilities in Vietnam. Local buildings were not suitable, and it became clear that the Air Force needed a deployable solution. Starting in 1966, the Air Force began shipping large, modular 10-foot by 40-foot steel boxes to Vietnam and converting them into stationary hospitals. By 1968, the Air Force hospital at Cam Ranh Bay Air Base in Vietnam was the second largest in the Air Force, with 475 beds and a casualty staging facility with another 100 beds. Cam Ranh Bay became the aeromedical evacuation hub for the entire theater. Aeromedical evacuation took many strides during the Vietnam War. U.S. air superiority over much of the theater made rapid and regular casualty evacuations possible. Quick evacuation by helicopter, followed by jets, moved casualties to hospitals in Japan, the Philippines and even the U.S. much more quickly than was ever possible before. The Air Force also introduced the first plane specifically designed for aeromedical evacuation in 1968. The McDonnell Douglas C-9A, called the C-9A Nightingale was unlike other aircraft modified to carry patients. Designed to safely carry litters, gurneys, and ambulatory patients, the C-9A facilitated medical care during flight. It stayed in service until 2005 as one of the Air Force’s primary aeromedical evacuation platforms, undergoing many modifications and improvements. Its initial deployments in Vietnam demonstrated the value of having specially designed aircraft to improve patient transfers and provide care in the air. Women’s roles in AFMS increased during the war. Many jobs, traditionally only open to men, became open to women. The Nurse Corps expanded opportunities for women, in part to meet the increased need for medical care in Southeast Asia. The Air Force assigned the first female nurses to Vietnam in February of 1966, many to Cam Ranh Bay. Female flight nurses began flying aeromedical evacuation missions over Vietnam in 1967, providing care to wounded service members during transport. In many ways, the Vietnam War marked a turning point, for the U.S. Military and the AFMS. Constant small-scale engagements became the norm, unlike the sprawling battlefields of World War II and Korea. The enemy in Vietnam rarely had access to heavy weapons, and a higher percentage of injuries were from automatic weapons. Increased access to the battlefield made quick evacuations possible. The Vietnam War saw incremental improvement in the rate of wounded U.S. service members who survived their injuries, to about 72.5 percent. In Korea and World War II, the survival rate was under 70 percent. As the practices developed in Vietnam have improved and been refined, these trends continued. More than 90 percent of wounded service members in Iraq and Afghanistan survive their injuries. This is the lowest mortality rate of any war in history, and the AFMS is a key component of the aeromedical evacuation system that makes it possible.