The Medical Plan for the Fifth Army in Bangladesh – The Experience of Madhurya in the Chittagong Hill Tracts

Major General (Retd) Sujan Singh Uban  AVSM, the former Inspector General of Special Frontier Force published a book that is titled ‘The Phantoms of Chittagong: The Fifth Army in Bangladesh’. He narrated the story about his  Special Frontier Force that liberated the Chittagong Hill Tracts during the India-Pakistan War of 1971. He did not discuss the Medical Plan for the evacuation of battle casualties.

THE ORGANIZATION OF MEDICAL SUPPORT IN THE BATTLEFIELD:

Each Unit or Regiment of the Armed Forces operating in the Field have to initially take care of their wounded soldiers at the Front Line of real combat. Units in the Field often set up a Regimental Aid Post (RAP) to give medical support. The Army Medical Corps positions its staff which includes Ambulance Assistants, Nursing Assistants, and Medical Officers who give this morale-boosting blanket of comfort. However, the medical resources that are available at RAP are very limited. Because of the distances, time, and practical difficulties involved, the battle casualties are evacuated from the forward-most line of contact to the nearest Field Hospital of the field formation/Division by positioning Staging Posts along the Chain of Medical Evacuation. A Staging Post that is often used is known as the Advanced Dressing Station (ADS) which supports the regimental Units of a brigade. At the ADS, the battle casualty could be resuscitated by intravenous fluids. Apart from resources like stretchers and blankets, the ADS can deploy ambulances to speedily evacuate wounded men to a Field Hospital or another intermediate Medical Staging Post. 

THE MEDICAL PLAN FOR THE FIFTH ARMY IN BANGLADESH:

The Fifth Army was tasked to operate independently with very limited logistical support. During the initial phases of the military operation in the Chittagong Hill Tracts, the men had operated on foot, on a ‘Man-Pack’ basis in roadless forests. A military Field Hospital with a Surgical Team was established at Lungleh or Lunglei in the Mizo Hills. Between the battle field and the Hospital, there were no Medical Staging Posts along the route of Casualty Evacuation. The Fifth Army did not set up any Advanced Dressing Stations. The Medical Plan was to initially provide medical support at any place selected by the Battalion in the Field and to directly evacuate the casualty to Lungleh by using helicopters. It was indeed a simple plan. None of us including my Battalion Commander Colonel B K Narayan, Brigadier T S Oberoi, the field Commander of this task Force, and his Chief of Staff Colonel Iqbal Singh had ever imagined that there could be a big surprise in the execution of this straight forward Medical Evacuation Plan.

A SHOCKING SURPRISE AND A COURAGEOUS RESPONSE:

The first attack on the enemy position was made by the men led by Major Savender Singh Negi and Major G B Velankar of my South Column Unit which was Commanded by Lieutenant Colonel B K Narayan of the Regiment of Artillery, the first Gunner Officer to Command and participate in an Infantry style assault in the conduct of military action. Another Gunner Officer of the Regiment of Artillery, Lieutenant Colonel Krishan Lal Vasudeva Commanded the Central Column Unit of this Operation . Later, both the Company Commanders of my South Column Unit received the Gallantry Awards of Vir Chakra for the courage displayed by them. In the India-Pakistan War of 1971, these two Officers were the first  decorated apart from Major Raj Kumar Malhotra 4 PARA who was with the North Column Unit under the Command of Lieutenant Colonel Prasanta Coomar Purkayastha of Garhwal Rifles. As this successful attack of South Column Unit was concluding, my Unit Commander was informed that an airlift of battle casualties was not possible due to tactical and working difficulties as at that time the Prime Minister of India did not specifically sanction the entry of Indian aircraft into the Pakistani airspace. A helicopter flight to the enemy post that we captured was not possible on that day. Most of the enemy defenders of the post that we attacked had escaped into the forest. The enemy could regroup and launch a counterattack to retake their lost position. Our men without wasting any time had taken up the defensive positions and were ready to fight if the enemy wanted to retake the post.

The use of helicopter airlift for air medical evacuation was vital to ensure the success of our military expedition. The men reacted to the news with a sense of utter disbelief. We were inside the enemy territory without stretchers, blankets and equipment for the proper conduct of ground medical evacuation. The nearest Border Security Force (BSF) outpost on the Indian border was over forty miles away. This BSF Post had a secure helipad. The challenge we had faced was to carry our battle casualties across a difficult terrain and to keep them alive until they could get to the helipad. None of the wounded were in a condition to walk on their own. All of them needed transportation as lying patients in stretchers. The Unit had not come ready to use any of its men as Stretcher Bearers. Each man had an assigned role in his own Platoon/Company. I willingly accepted to respond to this challenge and assume the responsibility to safely evacuate my patients and go with them on a foot journey to the BSF Post. The morale of the men got instantly boosted up. Pointing towards the stands of Bamboo, I suggested to the men that we could make our own improvised stretchers. It was a pleasure to watch these smart and talented men who went into action and the stretchers were assembled and ready for use in a short time. I did not get a chance to offer any guidance about how to prepare an improvised stretcher. They had entirely acted on their own.

THE MEDICAL EVACUATION – A MEMORABLE FOOT JOURNEY:

My South Column Unit Commander Lieutenant Colonel B K Narayan had to make a very difficult decision. He had to spare his fighting men for performing the duty of stretcher bearers. He assembled a party of about sixty or sixty-five men to lift and carry the stretchers and to defend the party. Stretcher bearing is a difficult task. A Bangla Muslim refugee was given to us as a guide. He did not depute any of the Infantry Officers to go with us on this tedious mission. I did not make any such demand. My medical staff, the AMC Nursing Assistants were distributed to different Companies and I wanted them to stay at their posts as the situation on the ground was still unpredictable. Hence, I was the only Army Medical Corps medical support person in this entire party proceeding on a foot journey to the BSF Post at Bonapansuria in Mizo Hills. After marching for over three hours, the nightfall and darkness obscured our path and we could not move any further. We decided to halt for the night on that jungle track. The men took turns to stay awake and remained vigilant. I kept a close watch on the condition of my patients, provided comfort and assurance and encouraged them to keep drinking small amounts of water to keep them hydrated and to prevent shock associated with blood loss due to injuries. I administered the water and medications (broad spectrum antibiotic pills to prevent wound infection and Injection Tubonic Morphia to relieve pain), checked and applied dressings and bandages as needed. We were concerned about the Mizo rebel activity in those forests. Fortunately, we spent the night without any untoward incident. We continued our march early morning before the sunrise and finally reached a stream that marks the boundary between the Indian Mizo Hills and the Chittagong Hill Tracts. The water level in the stream was low. We waded through knee level water with our stretchers. The BSF Post police personnel at Bonapansuria were delighted to receive us. They had rejoiced because of our recent victory and for capturing the enemy post. The staff at the Bonapansuria BSF Post were among the first group of Indians who knew about our military expedition and its success in the Chittagong Hill Tracts. The helicopter had soon arrived at that BSF Post to further transport my patients to the Field Hospital in Lungleh. All of my patients survived this prolonged ordeal. They remained calm and hopeful during the entire trip. I only used the very basic principles of Medicine and Resuscitation to give support to my patients. I had arrested bleeding, prevented further blood loss, provided relief from pain, and kept them well-hydrated. My physical presence provided them with a sense of reassurance that they needed. I was their doctor, their nurse, and their medical attendant during our march. This was a memorable, one of its kind medical evacuation story in the history of the Indian Army Medical Corps. If I had shown a sense of resolve, determination, and confidence, it was because of  all these wonderful people acting as my eyewitnesses. I was performing in front of their eyes. They had absolute trust in my abilities. My patients not only survived but also cheerfully provided a telling testimony to others who had visited them at the Field Hospital in Lungleh. That was the Force/Energy/Power of ‘Krupa’ that had lifted us and carried us through this difficult medical mission. 

THE EXPERIENCE OF ‘MADHURYA’ (SWEETNESS) AND A CHAKMA EYEWITNESS:

The hand that bestows ‘KRUPA’ would not be seen. I describe ‘KRUPA’ as a Force/Energy/Power. The recipient of ‘KRUPA’ would only experience ‘MADHURYA’ or a sense of Sweetness. At the conclusion of our medical mission, we were not feeling tired. We were simply filled with JOY. We were ready to walk back immediately and rejoin the Unit in the Chittagong Hill Tracts. We started back, briskly walking through the forest without any breaks. Due to security concerns, we did not bunch up as a single group. The men remained vigilant with their loaded weapons and were fully ready to engage any enemy. During that return trip through the forest, to my utter surprise, a young Chakma male appeared before me, apparently from nowhere. The Bangla Muslim refugee guide who was walking slightly ahead of me had stopped. The Chakma tribe speak a Bengali dialect. He spoke to the Bangla guide and could communicate that he needed my help. His father was bedridden and was in great pain. I was totally shocked to know that this unknown Chakma living in the middle of a forest had correctly identified me as a doctor of medicine. At that moment, I just looked like any other soldier. My Olive Green uniform was crumpled and dirty. I was in the same clothes for more than seven days both day and night. I had not changed my socks. I had no shower and I had not shaved. This Chakma youth had not bothered to stop other men who were in my party hurriedly walking. He had not only approached me, but also he had a very specific reason for stopping me. For he had correctly known my identity, I guess that he had actually observed me while I was at work. He was my silent eyewitness. He knew the trip we made through the forest on the previous day. He had quietly observed while I nursed and treated my patients. I did not want to refuse his request for help for he had correctly identified me . I was a known stranger. I was not a soldier running through the forest. The Chakma had eyes that could see. He correctly comprehended my trade and understood that I help people who are in pain. When our party was returning, he decided to make use of that opportunity to seek my help. He did not treat me as a threat to his existence but as someone who could help his existence. I agreed to go with him to his house. I was shocked when he pointed his house to me. He lives in a tree house which was hidden from our view when we walked on the track near the house. He dropped a ladder for my use. I asked my Bangla Guide to stay on the ground. My escort party of armed men were not alerted and they stayed at about twenty feet distance from that tree and had no clue about my sudden disappearance. I did not want the Chakma family to feel intimidated by our presence in their area. I climbed up and entered the living room to find a Chakma man, the father of this young man who had stopped me. He was lying on the floor and was in pain. He had an ear infection which was giving him a terrible pain. I dried up the ear discharge and showed him  the importance of keeping the ear dry by using the cotton swab sticks that I provided him. I instilled antibiotic ear drops and showed him the way to instill ear drops after gently drying any discharge. I had a tube full of antibiotic pills. I also gave him pills for his pain and a supply of multivitamin pills. All of these pills come in different colors. I could instruct him in the use of the  pills that I dispensed. I personally administered the pills and he felt better with my brief visit and intervention. I climbed down the ladder to rejoin my Bangla Guide and the escort party and we made a safe return trip to our Unit location.

THE FORCE, ENERGY, AND POWER OF ‘KRUPA’:

During this entire foot journey of over eighty miles, I had no sense of tiredness or physical fatigue. I had no sense of resentment or bitterness for making this trip which was not included in our initial Medical Plan for Casualty Evacuation. I did not experience even a trace of fear about my personal safety or wellbeing. The experience of ‘MADHURYA’ was such; I was not irritated when a Chakma man had suddenly stopped me. I gave him no excuses. I entered the stranger’s house without my personal weapon and without any concern about my personal security. I provided him the medicines he needed for his recovery.

The young Chakma man displayed courage in approaching me and stopping me while I was in the company of a  large group of armed men. The previous day he had apparently watched us silently as we journeyed through the forest. He had overcome that sense of fear that forced him to stay mute. He was able to communicate with a stranger who does not belong to his Land or Community. On my part, I had no desire and had no initiative that could have let me climb a tree and enter a treehouse. Just like a physically handicapped person would have declined the challenge of climbing a tree, I would not have exercised my physical ability in climbing a tree and taking the risk of entering an unknown dwelling. The Chakma did not use a threat or coerce me in any way. My actions were directed by a higher Force which dispelled any concerns about personal security.

If I had crossed  and jumped over a physical barrier, I should attribute that action to an external Power that lifted me from the ground. I simply acted in obedience to a higher Force or Energy and not according to my personal will and choice. I was propelled by an external Force of compassion to serve an unknown person who was confined to his treehouse.

I do not seek any personal credit or recognition for rendering medical help to an unknown forest dweller. I did not discuss the findings of my house visit with my Bangla guide or with the rest of the soldiers who were waiting for me. I did not describe this incident to my Unit Commander and to other Officers upon joining them. We just got busy with preparations for our next move to accomplish the goals of our military expedition to the Chittagong Hill Tracts.

I am describing this incident and making an effort to put this incident into Public Record to recognize ‘KRUPA’ as an external Force that changes the human behavior and actions. We respond to its Energy and act in obedience to its Power. The Force of ‘KRUPA’ changes the course of our physical life. ‘KRUPA’ empowers the human mind and propels our life’s journey in a new direction.

In the Armed Forces, the Code of Conduct demands that its members should greet and ‘SALUTE’ a Superior Officer. I ‘SALUTE’ that Superior Power of ‘KRUPA’ for I recognize its ability to control my physical movements and actions.

WHO HAS EVER SEEN THE ‘HAND OF KRUPA’ ?

When we speak about Lord’s Compassion and Mercy and when we seek His Grace to protect our existence, do we ever get a chance to actually see the ‘HAND OF KRUPA’ which might deliver us the uplifting feeling?

This Chakma man was sick and was suffering with pain even before Indian Army attacked the enemy post in the Chittagong Hill Tracts. He was confined to his treehouse unknown to any of us. He had no chance of getting any help from the external world. We carefully planned to avoid any direct contact with Chakma tribal, forest dwellers and other civilian noncombatants during the course of our military expedition. We planned to directly attack the enemy positions and help the Bangla Muslim refugees to return to their homes which were at a much farther distance in fully inhabited areas. This foot journey for medical evacuation was a total surprise and was not planned. I wonder if the Chakma patient prayed for the medical intervention that had happened. If the helicopter had arrived to provide airlift, I would have never made that journey. Did the prayer of the Chakma patient had the power to stop the helicopter arriving for the battlefield casualty evacuation? The next day, a helicopter flight  landed at that particular enemy post without any problem and an Officer who was posted to our Unit arrived to report for his duty.  

Dr. R. Rudra Narasimham, B.Sc., M.B.B.S.,

Service Number. MS-8466 Rank. Captain AMC/SSC 

Medical Officer South Column Operation Eagle 1971

Headquarters Establishment No. 22  C/O  56  A.P.O.