Sahara medical emergency guide (suitable airports)

[Omegant]

Hi, I recently did a flight to Lagos (Nigeria) from Europe. We had a possible medical emergency on the return flight, it finally was nothing but a faint. But we had a discussion at cockpit about how to proceed. Captain wanted to divert to Tamanrasset because it was the nearest airport. I told him that it was almost the same as letting someone die at a mountain road, that there are no mayor hospitals at Tamanrasset worth the name and even if there are, at 4 am no doctor is going to be ready. My point is that it´s safer to keep north for an hour or so and get at least to northern Argelia, and from then in 15 more (depending the urgency min you can be at an European hospital (Malaga, Ibiza, Cagliary, Malta, etc..).
Even our Head flight attendant had a previous experience diverting to Tamanrasset on a medical emergency, the whole aircraft was kept there till a "Tax" was paid, and the passenger with a stroke had to call a private aircraft to come pick him up (he luckily was a wealth guy). Not a recomendable experience at all. Even then the captain was convinced that is what he had to do, because if not he thinks he could be charged in a trial for not trying "something".:ugh:

Long story short, somebody told me that there is a BA guide for medical diversions in North Africa (which airports and cities have suitable hospitals and such). Does anybody has this (or a similar) guide?, I would really appreciate if someone could send me or point me to a place to get it, even if it´s not up to date.

I would like to provide it to our Chief Technical Pilot as a base to develop our own guide. Hopefully this way some lives will be saved and some bad experiences avoided.

[ASRAAM]

Following advice from Medilink we diverted to Tamenrasset on a flight from London to Abuja. Allegedly there was a critical care unit in Tamenrasset. The diversion was initiated using CPDLC and actually went fairly smoothly from an ATC point of view. Concluding in a VOR approach.

After landing it took a while to get steps onto the aircraft and it then became clear that the ambulance was coming from some distance away from the airfield. When it did arrive some 40 minutes after landing the local authorities would not initially allow the seriously ill passenger( a Nigerian gentleman) to disembark in case he was unable to pay his medical expenses. Eventually suitable reassurances were provided and the ambulance left for the hospital about 90 minutes after landing.

We then had to borrow some 4200 USD from a first class passenger to pay the landing fees (B777) as the B A company credit card was not acceptable.

I think it unlikely I would wish to repeat the experience.

[Omegant]

Thank you, That´s exactly my impression on what would happen, for all that trouble is better to continue and land at an EU country, it´s better for both the ill passenger and the rest of the passengers and crew.

So I understand that you don´t have general guidelines for medical emergencies over Africa, you always contact Medilink?. I´m looking for more information on Medilink but I´m unable to find it. How does it work, what are your procedures?

[172driver]

Omegant, in my line of work I have seen a fair number of African hospitals (although not the one in Tamanrasset).

Your line of reasoning is, IMHO, 100% correct.

[TopBunk]

Omegant

It is MEDLINK not medilink. They are a Phoenix, USA based company contracted by BA (and others) to provide diagnosis, medical advice, and on the need to divert/continue and have knowledge on facilities available worldwide and will arrange for ambulances/doctors to meet diversions etc.

The ultimate decision rests, of course, with the Captain.

Edited to add: they are contactable by ACARS and Satphone]

Hope that helps

[dasher3]

I don't even like making a fuel stop there, let alone doing something outside their very limited envelope of understanding.

[Omegant]

Thank you Topbunk I was having problems identifying which medilink company it was :} (There are quite a few of them). Now I got it. I´ll recommend the company to my boss, it´s a good idea to have such service available. Although almost 90% of the time there is a doctor on board I rather have the option to call them.

None of you have ever heard of a list of suitable emergency airports+hospitals?. It would really be very handy as an starting point.. I guess flying over the Sahara for medical matters must be considered almost as being in the middle of the Atlantic.

Thank you again

[andrasz]

I guess flying over the Sahara for medical matters must be considered almost as being in the middle of the Atlantic.

Absolutely. I have fairly extensive first hand information about on-ground conditions of most Saharan areas, would not consider any of the airports listed as technical alternates for a medical diversion. I would avoid landing an airworthy aircraft for any reason in Libya south of the Mediterranean coast, and anywhere in Niger other than Niamey. I'm not up to date on whether overflying Mail is possible now, but same applies. Chad and Algeria are OK to land for a technical reason if continued flight is unsafe, but as previous posts have shown, expect lengthy delays and zero facilities.

[ZAZOO]

A medical emergency or urgency inflight. So how do we define this agonising situation and make a reasonable life saving decision or effort as flight crew members.

Are we trained to diagnose the problem with the passenger, how do we know if what he has is a mild problem or life threatening. How do you know that there are no major hospitals at Tamanrasset worth the name and even if there are, at 4 am no doctor is going to be ready.

Supposing the passenger gets worse and even dies as you keep north for an hour or so and get at least to northern Algeria how would one explain that and get the ok knod that your decision was at least fair.

And say after talking to MEDILINK "if u have that service" which I dont..They recommend immediate hospitalization and diverting asap..

And finally what would you do if this same situation happened to you and nearest airport was Tamanrasset.

I'm definetly thinking about this one. Thanks Omegant

[andrasz]

what would you do if this same situation happened to you...

Knowing the ground conditions first hand, the decision to me is clear. If there is no imminent threat to the airworthiness of the aircraft itself, I would press on to at least the North Algerian coast, but preferably till the closest European airfield (Malaga, PMI, Catania depending on the routing).

If the emergency is such that the affected person will not survive another 2-2.5 hours on the aircraft, then there is a close to zero chance that landing at any of the Saharan fields will achieve anything. Given the available infrastructure, even if medical facilities are eventually available, it is extremely unlikely that the passenger will receive the necessary care within 2 hours of landing. In a critical situation it would be much better to have a forewarned emergency team ready at the bottom of the stairs in two hours, than to land immediately and start lengthy negotiations at an unprepared Saharan locality. As I'm sure all of us regularly conducting our affairs on the fine continent know, haste is an unknown concept south of the Mediterranean (some would argue south of the Alps, but the jury is still out on that one :)).