U.S. Navy -- When the Naval Air Transport Service (NATS) Douglas R4D broke through the clouds of volcanic dust and smoke to land on Iwo Jima on March 6 1945, it carried more than whole blood and medical supplies for the wounded. On board this inaugural air evacuation flight was a 22-year old nurse named Jane Kendeigh, marking the first time in history that a Navy flight nurse appeared on an active Pacific battlefield. Kendeigh may have become a symbol for casualty evacuation and high altitude nursing on that day, but she was far from alone in this daring mission.
From March 6-21, 1945, Kendeigh and her fellow flight nurses air evacuated some 2,393 Marines and Sailors from Iwo Jima. Pictures of these first combat nurses show them offering encouragement and comfort to the rows of littered patients along the battlefield runways.
For the physically and psychologically wounded warfighters of the Pacific, Navy flight were the military equivalent of Dante’s Beatrice—appearing at critical moments in their lives and escorting them from veritable pits of hell to the safety of hospitals on Guam, Hawaii and California. It’s little wonder why a special bond often developed between these patients and nurses. Mary Hudnall, one of the first flight nurses on Iwo, recalled that one patient being so grateful of his rescue he insisted on giving her a memento from the battlefield. “He asked me to take a small medicine bottle and said ‘It’s sand from Iwo Jima. I don’t want you to forget what we did here.’”
By the time of the invasion of Iwo Jima, the idea of casualty air evacuation was nothing new. The British had experimented in “air ambulancing” as far back as in the 1920s. And in 1929, the Colonial Flying Service and Scully Walton Ambulance Company of New York organized the first civilian air ambulance service.
During the Guadalcanal campaign, the U.S. South Pacific Combat Air Transport Command (SCAT) began using cargo planes to evacuate wounded servicemen marking the first time U.S. military used air evacuation in a wartime setting. These missions were initially free of medical personnel until November 1942 when Navy pharmacist’s mates (hospital corpsmen) were added to these flights.
In March 1943, SCAT formally established a joint medical section comprised of Army and Navy flight surgeons to supervise and select casualties for air evacuation in theater. Flight nursing first took off when the U.S. Army employed nurses on evacuation missions to North African campaign in December 1942. A year later, in June 1943, the Army formally established the Army Air Force School of Air Evacuation at Bowman Field, Kentucky to offer specialized training for its flight nurses. Two Navy nurses—Dymphna Van Gorp and Stephanie Kozak—graduated from the school in January 1944 becoming the first trained flight nurses in the Navy. Upon graduation, the Navy sent Van Gorp and Kozak to Brazil to establish an “aeromedical evacuation program” in the Brazilian Air Force Nurse Corps.
Seeing a need for flight nurses to support operations in the Pacific theater, the Navy established the School of Air Evacuation Casualties at Naval Air Station Alameda, California in 1944. Overseeing the school was a former United Airline stewardess and registered nurse named Mary Ellen O’Connor, later dubbed the most “flyingest woman in the world” for her long career aboard airplanes.
Prior to the war, O’Connor worked for United Air Lines (UAL) as a stewardess-nurse. At the time of her entry in the U.S. Navy she had already accumulated over 2,500,000 miles by air. After the war, she returned to UAL where in 1953, they honored her as namesake of the new Convair 340 aircraft (“Mainliner O’Connor.”)
Under O’Connor’s instruction, the evacuation school commenced its first class of 24 Navy flight nurses and 24 pharmacist’s mates on December 10, 1944. The school’s applicants were recruited from naval hospitals and each candidate were required to have “good character references” and be “excellent swimmers.”
The eight-week course consisted of lectures and demonstrations on survival training, air evacuation techniques, physiology of flight, first aid with emphasis on shock, splinting/redressing wounds, and treatment of patients in non-pressurized cabins. Students also learned about artificial horizons, and altitude through flight simulation exercises. The course hallmark was an intensive 18-hour “watermanship” training organized to simulate conditions of a water landing/crash scenario. The prospective flight nurses were required to swim underwater, swim one-mile, and be able to tow patients 440-yards in 10 minutes.
Following graduation in January 1945, twelve of the first flight nurses were sent to Naval Air Station Agana, Guam, to prepare for their first battlefield mission while the others were used to transport casualties in the Continental United States and from the (Territory of) Hawaii. By the end of March, after two more classes graduated from the school, the Navy had 84 trained flight nurses; almost all would be used for the next big challenge, perhaps the biggest of them all: Okinawa.
Fought between April 1 and June 22, 1945, the Battle of Okinawa accounted for 17 percent of the total Navy and Marine Corps casualties suffered in World War II. Owing to the enormous casualty totals, Okinawa was the largest combat casualty evacuation operation in U.S. military history and marked the first time the Navy evacuated more casualties by air than sea. Unsung heroes in this campaign, the Navy flight nurses, now using larger R5D which could accommodate up to sixty patient litters, helped evacuate some 11,771 to Guam. By comparison, the Navy evacuated some 11,732 casualties by APA, LST, and hospital ship. It could take a ship eight to ten days to transport casualties from Okinawa to Guam; whereas an R5D took about eight hours.
After Okinawa, many of the flight nurses were used to repatriate Prisoners of War from the Philippines to Guam. A few who stayed in service years after the war participated in the Berlin Airlift in 1948-1949. Owing to a longstanding ban on marriage that was renewed after the war, the choice of service and family was not possible for flight nurses and most left the Navy.
Today, the story of the brave women of Iwo Jima and Okinawa remains a footnote in most histories of military nursing; they never achieved any medals for their service let alone much notoriety. Then again, most would say that they were just happy doing their jobs. As Ens. Jane Kendeigh remarked about the role of flight nurses in World War II: “our rewards are wan smiles, a slow nod of appreciation, a gesture, a word—accolades greater, more heart-warming than any medal.”
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