To Islandgirl (and others who ask the same question): ...And where does the money come from? If a government doesn't even have enough money to fix a navigation beacon, how on earth would they be able to afford a "medevac capable" helicopter? Answer: They can't.
In Honduras, my boss provided our private helicopter as free emergency medical transport to the residents of our small island (Guanaja). The necessity of the transport was determined by the local doctor; I was not involved in the go/no-go decision (only the fly/no-fly one). It was supposed to be "life or death" and generally it was the case that the people I flew probably would have died otherwise...maybe.
Fortunately, the FH1100 converted easily and cleverly from passenger to stretcher configuration. Although it could accommodate a basic rectangular "backboard" type of stretcher, we fabricated a smaller one that was easier to use.
And no, neither the local government of Guanaja nor the federal government of Honduras had the money to provide such airborne service on their own.
In fact, one of the very sad ironies was that when I'd land in the nearest big city on the mainland (La Ceiba) we'd often find that there was no ground ambulance available either. See, there is no money to fund public EMS, so that service simply does not exist. In Honduras (and probably many small countries as well), if you're going to the public hospital, you have to get yourself there no matter how badly you're injured. (BTW I was prohibited from landing directly at the private hospital, and the public hospital does not have a heliport.) My passengers often finished their journey in taxicabs or the bed of a pickup truck. Many times it was heartbreaking (especially if you're familiar with the roads in poor Central American countries).
And in case that picture didn't post, try this:
http://bp2.blogger.com/_s8Qzr1EyjkA/...s+Pics+024.jpg
Maybe we've come to a point where people assume a certain standard level of care - that air and ground ambulances are always available everywhere. They are not. As an tourist, you have to realize that if you're seriously injured outside of your home country, you may very well die and oh well, tough luck.
And if someone lives on an island like Saba, they must do so with the sober understanding that certain sophisticated medical help may be unavailable. Just because there is a "sightseeing helicopter" nearby guarantees nothing...heck, doesn't even imply anything in the way of medical transport.
Municipal helicopters are great tools, but they are very, very expensive, especially as infrequently as they are needed and used in an EMS role. Assuming that every government can afford a helicopter big enough to function as an occasional 24/7 all-weather air ambulance is rather naive.