Remote and Geographical Challenges | Air Ambulance, Medical Repatriation

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Buhara Demir, Marketing and Key Account Manager of Redstar Aviation

Due to its location in Turkey, multiple patient transport capabilities and experience with carrying out evacuations from war-torn areas, Redstar Aviation often works with patients affected by war and terrorism in nearby countries such as Libya, Afghanistan, Iraq and even Djibouti, said Manager of Marketing and Key Accounts Buhara Demir at the (ITIC Global Barcelona 2017) “Remote and geographical challenges” session. The company is commonly challenged by patient visa issues, unreliable medical reports, permit access, overflight issues, and having to deal with multiple authorities for various individual missions. “This is often because neighbouring countries have issues or tensions with each other, or they are at war. Redstar Aviation carries out a lot of risk mitigation work – with airports, teams on the ground, and local contacts – to get an assessment of what’s happening on the ground at any point in time. Nevertheless, situations change very quickly, and even with the best preparation, plans often need to be adjusted or missions aborted in some cases.

Buhara gave the example of how a missile attack had changed a flight route in one case: the plane, coming from Libya, had to land in Malta because at the time it was the nearest place that would allow a plane to land from this country. Despite having to factor in whether the aircraft had sufficient fuel, the ground ambulance, naturally, had to be rearranged too, and so, said Buhara, it pays to have good partners to assist in such situations. Redstar categorises countries into three levels based on their individual risk and security assessments.

  • Level 1 includes ‘no-go’ countries, such as Yemen, Syria and North Korea.
  • Level 2 countries have airspace warnings or are internally assessed as posing a significant risk but are accessible, and include Iraq, Libya, Afghanistan, Pakistan and Somalia.
  • Level 3 countries require ‘caution’ and include Sudan, Djibouti, Iran and Saudi Arabia.

The company has a Safety Review Board that determines these categories based on airspace security, a country evaluation and available infrastructure. Pre-flight audits are also carried out, with further information taken from a number of international agencies, before the decision is made to ‘go’ (with Plan B options and an entry/exit strategy in place) or consider the area a no-fly zone.

Even with the best preparation, plans often need to be adjusted or missions aborted

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Buhara continued by providing examples of missions in which technical and security issues had been overcome, before looking in more depth at how the company provides services in Iraq, Libya and Afghanistan and the challenges faced when operating and planning missions in each of these countries. Over the past  15 years, the assessment of risk has changed, concluded Buhara. We need to be transparent and work together, he said, to find solutions for customers.


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