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Authors: Tom Mangold

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While the fearful destruction of Operation Cedar Falls devastated the landscape above ground, below in the tunnels Viet Cong surgeons operated against the clock to save Vietnamese lives. One of them became a legend and a national hero. This is his story.

Dr Vo Hoang Le was one of the most remarkable men to emerge from the Vietnam War on the Communist side. From 1967 on he was chief of the medical section of the Viet Cong's Military Region IV, which covered Cu Chi and the Iron Triangle. He ran the makeshift hospitals in underground tunnels that treated the influx of wounded Viet Cong after the most devastating battles, and was himself a front-line surgeon, expertly improvising surgical techniques in the most hostile conditions of war and shortage. He performed brain surgery with a mechanic's drill, and amputations without the use of anesthetics. He was grievously wounded in the chest, and lost half of his right hand. Today, the colonel-doctor heads the military hospital in Ho Chi Minh City. A square-jawed, open-faced man, he talks with animation and candor rare among the higher echelons of Vietnam's Communists. He is a Hero of the Revolution and an admired and respected figure; he can hold a
roomful of seasoned Viet Cong veterans spellbound by his experiences.

He was born in the Mekong delta province of Ben Tre in 1933, one of eleven children, of whom four would die in the war. His father was a Viet Minh fighter who was caught and executed by the French authorities. The young Le was first a messenger and then a courier with the Viet Minh. After their success in 1954, Viet Minh in the South—including Le and his brother—“regrouped” to North Vietnam. Their mother was imprisoned by the Diem regime as a former resistance member, was tortured, and died two years after her release in 1962. In North Vietnam, Le was trained as a guerrilla medic. He returned to the South in 1961. He met his wife, also a Communist, in the Iron Triangle, and married her on 3 November 1962, at a ceremony consisting of just a public declaration. Nguyen Thi Tham was from Saigon and had qualified as a pharmacist. They stayed together for one week; then she was reassigned to do espionage and subversion work for the NLF in Saigon. They were reunited in 1963 when the Saigon secret organization was broken up. They had four children in all; two of them were born in the jungle and later killed by shells and bombing.

Le qualified as a doctor without a formal education. In the Viet Cong he became a “physician's assistant,” picking up what he could from the surgeons he worked beside. “I learned from doctors, from friends, and from books,” he said. “For example, I had a friend who was expert on abdomens, and I went to discuss the subject and practice with him. Our school was everywhere: in the tunnels, in the forests, beside a patient's bed.” In the words of Dr Bruce Mazat, medical intelligence officer for the U.S. Army in Saigon in 1969, Le was an “on-the-job-trained doctor.” The first injection he ever gave was to a senior officer who was to command all the Viet Cong, General Tran Van Tra. He encouraged Le to continue his training. Le spent more time studying in the North and became a Bac Si, or MD, in 1966. He was assigned to rejoin the medical section of Military Region IV at a recovery hospital in Ben Cat district, just north of the Iron Triangle, code-named C4. He arrived just in time for Operation Cedar Falls.

The tunnel hospitals in which Dr Le worked astonished the Americans whenever they discovered them. Sergeant Bill Wilson was the tunnel rat of Company B, the 2nd/28th Infantry, the
Black Lions. He used to put a sweatband round his head, take a switchblade stiletto and his company commander's revolver, and go down into the earthy darkness alone. In April 1967 his battalion took part in Operation Lam Son (meaning pacification) '67, a sweep south of Phu Loi and only nine miles north of Saigon itself. At Lai Thieu they found a tunnel entrance. “I struck my flashlight in there and saw a big room about eight feet high, piled with linen. There was a doorway the other side, and there was a long corridor, approximately three hundred yards long, with beds down the side of it, with these rolled-open mattresses. It was a vast underground hospital. At the far end I could see candles burning. There were operating rooms. We found all kinds of medicine: medicine donated by the Quakers in Pennsylvania; most of the supplies and medication were French. There were two operating rooms down there with oxygen tanks.” One operating theater was, he noticed, ventilated by an ingenious air hole with a candle positioned at its base. This had the effect of sucking the hot stale air up into the shaft. Seriously wounded Viet Cong were lowered onto the operating table by a primitive elevator, a door-shaped board that was lowered fifteen feet down from the surface to slide the patient onto the table. Wilson noticed canvas bags containing parts of human bodies. In all, he found eight hospital wards underground. It was one of a succession of underground hospitals that the tunnel rats discovered over the years in Vietnam.

Typically, there were two kinds of Viet Cong hospital. One was a forward aid station near the battlefield for emergency treatment, sometimes called a dispensary. It was normally located in a tunnel complex and manned by a semiqualified physician's assistant, nurses, and male aides. The full-scale regimental or district hospital would be back in a safer area, made up of bamboo-walled bunkers with camouflaged palm-leaf roofs, and with connecting tunnels and bomb shelters underground. There a surgeon would operate in a fully equipped theater with an assistant and an anesthetist. The aid station could accommodate about thirty patients, the hospital one hundred or more. As ever, Viet Cong medics stole their enemies' equipment or cannibalized their enemies' products whenever possible. The walls of their underground operating theaters were lined with parachute nylon. Surgical instruments were made with the metal from downed helicopters (tunnel rat Harold
Roper once found an aero-engine in a tunnel, in the process of disassembly). The plastic tube that coated the electric wire that detonated a claymore mine was used for blood transfusions, instead of polythene hoses.

Electric power, a constant problem in the tunnels, was supplied at best by Honda motorcycle engines used as generators, at worst by adapted bicycles. Such luxuries as X-ray machines were found only in the safest rear areas near Cambodia. For operations, surgeons wore gowns but had no rubber gloves. They wore lamps like miners' lamps on their heads. Their instruments were sterilized in pressure cookers. Like their American counterparts, when battle raged above them, they worked to the point of exhaustion to save lives. Vo Hoang Le performed more than eighty operations over three days and nights in the aftermath of Operation Cedar Falls, snatching a few minutes' sleep between each one.

The majority of Viet Cong who were wounded suffered fragment wounds from bombing or long-range artillery, and the majority of those wounded in the chest or abdomen died before receiving treatment. There were three reasons why so many guerrillas died of their wounds. One was the lack of any intravenous fluid on the battlefield, which resulted in deaths from bleeding and shock. The second was the length of time it took to carry a wounded man to the nearest aid station, in a hammock slung between the two ends of a pole borne by two men. Evacuation could take several hours, and this delay was often fatal to the seriously injured. The third was the minimal surgical care available at the tunnel aid station itself. The consoling fact was that nearly all the VC or NVA who did manage to get to hospital then survived.

Even at regimental hospitals there were few proper facilities for blood transfusion. Blood could not be kept without refrigerators, and these were a rarity, usually run on kerosene. Dr Vo Hoang Le invented his own system. “We managed to do blood transfusion,” he said, “by returning his own blood to the patient. For example, if a comrade had a belly wound and was bleeding, but his intestines were not punctured, we collected his blood, filtered it, put it in a bottle and returned it to his arteries; at the front we did blood transfusion like that. All our military medical staff had their blood groups checked. And we analyzed the blood of a patient who was brought to us. If I
happened to have the same blood group, I gave him my blood.”

The Viet Cong's tunnel hospitals did not just cater for the wounded. Malaria was the second largest cause of death and loss of effectiveness, the Viet Cong's chief medical problem after battlefield wounds. (The Americans suffered exactly the same problem.) The commonest strain of the mosquito-borne fever in Vietnam in 1969 was falciparum, which is resistant to the standard antimalarial drugs. Captured documents indicate that nearly half of any Viet Cong unit had malaria at any given time, and half of those would need treatment in the hospital. There they would rave and sweat in delirious agony until the fever abated. The political cadres were urgently instructed to enforce preventive measures, like the use of mosquito nets, antimalarial drugs when available, and insect repellents. Other frequent illnesses among the guerrillas were the inevitable results of their unsanitary existence in sewerlike underground holes: amoebic dysentery, fungal skin infections, such as eczema, and intestinal parasites. “Out of all the people we examined in the prisoner-of-war camps for Viet Cong and NVA,” said Dr Bruce Mazat, “where we had the ability to do stool sampling, we found one hundred percent of them had intestinal parasites of significance—hookworm, roundworm, tapeworm, that kind of stuff. These parasites actually suck blood from the intestine, and it's a very common cause of chronic anemia.” The Viet Cong Military Region IV's Medical Plan for 1966–67 said: “The crucial area in preventive medicine is in resolving problems regarding water and excrement.” The poor food supplies caused vitamin-deficiency diseases such as beriberi. Above all, the cycle of debility was compounded, as Dr Mazat observed, by a general anemia among Vietnamese men—a low red-blood-cell count with a consequent reduced capacity to carry oxygen to the body. This was caused by both the protein-deficient diet and malaria; it also made the onset of malaria more probable and undermined the body's ability to withstand the effects of shrapnel and bullet wounds.

The NLF prided itself on producing its own drugs, many—such as the antidote to the bite of the bamboo viper—based on ancient Oriental formulae and herbal remedies. But in practice the bulk of their medication was bought or stolen from South Vietnamese sources. Antibiotics like penicillin deteriorated
quickly when stored in tunnel or jungle caches. The NLF had great public-health responsibilities because of the number of villages and districts in which it was the sole effective authority; a large part of its medical organization was given over to providing clinics for the villagers in the countryside. But the medical section of Military Region IV existed only to serve the guerrillas in the front line. The section was created in 1963. Its area of responsibility covered the whole of Cu Chi and Ben Cat districts and northward into Tay Ninh province as far as Nui Ba Den mountain. Half of its members were female. By 1966 it had two full surgical teams (called C3 and C5), a pharmaceutical platoon (C6), a dental platoon, an administrative staff, and six more or less mobile forward aid-station teams (all called C, plus a number). Both surgical teams were located in Cu Chi district: C5 was at the Cu Chi district military hospital at the hamlet of Ho Bo, less than two kilometers from the Americans' Cu Chi base camp; C3 was at Phu My Hung, next to the Viet Cong military and political headquarters of Colonel Tran Hai Phung and Mai Chi Tho. Every single one of the medical section's vulnerable bases was hit during Operation Cedar Falls in January 1967.

Hospital C3 was damaged beyond repair in the softening-up B-52 bombing raids that preceded Cedar Falls. The chief surgeon was killed and his assistant, Dr Vo Van Chuyen, took charge. Dr Chuyen was a native of Cu Chi who had qualified in Hanoi and returned to the South in 1962. He ordered all the patients and equipment to be moved from Phu My Hung across the Saigon River to the recovery area called C4 in the Tranh Dien forest northwest of Ben Cat. Local people were coopted to carry the wounded in hammocks. The newly qualified Dr Vo Hoang Le had just been assigned to C4; his wife, Nguyen Thi Tham, belonged to pharmaceutical platoon C6, then located a few hundred yards to the south. There was a huge cache of medicines at C6. A new tunnel hospital was quickly established at C4. Dr Le took charge when Dr Chuyen returned to Cu Chi to try to pull together what remained of the medical services there.

On 9 January 1967, the 1st Battalion of the 28th Infantry, part of the Big Red One, was helicoptered into Ben Suc, two kilometers south of C6 and C4. It was the first time the Americans
had come into the area, and the Viet Cong knew that a sweep northward through the hitherto untouched sanctuary of the Thanh Dien forest was a probability. Although a doctor, Vo Hoang Le found himself the highest-ranking officer in the two medical units. They were supposedly noncombatant and had few weapons. The pharmacy team numbered seven, including Le's wife; their spider holes would be the first encountered by the Americans advancing northward. They had just four old K-44 Russian rifles, one carbine, and a Thompson submachine gun. Dr Le had his officer's .45 revolver. He called a meeting and discussed the options. C6 was a major medical storehouse and C4 contained sixty wounded patients. But the medics had never fought the Americans, and most of them favored prompt withdrawal. Dr Le had to persuade them otherwise.

“After organizing our fighting positions,” he recalled, “I called a meeting of all my staff members and we passed a resolution: The liberation fighters would not surrender. There was no alternative to fighting and dying. We could not let the enemy capture us.” Le was in a quandary. Other Viet Cong units had orders to save their lives and fighting capacity by melting away through the tunnels. Le saw his duty as primarily to his patients; naïvely, perhaps, he decided to try to defend them. Each member of the pharmacy squad was given a spider hole from which to snipe at the oncoming Americans. They settled down for the night with foreboding about the next day's battle. Dr Le remembered his feelings. “While packing up the unit's supplies of medicine, my wife and I opened a machine-gun case which contained our personal effects. We found a photograph of our only child, who had been looked after by my family since he had been born. We missed him very much. We had intended to go and see him after the B-52 raids ended; we did not realize the enemy was going to launch a big operation. After looking at our child's picture, my wife said that perhaps we would never see him again. But she comforted herself by saying that some of our comrades might survive the next day's battle, and would tell our son that his parents had fought courageously and sacrificed their lives. He would be proud to have had such parents.

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