WW2 Air Combat Casualties
For many World War Two aviators, boyhood dreams of flying were made real in the seat of a fighter plane or a crew position on a heavy bomber. Many airmen saw warbirds as powerful yet submissive machines—super toys, really—which allowed men to escape the usual earthbound limitations of time and space. Since World War One, combat fliers had been revered for their courageous daring in the face of near constant death. As a result, most fliers, by necessity, treated the prospect of death with an attitude of cavalier indifference, each man attempting to out-story his peers regarding the narrowness of their combat escapes and dogfighting prowess. For some, however, the near constant stressors of combat brought about severe psychiatric debility, while the conditions associated with high altitude flight, flak and enemy fighter attacks exposed men to a multitude of medical conditions and potential injuries unique to air combat.
While the Eighth Air Force flying out of nearly 100 airbases in Great Britain was the largest bombing force in the European Theater of Operations, since all American airmen fighting in Europe faced the same medical consequences, this film relied on highly-detailed casualty records from the much smaller Fifteenth Air Force, who flew out of 21 airbases in southern Italy from September of 1943 to the end of the war.
For flights above 10,000 feet, airmen were required to wear oxygen masks to avoid anoxia; a potentially fatal lack of oxygen. From November 1, 1943 to May 25, 1945, 33 deaths from anoxia were reported by the Fifteenth, comprising 2.8 percent of all deaths listed as killed in action. Combined with the frigid temperatures airmen endured at altitude, 11 of these deaths were the result of frozen masks and oxygen systems.
A hidden killer, most airmen who suffered anoxia had no clue that their oxygen supply had given out on them until it was too late. Heavy bomber oxygen systems included a small ball-light valve in a transparent tube, which confirmed or denied the flow of oxygen into a given flier’s system, but under the chaotic stress of aerial combat, few men had the time or inclination to check the functionality of their oxygen supplies. Isolated and alone in the back of the plane, tail gunners were particularly susceptible to the dangers of anoxia.
An extreme example of anoxia occurred on a February mission in 1944, when four out of ten crewmen suffered life threatening episodes. At 27,000 feet, en route to the target, the ball turret gunner felt like he was not receiving a sufficient flow of oxygen, and after an examination of his system, he determined that his quick disconnect fitting on his hose had pulled out. Panic further hindered his ability to reconnect his hose, and he soon passed out from lack of oxygen. Five minutes later, when the navigator called over the intercom for an oxygen check, he received no response from the ball turret gunner, prompting him to order the left waist gunner to move forward for a physical check of his crewmate. Carrying a 30-minute walk-around oxygen bottle, he too passed out from a faulty connection. The radio operator, connected to the main O2 system by a long hose, went to the aid of his fallen crewmates, only to lose consciousness when his own line accidentally disconnected.
With three men down, the bombardier crawled aft with two A-4 walk-around bottles, accidentally dropping them out through the bomb bay when the doors were opened for the ship’s bomb run. He ran back to his built-in oxygen system, but lost consciousness before he could reconnect his mask. After the bombs were dropped, the pilot dove his Fortress down to 5,000 feet in an attempt to revive his fallen men. The copilot crawled aft during the twenty-minute descent, administering artificial respiration and emergency oxygen to the ball turret gunner, who had been off oxygen for the longest amount of time. The other three fliers revived spontaneously in the denser air, while the ball turret gunner finally came to after being unconscious for one hour and ten minutes. One study of 248 cases of aerial-induced anoxia revealed that 59 were the result of inadequate education, while 14 resulted from ground crew errors or equipment malfunction. The need for periodic oxygen checks by commissioned flight officers became a hard and fast rule on every heavy bomber mission throughout the course of the war.
In today’s world of pressurized cabins and shirt-sleeve comfort, it is sometimes hard to imagine the extreme discomforts for World War Two airmen at altitude. Given the rudimentary conditions aboard American-made heavy bombers during the war, questions arise about the absent competence or lack of human empathy exhibited by aircraft designers of the time. A solitary venture inside the interior of a B-17 or a B-24 reveals a bitterly harsh environment, devoid of seats or creature comforts of any sort. The skin of both planes was made of paper-thin aluminum, so thin that a screwdriver could easily punch through its aerodynamic veneer. Flying at altitudes absent of sustainable oxygen, bomber crews further contended with temperatures in the range of -40 to -70 degrees Fahrenheit, depending on altitude and the time of year. Uncloseable waist windows and drafty camera hatches exposed airmen to immediate frostbite when flesh was inappropriately exposed to the cold, resulting in 1,427 cases of frostbite in the Fifteenth during its tenure in Italy. After the Fifteenth’s formation, airmen were lectured about the dangers of attacking enemy aircraft, weather, midair collisions and flak, while little was said about the dangers of frostbite. In an early survey of 839 airmen at a combat crew replacement center, 83 percent admitted that they had not received adequate instruction on the prevention and treatment of frostbite at high altitudes.
Frostbite was soon discovered to be directly related to a given crewmembers assigned position in heavy bombers, particularly those most exposed to the elements. Waist gunners stood guard behind their .50 caliber machine guns, fighting off enemy aircraft in the face of frigid winds. Tail gunners removed canvas covers that reduced the speed and maneuverability of their guns, further exposing them to bitter cold. Flights up to eight hours forced airmen to urinate in their clothing, which quickly froze to their backs, buttocks and thighs. Ball turret gunner, George E. Moffat of the 482nd Bomb Group observed that, “By the time you reached your objective, you’re so miserably fed up you don’t particularly give a damn whether you ‘get it’ or not.”
When guns jammed in the heat of battle, men erroneously removed their gloves to clear the jam, only to have their flesh slough off when they tried to remove their fingers from the sub-zero metal. Electric gloves, boots and flight suits were employed to combat the problem, but the single series circuit technology frequently gave rise to “how did I freeze my right hand?” or “Why did my God damn left boot burn out?” For airmen in the throes of flak fatigue, men occasionally removed their gloves on purpose, effectively grounding them from combat duty while they convalesced in Fifteenth hospitals—a temporary reprieve from a fate possibly far worse.
Wounded airmen experienced a different kind of exposure risk, when they were forced to lay on frozen flight decks with blood freezing around their wounds. When flight suits were cut away in an effort to offer first aid, flesh froze almost immediately, despite the application of dressings or rarely-available blankets. Airmen were routinely hauled off heavy bombers with inflamed hands, feet and faces, hospitalized with wounds that first turned purple and then later a sloughing, necrotic black. One third of frostbite victims required hospitalization, while the remainder were grounded for upwards of two weeks of convalescence.
As a deterrent to frostbite, many airmen did not shave or wash their face before missions, leaving a protective buildup of oil on their skin. Lanolin and other greases were applied to potentially-exposed skin, while multiple layers of gloves and clothing were routinely employed under flight and flak suits. As the war progressed, frostbite and anoxia lectures increased to three to four times a week, and by June of 1944, the problem of inadequate indoctrination was virtually eliminated. Shutters were added to camera hatches, as well as waist window covers and improved heating systems on heavy bombers, making conditions at altitude tolerable yet still bitterly raw.
Another chronic health concern among bomber crews was aerotitis media, marked by a chronic inflammation of the middle ear caused by multiple descents from high altitude in a non-pressurized cabin. During the Fifteenth’s service in Italy, 40 airmen had to be permanently removed from flight duty due to severe recurrent aerotitis media, however, during the same period, a total of 2,958 cases were reported, with a resultant loss of 16,000-man days. Aerotitis media reached chronic proportions among bomber crews as the number of planes and aircrews reached its peak, accounting for two-thirds of all cases of airmen temporarily removed from combat duty.
During a 52-week period ending June 23, 1944, a total of 4,788 airmen were temporarily removed from flight duty because of aerotitis media, both in Eighth Air Force heavy bomber crews and Ninth Air Force medium bomber crews. In the study, the majority of aerotitis media cases befell heavy bomber crews, while lower incidence rates among fighter pilots further reflected the condition’s etiology, since fighter pilots remained at altitude for much shorter periods of time. One study of 51,944 crewmembers sent aloft during the month of September 1943, revealed a 39 percent incident of aerotitis media in bomber crews versus a 16 percent incidence among fighter pilots.
Although not as frequent as aerotitis media, Dysbarism—better known as the bends—became a recurrent problem with heavy bomber crews. The bends was initially a condition suffered by deep-sea divers, when nitrogen dissolved in blood at pressures greater than two atmospheres. For fliers performing the heavy work of defending against aerial attack, the risk for dysbarism became a tangible concern at altitudes greater than 23,000 feet. Should nitrogen bubbles lodge in the brain, headaches, blurred vision and appendage paralysis frequently occurred. Bubbles of nitrogen lodged in the small vessels of the lungs led to a sense of pressure in the chest, difficulty breathing and coughing jags. On occasion, bubbles of nitrogen formed under the skin, causing a crawling sensation along with feelings of intolerable itchiness. The incidence rate of dysbarism in fighter pilots was rare, due to the practice of washing out nitrogen by breathing 100 percent oxygen for 30 minutes prior to wheels up.
During its tenure in Italy, the Fifteenth suffered 25,577 casualties to her aircrews. 19,075 or 74.6 percent of the total casualties were attributed to missing in action, 5,008 or 19.6 percent were attributable to wounded in action, while 1,157 or 4.5 percent were killed in action. Accidents and other mechanical failures took an additional 337 lives. Once the Fifteenth had reached full capacity, of the 67,441 airmen serving in Italy at any given time, an average 28.3 percent were listed as missing in action, 7.4 percent were wounded in action and 1.7 percent were killed in action. Seen from a different numerical perspective, 37.9 percent of all Fifteenth airmen throughout the war were listed as one form of casualty or another. For those airmen killed in action, 801 died in operational aircraft accidents, 160 to flak bursts, 59 to ditching, 52 to bullet wounds, 52 to parachuting failures and 33 to anoxia.
In 1944, the U.S. Air Force reviewed 1,100 B-17 crew casualties with some surprising results. Exposed inside a semi-round ball of Plexiglas beneath the plane, ball turret gunners constituted less than 6 percent of all airmen killed or wounded in action. Exposed to head-on attacks by Luftwaffe fighters, bombardiers represented 17.6 percent of casualties, while navigators represented 12.2 percent of total casualties. Equally exposed to attacks from the rear, tail gunners made up 12.5 percent of those killed or wounded in action.
For airmen critically wounded in flight, untold numbers of men died before reaching land, mainly because the average airman lacked medical training or the equipment necessary to aid their fallen crewmates. For example, when a B-17 tail gunner had both butt cheeks blown off by cannon fire, gunners did their best to dress the man’s wounds, before placing a 140-pound ammunition box directly over the wound in an effort to staunch the bleeding.
While airmen suffered a myriad of medical injuries and conditions relating to high altitude bombing, airbase life contributed a variety of noncombat-related illnesses and injuries. Malaria was rampant at Fifteenth airbases, while infectious hepatitis affected both the Twelfth and Fifteenth air forces in the MTO, reaching a peak of 5,206 submissions for the Twelfth in the month of November 1944 (210.4 cases per 1,000 airmen). For the same period, the Fifteenth saw 1,401 submissions, or a monthly incidence rate of 19 cases per 1,000 men. During the same November survey, 75 men were treated for venereal disease, shedding further light on the frequency and scope of sexual relations between Fifteenth airmen and local Italian women.