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Air Medical Escort from Boston, MA to Kumasi, Ghana

Dominique Ghirardi
Sky Nurses flight nurse service from Boston, MA to Kumasi, Ghana

After suffering an anoxic brain injury in the United States, Sky Nurses provided flight nurse and stretcher services on Turkish Airlines to return Samuel to a hospital near his home of Kumasi, Ghana.

Our mission started long before the airliner left the ground. After securing a temporary passport and travel documents to replace the patient’s missing passport and visas, Sky Nurses worked with Samuel’s Boston-area hospital and our network in Ghana to find him a hospital close to his family’s home that could provide him the continuing care he would need.

And then, when that hospital accidentally gave away his bed hours before checking in, we worked to find another hospital near his familial home that could provide him the care he needed. No matter what happens, our flight nurses never leave our patients’ side until they are safe, secure and being fully cared for by suitable caretakers.

This is Samuel’s story…

When 35-year-old Samuel left his home in Kumasi, Ghana to work in the United States, he probably never expected that he would need the help of a team of air medical escorts to return.  After moving to Worcester, MA, Samuel was enjoying his time in the U.S., working and making a better life for himself.

When Samuel was found unresponsive by his roommate one February evening, everything changed.  He was rushed to the emergency room, where it was revealed he had suffered an anoxic brain injury. As a young man, Samuel didn’t consider that he would need travel insurance during his stay in the U.S.

For Samuel, the next few months were filled with tests, treatments and rehabilitative services, but resulted in little improvement.  After nearly two months at a nearby hospital, it was clear that in his current state, the best place for Samuel would be at a hospital closer to his home in Ghana, so he could be closer to his family.

Stretcher Services Offer an Affordable Alternative to Air Ambulance Services

With Samuel’s condition preventing him from traveling independently, the hospital case management team knew they would need to enlist the help of a medical escort service.  Fortunately, in a circumstance like this, a stretcher service can act as an alternative to an air ambulance service, even when the patient is unable to sit up during take off and landing, provided that they are hemodynamically stable.  The medical team at the hospital felt that Samuel would be fit to fly under the right circumstances.

Before Samuel’s trip could be arranged, there were two roadblocks standing in the hospital’s way: 1) confirming admission to the hospital in Ghana and 2) acquiring the necessary travel documents for the trip.

First and foremost, Samuel needed to have somewhere to go once he landed in Kumasi.  It was clear that in his current condition, Samuel would still require hospitalization during his recovery.  After coordinating with his family, there was concern regarding where the best place for Samuel would be and how to establish payment for a service that felt beyond the family’s financial reach.  To alleviate this concern for the hospital, the team at Sky Nurses contacted Samuel’s family directly on their behalf to discuss the options in their area.  To supplement these suggestions, Sky Nurses personnel also contacted facilities in the Kumasi area based on thorough online research.  At the end of their efforts, it was decided that Samuel would go to a local teaching hospital just a short drive from his family’s home.

The medical management team at Sky Nurses handled all the arrangements necessary for bed placement at the hospital in Kumasi, including coming up with some creative payment options.  Sky Nurses was able to find a solution which allowed the hospital in Worcester to send payment to the hospital in Kumasi.

Throughout these consultations and negotiations between both hospitals and family, Sky Nurses personnel were also hard at work navigating the process of securing the right documentation for Samuel to leave the United States in order to return to Ghana.  Though Samuel entered the United States through the usual immigration process, his green card was nowhere to be found.  And in his current state, Samuel was in no position to help friends, family, or hospital personnel locate it.

The case managers at Sky Nurses are no strangers to chaos and missing visas, green cards and other immigration documentation. Our team worked with our extensive network and secured a temporary passport and required travel documentation.

With a destination hospital secured and the necessary travel papers, Samuel was finally ready to travel and his family was eager to have him back.  It was at this point that Samuel’s assigned Sky Nurses case manager began to pick the skilled medical escort team necessary to see him home safely.

Because Samuel would not be able to sit up during take-off and landing, he would only be able to fly on a commercial airline by utilizing a stretcher service.  In order to ensure his safety and comfort, he would need the assistance of both a flight nurse and a flight paramedic, and because he had suffered an anoxic brain injury, this team would need to be highly trained in providing critical care.  With over 10 years of emergency response experience each, there was no better choice for the job than firefighter and registered nurse Joseph and experienced flight paramedic Dan.

The stretcher service medical team included a flight nurse and a flight paramedic to ensure Samuel’s safe travel to the hospital in Ghana.

While Joseph and Dan applied for their visas to Ghana, Sky Nurses went to work organizing the stretcher service through a Turkish Airlines flight from New York to Accra, Ghana, with a stop in Istanbul on the way.

Stretcher service flights can take anywhere from 7-10 days to arrange because of the medical and mechanical clearance required.  During a stretcher flight, the last row of middle Economy Class seats must be removed to allow the stretcher to lay across, so that the patient can ride in comfort and safety.  Because this involves reserving an entire row of seats, dates must be selected carefully to avoid overbooking the flight.  For safety and coordination purposes, stretcher services are only offered on nonstop or one-stop flights.

And finally, Samuel is on his way home with the medical escorts from Sky Nurses.

On December 1st at 3:30 pm (EST) Joseph and Dan arrived at the hospital to meet Samuel and conduct their assessment.  Joseph performed a physical assessment and found that Samuel was stable enough for his flight the next morning while Dan consulted with Samuel’s treating physician to confirm that everything was in place for Samuel’s discharge from the hospital.  They also confirmed that Samuel had his temporary Ghanaian passport in hand before they left.

At 5:04 am the next morning, Joseph confirmed with the Sky Nurses case manager on call that there were no changes in the patient’s condition.  (Sky Nurses’ staff are available 24/7 to ensure that all medical transports go smoothly.)  Samuel was still stable and ready to depart on his long journey home.  With Dan’s help, Joseph prepared Samuel for his trip before the ambulance arrived at 5:30 am.

To obtain the most direct routing possible with a stretcher service, the flight would be departing out of JFK International Airport, which meant a long ambulance ride for all three passengers.  Fortunately, Samuel’s condition remained stable with both Dan and Joseph by his side to provide suctioning and tend to his needs.

When transporting patients who require around-the-clock assistance like Samuel, it’s best to have two clinicians to ensure all of their needs are taken care of by someone who is alert and attentive.

Everyone arrived at JFK airport by 8:58 am, but it wouldn’t clear TSA until 12:11 pm.  Because this was a stretcher flight, Sky Nurses coordinated with airport staff to grant clearance for the ambulance to travel straight to the aircraft on the tarmac.

However, security at JFK airport is still pretty tight and all three passengers would need to pass through TSA before they’d be permitted to board.  Thankfully, both Joseph and Dan were well-versed on the details of the case and knew what to do to keep the process moving.  To allow Samuel to wait in comfort, Turkish Airlines moved the party inside Terminal 1 while all details were finalized.  By 1:03 pm, Samuel was safely on board the aircraft, resting comfortably on an eggshell cushion and sheet that Dan had purchased specifically for the flight.

A bare stretcher can be uncomfortable for long periods of time.  To avoid this, Sky Nurses upgrades what the airlines provide with a “stretcher kit” of a pillow, queen mattress cover, and a twin sheet to provide extra cushion during the patient’s trip.

Though there was a slight delay in departure, by 1:52 pm, the flight was ready for take-off.  The first leg of the journey went without incident and the crew landed safely in Istanbul by 7:28 am (local time) / 11:28 pm (EST).  Their next flight wouldn’t take off for another eight hours, so Joseph and Dan escorted Samuel to the Istanbul airport clinic to wait.

At 2:38 pm, Samuel and his medical escorts had boarded their next flight.  After a minor delay caused by the removal of an unruly passenger on board, the flight pushed off at 3:12 pm.  Following a mostly uneventful flight, everyone landed safely in Accra, Ghana by 8:35 pm (local time) / 3:59 pm (EST).  By the time they landed, Samuel had a mild fever, which Joseph attended to with medication.

The ambulance that Sky Nurses had arranged was waiting for them at the terminal when they disembarked at 9:55 pm.

Because only one escort was permitted to travel with the patient through customs, Dan and Joseph split off, with Joseph accompanying Samuel, keeping his passport and documentation safe as he did so.  Meanwhile, Dan worked his way through customs on his own and met up with Joseph and Samuel by 10:55 pm.

With a three-hour drive to Kumasi ahead of them, Joseph and Dan assisted with loading Samuel into the ambulance.  After a quick rest stop in New Afutu, the party arrived at the teaching hospital in Kumasi where Samuel’s family was waiting at 2:00 am.

We’d love to say that Samuel was admitted and the trip was completed… but it wasn’t. An administrative error at the hospital resulted in Samuel’s bed going to another patient.

At Sky Nurses, our job isn’t done until the patient is in equally qualified and capable hands. So medical escorts Joseph and Dan worked with the rest of the Sky Nurses stateside team, with Samuel’s family and with the staff at the Kumasi hospital to find an alternative medical facility.

It was Sky Nurses’ number one priority to make sure Samuel got to a hospital which could provide him proper care, and both medical escorts set forth to uphold that promise.  Dan coordinated with hospital staff to find an alternative hospital while Joseph tended to Samuel’s needs and met with the family.  By 3:00 am, everyone was on their way to a university hospital suggested by hospital faculty.  Joseph and Dan took care of the admission process while Samuel rested in triage.

By 6:17 am on December 4th, Samuel was finally safely at home in his hospital bed with his family by his side. 

It just goes to show that anything is possible with the right team by your side.  With the help of the Sky Nurses team and the clinical and cultural expertise of medical escorts like Joseph and Dan, Samuel was able to overcome lost travel documents, long-distance hospital admission restrictions, and complex travel logistics to return to his home and family in Kumasi, Ghana.  Having the assistance of a calm and collected flight nurse/flight paramedic team with expertise in emergency situations helped this trip to stay on track even when plans suddenly changed.  Additionally, having a dedicated team stateside monitoring the mission 24/7 allowed Samuel’s case managers at the hospital in Worcester to see that he got home safely.  Mission accomplished!

The above story was compiled from the intake files and stream of constant communications the case managers at Sky Nurses receive from the clinicians and air medical escorts throughout the repatriation trip with our patient. When you travel with a flight nurse from Sky Nurses, you’re travelling with an entire team of medical professionals and travel agents.

We take privacy very seriously.  All names have been changed to protect patient and clinician privacy.

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