Flying doctors to the rescue

It may not have flashing red lights and a siren, but for some seriously ill patients in west Africa, a white Beechcraft 1900 is the vehicle that means their chance of recovery has taken a sudden turn for the better. Alan Dron reports.

Roughly twice a week, a Beechcraft 1900 twin turboprop taxies out at Monrovia’s James Spriggs Payne Airport and roars off into the skies over the Liberian capital. When it returns, some hours later, it will be carrying a seriously ill patient.
The good news for those patients it picks up from countries around west Africa is that, once they are on board, their survival chances – even from life-threatening injuries such as traumatic amputations or severe burns – increase significantly.
Since Aspen Medical International (AMI) started flying medevac flights from Monrovia around 18 months ago, “We’ve had a 100% survivability rate,” said Ethan Bond, AMI’s chief operating officer. “If we can get them on the aircraft, their chances soar.”
That is because the aircraft – a South African-registered 1900C model – is fitted out to what Bond believes is the highest standard of any medically equipped aircraft in the region. “Anything you would find on a modern US or European ambulance is on board – oxygen, ventilators, a defibrillator, pharmaceuticals – anything you could imagine to keep a patient alive.”
There will also be at least a paramedic, frequently accompanied by a doctor if a patient’s injuries are known to be severe.
The aircraft and crew are certificated to Part 138, the highest level of aviation medevac standards. “It’s a hugely burdensome but ultimately invaluable process,” said Bond. “Your aircraft has to be to a certain standard and carry certain types of equipment. It’s an aircraft that’s built to be an air ambulance, with pressurisation and redundant systems. The pilots, paramedics and maintenance crew have to go through Part 138 training to use all the equipment.
“A lot of time and money goes into equipping and certificating an aircraft to that standard. Every year, we fly in an inspector from South Africa, who puts people through their paces to check they’re still up to standard.
“Anyone can charter our aircraft. We have agreements with around 30 insurance and assistance companies.”
Those companies started to sign up with AMI once they realised the level of on-board facilities: “It’s not a case of throwing somebody on a stretcher into the back of a Piper,” said Bond.
Many of the insurance and assistance companies are from Europe or even further afield. AMI has taken people as far as China, although for a journey of that length, a jet was chartered. However, AMI’s aircraft frequently operates into west African capitals such as Accra or Dakar “where there are some fantastic medical facilities and, of course, they’re much closer than having to ship someone back to Europe”.
AMI, a US-based company that established a clinic in Monrovia around two-and-a-half years ago, can make recommendations as to where it flies a patient. But, ultimately, it is the insurance or assistance company that decides the final destination.
“In addition, we have access to other people’s aircraft. If ours doesn’t have the ‘legs’ or is being used for something else, we can bring in another aircraft at very short notice,” explained Bond.
The Beechcraft “can get into reasonably rough strips – that’s one of the reasons we bought it,” said Bond. However, conditions at some locations can create problems, he added. “Those corrugated strips do mess up equipment, so we constantly have to recalibrate it. We’d prefer not to have to do it but, of course, if we have to, we will.”
The service in west Africa has been so successful that plans are well-advanced to station aircraft in northern and east Africa. AMI intends to transfer the Beechcraft to east Africa to support the company’s recently opened medical facility in South Sudan. Libya is the site of the planned northern African facility.
To replace the Beechcraft in Monrovia, AMI is considering a Lear Jet or similar executive aircraft: “We’ve decided that having longer legs in west Africa would be a good thing,” he concluded.