Crab,
If you look at the map or Sat Photo of the town/airport....a departure can be made so there are light references but not for long (contingent to wind direction)....otherwise it is simply a very dark area for many miles to the destination which is a very small settlement too that is a very small bunch of lights in a sea of darkness.
NVG's would greatly improve the Safety of that Operation....as using them is the only way to fly in the dark. The Mark I Eyeball just doesn't compare to NVG's for seeing in the dark. As you well know. There is not enough Carrot Juice in this World to enhance normal vision to compare with NVG's.
Is the CAA/EASA going to allow UK Operators to use NVG's at Night when doing the EMS/Air Ambulance mission?