Interview: Dr Joseph Lelo, Medical Director at AMREF Flying Doctors

AMREF Flying Doctors (AFD) is based in Nairobi, Kenya. What are the challenges and advantages of serving a global clientele from such a demanding location?

It’s a welcome challenge for AMREF Flying Doctors. Drawing upon our 65+ years of experience in operating flights in remote and underserved regions of Africa while simultaneously developing healthcare infrastructure, we can confidently assure our global clientele of secure and expert medevac services, whenever and wherever required. Our substantial investment in jet aircraft has enhanced our capacity for transcontinental and intercontinental operations, enabling us to overcome many of the challenges associated with working in Africa. Additionally, we have made significant investments in our personnel and infrastructure to ensure swift responses and enhance our overall availability.

In terms of frequently requested routes, can you shed a light on AFD’s popular mission destinations over the last five years? Additionally, how does the fleet cater to both regional and international needs?

The recent inclusion of jets in our fleet represents a significant enhancement in our operational capacity. We are now able to conduct longer flights with same-day turnarounds, extending our reach to remote islands in the Indian Ocean and Atlantic Ocean, as well as providing comprehensive coverage of the entire African continent. Our capabilities even extend to transporting patients from remote islands using smaller aircraft and seamlessly transferring them to larger planes, for instance, from Cape Verde to India.

What factors attract clients to utilise the services of AFD as a global operator rooted in Africa? Also, could you share insights into unexpected obstacles that foreign clients and providers encounter when involved in missions within Africa?

Our ability to efficiently and effectively accomplish tasks across the continent is a key reason why our clients favour us. This is a result of our extensive experience and strong relationships with government authorities and major hospitals throughout the region. In contrast, foreign operators from Europe or the US may encounter cultural clashes or, in certain cases, be viewed as having undisclosed political biases, especially in conflict-prone areas. Furthermore, obtaining technical support and repairs for aircraft malfunctions in certain parts of Africa can be a complex and expensive ordeal for many operators. Thus, by using a local provider with global experience, clients can rest assured that top-notch care and regional expertise are combined to provide the utmost service for every patient.

Could you provide a specific case that exemplifies the distinctive challenges posed by AFD’s location and the strategies employed to overcome them?

While travelling to visit relatives in Rwanda, a couple in their early 50s experienced a tragic incident – a severe road accident that left both of them with significant injuries. The husband suffered multiple spinal fractures, resulting in paraplegia, while his wife sustained a fractured pelvis.

Immediately following the accident, the couple were transported to a local hospital in Kigali. Given the severity of the husband’s injuries, he underwent extensive surgery, which presented considerable challenges. During the surgery, he faced substantial blood loss, necessitating an urgent blood transfusion. Meanwhile, though the wife’s fractured pelvis was not as life-threatening as her husband's condition, it still posed a complex medical dilemma that exceeded the capabilities of the local hospital.

Obtaining timely, comprehensive, and accurate medical reports became a complicated process. Language barriers and strain within the local healthcare system created obstacles for both the family and AFD staff in obtaining a clear understanding of the couple’s medical status, which needed to be communicated to the clients’ insurers. Consequently, AFD made the crucial decision to send a representative to the hospital in person to assess the situation.

Upon arrival, AFD promptly assessed the clinical condition, confirming the urgency of relocating both patients to a more advanced medical facility. Plans were set into motion immediately to organise a medical evacuation to Nairobi, where specialised care could be provided.

Within 12 hours of receiving approval from the insurers and following extensive medical consultations between AFD’s doctor and the insurance medical team, the couple were successfully transported to Nairobi. Given their need for intensive care, they were flown on separate aircraft. In Nairobi, the husband underwent additional surgeries and embarked on the long road to recovery, while the wife received orthopedic specialist care for her fractured pelvis.

This distressing incident once again underscores numerous concerns regarding the availability and calibre of emergency medical assistance in isolated areas on the African continent. Frankly, it serves as a testament to the vital role that AFD fulfills every day in delivering life-saving services amidst intricate and challenging circumstances. One of many complex yet successful missions that AMREF Flying Doctors performs every day for clients from all around the world.