The battle for Hue: casualty and disease rates during urban warfare.

Renewed nationalism with the ending of the Cold War has precipitated numerous conflicts between regions or countries that were formerly united. Hostilities between some ethnic and nationalistic factions have reached the point where regional security is threatened and United Nations-sanctioned military operations may be required. Because some U.N. operations could require the forcible removal of an entrenched faction from an urban setting, the present investigation seeks to determine the levels of medical casualties that might be sustained during urban warfare. Casualty rates and illness incidence were examined for U.S. Marine forces participating in the retaking of the city of Hue during the Tet offensive in 1968. The casualty rates were analyzed for different phases of the urban assault and contrasted with a different period of the Vietnam Conflict, and with the high intensity battle for Okinawa during World War II. Rates of casualties during the retaking of Hue were highest during the two phases of the operation that required close-quarter fighting. The house-to-house fighting south of the river yielded a wounded rate of 37.9 per 1,000 strength per day, while the fighting in the inner city yielded a rate of 44.4. Rate of wounded during the "mopping-up" phase was 5.8. The rate of illness incidence was stable over the month-long operation and showed no concomitant increase with battle intensity."