Richard Lineveldt, Chief Operating Officer
You’ve got two aircraft based in locations all over the world, including Johannesburg, South Africa, Singapore, Port Moresby, Papua New Guinea and Dubai. Where would you say your headquarters are, or where your operations are coordinated from? Why did you choose this destination?
Air Rescue’s headquarters are in Dubai and our offices are located at the Airport Free Zone, which is co-located with our global Mission Control Centre. The decision to establish HQ here was made with a view to take advantage of Dubai’s strategic location, modern infrastructure, and stable, business-friendly governance. It works well in terms of time-zones, based on where we operate and is, during normal times, a very convenient business travel hub.
Do you own the aircraft you operate? How long has it taken you to build a fleet of such a size, and what prompted the choice in variety of aircraft?
Our operating model is asset-light and our preference is to procure the aircraft supply through long-term provider agreements with trusted aviation partners. In so doing, we are able to tailor our offerings based on each region’s unique demands in terms of aircraft capacity and capability. We are first and foremost a medical service provider and our medical crew are highly trained and capable of delivering advanced life support and intensive care both in the field and in the air ambulance setting, supported by state-of-the-art medical equipment. The fleet composition we have today effectively addresses the current needs of our clients, but we are continually working on reshaping the delivery models in order to anticipate future demand and shifts in activity levels.
You say on your website that you are the ‘only licensed provider of air ambulance services in Dubai’. Could you explain in more detail what this statement means – licensed by whom and to do what? Do you have a monopoly on business out of Dubai?
We are proud to be licensed by the Dubai Health Authority (DHA) as a healthcare provider. The local regulations are extremely stringent and Dubai is world-renowned as a center of medical excellence. This endorsement and the strong relationship we have with DHA reaffirms the standards we set and strive to exceed on each mission. We obviously gain some benefit from being based in Dubai and our local network and infrastructure are deployed to best serve our clients, but we do not take this for granted and most certainly don’t consider ourselves to have a monopoly.
Accreditation can be a vital symbol of adherence to quality standards. Are you finding that more customers are seeking accredited providers these days?
It varies from client to client, and depends on the credentials of the provider in question. We have been in business for more than 20 years and our clients have come to appreciate the quality standards we have in place – we are certified ISO 9001:2015. We have extensive processes in place to manage quality and safety, covering both aviation and medical components as well as including independent audits, resulting in the accreditations we maintain with the European Aero-Medical Institute (EURAMI) and local air ambulance regulators.
How has Covid-19 affected Air Rescue Group’s operations?
As most colleagues in the industry can attest, the start of the pandemic saw a significant reduction in evacuations due to restrictions that were put in place, virtually overnight. The first few months saw us finding our feet in a totally new environment with a myriad of new conditions and restrictions, which ranged from protocols for transportation of infected patients to securing destinations that would accept these evacuees. Once the landscape became clearer, we hit our stride and have been exceptionally busy ever since. We are especially satisfied with the way in which we have been able to support longstanding clients with very challenging mission requests. Although flights have had to be longer and more complicated (which translates to lengthier activation times and increased costs), we have always been able to find workable solutions.
I am especially proud of the resilience shown by our Medical and Operations teams throughout the pandemic. They have overcome an immense amount of adversity to provide life-saving care to our clients and embodied our values throughout.
As our activity now starts to rebalance back to business-as-usual work, we are in a great position to restart work on our longer-term growth agenda.
Dr Fraser Lamond, Group Medical Director
Could you give us a brief inight into your background in the aeromedical industry?
It seems like only yesterday my trauma unit pager went off telling me to get to the helicopter for my first HEMS mission as a flight doctor; it was a real thrill! We did six missions during that shift. This was back in the late 90s on the Johannesburg Hospital Flight for Life HEMS – the only 24-hour HEMS in Africa.
Some seven years later, and with many hundreds of memorable missions under my belt, I moved more into the fixed-wing aeromedical sector and was working as a flight doctor for an assistance company when I was approached to set up and run what was then the beginnings of Air Rescue in Africa.
We commissioned the first fully dedicated jet air ambulance in June 2000. The rest is history. By 2007, we were the busiest jet air ambulance operation in Africa and had achieved Commission on Accreditation of Medical Transport Systems (CAMTS) accreditation. We were the first air ambulance operation outside the US and Canada to achieve CAMTS, and EURAMI followed soon after. By 2015, we were running three air ambulance jets and performing upwards of 30 missions a month.
What is recruitment of medical crew like for you – is it always a challenge to fill requirements, or are you spoilt for choice?
In South Africa, we are very fortunate to have medical staff who gain enormous practical experience in all types of emergency paediatric, adult and obstetric care. It’s the mix of a very developed healthcare system in a developing environment. The additional training available to those with an interest in emergency care, transport or retrieval medicine is freely available, so skills are easy to find – in my view. The challenge is the turnover of medical staff who, of course, do not want to spend their lives constantly in the back of an aircraft. Good planning, recruitment strategy and strong medical leadership are essential to stay ahead of the game.
Do you think that wing-to-wing missions are necessary in international medical repatriation services? Is there anything that can or should be done to enhance patient safety during such missions?
I do believe there is a need, simply because of logistics and the fact air ambulance companies cannot perform every mission themselves. It can potentially pose a risk if the cases are not properly medically triaged for such missions and the risk, if any, should be mitigated by using reliable air ambulance partners with recognized accreditation or standards of practice. We, for example, have done wing-to-wing repatriation missions, but using our own air ambulance based in Dubai to meet up with our air ambulance based in Johannesburg (JHB) to allow for a seamless uninterrupted transfer to South Africa.
When it comes to working with international medical assistance providers, what is the most important aspect of maintaining a good working relationship under time-sensitive, stressful and costly mission parameters?
It’s all about real-time open communication pathways and processes agreed in advance to meet the clients’ requirements for information, both logistical and medical. Direct relations with the client stakeholders – for example, medical director to medical director – in any challenging situation is essential. Using tools like flight tracking to help clients follow the flights in real time themselves are also helpful.
What’s the most challenging mission you’ve ever undertaken?
For me, it’s always the emotional cases that can lead to clinical dilemma. I can recall flying a tourist who was involved in an aircraft accident in Kenya, and I was tasked to bring him to South Africa for specialist burn unit care. He had 90 partial and full thickness burns with some inhalation injury. He was 48 hours after the accident, but his calculated mortality was still over 100 per cent. I knew he would end up on a ventilator and his care locally had not been adequate. He was fully conscious so I explained to him what his situation was and that I would prefer to be conservative and not ventilate him for the flight and manage his pain as the priority. His wife was flying from Europe and would meet us in JHB. He agreed as he knew he may not speak with his wife again. We spoke a lot on the four-hour flight back to JHB; his wife was waiting in the ER on our arrival. They spoke; he died seven days later.