Up in the air: how Tangiers handles medical evacuation

It’s the news many of us would welcome with a weary smile.

“The medevac has been arranged. A plane is on the way,”

But the planning and effort that goes into ensuring an ill or injured patient can be safely transported across international borders is far from simple.

Tangiers International employs medical evacuation as a crucial tool when a patient’s health issues cannot be treated any further in-country.

Achieving the safe evacuation of a claimant – sometimes stranded in an active conflict zone or in need of urgent medical attention – requires the concerted efforts of field agents, case and operations managers and third party providers.

Carlos Hernandez, Tangiers’ operations manager, has overseen hundreds of medevac cases, with dozens involving air ambulance services.

He explained that the key to executing a successful evacuation is a methodical approach which takes into account the numerous logistical, legal and practical obstacles which often arise.

He said: “The first thing we start thinking about are clearances and permits – ensuring we can get people across borders. It’s not just obtaining an ambulance that can travel from A to B, but making sure everything is in place along every step of the route.”

This includes ensuring that the air ambulance providers tasked with collecting and delivering an ill patient are fully qualified, certified and experienced.

“In regards to air ambulance, we are quite stringent with who we work with and what we do,” said Carlos.

“There are minimum requirements that we will accept relating to the equipment and personnel they will provide, but also the age of the aircraft they’re using, how long they’ve been operating, etc.

“In the EU, we expect them to be accredited by EURAMI (European Aeromedical Institute), while in Africa, for example, we require as close as possible to that accreditation in terms of experience and qualifications.”

Tangiers International operates in some of the world’s most dangerous or remote regions, meaning the already difficult business of repatriation can be complicated further by political upheaval, poor weather or bureaucratic hurdles.

For Carlos, this means being adaptive to rapidly-developing situations and relying on a network of regional experts – including Tangiers’ in-country field agents – to tailor a medevac operation to the current reality on the ground.

“At the moment, it’s very difficult to get planes into Syria, for example. There are companies out there who may be able to fly into military bases, but this cannot be done on the spot. They need time to check and get access permits.

“Of course, then there are the risks involved with flying into a war zone.

“When evacuation by air is not possible, we look at other options. In a case like that, we may be able to transport them from Syria to Lebanon, where we can fly them out. Our main priority, of course, is the safety and security of the patient.”

With so many successful evacuations under his belt, Carlos understands the benefits of personal relationships for overcoming the myriad obstacles he can face arranging medical evacuation.

“It requires a lot of connections. You build a rapport with the people at the airports and your providers and with companies who you know can help you. Fortunately, at Tangiers we also have field agents who can often liaise in person with the ground ambulances or the airport staff.”