When Malaysia was celebrating its 64th Independence Day on August 31st 2021, our operations team received a case notification of a patient in Vientiane, Laos awaiting medical evacuation to Malaysia for treatment.
The Background
It all started when Don was throwing up coffee ground vomitus and noticeable bleeding in his stool. Don, who has a history of heart problem and is on long-term medication, admitted himself to a hospital immediately. He knew something was not right and thought it could be due to the change of medication prescribed by a doctor who wasn’t his regular General Physician. The doctors at the hospital carried out an ultrasound and that’s when they found out he has severe liver cirrhosis. What comes after this would be a series of treatments. The treating doctor informed him of the complications that may arise if he goes through with the treatment plan at the local facility. In case of severe bleeding, extensive surgery cannot be done due to the lack of technology and expertise. Understanding the high risk compounded by the limited medical capabilities in the country, Don shared his situation with his employer who is based in Malaysia.
The request made to us was simple – to evacuate Don, A.S.A.P.
Who Is This Patient?
Don has been working in this company for 3 decades and to the owner of the company, Don is part of the family. It is worth mentioning because this is a private case (non-insured). Don needs to be treated at a medical facility that is capable of providing him the level of care with multidisciplinary approach. After discussing with the doctors in Malaysia, Don was to be transferred to Kuala Lumpur, where his employer is also able to personally care for him and his wife throughout his admission.
Our Role
The request made to us was pretty simple – to evacuate Don, A.S.A.P.
Challenges
In view of the global pandemic situation that we’re in today, cross border transfer requires clearance from many levels. Fortunately, the patient has completed 2-doses of Covid-19 vaccination. The PCR test done urgently showed he is Covid-negative which made the process a lot less complicated.
1. Regulations vary from country to country and fluid. This resulted in us receiving different information from different parties.
2. Commercial flight transfer was not viable. Flight options were limited, and the journey would be too strenuous for the patient.
3. Don’s condition is deteriorating fast.
Action
In discussion with the treating doctor, our medical director assessed Don’s medical records and recommended an air ambulance transfer. We secured confirmation from the receiving hospital of the client’s choice and sorted out all the paperwork required for a cross border transfer.
The medical evacuation was carried out the next day, within 48 hours upon confirmation from the client to proceed.
• Hawker 800xp with life support system and mobile ICU arrived in Vientiane at 16:00hrs local time. Patient was handed over to the medical team without any complications.
• Aircraft departed from VTE airport to SZB airport, arrived at 20:30hrs local time.
• Regal Ambulance, our own fleet of ground ambulance awaiting at the tarmac, received the patient.
• Don was safely handed over to the receiving hospital.
• Mission completed at 22:15hrs local time.
How do we feel?
In retrospect, though the logistic coordination for this case was fairly smooth, it is not common to carry out a cross border transfer in such a short time frame during pandemic times. The local authorities are at their maximum capacity in coping with the increasing Covid-19 cases in the country and is often slow to respond through the usual communication channel. A lot more effort was put into ensuring all the necessary paperwork are sorted in time.
At the end of the day, that feeling when the patient’s family says “Thank you” never gets old…