Air ambulance more than a life saver.

Aerial medical evacuation and emergency services in hazardous terrain rank among the key Army National Guard contributions to U.S. military operations in Afghanistan, officials said.

A case in point is the 126th Medical Company (Air Ambulance) of the California National Guard, which received a preliminary alert on Christmas Day 2002, and mobilized for operations in Afghanistan in January 2003.

The 126th flew two brand-new Sikorsky HH-60L medical evacuation Black Hawks. Company commander Maj. Bruce Balzano said he received only about 12 hours of training in the "glass cockpit" Black Hawk before his deployment.

The Medevac HH-60Ls come with multifunction displays and other advanced hardware. But the downside to employing the new helicopter is that spare parts are hard to come by.

"If one of those broke, we didn't have one on the shelf," recalled Balzano. "But the program manager did a good job of feeding those to us. We never had downtime because we didn't have a part."

The Medevac unit departed for Afghanistan with 41 people and six Black Hawks-two UH-60As, two new UH-60Ls, and the advanced HH-60Ls. Detachments ultimately based at Bagram, Kandahar and the Forward Operating Base Salerno covered the entire country with just two pilots, one crew chief and one medic per aircraft.

"Our biggest contribution over there was our medics," said Balzano. All medics in the 126th are qualified civilian emergency medical technicians. "The wounded we treated got care far above that available from the active units."

The 126th flew 153 medevac missions during its six-month deployment--about one pickup per flyable weather day in Afghanistan. That included several pickups under fire. The air ambulance also transferred patients, performed medical re-supply and repositioned medical personnel. A single medevac Black Hawk in mixed formations of Chinooks, Black Hawks and Apaches provided medical care in the area before troops hit the ground.

Each of the six helicopters of the 126th accumulated about 150 flight hours per month, three times their peacetime operational tempo. Readiness rates were above 90 percent, thanks to ample spares. "We didn't get the right uniforms for the first three months we were there, but fortunately they had an aviation supply center with almost anything we needed," noted Balzano.

Pilots of the 126th flew more than twice their usual hours per month in dusty high-and-hot conditions that taxed helicopters severely. Base altitude in Afghanistan is 5,000 feet above sea level. "It just gets worse from there," said Balzano.

The unit was lucky to have several pilots who graduated from the Colorado high-altitude training school. The California unit, which makes a dozen rescues a year in the Sierra Nevada mountains; also was experienced in high-altitude flying. "Being on duty every day for that period was kind of tough, in that environment," said Balzano.

The company commander flew 10.5 hours in one day. Around-the-clock operations in Afghanistan have led the 126th to require all aircrew be fully qualified on night-vision goggles. Active units are required to maintain full NVG qualification for just 25 percent of their pilots.