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  4. AMREF: Experiencing health and business risks during the pandemic

AMREF: Experiencing health and business risks during the pandemic

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Assistance & Repatriation

1 Apr 2022
AMREF Flying Doctors Team
Featured in Assistance & Repatriation Review | April 2022

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AMREF Flying Doctors case study
Adapting to life in a pandemic

The Covid-19 pandemic has had a highly heterogeneous impact. AMREF Flying Doctors share the significant domestic and international challenges in operations and business activities during the first worldwide lockdown

Our capacity to move patients from the region into Nairobi – the location of the region’s centre of medical excellence – and onward transfers to international destinations was initially seriously compromised. The shutdown of the hospitality industry, as well as restrictions on international, regional, and local travel, meant that we were unable to provide the majority of our air ambulance and related services.

Health risks to staff, clients, and the public

The immediate challenge was the health risk posed to our staff, clients, and the general public as we sought to continue providing our services even in the Covid-19 context. Due to the highly contagious nature of Covid-19, we had to take strict measures to ensure that our medical, air and ground crews could handle patients safely. 
At the onset of the outbreak, we immediately formed a task force led by our medical director that reviewed and put together protocols affecting all areas of our operations. These protocols enabled us to continue operating with minimal disruption, lobby various governments and authorities for mission exemptions, and foster a reassuring work environment for all our stakeholders. This task force is still operational today and continues to play a critical role in guiding our daily operations.
We also implemented a strict work-from-home policy for non-essential employees and later implemented a rotational reporting system for all staff members. This has worked exceptionally well in supporting our 24/7 emergency operations while exposing staff to the lowest possible level of Covid-19 infection.
 

AMREF Flying Doctors case study 1

Business impact

The second challenge was the impact on our bottom line as a business, particularly considering the industries we serve, such as the insurance and assistance market, the tourist market, and others who were heavily negatively impacted by the outbreak.
The near-total decline in business from visitors to Eastern Africa was replaced by an unprecedented surge in demand for regional and international transfers – including numerous Covid-19-related cases. As a result, our prompt decision to expand our capacity for evacuating highly contagious patients paid dividends sooner than anticipated.
Secondly, due to our strong relationship with the government of Kenya and several public sector agencies, we were able to acquire an assignment to train staff from different government agencies at Eastern Africa’s eight international airports in advance of the airports’ resumption of operations. We believe this had a significant ripple effect, not only on the company’s profile, but also on our bottom line, during these trying times.

AMREF Flying Doctor case study

Logistical challenges

Thirdly, we were faced with the logistical nightmare created by the closure of borders, restrictions on travel and movement of people, and other government directives aimed at halting the virus’s global spread. This was exacerbated by the fact that these directives and restrictions changed over time, making it extremely difficult to plan, manage costs, and commit to missions as requested by clients.
We took a two-pronged approach to overcoming logistical obstacles. One was establishing close ties with regional governments and authorities. From the onset of the outbreak, we maintained contact with the region’s relevant government agencies, offering our assistance and insight where possible and providing information that would help them understand the critical need for us to continue providing our services. 
Second was providing support to our operational staff, who saw their workload per mission increase significantly because of the numerous and constantly changing protocols required to conduct a successful medevac mission. The management also became more involved in day-to-day operations to ensure that mission-critical staff received the support they required at various operational touchpoints and worked in a supportive environment to ensure the best outcome possible in a challenging situation.

AMREF Flying Doctors case study 2

Managing evacuations at a time when Covid was an unknown risk 

Due to the extremely contagious nature of Covid-19, we had to implement stringent precautions to safeguard the safety of our medical, air, and ground crews. We invested in portable patient transport chambers and other relevant medical equipment such as personal protective equipment (PPE), making us the first air ambulance operator in East and Central Africa and the first emergency response organisation to do so. Within the first six weeks of receiving the isolation chamber, we successfully transported over 20 Covid-19-associated patients and have successfully transported over 500 Covid-19-associated cases to date.
Demand for air ambulance services increased significantly during Covid-19, enabling AMREF Flying Doctors to expand and enter new markets. To meet increased demand for local and international air medical evacuation, we extended our fleet composition by adding the long-range medevac capabilities of the Cessna Citation Sovereign C680 aircraft to our fully owned fleet. 
Additionally, we opted to expand our wing-to-wing partnerships to alleviate commercial flight restrictions and related logistical complications. This substantially aided in the continuation of regional and international patient transfers to and from Africa.

Lessons learned, services enhanced 

Given the learnings from operating in the Covid-19 context and in line with our company strategy, we are looking to strengthen our capability to respond to such health crises should they occur in the future. This is with the intention of continuously reviewing market innovations to which we can adapt much more quickly than in the past, thereby assisting us in better preparation for such occurrences.
Secondly, we are striving to build better collaborations and partnerships with other institutions to ensure that as many people as possible in the region become members of the Maisha Medical Evacuation Plan and have direct access to our services in times of need.
Lastly, we will continue to invest in critical strategic capabilities that drive to maintain our market leadership for the benefit of our customers.

Case study: Transfer of three Covid-19 patients from Afghanistan to Kenya

In Kabul, the patients arrived in one ambulance, two of them without oxygen, in respiratory distress and with SpO2s at 80 per cent. They were stabilised and loaded into AFD’s isolation units. In Muscat, the aircrew was changed. The outside temperature was 46°C, making it very uncomfortable for patients and crew. Due to the delay in Kabul for patient stabilisation, the next fuel stop in Somaliland was no longer possible due to early airport closure. Instead, after four hours of negotiation and on the condition that nobody left the aircraft, refueling was arranged in Djibouti. Used to unexpected circumstances, the AFD team was carrying enough oxygen, medical equipment and supplies, and the mission ended successfully, with all patients making a full recovery

Assistance & Repatriation April 2022 Cover

This article originally appeared in

Assistance & Repatriation Review | April 2022

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Publishing Details

Assistance & Repatriation

1 Apr 2022

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AMREF Flying Doctors Team

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