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Death of the Golden Hour and the Return of the Guerilla Hospital

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Death of the Golden Hour and the Return of the Guerilla Hospital JSOU JSOU Report 17-10 The Death of the Golden Hour and the Return of the Future Guerrilla Hospital Farr JOINT SPECIAL OPERATIONS UNIVERSITY Members of the 3rd Special Forces Group transport a simulated casualty to a medical evacuation zone at Camp Shelby Joint Forces Training Center in Mis- sissippi during training exercise Southern Strike 17 on 27 October 2016. U.S. AIR FORCE PHOTO BY SENIOR AIRMAN CLAYTON CUPIT. Colonel Warner “Rocky” Farr has made an important contribution to the body of SOF knowledge with this well-researched monograph. He advances the understanding of the many challenges and accom- plishments related to guerrilla warfare medicine—care provided by predominantly indigenous medical personnel under austere con- ditions with limited evacuation capability —by providing a survey of the historical record in UW literature. Colonel Farr relates many historical experiences in the field, assesses their effectiveness, and lays a foundation for further in-depth study of the subject. The Joint Special Operations University is pleased to offer this monograph as a means of providing those scholars and operators, as well as policymakers and military leaders, a greater understanding of the complex and complicated field of guerrilla warfare medicine. Joint Special Operations University The Death of the Golden Hour and the 7701 Tampa Point Boulevard MacDill AFB, FL 33621 Return of the Future Guerrilla Hospital https://jsou.libguides.com/jsoupublications Warner D. “Rocky” Farr JSOU Report 17-10 ISBN 978-1-941715-28-4 Joint Special Operations University Brian A. Maher, Ed.D., SES, President Boyd L. Ballard, Director, Center for Strategic Studies Francis X. Reidy, Deputy Director, Center for Strategic Studies Robert Nalepa, Lieutenant Colonel, U.S. Air Force, Ret., Editor in Chief Lisa Sheldon, B.A., Advertising, JSOU Press Editor Joint Special Operations University and the Resident Senior Fellows Center for Strategic Studies Peter McCabe, Ph.D., Political Science, Colonel, U.S. Air Force, Ret. Will Irwin, MMAS, Lieutenant Colonel, U.S. Army, Ret. The Joint Special Operations University (JSOU) provides its publications Paul Lieber, Ph.D., Mass Communication & Public Affairs to contribute toward expanding the body of knowledge about joint special David Ellis, Ph.D., International Relations, Comparative Politics operations. JSOU publications advance the insights and recommendations Editorial Advisory Board of national security professionals and the Special Operations Forces (SOF) Roby C. Barrett William W. Mendel students and leaders for consideration by the SOF community and defense Ph.D., Middle Eastern & South Asian History Colonel, U.S. Army, Ret. leadership. Public Policy Center Middle East Institute and JSOU Senior Fellow JSOU Senior Fellow JSOU is the educational component of the United States Special Operations Alvaro de Souza Pinheiro James J.F. Forest Command (USSOCOM), MacDill Air Force Base, Florida. The JSOU mission Major General, Brazilian Army, Ret. Ph.D., Higher Education Administration JSOU Senior Fellow is to prepare SOF to shape the future strategic environment by providing Associate Professor, School of Criminology and James F. Powers, Jr. specialized joint professional military education, developing SOF-specific Justice Studies, University of Massachusetts Lowell and JSOU Senior Fellow Colonel, U.S. Army, Ret. undergraduate and graduate level curriculum and by fostering special opera- JSOU Senior Fellow Mario Forestier tions research, analysis and outreach in support of USSOCOM objectives. Chief Warrant Officer, U.S. Army, Ret. Bryan C. Price JSOU conducts research through its Center for Strategic Studies (CSS) Director, Joint Special Operations Command Lieutenant Colonel, U.S. Army Center for Counterterrorism Studies Ph.D., Political Science where efforts center upon the USSOCOM mission: Director, Combating Terrorism Center at Thomas H. Henriksen West Point USSOCOM mission. USSOCOM synchronizes the planning of Special Ph.D., History Operations and provides Special Operations Forces to support persistent, Hoover Institution, Stanford University Richard H. Shultz, Jr. and JSOU Senior Fellow Ph.D., Political Science networked, and distributed Geographic Combatant Command operations Director, International Security in order to protect and advance our Nation’s interests. Bernd Horn Studies Program, The Fletcher School, Colonel, Canadian Dept. of National Defence, Ret. Tufts University and JSOU Senior Fellow Ph.D., War Studies Press publications are available for download from the JSOU Library Command Historian, CANSOFCOM Education Robert G. Spulak, Jr. and Research Centre Ph.D., Physics/Nuclear Engineering web page located at https://jsou.libguides.com/jsoupublications. Sandia National Laboratories Russell D. Howard and JSOU Senior Fellow Brigadier General, U.S. Army, Ret. Jessica Glicken Turnley John D. Jogerst Ph.D., Cultural Anthropology Colonel, U.S. Air Force, Ret. Galisteo Consulting Group James Kiras and JSOU Senior Fellow Ph.D., History Rich Yarger School of Advanced Air and Space Studies, Ph.D., History Air University and JSOU Associate Fellow JSOU Senior Fellow The Death of the Golden Hour and the Return of the Future Guerrilla Hospital Warner D. “Rocky” Farr JSOU Report 17-10 The JSOU Press MacDill Air Force Base, Florida 2017 Comments about this publication are invited and should be forwarded to the Director of the Center for Strategic Studies, Joint Special Operations University, 7701 Tampa Point Blvd., MacDill AFB, FL 33621. ******* The JSOU Center for Strategic Studies (CSS) is currently accepting written works relevant to special operations for potential publication. For more information, please contact the CSS Director at [email protected]. Thank you for your interest in the JSOU Press. ******* This work was cleared for public release; distribution is unlimited. Printed in November 2017. ISBN 978-1-941715-28-4 The views expressed in this publication are entirely those of the author and do not necessarily reflect the views, policy, or position of the United States Government, Department of Defense, United States Special Operations Command, or the Joint Special Operations University. Authors are granted academic freedom provided their work does not disclose classified information, jeopardize operations security, or misrepresent official U.S. policy. Such academic freedom empowers authors to offer new and sometimes controversial perspectives in the interest of furthering debate on key issues. Recent Publications of the JSOU Press Property Rights and Social Justice as an Indicator of Stability: The SOF Nexus, JSOU Report 17-9, Bill Mandrick Transitioning from War to Peace: Post-Deployment Support for Special Operations Forces, JSOU Report 17-8, Jennifer M. Hazen 2017 Special Operations Student Essays, JSOU Report 17-7 Special Operations Theory, JSOU Report 17-6, Volume 3, edited by Peter McCabe and Paul Lieber Special Operations Contracting: 21st Century Approaches for Service and Technology Acquisition, JSOU Report 17-5, Benjamin Tkach Outside the Box: A New General Theory of Special Operations, JSOU Report 17-4, Volume 2, Tom Searle On the cover. Army Special Operations Resuscitation Team member, 528th Sustain- ment Brigade, examine a patient on Crestview Airfield, Florida, on 23 April 2015. Emerald Warrior is the Department of Defense’s only irregular warfare exercise, allowing joint and combined partners to train together and prepare for real world contingency operations. U.S. AIR FORCE PHOTO BY SENIOR AIRMAN CORY D. PAYNE/RELEASED. Back cover. Members of the 3rd Special Forces Group transport a simulated casualty to a medical evacuation zone at Camp Shelby Joint Forces Training Center in Mis- sissippi during training exercise Southern Strike 17 on 27 October 2016. U.S. AIR FORCE PHOTO BY SENIOR AIRMAN CLAYTON CUPIT. Contents From the Director ........................................................................vii Foreword ......................................................................................ix About the Author ...........................................................................xi Introduction ................................................................................... 1 1. History of Conventional Military Medical Support ..................... 5 2. SOF Unique Medical Support Requirements .............................. 7 3. WWI SOF and Medical Support: Africa and the Middle East ............................................................................ 11 4. WWII SOF and Medical Support: From OSS to the Philippines ............................................................................. 15 5. The Cold War and the Korean Partisan Rangers ........................ 25 6. The Emerging SF Doctrine: Post WWII ..................................... 33 7. Vietnam, Special Action Forces, and the Green Berets ............. 43 8. The Rise of SOF and the Small Wars of the 1980s and 1990s ......................................................................... 49 9. The Global War on Terrorism and its Golden Hour .................. 53 10. The Platinum Ten Minutes ...................................................... 59 11. Back to the Future: Prolonged Field Care ............................... 61 12. Technical Challenges, Improving Sustainment, Reducing Footprints .................................................................................... 67 v 13. Conclusion ............................................................................ 71 Appendix:
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