MAJ. J. ANDREW BIRMINGHAM
F Company, 1-171st GSAB (MEDEVAC)
Mississippi Army National Guard

When I became a company commander in November 2013, I had no idea what my requirements would be over the next three years. I was taking command of F Company, 1-171st, an Army National Guard UH-60A/L company with two FSMPs (five aircraft), an E Detachment and a D Company Detachment. I had a very young and eager crop of aviators, platoon leaders and NCOs. What they lacked in experience they made up for with enthusiasm and dedication.

The company was short on senior warrant officers. We did not have our full complement of pilots in command, tracked aviators or qualified flight paramedics. The first sergeant and I would need to train all sections and build our experience base over time. We’d have to focus on individual MOS training as well as realistic collective training that included point-of-injury evacuation, tail-to-tail patient transfers and battlefield circulation of medical personnel and supplies.

We developed a robust and multi-tiered training plan to build individual and collective knowledge, unit cohesion and experience across our formation. Lastly, we adjusted the unit’s mission-essential task list to include our stateside mission of humanitarian assistance in accordance with the approved missions in Army Regulation 40-3. However, we focused more on the warfighting tasks in our METL.

At our first collective training event in April 2014, we participated in the Emerald Warrior 2014 exercise in south Mississippi. This exercise was a joint training event with U.S. Marine, Navy, Air Force and Israeli air force units. We were conducting POI evacuations with ODA teams, tail-to-tail transfers with C-130s and C-17s, area medevac coverage and dedicated coverage for named operations. Additionally, we were providing fire suppression support to the Bienville National Forest. I wouldn’t say our first training event went smoothly, but it was manageable and we were making progress — or so we thought.

In late April, a major spring weather system worked its way across the country, hitting northern Mississippi with strong thunderstorms and tornadic activity. The most devastating tornado was an EF-4 that tore a path across four counties and devastated the city of Louisville. This tornado was on the ground for 34 miles and resulted in 10 fatalities, multiple injuries and many destroyed homes and businesses.

The unit had spent its first year building the company and preparing for a combat deployment. With significant personnel augmentation, the second year was spent in Afghanistan. We’d never conducted a humanitarian support or Defense Support of Civil Authorities mission, so this would be our first foray into DSCA operations. Unfortunately, we weren’t ready.

The Mississippi Emergency Management Agency requested support, and we were tasked by our director of military support with providing four medevac aircraft. At the time, we had two fully mission capable medevac aircraft. With the help of our state’s air assault company — A Company, 1-185th Aviation Regiment — we were able to piece together four airframes and crews for response. We immediately realized the following shortcomings:
  • Medical equipment sets were incomplete.
  • We had no compliment of meds and no mechanism to draw them during an emergency. We only had training packages.
  • Aircraft medical configurations were not standardized.
  • We were unsure of the mission approval process and FMA requirements for DSCA support operations.
  • We had no air-to-ground communications capability with civilian ground crews.
  • We were not prepared to work with civilian medical professionals and first responders.

Despite these shortcomings, we were able to integrate with the incident commander and were on station and ready to receive missions as soon as the storms passed. As a testament to MEMA and the first responders in northern Mississippi, they responded to all emergencies, recovered the victims, treated the wounded and provided essential services without needing aviation support. This turned out to be the most realistic alert and launch process we could have hoped for. This disaster response was the beginning of the company’s indoctrination into coordinating with civilian authorities.

Upon returning from the disaster response missions, we began to make adjustments. We coordinated with the state surgeon, the University of Mississippi Medical Center and the J4 to create a line-item meds package for emergency response. We coordinated storage of these meds packages at certified medical facilities. We fine-tuned medical protocols and multiple formularies. We standardized the MES kits and mandated that they would be loaded in the aircraft during all missions, to include ATM training. This was especially important during our fielding of the Integrated Modular Medical Support System. We also trained LNOs to support incident commanders and provided communications capabilities to improve air-to-ground coordination.

In addition to these adjustments, key leadership within the company attended the Search and Rescue Workshop at College Station, Texas, in 2014, and the Helicopter Aquatic Rescue Team Conference in Raleigh, North Carolina, in 2015. We developed a close working relationship with the DOMS office, which manages MEMA requests and allocates missions for the state. We also conducted face-to-face coordination and integrated training with MEMA executives and operations personnel. This culminated in the summer of 2016 with a combined training exercise that coordinated operations with F Company, 1-171st MEDEVAC and the MEMA SAR Task Force personnel and equipment.

We conducted slow, methodical and deliberate training that included equipment and capabilities familiarization, cold/hot load training, coordinated ground and air SAR missions, patient triage and prep for flight, and hoist operations. The ultimate goal is to build a fully integrated, statewide civil/military SAR Task Force that can rapidly deploy to save life, limb or eyesight during any state natural disaster.

During the two years after the 2014 tornadoes, F Company, 1-171st, conducted five SAR missions over land, a SAR mission over the Gulf of Mexico for lost swimmers, a SAR mission on the Mississippi River for lost fishermen, damage assessment flights for flood response and numerous fire-suppression missions for the U.S. Forest Service.

We are still learning with every mission and make mistakes every day. However, with each and every mission, we are improving our coordination, planning and mission execution capabilities. As I leave command, I often reflect with great pride on what my leaders and Soldiers have accomplished.