OPINION | Winning "Hearts" and Minds : A New Challenge for the Indian Air Force

Technology is advancing by leaps and bounds, but there still would be occasions when human ingenuity and cooperation could help things along

By Group Captain (Retd.) Murli Menon 
Indian Air Force

An Indian Air Force medic provides emergency response on a mannequin patient during a U.S. Air Force medical demonstration as part of exercise Cope India 2009. (U.S. Air Force photo/Capt. Genieve David)

Image Attribute: An Indian Air Force medic provides emergency response on a mannequin patient during a U.S. Air Force medical demonstration as part of exercise Cope India 2009. (U.S. Air Force photo/Capt. Genieve David)

Sitting  far away from home shores as I do now, the heart aches to hear and read media rambles about the ongoing travails of the Indian Air Force (IAF) as a system, what with the shenanigans of the politico-bureaucratic nexus and the supposed wrongdoings and vulnerabilities of our equipment procurement processes. Be that as it may, perhaps  now is the time to refocus on the strengths of the service and how better it could serve the nation and its people in the years ahead. 

The existing IAF Doctrine does indeed talk of missions such as aid to civil power and casualty evacuation. Indeed recently we saw IAF choppers in action in Uttarakhand fighting forest fires, an altogether new role for the service. Many of us would recall the Timber Trail  rescue some years ago. Thus we constantly see evolving employability for the boys in blue, well beyond what is  initially envisaged by the nation  in the traditional ambit of things. 

Nothing, indeed nothing, is beyond the pale of possibility when one talks of employing national air power. Two recent events have contributed to this particular article, the first being an unplanned exposure this author had  to  the tremendous leaps taken by the Indian medical fraternity in handling highly advanced organ transplants, such as those of the heart, lungs, eyes, kidneys and other critical body parts. The civic consciousness and expertise in heart transplants especially are remarkable in cities like Chennai and Kochi, some excellent pioneering work having been done by some highly dedicated Doctor- support staff teams in these “ golden heart “ cities. 

The second contributing factor is with respect to what the Norwegian Air Force recently did, flying across a heart-lung machine, at supersonic speeds, to a patient 450 Kms away, cutting down on the critical time factor available, statedly to 25 minutes from several hours otherwise by road. Fortunately here the F-16 fighter had a convenient external hold to transport the equipment. For critical organs, the space required would be considerably lesser of course.Some older veterans would recall (though this example should only be taken as one to illustrate the availability of  space in  a fighter and not otherwise!) the considerable space even in a MiG-21 gun bay that was ingeniously exploited  by some occasionally to transport valuable cargo such as frozen pomfrets to parched palettes in the interior hinterland, from their fresh catchments in the Bay of Bengal! Newer machines such as the SU-30 would have much greater wherewithal in this context, with an additional cockpit to boot.

Time Criticality in Organ Transplants:

I learned from my recent experience at Chennai that a harvested human heart needs to be inside the recipient within three hours. There is a whole slew of other key activities that need to be gone through before a heart is transportable, such as cross-matching of the donor-receiver blood, assessment of receiver lung capacity to accept the heart , time frames to convey the organ from the donor ICU to the nearest airport etc. These other intangibles often lead to many a useful organ going abegging in our country. 

Also, currently, the radius of action for acquiring a donor organ is limited by the speed of the chartered aircraft, normally when a Beechcraft type or an even slower helicopter taken into account. Thus, for a heart transplant in Chennai, we could have donor hearts being brought in from origin cities like Mumbai or Hyderabad at best. But if we have a high-speed fighter jet at our service, like indeed demonstrated by the Norwegians, the envelope expands dramatically, perhaps even to areas such as Delhi, Calcutta or Ahmedabad. 

Of course, the harvesting drill would need honing by the concerned organizers so that no time is wasted. Another key aspect is that of cost. Presently only the affluent could afford a heart transplant in India. But should we be able to bring in IAF fighter / transport/ helicopter assets  into the equation, many a dire situation could be salvaged, especially for the underprivileged and marginalized sections of the society. 

The political and national goodwill that would accrue from such humanitarian efforts would be intangible and out of proportion to the manpower and other operating costs for the IAF. Needless to say, operational priorities would reign supreme, the medical mercy missions being undertaken only when they permit. It may be pertinent to mention that a heart transplant in Chennai costs INR 20 lacs today with an additional INR 10 lacs for the air charter. The figures in New York, for instance, are USD 2.6 million (approx. INR 20 Crore rupees) for the operation and a similar amount for post-operative care. For outsiders, there is near two-year wait period too, something which most patients would not have the luxury of. Besides, it has been established recently at international symposia that Indians are a reasonably homogeneous race as far as chances of organ rejection are concerned, as compared to the Americans or Europeans. Koreans and Japanese of course, are the best  for homogeneity.In every way, therefore, any Indian wishing to have a serious organ transplant procedure should only look at India.

Importance for Mercy Missions:

The IAF and the other two armed forces have been doing casualty evacuations of civilians and indeed several other goodwill – generating missions over the years, be it in medical exigencies or natural calamities such as earthquakes and floods. 

Recently the IAF used one of its Dornier aircraft to transport a donor heart for one of its airmen. If we could enlarge the scope of this endeavor by incorporating the fighter fleet, selectively of course as I have cautioned earlier, we would end up generating an amazing amount of goodwill for the services amongst our countrymen. 

After all the entire armed forces machinery belongs to the nation, relates to it social fabric-wise and how to employ it optimally during peace time would be dictated by national priorities, including such assistance in dire medical situations. Another key factor in making suggestions such as these routine are the involvement and readiness for organ donation amongst our citizens. I believe, a Malayalam movie on organ donation has a lot to do with changing the mindset of young Indians to this noble social contribution. We need to spread this awareness elsewhere in the country too. For example, in Chennai, the entire police force is involved in creating a “Green Corridor” to transfer the harvested organs posthaste from the airport to the hospital through mind-boggling traffic.

Conclusion:

We are getting increasingly globalized, by the day literally. In the developed world one sees an altogether nuanced approach of the establishment and civil society to social issues and Human Rights. It would surely take India a while to get there, but we should take heart as our Republic is still 66 years young and cannot be expected to react in social situations like a Norway or the USA. However, a video which I saw at a small Chennai hospital says it all .. “ We are soon going to be in a global visa –free regime. The HEART will be the visa”. 

Indian medical tourism has come of age and coupled with the immense cost differential between the West and us, makes India even more attractive as a destination to treat sophisticated medical ailments..every citizen has a role to play in enhancing this reputation even further. The armed forces medical establishment and organs such as the Air Force Wives Welfare Association (AFWWA) and the Army Wives Welfare Association (AWWA) need to be energized to address local requirements in organ transplants and  to coordinate with the operational staff and leadership. 

Along with our traditional “Athithi Devo Bhava” culture and our leapfrogging economy, our country would only get stronger in this field in the future. At Chennai one saw a tiny Siberian girl who had been sent by Vladamir Putin himself to find a young Indian heart! Pakistanis have been coming to India for a while now for the heart, kidneys, and eye transplants. My suggestion to rope in IAF’s fighter fleet to beat the time frame conundrum involved in major organ transplants should be seen in this light. 

Technology is advancing by leaps and bounds, but there still would be occasions when human ingenuity and cooperation could help things along. We are soon going into an era where in high-speed Unmanned Aerial Vehicles (UAVs) would be used to transport human organs across large distances. Some Chennai doctors are already working on this concept. Then again , can you imagine the diplomatic payoff, (sometime in a rosy future!) of an Indian heart being flown to Karachi or Dacca or Colombo in an IAF fighter to save a life in one of these countries? SAARC would have a new meaning altogether by thinking big and simultaneously extending necessary support to our surgeons and other medical professionals. This is the least the IAF could do to depicts it's humanitarian side and eventually winning "hearts" and "minds" in the true sense. 

About the Author:

Group Captain (Retd.) Murli Menon
Group Captain (Retd.) Murli Menon served in Indian Air Force for 32 years, transiting it tactical, operational, strategic and conceptual appointment spectra with credit. He was India’s Air Advisor to Indian High Commission at Islamabad, Pakistan (2000-2004). In his second avatar, he served for 8 years with India’s Cabinet Secretariat, including a stint as Consular at Ankara, Turkey from 2008-2011.       

He was one of the pioneers in the IAF’s Doctrine Think Tank – “Air War Strategy Cell” that produced India’s first Air Power Doctrine, the IAP 2000 in 1995. His interests include strategic studies and since post-retirement, he contributes to various think-tanks based out of New Delhi, India.

Cite this Article:

Menon, M. "OPINION | Winning "Hearts" and "Minds" : A New Challenge for the Indian Air Force " IndraStra Global 002, Issue No: 05, (2016) 0012,  http://www.indrastra.com/2016/04/OPINION-Does-India-Need-Offensive-Special-Forces-Air-Power-002-04-2016-0067.html, ISSN 2381-3652
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IndraStra Global: OPINION | Winning "Hearts" and Minds : A New Challenge for the Indian Air Force
OPINION | Winning "Hearts" and Minds : A New Challenge for the Indian Air Force
Technology is advancing by leaps and bounds, but there still would be occasions when human ingenuity and cooperation could help things along
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