KANDAHAR, Afghanistan — As soon as the Taliban bullet struck 24-year-old Afghan Sgt. Nazir Moradi’s leg, the men in his unit began brainstorming a way to get him off the battlefield.
The roads were too dangerous for an army ambulance. The Afghan soldiers, in several calls to their commanders, repeated one plea: They needed a helicopter.
The Afghan air force didn’t have any working aircraft available. The U.S. military, in the midst of drawing down its air support, denied a request for help. Instead, Moradi was carried for miles and eventually put in an unarmored ambulance impeded by rough terrain and the threat of roadside bombs.
By the time Moradi arrived at the Kandahar Regional Military Hospital, more than three hours away, he had bled to death from a minor wound. Hospital workers carried him to the morgue in a flag-draped coffin, the ritual they perform each time a soldier arrives too late.
“We kept waiting for a helicopter, either American or Afghan. But it never arrived,” said Pvt. Morabuddin, Moradi’s best friend. “He did not have to die.”
For the past decade, the Afghan army has relied on hundreds of American helicopters to pluck wounded soldiers from remote battlefields and outposts. Now, the U.S. helicopters are leaving Afghanistan just as the country’s army embarks on its toughest fight, assuming formal responsibility for security this summer. The Afghan air force has 60 helicopters, but many are out of commission at any given time, and none is dedicated solely to casualty evacuation.
The war here is full of asymmetries between one of the world’s strongest militaries and one of the world’s newest forces, dependent entirely on foreign aid. The staggering gap in air evacuation capacity raises questions not only about how Afghan troops will defeat a resilient enemy, but how they will avoid countless unnecessary deaths. About 250 Afghan soldiers and police officers die every month, a toll far higher than that suffered by Western troops in their deadliest period.
The United States has invested millions of dollars in training and supplying the Afghan air force, but American officials acknowledge that Afghan pilots will be able to evacuate only a fraction of wounded soldiers and police officers. Last year, the United States evacuated 4,700 Afghan soldiers by air, compared with the Afghan air force’s 400.
With American air support vanishing, the rest will have to rely on unarmored ambulances, even though soldiers are often wounded hundreds of miles from an adequate hospital, separated by roads peppered with homemade bombs, known as IEDs.
“Your helicopters are our life support, and they’re leaving,” said Ahmad Zia Safai, a surgeon at the Kandahar hospital.
A crisis of confidence
When its troops are wounded, the U.S.-led International Security Assistance Force (ISAF) has long relied on a massive fleet of Black Hawk helicopters operating 24 hours a day. Rapid air evacuation is credited with saving hundreds of lives in the past decade of war. The coalition deems transporting its own casualties from the battlefield in ambulances too dangerous.
The Afghan air force, meanwhile, has about six working helicopters in all of the restive south. Afghan pilots don’t have the resources, such as night-vision goggles, necessary to fly after sunset, and their weakness in ground combat means that they are seldom able to land in hostile territory.
The Afghan fleet is expected to require NATO support until at least 2017, according to U.S. officials, due in large part to concerns about maintenance.
“There’s no way the Afghan air force will be able to cover what we’ve been covering,” said Col. Michael Paston, the U.S. 438th Air Expeditionary Advisory Wing surgeon general. “Are they going to be surprised when they call on ISAF [to evacuate a casualty] and ISAF says no? That’s happening now.”
That new reality has prompted a crisis of confidence in many Afghan units. Some commanders worry that troops might be less willing to put their lives at risk knowing that they lack once-dependable medical support.
“How can we fill the gap as the U.S. withdraws? It’s impossible. We can’t grow fast enough,” said Col. Asrail Wardak, the deputy commander of the Afghan air force’s southern fleet.
As the Taliban’s summer fighting season went into full swing this month, the dead and critically wounded soldiers poured into Kandahar Regional Military Hospital in almost equal number. All the men who arrived with life-threatening injuries had been evacuated by U.S. helicopters.
After performing a double amputation on a soldier who had stepped on a makeshift bomb, Khadir Tajik, a physician, emerged from the operating room with beads of sweat on his forehead.
“Without a helicopter, there’s no question he would have died. An ambulance would have taken way too long,” he said.