By Tom Coghlan, Kandahar

As Sergeant Matthew O’Neill spotted the thin copper wire snaking through the dust he knew, too late, that it was attached to a roadside bomb. It exploded under him an instant later, picking up the stocky, sandy-haired US Marine combat engineer and catapulting him more than 20 feet.

From a ploughed field in southern Helmand to the medical care of the main Nato field hospital in Kandahar is a journey of 100 miles — and getting there, or to the British hospital at Camp Bastion, is a race against the clock. Make it in less than an hour and the rate of survival is well over 90 per cent. Any longer than that, and the chances of survival begin to ebb away.

Meeting that target is the job of the 55th Expeditionary Rescue Squadron, a US Air Force unit now nearing the end of a three-month tour. They have flown nearly 1,500 missions so far, making them the hardest-working American casualty evacuation unit since Vietnam. “This is the highest tempo of missions we have ever seen,” says their commander, Lieutenant-Colonel Jim Kuehn, 41.

As Sergeant O’Neill crashed to earth, adrenaline surged through his body and carried him straight back to his feet. A figure bolted across the field ahead of him. Sergeant O’Neill was sure it was the bomb’s “trigger man”. He opened fire and the figure collapsed. Only then did he realise that he was injured.

He had third-degree burns to his left hand and face. His hearing was gone in his left ear and the vision in his left eye was blurred. The bones in his left forearm — the arm that had just supported and held his rifle steady — were fractured. His left side and face were peppered with high-velocity dirt and stones picked up by the blast. It was not immediately clear whether the pressure wave from the blast had caused damage to his internal organs and brain. At Kandahar airbase, the casevac crews wait for the call to scramble in a hut by the runway, much like the fighter squadrons of the Second World War, although these days the news comes with the simultaneous bleeping of pagers. The crews are in the air within five to seven minutes, flying in what Colonel Keuhn describes as “the single worst helicopter environment in the world”. Afghanistan’s high altitude air is thin; the heat reduces lift for rotor blades and the mountains incubate storms; the fine, dust of the plains attacks electronics and moving parts. The helicopters are regularly hit by enemy fire, but a bigger danger are the “brownouts” of dust whipped up around a descending helicopter.

As they fly into hastily prepared emergency landing sites to pull out wounded men, often from rough fields littered with drainage ditches, the pilots are blinded by a dense dust cloud for the last 50 feet. The casualties appear through the haze, carried by their comrades, while the rotor blades are still turning.

“The violence here is very ‘in your face’,” says Captain Colin De Groote, 27, from Los Angeles. “To see kids injured, to see Brits and Americans with horrific injuries, in a lot of pain, to see their buddies’ faces of shock and disbelief . . . a lot of guys I replaced were really ready to go home.”

As Sergeant O’Neill was lifted into a helicopter, it was clear that he was incredibly fortunate. “He was the first guy I’ve seen get blown off an IED (improvised explosive device) and not get any appendage loss,” said Senior Airman Lucas Ferrari, 27, who treated the wounded Marine as a helicopter carried him off the battlefield. Further examination in Kandahar hospital would also show that he had suffered no internal injuries.

Swathed in bandages in his hospital bed, Sergeant O’Neill was phlegmatic about the experience the next morning. “I was out chasing command wires,” he told The Times with a shrug. “I stepped on a bomb.”

The number of casualties recorded during the summer months has begun to drop with the onset of cold weather, but a steady stream of broken bodies still arrives in Kandahar aboard the Black Hawk helicopters. On Friday night Sergeant O’Neill’s arrival was closely followed by three young American soldiers wounded in a mortar blast. On Saturday morning they picked up a dead American and a British Special Forces soldier with a serious bullet wound to the neck.

The medics say that some badly wounded patients can become extremely violent in the helicopters; drawing on, as one medic puts it, “some sort of primordial survival instinct”. Others are freakishly calm. A British Special Boat Service soldier who was shot through the face earlier this month astonished the helicopter medics by refusing morphine and calmly picking bits of bone and teeth out of his own wound. “Some people are just tougher than others,” said Staff Sergeant Brian Oswald, who treated him. “I guess it is no surprise that they tend to be in the special forces.”

As well as rescuing the living, the evacuation crews must collect the dead; eight in one day late last month. The crews drape the body bags with the national flags of the dead soldiers as they carry them from the aircraft.

They have, they believe, saved the lives of about 300 soldiers and civilians who would not otherwise have survived to reach hospital since September and they have carried a further 500 who did not have immediately life-threatening injuries.

Almost 50 per cent of their patients have been Afghans, many of the rest have been British soldiers. A letter on the wall of the squadron hut in Kandahar airbase from Colonel Rob Thompson, whose 2 Rifles have suffered the worst casualties of all the British units, reads: “It seems you’ll fly through anything and land anywhere just to be there for our wounded Riflemen within the shortest time possible. I know that the speed with which your crews have made it to our emergency helicopter landing sites has saved a number of lives and we will be forever in your debt for that.”

From the Raleigh News & Observer, November 13, 2009 on Pg. 1

By Jay Price, Staff writer

KANDAHAR, Afghanistan -- As Chief Warrant Officer 3 James Woolley eased the giant Chinook down into the mud-walled compound, Special Forces troops on the ground dashed to form a perimeter to protect the helicopter, a prize target for Taliban insurgents.

The landing zone in the western Afghan province of Badghis wasn't under fire when U.S. Special Forces called for help to evacuate five wounded U.S. soldiers. But seconds after the Chinook, call sign Flipper 76, touched down, generating its trademark cloud of khaki-colored dust, the attack began.

Woolley, of Sanford, N.C., and the other pilot, Chief Warrant Officer 2 Eric Slover, of Hope Mills, noticed a puff of smoke maybe 175 yards away up a slope, and the chopper immediately lurched like a car hit in a fender-bender.

As a medic began rushing the wounded men to the rear ramp, the thin-skinned helicopter, unknown to its crew, now had a live rocket-propelled grenade aboard -- a weapon capable of disabling an armored vehicle.

The incident, which turned into one of the biggest medical evacuations of the Afghan war, occurred on Nov. 4. On Thursday, the commanders of the 82nd Combat Aviation Brigade, based at Fort Bragg, cleared the crew to tell the story of a miracle that came within inches of disaster.

The story began when two 82nd Airborne Division paratroopers, based at Fort Bragg, went missing in a river during a resupply mission.

A massive U.S.-Afghan manhunt turned into a fierce firefight with insurgents. Four Afghan soldiers, three Afghan police officers and an interpreter were killed, and 22 men were wounded, including the five Americans.

NATO is investigating whether some of the friendly casualties were a result of errant fire from U.S. aircraft that were called in to help.

The body of one missing soldier has been found.

The crew of Flipper 76 didn't know any of that when the medevac call came about 4:30 p.m. It had just finished dropping off troops and supplies at a small U.S. base nearby, along with Flipper 13, another Chinook. Flipper 13 stayed put while Flipper 76 headed for the compound, which was in a rural community with several other compounds.

A grenade to the head

The rocket-propelled grenade punched through the nose of the helicopter. It zipped between Woolley and Slover, went down a short passageway and struck the door gunner, Sgt. Roger Rathbun, in the back of his head.

The impact ripped away a palm-size chunk of his flight helmet, and propellant from the rocket scorched his neck as it deflected up into the ceiling of the cargo area. Rathbun was spun halfway around and knocked to the floor. Chinook pilots can't hear much of what's going on around them, but after hundreds of hours flying helicopters, they develop a musician's ear for any odd sound or change in the tone of their engines and rotor blades. Pilots quickly learn to recognize the "tink" of small arms fire hitting the fuselage. This hard slap and shudder was new for Woolley.

Slover, too, was startled. "What the ... was that?" he said.

Woolley saw damage to the nose of the chopper and immediately guessed that it had been struck by a rocket-propelled grenade, the weapon that brought down the helicopters in the famous Black Hawk Down battle in Somalia.

Slover was wondering why they were still alive.

"I think we both knew, even though I was trying to convince him it possibly might have been something other than an RPG, because I was trying to convince myself there was no way we had just been hit by an RPG but survived it," Slover said.

Rathbun, of Bunnlevel, up the short passageway, motioned to the pilots that he could hear them, but that his microphone had been torn away. His injuries turned out not to be serious, but he was shaken.

Then the pilots saw puffs of dust around the helicopter as the insurgents began firing small arms at them.

"The biggest thing was sort of sticking it out when they started engaging us with small arms fire," Woolley said. "Fortunately the ground guys did return fire, which helped us.

"We were kind of scrambling inside the aircraft in the front, trying to assess Sgt. Rathbun to see what his status was, and also taking a look at the aircraft to see what kind of damage we had sustained.

"All the while the ramp gunner was continuing to load casualties, and he said 'Ah, they're shooting sir, there's rounds popping,'" Woolley said. "I could see 'em, and I said, 'I know, just stick it out, and get these guys on.'"

It took maybe two or three minutes to get everything sorted out in the helicopter, call in close air support to help suppress insurgent fire, and get the other wounded men aboard, but it felt like two or three hours, Woolley said.

Then began a long odyssey to get the five wounded Americans - and later the wounded Afghan troops - to safety, and also get the dead out of the combat zone.

Would it fly?

They weren't sure the helicopter could fly. Their luck held, though, and they zoomed back to the small base nearby and put it down inside. Woolley badly wanted to know where the exit hole was and whether the RPG had hit anything vital.

When the crew couldn't find a second hole, he told them to start looking for something worse: a live grenade inside the chopper. After two or three long minutes, one of the soldiers found the grenade on the floor between a helmet bag and a set of goggles.

The pilots shut the chopper down, and Slover dashed off to find explosives experts and medical help for the wounded soldiers.

The rest of the crew started pulling the wounded off Flipper 76 and transferred them to Flipper 13 for the flight to a medical facility in Herat.

En route, they learned that the RPG had been removed, so after they unloaded the casualties they headed back. Casualties had mounted during the search for the missing paratroopers, and both choppers were needed. For the second trip, they loaded 14 wounded Afghan troops and six dead.

They headed to Herat, but there wasn't room for the wounded there, so they pushed on to another base, where they dropped off the casualties.

After a long night of flying back and forth across western Afghanistan, they headed for a small staging base.

The 82nd Combat Aviation Brigade crews are all flying a new model of the Chinook. After Flipper 76's RPG miracle, a standard joke among them now is that the new version has been equipped with a secret device that disarms enemy munitions.

Inches from death

No one had to tell the Flipper 76 crew how lucky they were. Even when a rocket-propelled grenade doesn't explode, it can tear through a person; and this one passed inches from both pilots and grazed Rathbun.

It wasn't Woolley's first brush with death. A Chinook he was flying in Iraq once took 32 bullets. Another, in an earlier stint in Afghanistan, caught several rounds in the Plexiglas windows of its bulbous nose. In 2007, he was just five helicopter lengths behind another Chinook that was hit by a Stinger anti-aircraft missile and went down, killing all five crew members and a British military cameraman who was aboard.

This time, when he got back to base he called his wife to tell her what had happened.

"Boy, you are crazy," she said. "Quit using those lives up!"

Then she asked if they'd evacuated all the wounded men. He said he had.

Woolley said Thursday that there's some question in the unit about whether flying with him is a bad idea - or really, really smart.

"Either they want to or they don't. The jury's still out on that," he said. "Either I'm lucky or I'm unlucky."