The area where this mission took place was the Red River Delta in northern Vietnam. Gia Lam was the airfield serving Hanoi from across the Doumer Bridge spanning the Red River. The defenders of the outpost were the French in the early 1950s.1 By the end of 1953 the French in Indochina were using eighteen medical evacuation helicopters. From April 1950 through early 1954 French air ambulances evacuated about five thousand casualties.

In these same years the U.S. Army, which had used a few helicopters for medical evacuation at the end of World War II, employed helicopter ambulances on a larger scale, transporting some 17,700 U.S. casualties of the Korean War. Several years later in the Vietnam War it used helicopter ambulances to move almost 900,000 U.S. and allied sick and wounded. The aeromedical evacuation techniques developed in these wars opened a new era in the treatment of emergency patients. With their ability to land on almost any terrain, helicopters can save precious minutes that often mean the difference between life and death. Today many civilian medical and disaster relief agencies rely on helicopter ambulances. For the past thirty years the U.S. Army has played a leading role in the development of this new technology.

Early Medical Evacuation

Although surgeons often accompanied the professional armies of the eighteenth century, the large citizen armies of the early nineteenth century, whose battles often produced massive casualties, demanded and received the first effective systems of medical evacuation. Two of the officers of Napoleon Bonaparte, the Barons Dominique Jean Larrey and Pierre Francois Percy, designed light, well-sprung carriages for swift evacuation of the wounded. Napoleon saw that each of his divisions received an ambulance corps of about 170 men, headed by a chief surgeon and equipped with the new horse-drawn carriages. Other continental powers quickly adapted the French system to their own needs, but the British and American armies lagged a full half century in learning the medical lessons of the Napoleonic era.

In the Seminole War of 1835-42 in Florida, the U.S. Army Medical Department experimented with horse-drawn ambulances and recommended their adoption by the Army. But the Department apparently got no response. A few years later experiments were resumed, and a four-wheeled ambulance proved successful in the West. But by the outbreak of the Civil War in April 1861 the Army had ac-

1This incident is related by Valerie André, a French Air Force medical pilot who flew in Indochina, in her article "L'Hélicoptére sanitaire en Indochine," L'Officier de Réserve, vol. 2 (1954), pp. 30-31.