Empathy, Teamwork Critical To Successful Aeromedical Flights

LONDON–According to the much-quoted proverb, raising a child requires the entire community to contribute. The same is true when repatriating children and babies by air, according to Charlotte Young, chief operating officer of the charity Lia's Wings.

The work the charity does, she told a recent British Business and General Aviation Association (BBGA) conference here, cannot happen in a vacuum.

Lia's Wings, which is based at London Biggin Hill Airport, does not operate its own aircraft but funds and organizes transfers of children and babies between hospitals, both domestically inside the UK and internationally. It works with a pool of aeromedical service providers that operate permanently configured air ambulance fleets—usually Beechcraft King Airs or Learjet types. Many of its flights involve babies, some born prematurely, so in addition to the standard equipment installed on air ambulances, Lia's Wings has its own flight-ready incubator it deploys as needed.

Ensuring this 100 kg (220 lb.) piece of equipment can be carried and operated correctly is a significant challenge, but so too is managing the other likely passengers.

"When traveling with children, you've got to remember that you're traveling with parents," Young says. "So it's not just the medical care that the child needs [that has to be considered and delivered]—you've also got parents who are very emotional, very traumatized by what they're going through. So, as a team, we must be looking after them as well."

And while Lia's Wings' staff will handle most communication with the operator, aeromedical service providers also have to understand the fraught dynamics at work when dealing with parents. If the patient on a repatriation flight is an adult, and even when that flight may be operated for a travel-insurance company, the operator will often need to deal with anxious family members. However, flying an infant requires a particularly deft touch from all parties.

"A lot of the time, the management of the child is much easier than managing the parents," says Gareth Evans, aeromedical services director of Belfast-headquartered repatriation fleet operator 247 Aviation. He offered the notional example of a family who have traveled early during pregnancy and experienced premature birth while abroad.

"Logistically, they're already in a foreign environment," he says. "They've given birth not expecting [to do so at that stage], and then all of a sudden they now need to get back. We can quite often involve the hospital [and begin] to speak to the UK NHS [National Health Service] accepting teams, who are in communication with the hospital abroad to deliver a collective plan for the child. But the parents are quite often left on their own."

Just as important is ensuring parents understand what is happening, how, and within what limitations. For many people who find themselves in need of emergency repatriation, in addition to the obvious and pressing difficulties, this will be the only time they may ever travel on a non-scheduled flight or perhaps on an aircraft smaller than an airliner.

"It's probably the first time they're on a private jet, and they don't know the environment," says Dr. Leemeshan Moodley, deputy medical director, aviation and maritime, at remote medical, security, and operational support provider MedAire. "Something as simple as luggage: they're on holiday and they've got four suitcases, [but the operator has to explain that] it's a medicalized aircraft, so [they should only carry] a small hand luggage bag, if possible."

Finding staff with the necessary combination of empathy, organizational skills, and specialist medical and aviation knowledge is a huge challenge. But this specialist sector does not struggle with retention, according to Lisa Humphries, business development director of Gama Aviation's special-missions division.

"A lot of the operations people have been in an ops department for many years," she says. "Thirty years ago we had young operations people who started to learn about air ambulance; you pick it up and you just teach, recruit, and promote within. It's not something you see a big turnover of staff in, because it's such a rewarding thing to do."

Even some of the most implacable opponents of business aviation—whether on environmental or social-justice grounds—consider emergency and medical repatriation flights to be an acceptable use case. However, Young stresses, those ostensibly less necessary flights sustain the businesses—operators, FBOs, airfields—that enable the medical flights to take place.

"We're all part of a big network," Young said. "I think sometimes perhaps the negativity might come from the perceived stereotype of a rich person getting on a plane and going from one place to another. But actually, if those people aren't doing that, then an infrastructure doesn't exist—and we all need to remember that we're operating as an industry, and our part couldn't happen if those parts didn't happen. So I think it is about balance. Everyone serves a purpose."