Earlier this month, Defence personnel in Canberra were treated to a fascinating speech by Australian of the Year Craig Challen about the challenges of extricating 12 boys and their soccer coach from a flooded cave in Chiang Rai, Thailand.

While most Australians probably remember watching the drama unfold on their television screens in June and July last year, few would have been aware of the perils the team faced to save the members of the Wild Boars team.

Speaking at the R1 theatrette, Russell, on June 20, Dr Challen said there were similarities between some military operations and what the rescue team did.

“You’ve got an objective that has to be attempted; you may not have the resources, the expertise and the knowledge to do this. You might even be in a situation where the likely outcome is pretty disastrous, but you have no choice but to press ahead and give it your best shot because the alternative is a complete disaster,” Dr Challen said.

He said cave diving rescues were rare as opposed to dry caves, for which there are well established organisations for rescue.

“Sad to say there is a very long history of people drowning in caves because they were divers that thought they could cave dive and didn’t have that set of skills and knowledge of the rules and techniques they need to use to stay alive,” Dr Challen said.

Dr Challen said the cave was not dangerous to experienced cave divers.

“We did not at any time feel there was very much risks to ourselves. The boys were totally 100 per cent doomed if we didn’t do something,” he said.

“At the time we were totally convinced we would have at least some casualties. It seemed fanciful we would have a 100 per cent success rate and we never would have undertaken this unless there was absolutely no alternative. We tried everything we could think of to get out of doing this [rescuing the boys by diving].

“The main pressure was we knew the monsoon rains were coming and they were coming really soon. Once they really arrived this cave was going to flood completely and there was no way to gain physical access to it after that; the flow coming out of the cave would be so strong you wouldn’t be able to drag yourself in.

“We’d be lying awake at night listening to the rain on the roof and wondering if it was possible we’d be getting back in the cave the next day, or the flow would be so strong the boys would be trapped in there.”

The Rescue

Dr Challen went into detail about the intricate medical logistics of anaesthetising the boys.

“All of the other plans fell away, and to our consternation we are left with this cave diving plan. It [then] gets a little bit worse because we are starting to discuss the possibility of sedating the boys and that conversation progressed to actually anaesthetising them for the trip out,” he said.

“At face value it seems pretty straight forward, that we’ll give these kids an expedited lesson in cave diving, stick a scuba on them and say ‘lie still and we will swim you out’. But this was expected to be a three-hour journey…where they were going to get a bit of rough treatment, they could not see anything, didn’t know what was going on in a totally foreign environment. We thought that we would need to anaesthetise them, which has never been done before.

“You don’t need to be a medical person to realise anaesthetising people and then sticking their head under water is not something that you do. When this was first suggested the reaction was ‘that’s impossible it cannot be done, you need to find another way’. Unfortunately there was no other way.

“My dive buddy, Dr Richard Harris, is an anaesthetist – he was absolutely critical to the operation. The anaesthetic only lasted for 45 minutes and so during this three-hour journey out the boys were going to have to have multiple top-ups of the anaesthetic. The other divers involved in the rescue – a fireman, a road access worker, and a couple of IT dudes – some had never even given an injection before, so they had to be taught how to how to use a syringe and needle.

“It was particularly difficult for the swimming divers bringing the boys out, not only did they have to cope with giving these anaesthetics, which they were far from confident about, but they were expecting some of these kids would probably die, they had no method of monitoring the kids apart from if … there were still bubbles coming out of the face mask.

"Even to this day ... I cannot believe it worked. At the time we were totally convinced we would have at least some casualties."

“They were basically told how to recognise the signs of the boys starting waking up, how to choose a dose to give them – we made that as simple as we could – they each had a dilly bag full of syringes pre-loaded with ketamine [the chosen anaesthetic] – marked with large or small and they would make a choice about whether they were dealing with a little kid or a big kid; and whether he was a little bit awake or a big bit awake. And select their dose accordingly and inject in the boy’s leg through the wetsuit and wait a few minutes, he’d go back to sleep and on they’d go.

“The instructions to these guys were if their child was to stop breathing they just were to keep swimming. There is no such thing as underwater CPR and there was nothing they could do in that situation, the bodies still had to come out so they should just go for it. If they swam as hard as they could there was just that outside chance that the kid might still be alright when he made it back to the surface, but that was more wishful thinking than reflecting any sort of reality.

“The fact that it subsequently came to work, nobody is more surprised than me. Even to this day, sometimes I reflect on this, and I think to myself I cannot believe it worked. At the time we were totally convinced we would have at least some casualties.”

The audience was interested in the command and control aspects and lessons learnt of such a major international operation.

“When we arrived on site it was chaos, it really was,” Dr Challen said. “In the early days of the search particularly, all sorts of people were turning up from all over the place and just wandering in the cave, some of them were jumping in the water and going cave diving.

“There was no coordinated effort to do this. People were turning up with pumps and pipes, even running a communications cable in to where the boys were – they got about 50 metres inside and gave up and just dropped the thing. [Later it] started to unravel and in our diving operations we were continuously getting caught up in this stuff and having to cut it off ourselves.

“A lot of credit in the story belongs with the US Air Force guys, a para-rescue squad that came down from Okinawa. Two of their guys, Major Charles Hodges and Master Sergeant Derek Anderson, really took the lead with rationalising the whole situation and looking at all the different plans that were put forward.

“We did not, as cave divers, have a great deal of credibility with the Thai authorities, we’re just a group of people from around the world, and they’ve got all sorts of other people presenting these other plans to them and they don’t know what to make of it.

“The US Air Force team had diving experience, and assisted by reviewing the plans, eliminating them one by one. Only the cave diving plan was left over, they took that to the Thai authorities. At all times the final decision rested with the Thai authorities.”

Associate Secretary of Defence Rebecca Skinner said Defence personnel were always interested in aspects of leadership.

“We love to tell stories of leadership here, as you can see by the attendance,” Ms Skinner said. “Defence had its own role in supporting our friends in the Thai Armed Forces throughout that rescue and we were proud to play our role.”

Vice Chief of the Defence Force Vice Admiral David Johnston thanked Dr Challen for sharing his story and for his insights.

“You’ve been very generous with your time and you’ve captured the interest of everyone, but I don’t think you’ll ever convince me to go cave diving,” he said.