What makes an effective medical or security assistance operator? Certain qualities are pretty fundamental, including adaptability, calmness under pressure and not being phased by the unexpected. Alongside these traits, military, police or medical personnel training is indispensable, involving experience in hostile and complex environments such as war zones. Effective medical and security assistance in high-risk circumstances involves first-class communication and tracking, crisis and evacuation management – including contingency planning for unexpected challenges – and the implementation of suitable support measures for affected personnel, including psychological counselling and medical attention.
Rick Sheer is Security Director at Northcott Global Solutions (NGS), which specialises in providing evacuation assistance, external resources, and strategic integration to a client’s operating model. He shared with ITIJ important elements of working in challenging environments: “Evacuation planning and information pertinent to alert phases, asset availability, evacuation options and critical steps to take during an instability event are an essential part of risk management. Preparations must be reflective of local, regional and national influences, and applied to all static and mobile client activities. Consideration has to be given to the different requirements of all parties, management teams and country resources.”
Sheer explained that the ultimate decision to evacuate remains with the client, but NGS has crucial involvement in most stages of the planning process and can assist with information analysis. Providing details on key factors, he said: “Any evacuation could have a significant impact on business activities, as well as the safety of personnel. As the risks increase during an instability event, a client may naturally begin to draw-down or limit operations. However, if risk tolerances are higher and infrastructure can reduce the impact, other response options need to be considered (lockdown, hibernation, shelter-in-place).” The following factors must be reviewed in detail during the planning process:
- Overall threat level and risk to personnel, assets and reputation
- Resource availability, environment and client location
- Routes, number of evacuees and/or assets (and order in which non-essential/essential personnel will have to move)
- Experience of in-country personnel, client crisis management/response team
- Shifting security, political or social situation, business continuity and commercial impact
- Visa status of applicable personnel and nearby border rule changes
- Any ongoing medical situations/cases
- Main point of contact (POC) in and out of country.
Preparations must be reflective of local, regional and national influences
Looking at the common qualities of security and medical assistance operators, there appears to be a lack of a minimum standard and official qualifications. Training isn't everything, and must be combined with experience, knowledge, understanding and preparation to reap effective results.
Ariel Kern, Director of Special Operations at Global Guardian, is well aware that the required skillsets are varied and adaptability is key: “Just because someone is ‘medically trained’, it doesn't qualify them for the medical assistance sector,” he said. “Being well travelled matters: the world isn’t fair, equal or kind – reality must be known and understood by city, state, country and region. Most of the world is fraught with dangers, challenges and uncertainty if not prepared. Understanding culture and language matters. If you cannot visualise the environment, solving only the medical situation could leave your client/patient exposed to other multiple threats.” Kern went on to list the key traits of an effective medical assistance operator: “Effective communicator; self-controlled and calm under pressure; adaptable; comfortable with uncertainty; outgoing and compassionate; and nothing about the human body can be intimidating (blood, organs, functionality, etc),” he stated.
Training and background
Kern’s own training includes more than 20 years in the military, active and reserves, across special operations including war zones (former Yugoslavia, Middle East). He also worked with locals/foreign nationals as a liaison officer, private security industry professional and in Executive Protection (EP). “I’ve travelled to 79 countries, including private trips,” he said.
Reflecting on his training and background, and that of his team, Sheer said that most personnel who work in an operational capacity at NGS are former military, police and medical. “Experience is gained from years of response work for medical and security-related incidents, including evacuations,” he said. “Added value and context comes from operating in high-risk environments such as Sudan, Afghanistan, Iraq, Ukraine and Somalia. All response work is backed by risk analysts with a strong academic background, who understand the geopolitical/threat landscape.”
Solace Global Risk provide global security and travel risk management services. Its Operations Director is former UK Special Forces, having been in the Special Boat Service (SBS), and told ITIJ: “The company was started, and is still owned, by a former member of UK Special Forces. We have a strong core of staff, with former military experience in hostile environments and conflicts, with a good understanding of what these situations are like. This is complemented by our other staff who have vast experience in intelligence, technology and crisis management. All of which gives us the ability to react to complex situations and assist clients wherever and whenever needed.”
The background and training of Pascal Michel, Managing Director, SmartRiskSolutions, is also impressive: “I am a former member of a German government security agency, where in my last function I founded and led its training unit, preparing staff to operate in war zones,” he said. “After 17 years, I moved to the private sector and have been working as a security and crisis response consultant. I was exclusively retained by a British crisis response company for several years, responding worldwide to kidnaps, extortions and (non-medical) evacuations for insured clients. I have managed many out-of-country evacuations, in DRC Congo, Libya, Egypt, Iraq and in Ukraine this year, at the start of the Russian attacks.”
AMREF Flying Doctors is one of Africa’s largest providers of medical evacuation services. Medical Director Dr Joseph Lelo shared details of an incident where the team, patient and aircraft were left unscathed, because they followed procedure and maintained situational awareness: “We had been on the ground in Mogadishu waiting for a patient when the airport came under attack. A vehicle-borne explosive device was detonated a few hundred metres from our plane and crew. We took shelter in the bunker at the airport, managing to depart with the patient when the all-clear was given,” he recalled. “Fortunately, there were no injuries to the crew or patient and no damage to the aircraft. When on missions in conflict areas, the crew must maintain situational awareness, even on the ground, familiarising themselves with escape routes and security procedures.”
Through overcoming adversity, medical and security assistance staff have learned lessons and accumulated experience and advice that they can impart. Here’s an example from the Solace Global Risk Operations Director: “Three sayings I have learned over the years and stuck by are: ‘plan for the worst and hope for the best’ – simple, but so true; ‘rehearsals, rehearsals, rehearsals’ – the more your team knows and rehearses for, the better; and ‘no plan survives contact with the enemy’ – even the best-laid preparations come unstuck, but if you have heeded the first two, you will be in a good place to manage,” they explained.
Being well travelled matters: the world isn’t fair, equal, or kind – reality must be known and understood by city, state, country and region
However, things don’t always go to plan for those responsible for evacuation planning, as Sheer confirmed: “Sadly, some reviews point towards a lack of preparedness and training from those in positions of responsibility. Additionally, a reluctance to mobilise external third-party resources in good time results in delays triggering draw-down operations, moving non-essential staff/dependents, and subsequently all personnel and/or assets. Consideration must also be given to the financial implications of evacuating, commercial/reputational impact, and attempting to contain-cost at the wrong time.”
Again, preparation is emphasised as key. “Often, we find there is no client crisis management team or some individuals with blurred lines of responsibility,” Sheer continued. “At NGS, we have evacuated personnel and assets from all environments and our advice remains consistent: maintain reliable communications, have clear escalation channels/financial delegation and authority, while being accurate with paperwork and manifests, alongside coordination of response assets. That’s a considerable amount of people and resources. Finally, trust in your emergency response company – that’s why you retain them.”
Advice from Solace Global Risk’s Operations Director is: “We always recommend that you plan, brief and drill, then brief and drill that plan again. Regularly review it too, as roads change, your staff footprint will change, and new people will join who are not familiar with the landscape,” they explained. “The more you practice this, the greater your chance of a successful evac should the worst happen. You want it to be muscle memory, for your team to be able to do it in the dark/rain/snow/blazing heat, while knowing options B and C. Good intel, communications, tracking and understanding what dependents will fall under your evac plan is critical, allowing the right companies to be part of the planning, furthering your chances of success.”
Michel agreed with the importance of other options: “Do not rely solely on the embassy – always have other plans in place. Expect that during a crisis the cost will go up and have cash. And remember contingency planning, because a lot of things can go wrong during an evacuation,” he advised. “For the reception team, the expectations of evacuees can often differ from the reality, creating anger. It is therefore important that the company properly meets the evacuees immediately once out of the country.”
Kern emphasised the value of first-hand experience: “There is no substitute for real-world exposure, which cannot be gained in a classroom or corporate environment – combat, inner-city violence, terrorism, mass shooting, active shooter, mass casualty events and natural disaster response. These all provide enormous value in determining if someone can operate in a medical assistance environment at a high level,” he said.
An understanding of the world, and the countries, cultures and languages within it, is essential. Things can and will go wrong, therefore contingencies must be in place to ensure you are prepared for the unexpected. Ultimately, it’s not an easy job and requires a certain character, as Kern articulated: “Our medical operators all possess a superpower that makes them leaders in all facets of trauma under extreme pressure – saving people’s lives anywhere, anytime, anyplace.”