NSA Station Hospital, Da Nanag: A Personal History - Part 3
By Jim Chaffee
After I left, I buried my personal experience, studying mathematics, then working in industry. It was a number of years before I really learned about where I had been and its mission. After three decades ignoring my past, I decided I needed to go back. I searched the web and wrote organizations, but didn't get any information. It seemed the place had been forgotten. Then one day I got a hit; I found the abstract of a paper written by some Navy physicians about a study done at the hospital and wrote for a copy of the paper.
Between January 68 and June 68, a study followed wounded patients from initial resuscitation through final disposition. Part of this study took place during my own triage service. The study was shelved for decades. Published in March, 1988, in Military Medicine, the paper is entitled Naval Support Activity Hospital, Danang, Combat Casualty Study. The authors were Capt. B. G. McCaughey, MC USN, J. Garrick, MD, L. C. Carey, MD, and J. B. Kelley, BA. It had remained in archive at the Naval Medical Research Institute for twenty years, though Dr. Garrick did analyze the data initially and described the results in a lecture in 1969.
The paper backs up my memory of the personnel staffing the triage-surgical theater. There were three anesthesiologists, and only two nurse anesthetists, and as I told the former Army nurse, those two nurses did not work the triage. In fact, on the rare occasion when there was a particularly difficult intubation to be performed (as on one occasion when a child blew open his mouth chewing a blasting cap), an anesthesiologist handled it, but usually a corpsmen performed the intubation.
The statistics from the study make for interesting comparison. According to The Vietnam War Almanac, by Harry G. Summers, a former Army Infantry Colonel, the mortality rate for wounded Army personnel was nearly .036, while for Marines it was about .028. The NSAH study indicates that the mortality rate at the hospital was about .021, a significant improvement. Even if one includes the number considered DOA at NSAH, the figures are about .027. Of course, many factors affect these figures, only one of which is emergency unit effectiveness, but the fact that the Marine Corps bore the brunt of the fighting in the I Corps, where the enemy was better equipped and trained than in other sectors, seems to indicate to me that the Navy corpsmen and physicians who served as medical personnel for the Marine Corps offered better service for their wounded.
A few comments in the study make these numbers even more impressive. "The types of casualties sent to NSAH were not representative of all those occurring in Vietnam, because the NSAH was staffed by a larger variety of specialists and thus more capable of handling difficult medical problems." When I talk to Marines who served in the area from Chu Lai to Hue, including all the hill country around Da Nang and such hot spots as An Hoa, many of them remark on the NSA Hospital, particularly those who were wounded. I recall a retired Gunny who had spent time with the MPs who provided security for the hospital saying it was the best emergency hospital in the world at the time. He was probably right. Staffed with experienced and senior medical personnel, the hospital mission was to handle the most difficult cases.
As with most of the hospitals in Vietnam, the bulk of the casualties came directly out of the field without first passing through aid stations. The helicopter made this possible, and it saved an incredible number of lives by shortening the time between being wounded and receiving care. This was also noted in the study: "Combat casualties were generally taken to NSAH via helicopter and without primary definitive care." This can explain how the number of Marine Corps KIA in Vietnam was so much smaller than for the Marines in WWII, even though the number of wounded was comparable. In WWII, transit time was generally 6 to 12 hours, while in Vietnam it was more like 2 to 4 hours.
The study does mention that the mean transit time was about 5 hours, suggesting that there were large outliers affecting this average. The authors wonder whether it might be the result of transfer of casualties from other units, but my experience is closer to that of Doctor Garrick, who recalls the difficulty of getting choppers into hot areas, particularly at night. The Marine Corps was using CH-46s, much larger and slower than the Army's Hueys, which were more effective at getting into tight spots. I recall getting huge loads of casualties on ‘46s who had clearly been lying in the field for some time, covered with mud and leaches, often dragged out of inaccessible areas on ponchos and carried on stretchers fashioned from bamboo poles and ponchos. These men were outside the norm of the transit time of 2 to 4 hours because of the vicissitudes of combat.Medevac Photos
This article showed me clearly what I had known intuitively all those years: NSA Hospital was a special field hospital, staffed with specialists and stocked with all the medical supplies required to be a modern emergency hospital. The spirit of the place was dedicated and proud. We would have been hard pressed to provide better service to our wounded.
Two return trips to Vietnam within the last few years, along with discussions with former Marines on the internet, by phone, and in person, have helped me rediscover the special unit where I served, and also perhaps a bit about myself.
It's easy to find the former hospital site. Before you get to the Marble Mountains heading south, you pass a pagoda set back off the road, hidden by trees. This is the Khuy Bach Pagoda, part of the Bac My An Village. The village consists of the My Da, My Thi and Daman Hamlets. The Daman Hamlet was on the hospital's rear perimeter, and the Khuy Bach Pagoda was on its northern perimeter.Khue Bach Pagoda Photos
The village has since spread over the whole area where the hospital once stood. The pagoda sat just outside the concertina, as did the hamlet, and when I first arrived at the hospital there was a little foot path running along the concertina to the hamlet. Later it became more of a dirt road. Now it is paved. Facing the road and the old hospital grounds is a large red building, a museum to what was called Secret Area K20. That was the Viet Cong code name for the Bac My An Village, an active area of Viet Cong resistance. Inside the museum is a model of the area, showing the tunnels by the river where VC hid.
The former Marine Gunny on security for the hospital told me that they knew about the activities of the village. It is no surprise, since inside the museum is a map detailing the October 1965 attack on MAG-16 in which the hospital was also overrun. However, there is no indication of the hospital on either the map or the model.
Nonetheless, two old pictures of the Pagoda, taken from the hospital grounds, hang under the gaze of a statue of Ho Chi Minh. I donated them to the museum on my first trip back. The curator of the museum was excited by my old pictures, as they had none from that period. I also spoke to villagers who remembered the hospital and, in one case, had worked there.
NSA's withdrawal from the area began in May, 1969, with the goal of handing over its extensive facilities to the Vietnamese military. The hospital was completely turned over to Vietnamese Army control in May 1970, about a year after I left. I learned from the curator of the K20 Museum that it was dismantled some time after that, when the Army pulled out of the area. You can still see parts of the hospital in the old part of the hamlet: gate posts of felled telephone poles, cut in half, and concrete walkways cut up into paving stones.