Coordinating Evacuations During a Pandemic – Part 2

Listen to episode #11 of NAVIGATE to hear AMREF Flying Doctors share what it means to be an assistance provider during a global pandemic.

Managing overseas evacuations during COVID-19 – Part 2 | AMREF Flying Doctors:

Voice Over

0:00:00 – 0:00:20

Welcome to Navigate, the podcast that helps you safely and securely traverse the globe. Alongside travel industry experts and global travellers, we’ll gather insights and advice that help you manage any pitfalls or problems that may occur while you’re away from home. Our voyage of discovery starts now.
Debra Harvey

0:00:20 – 0:00:52

Welcome to Navigate. My name is Debra Harvey and I am the Operations Manager of Clinical Services at World Travel Protection. I would like to welcome back AMREF flying doctors. This is our second episode with them and the last in our season one. I have joining me today, Stephen Ombuya, Chief Commercial Officer, and Jane Munyua, Medical Assistance Manager. Thank you both for joining me today. Jane, would you like to tell me about a bit of a day in the life at AMREF Flying Doctors?
Jane Munyua

0:00:52 – 0:02:38

Thank you for that question, Deb. So as the Medical Assistance Manager, what I do is report to the office and most times in the mornings. And what I will do is get a brief of the ongoing activities whether it’s pending or active ambulance requests or whether there are other activities like medical escorts or assistance services. So the assistance services are typically guarantees of payments that we’ll place on behalf of our partners, like WTP, provide ground transport, gathering medical reports, and then sometimes we have out of the ordinary activities, you know like training because we have quite an active training department. So this involves uh conducting our advanced cardiac life support, basic life support for state courses. And then we have, usually have, other requests like medical standbys, you know, for schools or sporting events and then basically, channelling out quotes for the ambulance requests and just following up on feedback for such requests, whether a client is going to use us or not. So usually my responsibilities and my immediate focus usually is to review the assistance cases, whether they came as a result of a direct air ambulance request or it was a direct request from our partners. So what I do is usually sit down with the staff who is involved in handling the case management and reviewing, you know, each case one by one just to see that all issues are addressed. You know, one thing about assistance cases and I’m sure you also may be aware of it is that it’s very detailed in nature. You know, it’s sort of like a day to day plodding away at the process.
Jane Munyua

0:02:38 – 0:03:52

You have a partner like yourselves far in a way back in, you know, far as Australia and you’re relying on AMREF Flying Doctors to assist, you know, your client who is in a critical situation and needs assistance so they can be quite tense, be a bit frustrating when you’re not able to get obtain information as quickly as it’s needed. But of course that doesn’t happen all the time. But, you know, it’s like I said, it’s a day to day plodding, hacking away at assistance cases and making sure that they get completed. But I would say Deb that we, AMREF Flying Doctors, has built a very good network in the Eastern Africa region and we have built very reliable core relationships with key service providers in the region, whether it’s hospitals, whether it’s the transport industry, hospitality industry, you know, sometimes you have the unfortunate task of assisting with repatriation of human remains. So, you know, a funeral home, you need to have a few contacts of those and and and basically, you know, just building a good relationship with our local and regional representatives. So that’s really a day in the life of Medical Assistance Manager.
Debra Harvey

0:03:52 – 0:04:33

Absolutely. I guess that you’re correct that this assistance business is all about relationships and communication because the cases are really challenging and complicated when you’re moving people who are critically unwell anywhere around the world, especially during pandemic. It takes a lot of logistics and it’s all about the detail if you get one thing wrong, it can have an adverse effect, which is almost the best part and the worst part about the job. I like that it’s challenging and the variety, it’s really interesting and you do collaborate a lot with different providers. So what do you like most about your role?
Jane Munyua

0:04:33 – 0:06:07

Well, I, you know, as you correctly said, it’s about building relationships. I mean I’ve been in AMREF for quite a while and I think over the years we’ve built lots and lots of relationships with different, you know, partners, whether it’s, if somebody in Uganda for example, you know I’m able to easily call up our local representative and, I know he will sort me out. The fact that it’s it’s never the same today – how I handle a case today will not be the same as I will handle it tomorrow. So you know that variety and that dynamism, the challenge. And I guess at the end of the day it’s really the success stories. You know, you have you have somebody come from so far, you pick them up by ambulance and then they come into Nairobi. You know you’re doing the day to day follow ups, you’re collaborating with physicians or the consultants who are looking after the patient. You’re collaborating with the finance departments in that facility, you know the the lab technicians, the pharmacists, you know, just to make sure that uh our partner’s clients are are well taken care of and then, you know, comes the completion when we’re told, okay, I think we’re ready to repatriate this client back home and would like AMREF Flying Doctors to close the case. And then you know, we move on to the next process. So maybe it’ll be arranged a commercial escort. So it’s just that that variety and it adds a lot of oomph to the case management.
Debra Harvey

0:06:08 – 0:06:16

That’s right. Can you tell me about a recent assistance case that was interesting or challenging for you?
Jane Munyua

0:06:16 – 0:08:03

Yes, so we had we had a request – and this was actually a request from one of your subsidiaries WTP Canada. They had a patient whom we had to pick up from Bagram in Afghanistan. And there was the logistics bit of organising for the medevac flight and you know, in in a Covid situation, that whole process has become quite rather prolonged. You know, you have to get a PCR test whether it’s positive or negative and this happened to be a positive Covid case. There’s the clearances and the permits and and and all that needs to be sorted. So we eventually got the patient into Nairobi and we were requested to provide assistance with placing guarantee of payment at at the hospital. So what is a guarantee of payment involved? It’s really, AMREF Flying Doctors extending credit on behalf of WTP and saying that we are going to take care of the medical costs. We are going to follow up on the medical reports. We are going to ensure that the patient is receiving the care that he needs to receive or she needs to receive and then, you know, making sure that when the time comes for the patient to be discharged, we’re keeping WTP updated on what’s going on so that they are also able to make a decision whether it’s being repatriated back home or you know, going back to his place of employment. Yeah, so the challenge really was in for these cases was keeping costs, keeping a tab on the costs. You know, we were saying that when we, you know, we take on an assistance case on your behalf, we also want to manage the costs. We don’t want the patient to be overcharged. We want to make sure that you’re getting a value for money, so to speak.
Jane Munyua

0:08:03 – 0:08:36

Um, you know, we we make sure that the patient has been admitted, was admitted under the right panel of doctors because we, you know, over the time, as I said, we build relationships. So following up on the reports, keeping a top on the course which have already mentioned and eventually when this patient was ready to go back home, you know, facilitating a Covid test, ensuring that it’s negative, that he has a fit to fly, so that his repatriation back to Australia, because he was Australian, uh, that was sorted out and he was able to travel back home without any hitches.
Debra Harvey

0:08:36 – 0:08:49

And I guess obviously travel will resume again. And when it does obviously, what do employers, businesses and other organisations need to consider when they’re deploying staff to Central and Eastern Africa?
Jane Munyua

0:08:49 – 0:09:51

Yeah, I think it’s it’s just really for them to have the comfort of knowing that there’s a professional provider in the region who can assist their clients whether that’s WTP or other partners, you know that we can assist with evacuation and their medical assistance needs. And you don’t have to have the worry of wondering what do you know, who’s going to take care of where does our patient or a client or our member or employee need to go, you know, in case they fall sick. You know, we have been involved in an emergency response drills and just ensuring that we’re able to give them real time information on whether it’s airstrips available, airstrips available, medical facilities within the area. The employees could go in case they become unwell and also, you know, we had challenges with bed capacity. So we would be easily, you know, we’re able to let you know that, you know, yes, your patient can if they’re coming to Nairobi for example at least there’s an availability of a critical bed and et cetera.
Debra Harvey

0:09:51 – 0:10:11

It’s a lot to consider. But I think as we move forward we’ll be living with the pandemic for years to come. I think it’s going to change the way people travel. People will still travel, but again, it’s all about that communication and technology and relationships and people who have on the ground knowledge and sharing that knowledge.
Jane Munyua

0:10:11 – 0:10:34

Yes, that’s very true. And I mean I’m happy to say that we, you know, our relationship with WTP, for example, has not come just yesterday. It’s been years. Yes. It’s been years building building that relationship and I think it’s going to take us places, you know, you’ve been thinking into the future –
Debra Harvey

0:10:34 – 0:10:35

Definitely
Jane Munyua

0:10:35 – 0:10:43

– as we, as AMREF Flying Doctors, also things of expanding its network. You know, who knows? One day we might be and the Australian market.
Debra Harvey

0:10:43 – 0:10:53

Maybe, you never know. Honestly. I I don’t say ‘never,’ say ‘never again’. Yeah because look at where we are now. Yes.
Jane Munyua

0:10:53 – 0:11:17

You know, the other, the other important information that we give to our partners is, you know, just letting them know about the challenges of uh that are prone to a region, you know, from a logistical or safety point of view. And you know what security challenges there might be in uh you know, certain parts of the region. I remember –
Debra Harvey

0:11:17 – 0:11:20

Oh and payment, remember payment is a big issue in certain countries
Jane Munyua

0:11:20 – 0:11:29

Yes, exactly. You and you’re not able to move, you wouldn’t be able to move money as easily as you would like to.
Debra Harvey

0:11:29 – 0:11:31

You have to take cash sometimes, don’t you?
Jane Munyua

0:11:31 – 0:11:33

Absolutely. Yeah,
Debra Harvey

0:11:33 – 0:11:37

Because they won’t discharge the patient. I think we’ve had that quite a few times.
Jane Munyua

0:11:37 – 0:12:23

Yes, because they want a cash payment. So you know, that’s where we’ll come in and say, hey, we will we will guarantee the payments and you know, we arrange an EFT, you know, money transfer as soon as possible but just let the patient be discharged and go home. Yeah. I was just going to say if you recall there was a volcanic corruption in in one of – in the DRC recently and you know we had questions about can we fly into Goma, can we is it safe for our employees? Employers wanted to know whether it’s safe for their members to be in the region. So it’s real real-time information that we are able to provide for for our partners.
Debra Harvey

0:12:23 – 0:13:32

It is definitely I guess we’ve discussed before that obviously the pandemic has had a huge impact on all of our businesses in terms of, you know, we’ve had to change direction. We’ve had to do things that we’ve never had to do before in terms of liaising and communicating with a lot of different areas that were straightforward before. I guess with Covid, I guess we will travel again, but it won’t be the same. I guess the pandemic – even at the beginning I was thinking, oh, this may be a short term thing, but as it’s now going on for over 12 months, I’ve realised that Covid will impact our lives probably for the rest of my lifetime, I guess. So as organisations, businesses and employers kind of grapple with that – because people will travel, businesses still need to operate. And when global borders do open again as more more people get vaccinated. What do you think businesses, organisations and employers need to consider when they’re thinking of sending staff to Central or East Africa?
Stephen Ombuya

0:13:32 – 0:15:17

Thanks. Deb great to be here. So I think there definitely has been a very interesting period for the for the world in this Covid related emergency. And I think what we’ve seen definitely in the region and previously we work very closely with partners like WTP who have members or clients in our region Eastern Central Africa, specifically from an assistance point of view. And initially we’ve provided, if you like, information support. So when the members come to the area, we have sort of on the ground information from a point of view of assisting them from, you could say almost from emergency response or health related assistance. So looking at where they are based and what would be the logistical support they would need in the event of an emergency. Looking at what are the medical facilities around where they operate so that they can be assisted in that regard. And even in some situations where it’s possible, we do even do drills just to support and they can be able to function and have peace of mind as they’re doing their projects. And I think in the Covid context, think one of the learnings that we have is being very aware of the different, like Africa is a big continent. So we have, you know, over 50 countries on the continent with different requirements for Covid in relation to Covid restrictions and travel. And so it’s very important to be aware of where you’re going to specifically be based or be traveling and what is the specific requirements for that country or for that region, but not only what is formally put out by the authorities. Uh, there’s usually a time lag or discrepancy if you like, of what’s put out and what’s actually happening on the ground.
Stephen Ombuya

0:15:18 – 0:17:08

And there’s a lot of dynamics um around that and part of the work we do in supporting our partners is having on on real time information and being able to to share that in our system. With that, I think we also, in the interim, with the sort of vaccination drive that that’s happening, there is a low uptake and globally, but definitely in Africa, it’s a bigger challenge from just a supply point of view already. But also it’s expected with the complexity of the African continent that you have a different approach for the uptick or implementation of it. So we expect that COVID in the in the next 12-18 months will still be a challenge for the continent. And and so I think it’s important that businesses that have projects who are considering or have members coming to Africa to be aware of that risk continues. But with vaccination with the requirements and with organisations like ours, we can provide the support and we can be able to, you know, give them the comfort that if this situation happens one, we are very aware of the challenges in the region as a very dynamic continent, as you know, that we are able to respond to medical emergencies from the evacuation point of view and get them to medical facilities. We are able to provide even information from an assistance point of view of what what you can do. And so that we do have even right now, obviously organisations that continue to function in this region. And I think the value add for us and that we’re able to provide them is that support. And so that so that they feel that even if you have sort of a risk environment, there are mitigations and there are organisations on the ground that can help help them if need be.
Debra Harvey

0:17:08 – 0:17:56

I think absolutely when I’ve been thinking about what travel looks like and even just traveling myself now in Australia where I hadn’t been before, it made me even think about like getting to the airport, how long do I need to go through the airport. What do I need to consider if something changes? And I guess there’s two things for me I think that will be critical in people having some certainty around the uncertainty of now the world we live in. And I think it’s technology and communication. And I think obviously there is with Africa, as you said, it’s a big, big place, it’s a big continent. And having you as our partner, giving us that information of what’s happening now is critical. Would you agree?
Stephen Ombuya

0:17:57 – 0:19:44

Yeah. So I think that one of the things that I can say we’ve we’ve learned in this Covid context is one that we see ourselves working a lot more closer with with the industry. I think one of the strengths of being part of the insurance and assistance industry was the ability to get real time information from partners in different regions. And I think we are very keen to work closer. In fact, one of our experience we learnt during the full evacuation point of view, it was a very complex time because of the different requirements. The authorities had to move patients around and we relied quite a bit on wing-to-wing operations with other operators. But also we relied on our partners who are our clients like WTP where you are even moving patients out. And you needed information. On the other hand, that was changing as well. Uh, and I think one of one of the things we have learned in in the interim is we want to build stronger collaborations with partners in the industry going forward. We still think there will be a lot of Covid movements in the in the Eastern African continent. So we being based in East Africa, and Nairobi being the Center of Medical Excellence that pretty much covers the staff Eastern African region, including Central Africa, the oceanic islands like Seychelles, Mauritius, Comoros, we still see that there will be more influx into Nairobi for stabilisation. And so so a key thing for us again with getting closer with monitoring the stability of even the center itself. So whenever we’ve had fluctuations of Covid and we have bed capacity challenges, then working out what happens if Nairobi, as a center of Excellence, is battling with challenges with beds and what other solutions we can have.
Stephen Ombuya

0:19:44 – 0:21:40

And this is part of the engagement we have within the industry of getting that information and finding solutions of where you can still move patients whether you can still provide assistance when the system itself is struggling to do that. And I think also we are keen to build our agility. I think it was a, we adapted fairly well with a lot of pain. I think we’ve talked about agility before as organisations, as as an industry or even as leadership, but last year was a good test of how agile you need to be. And I think we are looking at our systems even more to prepare for what is turning out to be what we real – we call a change. We always say change is constant, but I think Covid has made it very tangible and so asking ourselves, how well prepared are we to adapt to certain situations and how best can we be better prepared to be flexible if you like and be able for different teams within the organisation, even different skills to be arranged differently to respond and to give our partners solutions. And I think also I think one thing we’ve also learned is I think as an industry and that it’s important for the industry and even in our situation take a little bit of more leadership to advice. I think we are very niche, unique industry that provides a very critical service and I think we saw how it was useful for us to also get in the driving seat, work with authorities in the region who everyone was struggling to know what to do and we sort of with the support of the industry, with the support with our understanding of our experience and expertise to say we can provide solutions in this difficult situation. So I think these are these are the things we are working hard to get better at having been a very successful but grueling, grueling 12 months as a team.
Debra Harvey

0:21:40 – 0:22:47

Nothing has tested our business more than Covid. But it has also giving us an opportunity I guess to look at our processes, leadership, where to now, and prepare for when travel does return. Obviously cases we’re still managing cases and they’re just a lot more complex and logistically challenging and with all the, the extra things that you need to consider. But I think it’s future proofing thinking, Okay, this is not a one-off event, things will change in the future probably in the next 6, 12, 18 months, two years but how can we be better? And I think that collaboration piece I think is really important and I agree is that especially if we are going to travel and people will and obviously you know Nairobi being that Center of Medical Excellence and obviously people traveling again back to these areas are working. We have to be prepared if the worst happens because the worst did happen. But it could happen again.
Stephen Ombuya

0:22:47 – 0:23:41

Yeah, absolutely. So I think that collaboration is I think it’s very useful. I think as an industry we are very grateful actually to be part of it because we did get a lot of information support just to understand what’s happening globally can help us prepare. And I think also we’ve learned to work much closer with our providers as well and really understanding that the whole chain is critical. So we’re looking forward to the travel coming back. I think the entire world is in need of of travel and we want to be part of that industry that gives the assurance or at least provide some certainty for both from an information point of view, but also that we are prepared when or if this situation happens again or gets worse. That we are also, we can provide support and allow the travel industry to continue to function even in where there’s sort of difficult situation as this one here.
Debra Harvey

0:23:41 – 0:24:11

I’ve said it a lot of times in the last few days I think we just need to provide some certainty when there is uncertainty. That’s the nature of our business. We’ve always done that, we’ve been tested but I think that that’s the future travel will resume and how can we be most prepared and ready for when the travellers do travel again. Well thank you, thank you for joining us. This is obviously the last of our session for season one and we look forward for you to joining us in season two.
Voice Over

0:24:11 – 0:24:39

Thank you for listening to this episode of navigate the World Travel Protection podcast that steers you in the right direction, helping you explore the world safely. For more information on how we protect millions of global travellers each year, visit World travel protection dot com or follow us unlinked in. We’d love to connect. Finally, if you enjoyed this episode and you want to hear more from my experts, be sure to hit subscribe or follow or police leaders a review until next time, Keep traveling and stay safe.

World Travel Protection’s Debra Harvey finishes this medical assistance podcast series with Chief Commercial Officer, Stephen Ombuya, and Medical Assistance Manager, Jane Munyua, from AMREF Flying Doctors.

In episode #10 – Part 1, we learned aeromedical evacuations are a complex task that have only become more intense since the pandemic began. Evacuations require communication, compliance and coordination in a situation where there’s no room for error. Listen to Part 2 to discover how assistance providers complete successful evacuations day in and day out.

With close to 60 years of experience in Central and Eastern Africa, Stephen and Jane tell us what organisations should consider before deploying staff to this part of the world. Having a safe payment process – as some hospitals only accept cash – and local knowledge of a continent with more than 50 countries is just the beginning of their list.

To wrap up the episode, hear their predictions on how lessons learned from COVID-19 will continue to influence the assistance industry moving forward.

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