ACE Air & Ambulance's response during Cyclone Idai

Ann Beattie reports on how ACE Air & Ambulance (ACE) responded during Cyclone Idai
 
In March of this year, the cerulean water of the Indian Ocean, which usually soothes and beckons beachcombers, turned into an angry tempest of destruction on the east coast of southern Africa. The warnings came too late for most, and Cyclone Idai pummelled through Mozambique with winds of almost 200 kph and continued its devastating and deliberate march through the Chimanimani and Chipinge districts in the eastern highlands of Zimbabwe, dumping over 30 inches of rain in a record amount of time and resulting in massive flooding.
 
Cyclone Idai’s track
Idai began its decimation in Malawi on 15 March, and then veered back out to sea where it recharged and gained strength for a second assault; the category-three storm travelled into the Mozambique Channel, where it pounded the coast for days, hampering the efforts of any rescue operations. Having killed hundreds of Mozambicans and affected approximately three million people, Cyclone Idai then set its sights on eastern Zimbabwe, a part of the world that rarely sees natural disasters of this enormity. The carnage and ruination left in Idai’s wake was a humanitarian crisis of untold proportions, leaving the United Nations to classify the cyclone as ‘one of the deadliest storms on record in the southern hemisphere’.
In the blinding rain and the swollen rivers of Chipinge and Chimanimani, thousands of terrified victims were clinging to tree branches and scrambling for rooftops, if they were lucky enough to have a roof left at all. As the waters rose, Zimbabweans watched helplessly as homes, roads, bridges, animals, crops and whole mountainsides crumbled under the deluge, and cars and buses full of people were turned upside down. Driving winds and torrential rainfall hammered the area for tortuously slow hours and days, forever altering the landscape of eastern Zimbabwe. Whole villages have been erased from the map and the broken families continue to search for lost relatives buried under the rubble, debris and mammoth rocks, some the size of a canyon. 
 
Rescue mission
Natural disasters of this magnitude create breeding grounds for deadly diseases, dangerous living conditions and horrific circumstances. But they also create heroes. The stories that have come out of the remote rescues executed by ACE are incredible accounts of a brave team with an unerring determination to save as many lives as they possibly could. ACE had been commissioned from the beginning of the storm to assist with rescues in Tete and Beira, Mozambique, as they already had a helicopter in the area. Circumstances prevented the pilot from departing as the cyclone hit, and for three days he was stranded without any communication. Eventually, ACE headquarters learned that the pilot was safe but that the Bell LongRanger helicopter had been destroyed. Fortunately, the global resources that ACE has at its disposal allowed for a replacement Eurocopter AS350 helicopter to be brought in immediately, which was then fitted with full advanced life support equipment.
The carnage and ruination left in Idai’s wake was a humanitarian crisis of untold proportions
As the storm dissipated and the dreadful scenario of the aftermath emerged, ACE was anxious to get help to the survivors. Working closely with the Zimbabwe Government and military, private sector aid groups and private philanthropists, ACE helped to co-ordinate rescue missions in the most precarious situations. Gaining physical access to many areas in the expansive radius of approximately 500 km was a massive challenge; the roads and bridges were wiped out, the deep gorges and ravines were dangerous and unstable and the continuing rains impeded some of the rescue missions. The most critical and urgent need was medical aid, but stranded and injured victims also needed food, water, blankets and supplies. In a society that is not accustomed to readily available fresh water bottles, thirsty people were scratching around for containers of any kind in which to hold scarce drinking water.
A well-executed plan to deliver these supplies to remote and isolated areas was arranged through a collaborative effort that included seven donated helicopters, help from volunteer groups and overwhelming donations from ordinary citizens. Well-known businessman and philanthropist Strive Masiyiwa of Econet was responsible for funding the helicopters and the rescue mission. When his colleague asked if he was aware of the exorbitant costs his donation would incur, Strive responded by asking him what the price of one human life would be. 
 
Logistics
The logistics of the operation included positioning a mobile jet A1 fuel bowser at the Command Centre in the Mutare aerodrome in Zimbabwe. Fuel drums were placed in the faraway areas for refuelling purposes. This meant that dispatchers had to camp nearby to routinely check the supply and quality of the fuel. As food and medical supplies arrived through donations, both local and from abroad, they were helicoptered in.
ACE worked tirelessly flying their helicopter nonstop from sun-up to sundown. The ACE crew in the helicopter consisted of the pilot and two paramedics. The long hours of flying required carefully planned crew rotations in order to meet operational requirements. Each mission was at least 30 minutes to one hour. The lack of accommodation further complicated this aspect, and often saw crew camping with limited food resources. The team on the ground experienced communication difficulties as cell phone coverage was compromised by the storm, so ACE provided ground-to-air radios and set up a mobile air traffic control through the Zimbabwean Army in order to provide reliable communications.  
The handling capacity of the local hospitals and clinics had to be assessed continually as the patients streamed in. Because most of the local rural clinics had been destroyed in the storm, the medical facilities were critically lacking in staff, as well as the amount of equipment and medication needed to treat the high number of patients they were seeing. Many volunteer doctors were helicoptered in to assist nurses and ACE set up a patient triage system to determine the severity of individual cases. The more serious cases were sent directly to the provincial hospital in Chipinge, which remained unaffected by the storm (other than the higher volume of patients), or to Mutare Hospital. 
Shingi Chibvongodze, Public Relations Manager for ACE, and Leader of the Command Centre, commented: “The most heartbreaking stories are the ones of women and children.” He tells the story of one courageous mother who nursed her baby while suffering the unthinkable agony of two broken femurs. ACE airlifted her to Mutare Hospital for emergency treatment. Another challenge arose when some mothers refused help or treatment in order to protect the remaining surviving children who would be left behind. 
It was exhausting and traumatising work for all the rescuers as they faced the difficult decisions of which lives could be saved and in what order. In the first two weeks of the operation, priority one patients were ones with limb or life-threatening conditions resulting from polytrauma caused by crush injuries. The secondary cases were large numbers of compartment syndrome and secondary infection from unmanaged or home-managed fractures. After the second week, cases of dehydration, pneumonia and malnutrition rose, and later on, malaria kicked in. The complicated distribution of food, medical supplies, fuel, and medicines required constant attention and organisation, as the situation was fluid and subject to availability. Recalling the triumphs and victories at the end of each day kept the dedicated rescuers inspired to continue the gruelling work. 
 
The work continues 
A social media post from James Halsted, Managing Director of ACE, three weeks after the cyclone, vowed: “We are here for everyone, no one is charged and no one is left behind! We will continue the operation until every ill or injured person is taken to an appropriate hospital in safety and comfort. We are the only helicopter in the whole province attending to medical evacuations, so the day is fully booked up with calls from all corners of the province. Our team will do all it can to get to you in the shortest time possible!” 
Stories of catastrophic storms come and go, but much of the devastation left in their paths is permanent. For the survivors of Cyclone Idai, life will never be the same. The ACE team has single-handedly rescued more than 250 victims. Currently, at nearly three months post-storm, ACE continues its endeavours in assisting Cyclone Idai’s many sufferers and is immensely proud of their successful rescue efforts and the valiant team on the ground given the sheer size of the area, the complexities that exist in Africa and the severity of the storm itself.  
For more information about ACE Air & Ambulance, visit www.ace-ambulance.com. This rescue operation is on-going. If you would like to donate, please contact ACE.
 
Mark Smythe, the Operations Director of ACE and an active traumatologist who was instrumental in the task force deployment on the ground, helped rescue a seven-year-old boy with an arm broken in two places. When Mark asked the frightened boy about his family, he replied, “They’re already buried.” Mark also tells the harrowing story of a 43-year-old man whose feet were solidly trapped under a concrete slab. He held his wife and child by one hand, and his second child by the other hand. As the water levels rose steadily, the courageous man amputated both his feet in order to release him and his family from the jaws of death. 

 

One of the most amazing stories to come out of ACE’s rescue mission was the story of an elderly lady who was riding in a commuter bus in an attempt to escape the rising floods. The bus was washed away and rolled down the river amid the snakes, crocodiles and rough waters. She was the sole survivor. For seven days, the destitute woman camped by the bus, sitting on top of a muddy anthill. She survived on handouts from villagers. When ACE rescued her, they decided to break the rules of the original flight plan and reunited the senior citizen with her frantic family 25 km away. 

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