There are many planning obstacles when it comes to engaging North Korea in a conventional war, but one of the biggest is figuring out how to rapidly get wounded U.S. military personnel off the battlefield.

According to a late 2017 assessment by the Pentagon during war games in Alabama, the military would face a layered, deep air defense system in North Korea that would make medevac difficult if not impossible — at least until those defenses were dealt with. That would substantially raise the number of deaths for U.S. military personnel, planners noted:

Unlike al Qaeda or ISIS jihadists, however, North Korea is ready for an air war: A November 2017 assessment by the Congressional Research Service of the country’s military capabilities conclude that while Pyongyang’s air defenses are relatively outmoded, the North Korean Air Force possesses “a dense, overlapping air defense system of SA-2, SA-3, and SA-5” surface-to-air missile sites and other mobile and man-portable anti-air munitions — and that’s not even counting the Kim regime’s fleet of 1,300 Soviet-era aircraft intent on knocking U.S. assets out of the sky. Add it all together, and those air defenses spell trouble for an opposing force’s traditional medevac efforts.

“Modern combat medicine has made great advances in stemming blood loss, for example, but those procedures are typically temporary measures, carried out to keep a patient alive until airlifted to a higher-level, trauma-care facility,” political science professor and war scholar Tanisha M. Fazal writes. “That was possible in Iraq and Afghanistan, where the United States had undisputed control of the skies. But it would not be true on the Korean Peninsula, at least at first.” [source]

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