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Emergency medical evacuations (medevacs) are extremely technical. Evacuating a member within Africa complicates things even further. In this guide, we go into full details about how medevacs work, what they mean for the member, and how we overcome typical challenges that emergency situations in Africa present.
When a member falls ill or suffers an injury, there’s a chance the treatment they need isn’t available locally. In Africa, this chance is much higher. It’s a huge continent and, depending on the severity of the injury or illness, suitable medical facilities may be few and far between. This is where emergency medical evacuation cover comes in. If one of our members suffers a life-threatening of limb-threatening illness or injury, we transport them to the closest hospital for urgent treatment. We handle all aspects of the evacuation, including liaising with medical teams on the ground, logistics, securing admission at the destination hospital, and handling passport/visa issues.
A member (or their representative) calls our 24/7 emergency medical assistance helpline to notify us of an emergency. The number is +44 (0) 1243 621 155.
Our operations team assesses the situation on the ground, while our medical team establishes the particulars of the member’s medical condition.
We organise the evacuation destination and the means of transport that best suit the member’s interests. We take several criteria into account, including severity of the member’s medical condition and air ambulance availability.
With the member’s admission secured at a destination hospital, we dispatch transport. We collect the member from their medical team on the ground and get them to an air ambulance.
All our health plans come with cover for emergency medical evacuations as standard. But members can optionally upgrade their cover to Medevac Plus for additional benefits.
Cover
Medevac Standard
Medevac Plus
In most cases, a member (or a relative of the member) contacts our dedicated 24-hour emergency helpline at Charles Taylor. Sometimes, the member’s local medical team call the helpline. In a few cases, the member’s broker has contacted the helpline! It doesn’t really matter how: as long as someone calls the helpline, we can start the medevac process.
Given the emergency situation it is rare that we get calls directly from our member, but it has happened. When this happens, we simply engage Charles Taylor, our emergency assistance partner, on behalf of the member, and ensure that the member and Charles Taylor have open channels of communication as the clinical assessments, and logistical arrangements are made.
Two teams at Charles Taylor convene to progress the medevac case. The operations team gathers all relevant information about the member’s situation, while the medical team contacts the patient’s local care providers to establish the member’s medical condition.
If we don’t already know (very unusual), Charles Taylor let us know about the member’s medevac case. We check the member’s policy for eligibility and hand over the management of the case to Charles Taylor. Qian Huang, the Head of Claims at William Russell, keeps the senior leadership team informed about the case.
The operations and medical teams at Charles Taylor work together to form a plan suited to the member’s situation. Here, we take into account several factors (which we explain below).
The decision-making framework at William Russell is solely based on clinical best practice, and the safety and health of our members.
If an evacuation is necessary, our sole aim is to relocate our member to the nearest, and most appropriate medical centre of excellence. The purpose is ensuring the best clinical outcome. We, at all times, liaise with our members and their immediate family, as well as with their appointed representatives (if we’re asked to do so).
There are several factors that need to be considered as we determine both the destination, scheduling and method of evacuation:
Is the patient stable enough to evacuate by air or road? In 9 out of 10 cases we evacuate by air ambulance, and a key consideration is whether the route to the airfield facilitates a safe ground transfer.
This is extremely important in cases of head injuries, complex fractures, and/or spinal injuries.
We take into account the wishes of the patient. For example, we might evacuate the patient to a centre of excellence nearer to their home country.
We have pan African medical evacuation capability provided via a roster of specialist companies. The partners we use are experts in medical evacuations, and aviation medicine, which is a complex area of medicine.
The providers we engage are vetted against a rigid set of criteria that covers both geographical reach, company size, and performance KPI’s.
International travel means paperwork, even when it’s an emergency.
For example, transferring into South Africa requires a significant amount of paperwork, whereas Kenya is more straightforward and therefore evacuations to Kenya can be expedited compare to South Africa.
Any potential delays in getting our members to a facility does form part of balancing the clinical need of our members, with their preferred destination.
Over the last 30 years we have built extensive knowledge of rural runways across the African continent. Most rural runways have no lighting and so cannot facilitate flights after dusk. If we’re notified of a medical emergency in the afternoon, it is unlikely that we’ll be able to land a plane to evacuate the patient on the same day.
Generally, from being alerted of a potential medical evacuation case, to completing the clinical and logistical assessments, air transfers take place within 24 hours, and, for patient safety, they routinely need to take place during daylight hours.
Whilst we clearly need to operate within the terms and conditions of the member’s plan, we do routinely exercise discretion and flexibility.
In a recent case, one member suffered burns in Botswana. Our Clinical Team concluded that a satisfactory outcome could be achieved in Botswana. However, the best outcome would be delivered via treatment at a centre in South Africa, and the member was evacuated to South Africa for treatment.
Nationality affects the destination we select. Certain nationalities might have visa requirements or access difficulties, which are difficult to overcome in an emergency.
Restrictions in international travel as a result of the COVID pandemic, local outbreaks of disease, civil unrest and/or conflict all contribute to our decision making.
At all times in emergencies, expediting a transfer as quickly and safely as possible is at the centre of our thought process.
When expediting evacuations, we ensure the focus is on looking after members which includes only incurring costs that are relevant and appropriate for their plan level.
For emergency medical evacuations in Africa, we partner with Charles Taylor. Charles Taylor is a EURAMI accredited organisation and is one of the world’s leading providers of medical assistance and provide over 500 air evacuations per year.
We work with a number of air ambulances in Africa, on a case-by-case basis, including:
A number of variables will determine which route is taken, from which air ambulance company is used to medical treatment destination the patient requires. Here are some examples:
Location of patient
Origin of air ambulance
Destination of air ambulance
Back to Africa Hub
No. Our medevac service does not include search and/or rescue.
We handle emergency medical evacuations with the highest degree of urgency. We’re very aware of the expectation of our members and their families for instant (or ‘within the hour’ evacuations). However, this is neither medically possible nor safe for any insurance provider with customers in Africa, for legitimate reasons. Below, you’ll find an overview of our process.
Step 1. Our medevac team must undertake a clinical assessment of the member on the ground, and—where necessary—arrange for immediate life-saving medical interventions and care. The aim here is to safeguard the member’s well-being (and sometimes life), while we organise the logistics of the medevac.
Step 2. The medevac team must determine the most clinically appropriate centre of excellence to which we will evacuate the member. We’ll consider:
In short, we must undertake a full clinical assessment prior to medevac to ensure the best clinical outcomes for the member.
Step 3. Once we’ve established a suitable receiving hospital, we must work through several logistical issues, including:
—
These steps forms part of a rigorous process that aims to both safeguard the member’s life and to evacuate the member as quickly as logistically possible to the most appropriate centre of excellence.
We treat each evacuation on a case-by-case basis. We have a roster of companies we work with, and we choose the best one for the situation. For example, the best air ambulance service in Kenya is Amref, however if they are not available we will source an alternative.
Similarly, members in Botswana may expect Netcare911, but Charles Taylor may sometimes pick a different company. We commit to always having our member’s best interests at heart, so will always choose the right company for each evacuation.
Since we started providing health insurance to members in Africa in 1992, we’ve organised 100+ medevacs, 100% of which were successful. We had 12 medevacs in 2022 alone.
It’s hard to give a precise answer because there are so many factors influencing how the medevac unfolds. Some of those factors include:
Each medevac case is different from the next. They pose various challenges that our medevac team works through to ensure the best clinical outcomes for the member.
The speed with which we get our members airborne is not necessarily an important measure. After all, it’s worth noting that we only evacuate members in a life- or limb-threatening situation. The processes we adhere to exist to ensure the best clinical outcomes for our members in an emergency medical situation. Undue rush can endanger the patient’s life. In 2022, we completed medevac cases for 22 members: each member was safely evacuated in a timely and straightforward manner, receiving the right level of care at the most appropriate centre of excellence.
You can purchase local medevac cover alongside the cover you get from your William Russell plan. We appreciate that local providers might be quicker and have lower thresholds for evacuation. We only ask that, if you need a medevac, you decide between using the William Russell medevac service or your local provider’s service. If you choose to go with the local provider, but it doesn’t work out, we can step in—provided your medical situation is eligible.
Medevac Standard comes, as the benefit’s title suggests, as standard on all health plans. Members can upgrade to Medevac Plus for a fixed cost: US$169 per adult and US$152 per child.
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