 Okay, move out. In the fight for life, the race against time can make the crucial difference. For men wounded in combat, time has always been an enemy. But in the conflict in Vietnam, a wounded American soldier can receive hospital treatment or surgery in less time than an accident victim on our own highways. This race against time is being won partly by the helicopter and by advances in medical technology, but mostly by the dedication of the men and women of the United States Army Medical Service as they help the soldier in the fight for life. It was in Korea during the 1950s that a major element of the story of today's high-speed medical aid to casualties was written. In that land of treacherously steep terrain, round ambulances simply could not do the job, at least not in time. The helicopter was just coming into its own as a mode of military air-land, and the decision to try using the chopper as an airborne ambulance was one which has had revolutionary results. The practicality of evacuation by copter, direct from forward areas in the combat zone to well-equipped treatment facilities, was dramatic improvement. During the conflict, some 20,000 casualties received medical help in a fraction of the time that would formerly have been required. In a matter of hours, a casualty could be on its way in a long-range transport aircraft, fully staffed with trained medical personnel, for a swift trip to major medical centers in Japan or even the United States. A whole new concept of casualty evacuation was born. The war in Vietnam is fought against the deadly combination of a hostile environment and an elusive enemy. This long, narrow, mountainous country, covered with jungle and brush, crisscrossed with rivers and streams, drenched by summer and winter marmsoons, provides natural hideouts for Viet Cong guerrillas, but presents special handicaps for troops 10,000 miles from home. The battles have no fixed fronts, the adversary knows no fixed rules. To deal with the enemy, our soldiers must go where the enemy is. Through the tall grass, across the unspanned rivers, into the dense jungles, constantly facing hidden dangers, a booby trap, a buried mine, a sniper, a sudden ambush. From the moment a soldier is hit, no time is lost. For the wounded, the burden of an extra minute may just break the thin thread of life. The fight for life begins with the combat medic. Even as the battle is raging, he is there to give first aid. The call goes out for Dustoff, the affectionate code name for the medical evacuation helicopter. A landing area is cleared. The chopper pilot is contacted. The location is marked by smoke. The patient is rushed on board and Dustoff is on its way, all in a matter of minutes. The Medevac pilot considers the urgency of the most serious cases on board. If he has not received advanced information, he will contact the medical regulator located at the clearing station supporting a division or brigade and receive advice as to the nearest hospital that is staffed and equipped to provide the required treatment. Less serious casualties are normally evacuated to the supporting clearing station and when the chopper touches down, medical personnel are ready and waiting. At the clearing station, each casualty is checked by a physician who provides the required care and treatment or directs further evacuation to a hospital. If no time is to be lost in any step of the evacuation, the rapid sequence of events must have precise coordination. The Army Medical Service knows the necessity of reliable communications and streamlined procedures. A vital link in successful evacuation is the medical regulator who maintains radio contact with the medics in the field and relays information to air ambulance pilots. From the requesting unit, the pilot learns the location, number and condition of the wounded, the landing conditions and the enemy situation. Due to the courage, skill and efficiency of the air ambulance crews, the average flight time from any battlefield pickup to a well-staffed and equipped medical facility is one hour or less. Medical regulators direct the pilots to supporting hospitals. Normally, the air ambulance lands at a helipad immediately adjacent to the hospital. When this is not possible, ground ambulances work with the helicopters to bring battle casualties to the doctor. Within the base camps and cities, they shuttle patients between unit areas, dispensaries, hospitals and air fields. Whether transferring patients from air to ground ambulances or from ground to air, the single aim is to get them to the proper medical facilities as rapidly as possible. To the severely wounded, the first few hours may make the difference between life and death or between complete recovery and permanent disability. Yet swift evacuation is only one part of the teamwork. It takes every member of the Army Medical Team to preserve the life and fighting strength of our soldiers in Vietnam. When wounded reach the hospital, the fight for life goes into high gear. It's a fight that demands that everyone be at his battle station. The nurse whose care can alleviate pain and suffering in a way that drugs cannot. The doctor whose hands have the skill to wrestle with death to reconstruct the broken bodies of war. The laboratory technician whose scientific tests may enable the doctor to make a crucial decision in time. The clerk who provides nourishment to bring back health and strength once the initial crisis has passed. The clerk who keeps vital supplies flowing to the right place at the right time. Each one contributes to the saving of life and limb and the recovery of fighting strength. And this teamwork brings results. Among wounded reaching hospitals, the mortality rate is lower than two and a half percent. And for all the casualties treated in medical facilities ranging from the aid station to the evacuation and field hospital, the return to duty rate is high, about 80 percent. This means that as many combat experienced men as possible recuperate in Vietnam to continue fighting once their physical recovery is complete. But there is more to the war in Vietnam than combating the Viet Cong. This is a tropical country, poor in sanitary facilities and full of breeding grounds for hidden dangers to help. The native adults are relatively immune to many diseases which can put Americans out of action. Such an environment demands that the army apply a total medical service concept involving many activities beyond the care and treatment of battle injuries. For the hazards to health are everywhere. Nearly 70 percent of hospital admissions are for diseases such as skin disorders, malaria, dysentery, acute respiratory illnesses and infections caused by parasites. This challenge calls for a good program of preventive medicine. Insect and rodent control must be relentlessly enforced to curb the huge population of mosquitoes, flies, lice, fleas and rats. The busy carriers of malaria, plague and typhus. Water supply must be the object of round the clock surveillance. Probably only one third of the South Vietnamese people have access to pure drinking water. Endless research must be conducted to overcome the most pressing problems of tropical medicine. Research in epidemic control, entomology, zoology and other biological and medical disciplines. In remote areas deep in the heart of Viet Cong territory, a new chapter in the history of military medicine is being written. Today in a village outpost like this, you will find an army team that is unique in the long chronicle of combat. In countries where no conventional units have yet penetrated, the team carries out its mission. Its members are all special forces qualified, but they are something more. Each one is a highly trained medical scientist or technician. They are men of the Walter Reed Institute of Research and their laboratory is the jungle. This is where they do their research. The mosquito-infested swamps and thickets. The home of animals, insects, mites. Carriers of diseases just as deadly as the Viet Cong, who incidentally are never far away. Their unique mission is to go where no large body of American troops has yet come and search out in advance the types of diseases that must be expected and warded against when conventional forces do move into the area. This kind of advanced preparation has never been attempted before. But thanks to the dedication and skill of this special research element of the Army's medical service team, the work is bearing results today. To pick up a wounded man from the middle of the jungle, where there is no room for even a copter to land, has called for the development of some special devices. One of these is called the Flexletter. Completely enclosing the casualties body, it protects him on his journey up through the treetops to the Medevac copter hovering above. For the man with the wound which is perhaps less serious, but still requires treatment beyond what the combat medics on the spot can give, there is a sling-seat device called the Jungle Penetrator. Where no other means of pick-up is possible, it lives up to its name, penetrating the jungle, lifting to safety and immediate medical care, men who learn once again that whenever and wherever they need help, the medical service will find a way to be there. Music In spite of the difficult environment, American troops in Vietnam enjoy an excellent state of health. The low hospital admission rate, less than one per thousand per day, testifies to the effectiveness of prevention and research work. The sick and the wounded in this war are provided with more rapid evacuation and better care and treatment than in any other war in history. For here, there is a concentration of medical skills never equaled in wartime. Skills of all degrees, from the supply clerk to the experienced surgeon. A phased and orderly buildup of Army medical personnel has accompanied the growth of troop strength. Intensive and continuous care can be provided to each patient until complete recovery. There are facilities for treating every type of wound. Even vascular surgery, only occasionally used in the Korean conflict, is now a common procedure to save life and limb. And these skilled men and women are provided with an abundance of supplies, including whole blood. Music Despite the tremendous logistical problems of moving immense tonnages and great varieties of materials over long distances, their supply has been maintained without interruption. With firsthand knowledge of their own needs, medical service personnel have assisted the Army engineers in the design and construction of hospitals. Such large-scale hospital complexes are a major factor in reducing the death rate from combat wounds to the lowest level in history. Carefully spotted as they are throughout the combat zone, they have made it a fact that no casualty, no matter where he is, is more than 30 minutes away from the most complete hospital facilities the 20th century can provide. All operating rooms, intensive care wards, x-ray, and surgical supply rooms are air conditioned, a must in this tropical climate. And the word must has assumed a new meaning to the medical service. It stands for Medical Unit Self-Contained Transportable, a new mobile field hospital concept realized through advanced technology. One of its three main packages is the utility element, which provides electric power, air conditioning, heating, and hot and cold running water. The second unit is a ward unit, collapsed during travel, but quickly inflated by air pressure from the utility element. The double-walled fabric structure is coated with synthetic rubber. Designed for all climates, it can withstand winds up to 80 miles per hour. Its spacious interior can accommodate 20 combat casualties, together with all basic hospital ward equipment. Its controlled environment contributes to the cleanliness and speedy recovery of the sick or wounded. The third package is the expandable element which houses surgery, laboratory, x-ray, pharmacy, and central supply facilities. The most complex and delicate operations can be performed here. By combining a number of selected elements, a hospital facility of any size could be rapidly set up anywhere, completely equipped, and ready to function. The packaged elements can be shipped by almost any mode of transport, cargo plane, helicopter, or truck. Part of the must system is the dental element, which can provide a modern dental clinic in the wilderness, and on very short notice. Inside, every modern facility of dentistry is available. The dental patient and the working staff gain the advantages of a fully controlled atmosphere, despite the tropic heat and humidity outside. X-ray facilities comparable to those of any state-side clinic make possible rapid and exact diagnosis of individual patient needs. So thoroughly staffed and equipped is the dental element, that dentures can be repaired on the spot, eliminating the time loss involved in sending the work out to some separate facility. Whatever care the combat soldier's teeth may need, from a simple cleaning to extensive surgery, the must dental element is ready to provide it. Sometimes an ingenious improvisation, field expedient is the army term, provides an answer to the need of men in remote areas for prompt medical care. This dental clinic on wheels is a case in point. Its creator and army dentist designed the dental chair, which is made from a 55 gallon fuel drum, and worked out the installation of portable dental equipment in the back of a truck. Many a combat soldier on duty in some back country area has had his regular dental checkup on schedule, thanks to this kind of dedication and ingenuity on the part of members of the Army Medical Service team. The development of new highly mobile medical equipment has extended to such things as this portable X-ray unit. A member of the medical equipment family, not until now noted for its mobility. The sophisticated equipment now available in Vietnam includes the artificial kidney, which temporarily assumes the function of that vital organ during an emergency. With superior equipment and a wide range of medical supplies always available, the Army's skilled medical staff has been able to treat all types of casualties right in Vietnam. The total medical service concept extends service in depth as well as in breadth. Aviation medicine, for example, is now a specialized field and has been greatly expanded to meet the particular needs of the Army in Vietnam. The nature of warfare in Vietnam demands extensive use of helicopters and other types of aircraft as an organic part of the Army for combat, for resupply, for evacuation, and for observation. Army aviators and crewmen have an exacting and perilous mission. They require close and constant attention by flight surgeons to keep them in top physical and mental condition, and they get it. The flight surgeon lives with the air crew and knows the men as individuals. He performs a role like that of the family doctor in civilian life, problems related to fatigue, personal protective equipment, sanitation, rest and recreation, survival gear. All these are the concerns of the flight surgeon. Veterinarians are an important segment of the Army medical team in providing the best healthcare possible. In addition to inspecting foods and food sources, and the detection and prevention or control of diseases of animal origin, they provide highly effective care and treatment for the valuable four-legged members of the Army, the Scouts and Sentry Dogs. These animals receive all the care needed to keep them in top fighting trim. Periodic check-ups include a full variety of tests and X-rays to ensure that these canine members of the Army's combat team enjoy a full tour of duty in good health. The Army in Vietnam is also deeply involved in the battle for support and stability of the civilian population. For its medical components, this means medical civic action programs, or MEDCAP. The scarcity of Vietnamese doctors and sanitation measures contribute to a high rate of sickness and death among the Vietnamese. Estimates for infant fatality run as high as 255 per 1,000 births, and life expectancy is said to average 35 years. In addition, the enemy's terrorist tactics cause a great many civilian casualties. Army doctors, nurses, and medics give of their spare time and energy freely to care for and treat the sick and wounded of the civilian population. In large cities and in small hamlets, including mountain villages inhabited by the primitive tribesmen known as mountain yards, they meet the urgent need of the people for medical and dental care. Since 1963, United States Army medical personnel have been helping the military units of South Vietnam to organize and operate MEDCAP programs. And millions of villagers have received the benefits of modern medicine for the first time in their lives. Day by day and man by man, this effort is helping to win the people over to the side of the free world. But until peace comes to Vietnam, the American soldier's primary duty is to fight against the terror and tyranny of the communist enemy. This is the place where our adversary's plan of subversion and aggression is being tested. And he uses every overt and covert means at his disposal to undermine the strength and stability of the young republic. If political upheavals in Asia and elsewhere in the world are not to be precipitated by outside force, no matter how cunningly or persistently applied, the American soldier must stand firm in Vietnam. As long as innocent-looking terrain is infested with devastating enemy mines, or fertile rice paddies conceal caches of deadly weapons. As long as humble villages are harassed by guerrilla terrorists and flimsy huts connected with intricate tunnels, the American soldier will continue to deal with the elusive Viet Cong in a hostile environment, meeting ever-present danger with never-flagging courage. He will do so with the firm knowledge that the United States Army medical units work tirelessly to guard his health and will respond instantly at the time of sudden and desperate need. For in Vietnam, as in any other area of conflict, the mission of the Army Medical Service is to conserve the fighting strength of our combat troops, making every effort at any time in any place to win the fight for life.