An Air Ambulance Trip to Africa

Medical escort is a unique practice of nursing. I get the opportunity to meet people from all over the globe, often under some of the most dire circumstances. Despite their varied languages, cultural beliefs and medical needs, they all have the same the underlying hope, all these people just want to go home. Recently I was able to assist in making that dream come true.

Louis a hardworking family man from Dar el Salaam Tanzania came to America for a family wedding. While here he became ill with pneumonia was treated for his illness but never quite recovered. Still weak and fevered he was eventually diagnosed with ALS. Despite all efforts he was unable to be completely weaned off the ventilator and required tracheotomy and ventilator support at night. Unable to be transferred to a regular floor, Louis was stuck in the ICU. His wife had to return to Africa so he was left here alone.

The cost of an Air Ambulance trip can at times be prohibitive and a medical escort on a commercial aircraft can be a cost efficient method of transportation. The client must be in relatively good health with the ability to sit upright for take off and landings. After an extensive evaluation, Louis was found to be a perfect candidate for commercial medical escort. He was ambulatory for short lengths and able to sit up in a chair for several hours. He had a trach and only required 3 liters of oxygen during the day time, required minimal suctioning and only needed a ventilator at night to sleep. He was bolus fed through a PEG tube and tolerated it well. The greatest obstacle was the time and distance for the flight.

After careful research of the best flight match with consideration to flight times, airplane types and layovers, a flight was chosen for his commercial medical escort. It was going to take a minimum of 25 hours flight time plus 2 stops to get Louis home. It was time to formulate a plan of care to match his needs and provide him with a safe and comfortable flight. Special consideration was made to power all the needed medical equipment and meet the regulations of TSA, FAA and airline regulations. Due to the extensive flight time and large amount of equipment needed to provide care for him, it was decided to send 2 medical staff for the trip. A team approach with the Case Manager, primary ICU nurse, Primary care physician, Receiving physician and hospital in Africa and flight team was utilized to complete all the arrangements for the transport.

My first impression upon meeting Louis was to be dazzled by his bright spirit and wonderful smile. He was absolutely beaming from the opportunity to finally go home. After a tearful good by to the hospital staff who had become his American family he was ready to travel. The first leg of the commercial medical escort flight was 10 hours to Amsterdam and while I had planned on him resting during that portion of the flight, he was just too excited to sleep. We spent time talking by writing notes and watching the progress of the airplane as it journeyed towards his home. He was on Oxygen with continuous cardiac and pulse ox monitor and I was administering his scheduled medications and PEG tube feedings and suctioning his trach as he needed. He just continued to smile.

Landing in Amsterdam it was obvious that Louis was getting tired and we made special arrangements to board the next aircraft early to settle him in and put him on the ventilator for his rest period. We continued to laugh and joke as I compared him to a small child at Christmas who was trying to wait up for St Nick. He just smiled and held my hand as he drifted off to sleep. Our next stop Nairobi. Once landing in Kenya I transitioned him off the ventilator and back onto the trach mask and he was ready for the next short flight to Tanzania. While waiting for the flight in the lounge it was obvious that we were much closer to his home than mine. The mixture of English and Swahilli languages on the television and in the directional signs of the airport made him grin even more. He wrote me a note to tell me that we were so close he could almost smell his wife’s cooking from the kitchen.

Landing in Dar el Salaam Tanzania, we were met by his medical crew including his new attending Physician. We quickly passed through customs and all too soon were loading him into the ambulance. After a brief medical report and passing of his medical supplies and records it was time to say Good-by. With big hugs and tears I was happy to be the first to tell him Welcome Home! In the 35 hours together, while traveling over halfway around the world, we had become friends. Even without his ability to utter even a single word, we had learned of each others family, jobs and history and lives. I was proud to have assisted him to the one place he wanted to be, Home.

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