Case Study:
A safari gone wrong
In late June, the control room of AMREF Flying Doctors (AFD) received a distress call from a US-based assistance company asking for help in a medical assistance case at Mara Serena Lodge in Narok, Kenya.
The caller reported an injured female guest, aged 70, who was unable to bear weight on her injured foot due to severe pain. The patient was in Kenya for a safari in the Masai Mara, hoping to witness the renowned wildebeest migration that happens at that time of year.
Shortly after the accident, the patient notified her insurance company in the US, and the insurer immediately tasked the patient’s assistance company to contact AFD as their preferred provider in Africa.
Upon request, AFD provided a quote for a medevac flight to evacuate the patient from her remote location, and was subsequently activated to conduct an air ambulance transfer to Nairobi. The medical and flight operations teams immediately started to work diligently throughout the night to make all necessary arrangements. This included taking into consideration that most dirt airstrips in national parks and conservation areas are operational only during daylight hours.
The journey begins
Equipped with all essential emergency medical supplies, and staffed by an emergency flight nurse and a pilot, the AFD air ambulance took off from Wilson Airport on 30 June at 6:30 a.m. AFD’s proximity to Wilson Airport allowed for a swift response, making a dawn take-off feasible. The aircraft landed at the bush airstrip at 7:15 a.m., after the captain conducted a fly-past to confirm the absence of wild animals, ensuring safety for the crew and the aircraft. The patient, driven to the airstrip by lodge staff, already awaited the aircraft’s arrival.
Upon landing, AFD’s flight nurse assessed the patient’s condition thoroughly, administered necessary pain relief medication, and assisted her onto the aircraft. After securely placing her on a stretcher and relaying a brief report to the control centre at AFD, the plane took off at 7:35 a.m. and touched down at Wilson Airport at 8:15 a.m. The patient was then brought to the advanced life support ambulance that was waiting by the runway, and then transferred to the admitting hospital.
As AFD support various international assistance companies in Africa – specialising in diverse services throughout the continent – the patient’s assistance company had already requested AFD to guarantee payment for the patient’s medical expenses. It was also evident from the beginning that a repatriation on a commercial flight to the US would be arranged once the patient was declared fit to fly by the hospital.
From Nairobi to Nashville
Following a radiological examination that revealed the extent of the patient’s injury after she tripped and fell, surgery took place the same day. On the fourth day post-surgery, the patient’s assistance company confirmed the patient was fit for commercial airline travel, and AFD was tasked with providing a quote for nurse escorts from Nairobi to Nashville, which the assistance company immediately accepted.
Upon activation, AFD’s team pursued medical clearance from the airline with the most direct route to the patient’s home city, in an effort to avoid any unnecessary stress for the patient. During these preparations, the consulting surgeon already initiated physiotherapy for the patient in readiness for her discharge. AFD remained in constant contact with the contracting assistance partner, keeping them updated on the patient’s progress.
After nearly three weeks of hospitalisation, the patient was finally discharged and ready to start her trip back home. Two AFD emergency flight nurses accompanied her on her travels, transiting via Doha, Qatar, ensuring her comfort throughout the whole process. After a seamless journey, the patient was handed over to a local hospital in Nashville for further treatment back home.
This article originally appeared in
Assistance & Repatriation Review | October 2023
Shortly after the first contact, AFD was able to confirm that the patient held valid insurance and coverage and started making arrangements for the patient to be transported in a more adequate facility. It was determined that a transport to Nairobi, Kenya, was the best option for better medical access, as well as for organising the patient’s repatriation home. Quotes for the evacuation to Nairobi via Air Ambulance were obtained and the flight done by the AFD Team was confirmed for the following day at first light, as Arusha Airstrip is a daylight operation only.
Whilst AMREF Flying Doctor’s aircraft was on the way to Arusha, the hospital bill was settled, and the patient was prepared for transport. Upon arrival, AFD’s team picked up the patient from the hospital as per AFD’s policy of bed-to-bed-service, to assure seamless treatment and monitoring throughout the transfer.
As Nairobi had not been a planned destination for the patient or his wife, AMREF Flying Doctor’s team assisted with several services, such as placing a payment guarantee at the hospital, obtaining a phone SIM card for the patient’s wife, and arranging a hotel for her near to her husband’s hospital.
The patient remained in hospital for 24 days, during which he underwent various tests and investigations, had a surgical intervention for the fractures, and underwent physiotherapy. AFD’s medical team continued to monitor his progress, and when the patient was eventually declared fit to fly on a commercial airline with medical escort, AFD was tasked to arrange the same.
Being well versed in arranging commercial escorts worldwide, AFD’s team started the process by obtaining medical clearance from the commercial carrier that would take the patient, his wife and AFD’smedical escort back to Canada. AFD also purchased the tickets, arranged for ground ambulance and wheelchair assistance throughout the trip, and coordinated his arrival back home.
An in-person pre-flight assessment was performed by AFD’s medical escort prior to the flight to assure that the patient was sufficiently stable and well informed about all steps of the trip.
The repatriation went very well, the patient remained stable and was comfortable at all times. Upon arrival in Ottawa, the AMREF Flying Doctor’s team escorted the patient and his wife to his residence and returned to Nairobi the day after.
Another successful case and mission done by AMREF Flying Doctors – who are equipped for all kind of assistance and aero-medical needs in Africa. Due to AFD’s deep understanding of the circumstances and longstanding experience in providing medical services and assistance in Africa, AFD’s team could support the client on every step of the way. From the first medical information, followed by the initial aeromedical transport to the nearest centre of excellence, covering the costs in all hospitals, to the commercial medical escort that brought the patient home AMREF Flying Doctors was always there for the patient, while helping the insurer to fulfil the obligations towards his client in the best way possible.
FIRST PUBLISHED IN – Assistance & Repatriation Review | April 2023
