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When the Naval Air Transport Service (NATS) R4D broke through the clouds of volcanic dust and smoke to land on Iwo Jima on 6 March 1945, it carried more than whole blood and medical supplies for the wounded. On board this flight was a 22-year old Navy nurse named Jane Kendeigh, marking the first time in history that a Navy flight nurse appeared on an active Pacific battlefield. Ens. 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 to 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 these physically and psychologically wounded warfighters, flight nurses served as the military equivalent of Dante’s Beatrice, appearing at a critical moment in their lives and escorting them from the pits of hell to the safety of forward operating hospitals. It’s little wonder why a special bond often developed between these patients and nurses.
By the time of the invasion of Iwo Jima, the concept of air evacuation was nothing new. On September 1, 1942, the joint-service South Pacific Combat Air Transport Command (SCAT) began using cargo planes to evacuate wounded servicemen during the Guadalcanal campaign. These missions were initially free of medical personnel until November 1942, when Navy pharmacists mates were added to 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, KY to offer specialized training for its flight nurses.
Owing to the need for flight nurses in the Pacific war, the Navy established its own School of Air Evacuation Casualties at Naval Air Station Alameda, Calif. 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. On December 10, 1944, the first class, consisting of 24 Navy nurses and 24 pharmacist’s mates, commenced. 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. Hallmark in the course was the intensive 18-hour "watermanship" training organized to simulate conditions of a water landing/crash scenario. The prospective flight nurses were required to swim under water, swim one-mile, and be able to tow victims 440-yards in 10 minutes.
Before the Navy Air Evacuation School at Alameda was placed in operation in December 1944, Navy nurses Lieutenants (junior grade) Dymphna Van Gorp and Stephany Kozak—both graduates of the Flight Nurse School at Bowman Field in 1943—were sent by the U.S. Navy to Rio de Janeiro, Brazil, to inaugurate an air evacuation course for the first nurses of the Brazilian Air Force. Throughout the year they would work with fellow instructors from the Brazilian Air Force teaching fundamentals of air evacuation nursing—e.g., how to triage patients, and positioning patients on the plane according to need for specialized nursing care. Students would undergo a host of swimming exercises and drills (e.g., ditching drills with life rafts) and desert, jungle and sea survival training.
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 74 trained flight nurses; almost all would be used for the next big challenge, perhaps the biggest of them all: Okinawa.
The Battle of Okinawa alone 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, would help evacuate some 11,771 to Guam.
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 would participate in the Berlin Airlift. 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 would remark about her service: "our rewards are wan smiles, a slow nod of appreciation, a gesture, a word—accolades greater, more heart-warming than any medal."