Medical repatriation from Dominica after a fractured hip and leg during a hurricane


By Craig Wright, Operations Manager




At 5:10pm on the 18th September, 2017 - Traveller Assist received an urgent request for a medical repatriation of an expat businessman from the island of Dominica in the Caribbean. Urgent because just four-hours later, Hurricane Maria would make landfall and become the worst natural disaster to ever hit the island.


Our medical director, Dr. Andrea Pinto spoke with the treating medical officer at the hospital, who at the time was splitting his time between treating patients, and preparing the hospital for an imminent hurricane. He confirmed that the patient had a fractured hip, and leg, with lacerations to his face and arms - caused by falling off a ladder while boarding up windows and doors. Under the circumstances, the TMO deemed the patient ‘fit-to-fly’ to a destination no more than two-hours away for emergency surgery.


Our operations team spoke with the airport in Dominica to confirm which airlines had planes on the ground. They then spoke directly with each airline, but to no avail. All seats were taken, and the last of the flights would be taking off just 90-minutes later, which was not enough time to prepare the patient. The team even looked at fast-boat options, but it was deemed too risky.


At Traveller Assist, we use an internal proprietary software called ‘Eyes On.’ It’s a multi-layered, digital map platform that enables our operations staff to instantly view our medical network providers. In addition, every employee, contractor and ground agent carries our app which enables us to geographically pinpoint them, and send notifications, anywhere in the world. Our air ambulance partners also carry a GPS powered by Traveller Assist, which are colour coded. Red means there is a patient on board, or the plane is not available. Green means its an empty flight. This allows our operations team to instantly see what assets are available.


On this particular day, an air ambulance had just taken off from St. Vincent and the Grenadines, and the GPS indicated green. Our Head of Assistance made two simultaneous calls. The first to the underwriters at London Re to confirm coverage for an air ambulance evacuation. The second, to the air ambulance company where he pleaded with them to redirect the plane. They complied, and confirmed that the plane would land 30-minutes later. Our team were then ordered to be ready with the patient for a quick turnaround.


This posed a problem. The patient did not have his passport with him. It was still at his residence which was in the opposite direction to the airport. Our operations team arranged for the patient to be transported by ambulance to the airport, with his wife, while a family friend drove to the house to pick up their passports. The wind and rain made the road conditions treacherous, but the driver managed to get the patient to the airport, where the air ambulance had already landed and was waiting.


The patient was carefully loaded onto the plane, and the passports arrived shortly after. He was transported with his wife to one of our network hospitals in Cancun, Mexico, where the air ambulance was originally destined for. The patient was then transported by a waiting ambulance to the hospital, where he was x-rayed and operated on a few hour later.


Hurricane Maria slammed into Dominica at 9:15pm as a Category 5 storm, killing 37 people, and causing wide-spread devastation, stranding people without power, running water or communications, effectively cutting the island off from the outside world.


Traveller Assist provided guarantees of payment to the air ambulance provider, and the hospital in Cancun, and continued to provide cost-containment and assistance services to the insurer until the client was ready to be discharged. Our Flight Nurse then escorted the patient home to London, England.

The Foreign & Commonwealth Office and the National Health Service have up-to-date advice on staying safe and healthy abroad. For more on security, local laws, plus passport and visa information, see https://travelaware.campaign.gov.uk. Keep informed of current travel health news by visiting www.fitfortravel.nhs.uk. For up-to-date alerts and foreign travel advice, see https://www.gov.uk/foreign-travel-advice

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