Major General (Retd) Sujan Singh Uban, PVSM, 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. In his book, he did not discuss the Medical Plan for the evacuation of battlefield casualties. He coined the phrase “The Fifth Army” to make the distinction between Special Frontier Force and the Indian Armed Forces. For all practical purposes, the Special Frontier Force operated with the same infantry weapons, ammunition, field gear, equipment, and supplies used by the US Army in the Vietnam War. We have not deployed field guns or artillery and had very limited airlift support. As such, Special Frontier Force is raised to engage the enemy with unconventional warfare and the men are not trained in the use of field guns. However, we have several Gunner Officers who adopt to the tactics of Special Frontier Force that doesn’t need their expertise in Artillery Warfare.
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. Fundamentally the battle was designed as a covert operation and hence the use of field guns was excluded. 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 battlefield casualties to Lunglei Field Hospital by using the two Mi-4 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 Battlefield 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 as the flight was not sanctioned by the Prime Minister. 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. In fact, the grumblings of the men were loud, clear, and specific. It was not a sign of mutiny or the lack of trust in the Unit Leadership. Their concern was about the change of the game plan while we were in the middle of the game. I heard the men explicitly saying that they would shoot down any helicopter if it were to be deployed for any other operational reason without meeting the purpose of the battlefield medical evacuation of the casualties. I was not surprised for the men are not directly commanded by the leaders employed by India. The men have their own leaders and their leaders are involved in the planning and the execution of the battle operations. 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 Mi-4 helicopter had soon arrived at that BSF Post to further transport my patients to the Field Hospital in Lunglei. 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 Lunglei. That was the unique, one of its own kind of battlefield medical evacuation of lying patients with only one medical support person.
THE EXPERIENCE OF ‘MADHURYA’ (SWEETNESS) AND A CHAKMA EYEWITNESS:
Once my patients got airlifted, I had the experience described in the Indian tradition as ‘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 prepared 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 did not bother 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 middle 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. 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 while he approached me to get my attention.
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.
Was I predestined to help the Chakma patient?
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 tribe 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? Most interestingly, in 1964 while I lived in Nizamabad, Andhra Pradesh, studying for my Bachelor of Science degree, I suffered from an acute middle ear infection which ruptured the eardrum, the tympanic membrane. Fortunately, the rupture healed with treatment. The ENT Specialist ( Ear, Nose, and Throat Surgeon) at Military Hospital, Secunderabad examined me during the Medical Board Examination to assess my Fitness in 1969. He could easily discover the healed eardrum and approved my fitness to serve in the Indian Army Medical Corps. It amazes me even now that I had to unexpectedly provide help to a total stranger who was experiencing a medical condition which I had already experienced in my personal life.
Dr. R. Rudra Narasimham, B.Sc., M.B.B.S.,
Service Number. MS-8466 Rank. Captain AMC/SSC
Medical Officer, South Column Unit, Operation Eagle 1971
Headquarters Establishment No. 22 C/O 56 A.P.O.