JOINT BASE LEWIS-MCCHORD, Wash. -- Although strategic airlift has been a critical portion of Operation Enduring Freedom for almost a decade, nothing flown into the area of responsibility is ever routine; much less for aeromedical evacuation missions.

A prime example is when a C-17 Globemaster III crew was preparing to regroup at Ramstein Air Base, Germany, only to find themselves transporting 33 patients, one an embedded New York Times photographer, on an aeromedical evacuation mission from Bagram Air Base, Afghanistan to Ramstein AB in late October.

Maj. Steve Funanich, 97th Airlift Squadron flight commander and C-17 instructor pilot, here and his crew were tasked with that mission only 30 minutes prior to executing it.

"Missions flown in the AOR are never routine," said the 17-year Air Force veteran. "But when we were notified that we had become a medevac mission, our mindset changed."

When saving lives becomes more direct and personal, it adds yet another element of urgency for the mission to be accomplished.

"Every mission in the combat zone is important," said Major Funanich. "But when you're called upon to transport wounded soldiers and civilians to a place where they can get the proper care, it heightens your awareness and sense of urgency. What everyone does on the flight, from pilots, loadmasters and the aeromedical evacuation crew can mean the difference between life and death."

With 34 years of military experience and the loadmaster for the mission, Chief Master Sgt. James Caron, 97th AS resource manager knows about that awareness and urgency.

"When you're moving routine cargo and (passengers), your main focus is moving the mission as safe and as fast as possible," he said. "When you know it is an AE mission, your focus is on the safety and comfort for the patients and you forget about any other issues."

After arriving at Bagram AB, Chief Caron had to make sure the aircraft was ready as quick as possible to ensure a seamless setup for the AE crew.

"We arrived with a full load of pallets," said the Graham, Wash. native. "When we touched down, we had to quickly reconfigure the aircraft, so the AE crew could set up their equipment."

Master Sgt. Paul Melkers, 446th Aeromedical Evacuation Squadron here, examiner and medical technician says a C-17 can be reconfigured for a maximum patient load in about 30 minutes.

Sergeant Melkers, who wasn't on the flight but is a member of the unit that earned the award for Best Aeromedical Evacuation Squadron in 2010 for Air Force Reserve Command, relies on training when it comes to AE missions.

AE crews strive to maintain the highest standards and train to the highest levels, said the Seattle firefighter. During Operation Desert Storm the survival rates from point of injury were less than 80 percent. Today, the survival rates for AE missions are higher than 98 percent. That is due in part to being ready and trained.

Joao Silva, the New York Times photographer, can be included in the 98 percent. He was released from Landstuhl Regional Medical Center in late October where the other 32 patients were also transported.

Aircrews and aeromedical evacuation crews have performed more than 16,000 patient movements, averaging nearly 60 patient movements a day worldwide.

Lt. Col. Greg Wittman, 97th AS C-17 instructor pilot, sums it up in a sentence:

"This is another instance of one of our worldwide C-17 and aeromedical aircrews doing whatever it takes to get the job done."