N.Y. Air Guard medical technicians train with Canadian counterparts in the Arctic Published March 7, 2023 By Staff Sgt. Madison Scaringe 109th Airlift Wing NUNAVUT, Canada -- New York Air Guard medical technicians who normally transport patients on aircraft like C-130s are learning to do the same on the much smaller Canadian CC-138 “Twin Otter” in a month-long Canadian Arctic exercise. The three Airmen from the 109th Airlift Wing’s 139th Aeromedical Evacuation Squadron are part of a 60-Airmen contingent taking part in Guerrier Nordique 2023, a Canadian Forces exercise that began Feb. 22. This year, the annual exercise focuses on combat capability and lethality in temperatures ranging from -30 to -50 degrees Fahrenheit for weeks. The aeromedical specialists are testing their casualty evacuation capabilities in a degraded environment, according to Lt. Col. Robert Huhn, the 139th’s commander. “We are leaning into the Air Force’s concept of Agile Combat Employment by proactively looking for ways for aeromedical evacuation crew members to do more with less in new environments,” Huhn said. The LC-130H four-engine transports flown by the 109th are the largest ski-equipped aircraft in the world. The Royal Canadian Airforce’s 440 Transport Squadron operates the much smaller de Havilland CC-138 “Twin Otter” ski-equipped aircraft with only two engines. So, in keeping with the Department of Defense’s focus on Arctic agile combat employment, the 139th team is learning to operate with the smaller aircraft in smaller teams, said Maj. Nathan Phelps, a 139th flight nurse. “We not only modified our equipment footprint but our crew size as well. Normally, we fly with five medical aircrew members, but here we have found a way to function with only two. This is a much more deployable force package than our traditional system,” he said. The crew members must be able to perform their medical duties in various places, including aircraft and ground vehicles. Because the 109th Airmen were working with the Canadians of 440 Squadron, the aeromedical personnel got a chance to learn how to work in the Twin Otter, explained Senior Master Sgt. Jennifer Dippo, a 139th aeromedical technician. “The training involved actually getting on the Twin Otter and learning about the emergency exits and procedures, the equipment they have on board, and how we can configure and secure our patients for in-flight care,” Dippo said. The 139th medical technicians received similar training on carrying casualties in the Canadian Army’s Hagglunds “Bandvagn 206,” an all-terrain vehicle with two carrier compartments on power track, Dippo said. “We have to involve some of our Canadian Army counterparts so we can operate as a joint-function team in the case of an emergency,” Dippo said. The 139th team is also testing a new medical kit it created for the Arctic environment, Dippo said. “One of the key components we wanted to do was both validate and refine the medical kit that we spent the last year designing specifically for use in a tactical environment and to make sure that it was appropriate for both our patients and the Arctic area of operations,” she said. The 139th Airmen have been running a medical office in Resolute Bay with the Royal Canadian Medical Services and sharing best practices on functioning in the extreme Arctic conditions, Phelps said. The medical teams have established procedures on how and where to evacuate casualties from Resolute Bay, Dippo explained. “We’ve identified the capabilities of regional hospitals so we can make sure patients will be moved to hospitals with appropriate facilities, whether for surgical support, blood transfusions or advanced care,” she said. “Two key priorities during this exercise are cooperation and preparation, and that’s exactly what we’re doing,” Huhn said. “We’re collaborating with our allies in an exercise setting so that in the future, we can provide rapidly employable, high-quality medical care to our service members in a contingency environment,” he added. While the 139th has experience working in various tactical environments, the lack of advanced medical facilities in remote arctic regions like Resolute Bay presents a unique challenge, Huhn said. “To maintain the integrity of the exercise in a contingency environment like this, we felt that sending our own internal assets would provide an additional layer of safety and continuity for more rapid transport should a casualty occur in an environment like this,” Huhn said. According to the Air Force Arctic Strategy, interoperability is critical in the Arctic region. Huhn explained that by developing interoperable systems with allies, the Air Force demonstrates capability, enhances operational flexibility, and conveys a strong deterrent message with a commitment to the region.