The first helicopter medical evacuations came years before they became common in Korea:
For a six-week period in the summer of 1945 as fighting raged between American and Japanese forces on the island of Luzon in the Philippines, six helicopter pilots flew the first rotary-wing medical evacuations under enemy fire in history. Although the helicopter had been used in combat in the Burmese theater of operations in April 1944, the Luzon airlift was first to take place under enemy fire. And here’s the really crazy part of the story — the six American pilots were there not for medevac flights, but for repair and supply work!
Project Ivory Soap began as concept to use Army-owned supply ships as floating repair depots that could move with the US forces during the Pacific island-hopping campaign. Early in the campaign, it could take weeks, even months, for replacement parts to arrive at front-line units from the United States. Under Project Ivory Soap, USAAF aircraft could be turned around more quickly with the floating depot ships nearby. By December 1943, the program had evolved into using six Liberty ships and eighteen smaller vessels. The ships had helipads constructed on them so that Sikorsky R-4s could shuttle between the ships and airfields ashore with critical parts.
In June 1945 the campaign to liberate the Philippines from Japanese occupation was underway and three of the Liberty ships were deployed to Luzon with the Fifth Air Force while the other three Liberty ships were deployed to the Marianas to support B-29 Superfortress operations with the Twentieth Air Force. On 15 June, R-4 pilot Louis Carle received a request to pick up two soldiers with head injuries 35 miles east of Manila. With only 25 hours of helicopter time and no medical training, Carle arrived at the designated spot but they couldn’t locate the two soldiers needing evacuation. Men at the scene who greeted Carle had him fly out a platoon leader with a hip injury instead but they couldn’t fit the stretcher into the R-4. Carle ended up removing the other seat and laying the injured soldier on the floor.
News traveled throughout the area of the successful helicopter evacuation and soon Carle and the other pilots of the repair ships were getting requests for additional medevac flights. Given the primitive state of helicopter technology of the day, the flights into combat zones were grueling and often the six pilots were flying as many as six to seven medevac missions a day. Often the pick up points were near front line areas and the helicopters were attractive targets to Japanese units. Mortar and artillery rounds often impacted near the landing zones as well, and adding to the stresses, the pilots were the only crew aboard and they had to load the injured, make sure they were secured, and then fly their flimsy machines out of the combat zone to a field hospital near Manila. As the American forces pushed into the highlands of Luzon, performance of the R-4 and later R-6 helicopters suffered and often Carle and his men had to overspeed the piston engines to get enough rotor lift to get airborne, all while avoiding enemy gunfire.
Carle and another pilot survived crashes of their respective R-4s after ten days. Both men were escorted out of the jungle highlands by appreciative Army units.