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Tanisha Fazal on predicted US casualty patterns from war on the Korean Peninsula

Professor Spagat interviews Tanisha Fazal about a war-games-based projection of a high killed to injured ratio for war on the Korean Peninsula.
So now I’m here with Tanisha Fazal, and we’re going to talk about injuries. So you mentioned that you attended some interesting war games at the Air– Air War College. Air War College. Would you like to tell us about those? Sure. it was pretty intense. It was last fall, so in October of 2017. And I was invited to observe a series of simulations that were put on by the doctors, the military medical community of the Air Force.
And what they were concerned about was what would happen if a US airbase in South Korea was on the receiving end of what they call a face shot, so an airstrike or an artillery strike, by North Korean forces that, say, took out the runway and probably damaged some planes, some helicopters, and then, of course, there’d be a number of casualties, human casualties, on the base. And the reason, the overall reason that they were concerned about this is that part of the explanation for the dramatic increase in the United States wounded to killed ratio has been the ability to evacuate casualties via air rapidly.
And that’s actually now part of policy, where you don’t deploy people even beyond a perimeter whereby they couldn’t be evacuated within what’s called the first golden hour of injury. Because if you can give somebody higher level medical treatment within the first hour of injury, their odds of surviving go up. They just shoot right up. So the Air Force– this is a big part of their mission, especially in the military medical community. And so they’re trying to figure out, how would we deal with this problem if our ability to evacuate via air was compromised? So they put together a number of scenarios and they assembled a team, and I got to be kind of a fly on the wall.
And the kinds of questions, both medically and logistically and ethically that they’re going to have to deal with should this situation arise are, again, very intense. So for example, a military doctor on an air base in this kind of scenario would probably be told by her base commander that you have to prioritise people who are mission-essential, the people who can help repair the runway, repair the planes, fly the planes, et cetera, so as to defend the base from further attack.
But the probability is there’s at least some non-zero chance that the people who are most critically injured are not going to be the mission-essential people, and so the doctors are going to have to– It would seem to be a strong contradiction of– Of the Hippocratic oath. But this is part of the issue of being a doctor in war. There are a lot of really interesting ethical and moral tensions that they have to deal with. And some of the doctors in the room were saying I don’t have a problem with prioritising the mission-essential people because this is for the greater good.
But a lot of other people were so used to, in their own training, so used to being able to really prioritise the most severely injured people first that it was hard for them to reorient in that way. So that was one of the most interesting takeaways. But I think the other– stepping back from a broader perspective, the other interesting and important point to understand is that, should there be a new Korean War, US fatalities will go up, because we won’t be able to evacuate via air in the way that the US has been in Iraq and Afghanistan, where air superiority for the US has gone unchallenged. That’s really interesting. OK, well, thank you very much for a great interview.
I’m sure that my students will be very interested in this.

Tanisha had a remarkable opportunity to observe a US war gaming exercise aimed at illuminating likely casualty patterns for US military personnel in the event of war on the Korean Peninsula. The bottom line is that many US service personnel who might have been saved in Afghanistan and Iraq would die in Korea.

Watch the video to understand why.

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