A challenging repatriation of an elderly patient from Egypt to Slovenia

Repatriating a patient requiring medical care can be a complex and challenging task, particularly when dealing with elderly individuals.

This case study outlines the difficult repatriation of an 87-year-old woman from Egypt to Slovenia, emphasising the importance of careful planning, clear communication, and collaboration to ensure a safe journey.

Despite facing numerous obstacles, such as flight issues, medical documentation challenges, and financial constraints, the repatriation was successfully completed.

A hip fracture – and a refusal to board

The patient had suffered a hip fracture while on vacation with her daughter in Sharm El Sheikh. After undergoing surgery, she was in a stable condition. The medical teams in Egypt and Slovenia cleared her for travel, issuing a ‘fit-to-fly’ certificate, confirming her stability for air travel. Commercial flight arrangements were made in business class to ensure comfort during the journey.

However, upon attempting to board the first flight, the patient faced an unexpected challenge. Despite having the necessary fit-to-fly documentation, the pilot refused to allow her on board, citing concerns about her fitness to fly. This was surprising, as the patient had been cleared by both medical teams and all arrangements were in line with the standard procedures.

This refusal caused immediate tension. The patient’s daughter was dissatisfied with the situation, disagreeing with several operational decisions, including the flight route and the type of flight. Her dissatisfaction further complicated the situation, hindering the resolution process.

Compounding the issue was a limited financial budget, coupled with the peak summer travel season. During this time, flights are often fully booked, and airlines are less likely to accommodate urgent medical repatriations or special requests. The daughter insisted on a direct flight from Sharm El Sheikh to Slovenia, which proved to be an almost impossible request.

Exploring alternatives

To move forward, alternative flight options were explored. A plan was developed to fly the patient from Sharm El Sheikh to Cairo, where a connecting flight to Slovenia could be arranged. However, after much negotiation, it was agreed that the patient would first fly from Sharm El Sheikh to Cairo and then continue from Cairo to Ljubljana. The assistance and medical teams worked closely with local partners to ensure the patient’s safe transfer between the cities, arranging medical transfers and providing care during the layover.

Despite finalising the route and securing flight tickets, another complication arose when the patient faced yet another refusal to board. At the airport in Sharm El Sheikh, the pilot rejected the patient’s boarding due to incorrect medical documentation the daughter presented. This was particularly frustrating, as the patient had already been cleared for travel, and the delays were causing growing anxiety for both the patient and her daughter. Our team intervened, clarifying the issues with the paperwork and submitting the correct documents.

A successful repatriation

With this resolved, the repatriation was successfully completed on the same day. The patient was cleared for the next available flight, and the team ensured she was safely transported to Slovenia.

Throughout the process, the local assistance team in Egypt played a crucial role. Their support in obtaining the necessary medical documentation, arranging accommodations, and coordinating local transportation for the patient and her daughter was vital to overcoming the bureaucratic hurdles and ensuring the patient’s safety during transit.

This case demonstrates the complexity of medical repatriations, especially when dealing with elderly patients, family involvement, financial limitations, and limited travel options. The obstacles faced – flight rejections, incorrect documentation, and family dissatisfaction – underscore the importance of clear communication, flexibility, and collaboration with local partners. Despite these challenges, the repatriation was successful, showcasing the value of persistence, careful coordination, and teamwork in ensuring a patient’s safe return home.