Dennis Stoffel, Ground Operations Manager of Jet Executive, commented: “While we as an air ambulance operator have always been prioritised in the past to evacuate patients from all over the world in order to save lives or bring back families together, we were also suffering from restricted landing permissions, overnight possibilities for flight and medical crews and lack of possible fuel stops en-route to the final destination.
While some countries are slowly opening up, the majority out of Europe still remains a huge operational challenge. At the beginning, we thought that medical evacuation would be considered as essential, but the fear of spreading the virus within a country was the major concern of most states.”
Jet Executive, having served the international insurance and assistance market for over 30 years, tried to adapt to the new situation and challenges as much as possible to serve their clients – creativity, persistence, patience and positive thinking had to be applied for operating outside of Europe. The airlines were confronted with situations where all possible options had to be carefully evaluated, to decide on the safest and best solutions for crews and the patient.
Turkey, as one of the most important ‘fuel-stop-countries’ for Jet Executive, especially on the way to India and Southeast Asia, closed its borders at a very early stage, not allowing pilots to leave the aircraft or use the toilet facilities at the airport. From a business point of view, this resulted in a very heavy impact for air ambulance operators, because at the end of a northern hemisphere winter season, many European tourists spend their holidays in Asian countries.
“The Canary Islands became our standard pre-positioning stop for most of our evacuations out of Africa, as almost all countries closed borders for crew layovers,” explained Irena Dimitrijevic, Head of Sales. Each flight had to be performed with an extended flight crew, meaning three pilots in one of Jet Executive’s Learjet. “The so-called ‘heavy crew’ picked up quite a few patients out of West Africa during the Corona lockdown, none of them were tourists, but mostly expats or diplomats who fell sick in this region and needed a treatment back home,” she explained. “After the obligatory crew rest on one of the Canary Islands, the extended flight and medical team had a long working day ahead, with a quick turn-around at the patient’s pick-up destination, followed by a flight back to Europe with another fuel stop on the way.”
The Canary Islands became our standard pre-positioning stop for most of our evacuations out of Africa, as almost all countries closed borders for crew layovers
Before each operation was confirmed by aviation authorities, Jet Executive’s dispatch team in Düsseldorf had to undergo endless paperwork with the local handling agents and embassy personnel. “We had one mission out of Banjul in Gambia at the beginning of the pandemic, and it was the last day before the country’s lockdown, thus we performed the flight all the way to Germany within one day and received the permission for Banjul shortly before our landing on the previous fuel-stop on Las Palmas,” said Stoffel. “These situations are nerve wracking because we take the responsibility and the risk on our shoulders in order to speed up the evacuation as the patients are sometimes medically in a critical condition. One day later, an evacuation would have become very difficult and the patient would have most likely remained in Banjul for a few more weeks or months. But as everyone can imagine and identify with, in the early stages of the pandemic we didn’t know what to expect and how long these circumstances will last – and if we are all honest, we still cannot predict the further development and course of the disease.”
Going above and beyond
“Due to these special circumstances, our crews were eager to make anything possible and evacuate patients wherever they could, according to local rules and regulations. While major passenger airlines were grounded worldwide, our teams were happy to undertake each flight they could during these last few months. We have an extensive risk assessment before each mission, evaluating the medical and local circumstances with all involved parties. In most cases, our medical team required a negative Covid-19 test from the patient in order to protect our crews and to receive corresponding landing permissions,” continued Dimitrijevic.
Another dispatcher told ITIJ: “Once, we had a confirmed flight for a patient leg from Kinshasa in Congo, going to France. As Congo didn’t allow an overnight stay for our crews, we decided to rest in Cotonou, Benin. Due to a runway closure and construction work in Cotonou, the airport authorities cancelled our request and we had to switch to Accra, Ghana, which again took another two full days until the overnight permit was granted. The weekend was just knocking at the door, resulting in a postponed flight of another three days. These times are not easy for the patient, the family, the air ambulance provider, nor the patient’s assistance company, as feelings of insecurity and disappointment about a postponed return flight overpower the situation.”
In the process of applying for the permits, the French Embassy and European Union delegates on site were involved and assisted in obtaining the necessary authorisations in Ghana and Congo. Stoffel told ITIJ that he had received the mobile number from an army colonel who was responsible for medical flights to Accra. After five days wait, he finally received the permit – via WhatsApp.
“Due to the closure of most hotels, we were sometimes offered the chance to stay within the facilities from our handling agent (FBO). Even though our crews agreed to stay in their rooms, we were short one bed as we had an extended crew onboard again. We were getting very creative during these extraordinary times and were willing wherever possible to go the extra mile,” confirmed Andreas Soppa, Flight Operation Manager of Jet Executive, “but sometimes there are limits, such as missing beds for our crews who need an appropriate rest on site.”
Jet Executive also had a few flights to Thailand, from where it was incredibly challenging to remove a patient. To fly a patient out of Phuket, for example, was especially challenging because there was only one place for an overnight possible in Thailand – not even Bangkok International were allowing crew layovers at a dedicated airport hotel. And even if the authorities would have granted it, all the hotels were in obligatory lockdown by law. The landing permission could only be granted with the help of an Embassy again. The last stop before dropping off the patient in Scandinavia was Baku, which again had enormous permission request procedures to go through – the aviation authorities there required proof of a landing permission number from the next stop in Sweden before the permit was granted.
Solutions are possible, no matter what the challenge
These examples from a daily life in the unscheduled medical charter business provide a small snapshot of the wider aviation industry’s challenges and current circumstances, and should mainly inform insurance and assistance companies that no airline is able to avoid any of these local regulations. But as seen throughout these examples, Jet Executive always tries to find the best solution for a successful transport back home.
“Personally, I think we can be very proud of the longest repatriation flight during these difficult lockdown times, which took place at the beginning of June and crossed four continents in total,” concluded Dimitrijevic. The routing was Munich (home base) to Rio de Janeiro, Brazil (patient pick-up) to New Delhi, India (patient drop-off), and back to Munich. “Altogether, 545 emails were exchanged with all involved parties including the client, the Indian embassy on both sides, handling agents and all fuel stops along the way. It shows how much work is needed for making such a mission possible.”
In the meantime, after an extensive market evaluation, Jet Executive has purchased an isolation unit, enabling it to transport patients who tested positive for Covid-19 or other infectious diseases – hence, the company is prepared for the new circumstances and future evacuations.