Stability Operations Magazine
Volume 8, Number 1- July-August, 2012

Patient treated at a UN medical clinic

WHEN working in high risk, international environments such as Afghanistan, employees in all industries are exposed to foreign illness and tropical disease.  While precautions and preventative measures are taken to avoid sickness abroad, once contracting a medical ailment, it can quickly transform into life-threatening condition, without proper medical service assistance.  If a colleague begins to exhibit symptoms of illness beyond personal treatment, local, in-country medical centers can attempt to diagnose or suggest treatment.  However, with limited resources and medical equipment, the local assistance may be unable to treat or diagnose the ailment.  At this point, contact with the corporate HR department must be established to continue support through insurance.

By the nature of the industry, it should be obvious that expeditionary services are hazardous, evolving, and fast paced.  The example described above is unusual, but most difficult scenarios are unusual.  Constant review and alterations of corporate medical procedures must be continual in order to prevent a situation as mentioned above.  Failure on all sides may be apparent—from corporate offices, to insurance firms, to those working in-country—but ineffective procedures can lead to life or death circumstances.

When it comes right down to it, you need to have contingency plans in place in the event that on-hand resources are unavailable.  Therefore, it is incumbent on each person in the field to educate themselves on what the company plans and policies are in the event of an injury or illness so severe as to require medical evacuation.  Once you’ve reviewed your company program, ask questions—because it is your welfare at stake.

Another reality is that regular insurance companies do not have persons to deploy to the scene of a crisis. It is up to you to get to a hospital and only then will they begin their services. If you find yourself or a staff member in the middle of nowhere in critical condition, a regular insurance company is not going to be what you need. You will need to be evaluated, stabilized and evacuated as quickly and safely as possible.

Therefore, the following sample checklist provides steps to ensure you are properly educated and prepared for any emergency medical circumstance in-country:

• Work with your insurance firm to ensure that they understand your market and environment;
• Identify medical facilities and professionals in your area, both locally and regionally and create relationships with them;
• Make sure they understand the nationalities of ALL your employees and be clear on the types of coverage they provide to each;
• Ensure that illness and injuries that are not work related are covered by your insurance provider;
• Review your policy at least every 6 months, and each time you enter a new geographic market;
• Ensure that your MEDEVAC company has a facility located in the country in which you operate, with the proper licenses and assets to provide contracted assistance;
• Ensure that your HR department has realistic emergency response procedures, including notification lists, next of kin details and proof of life information for each employee that is updated annually;
• Require that your insurance company and MEDEVAC firm run simulations once per year with your team to review operations and procedures;
• Verify the type of coverage, limits and caveats that the MEDEVAC firm operates under, whether it be local national regulation (i.e.: no flying at night), or commercially imposed – which could potentially impact life sustainment efforts;
• Ensure that your MEDEVAC firm can assist anywhere in the world, and in the most difficult conditions.

Whomever your company chooses to work with, the goal should be the provision of world-class medical response, advice and evacuation. The MEDEVAC firm must be able to provide the medical and security expertise combined with an ability to deploy their own professionals to the exact location of your emergency and transport an employee to the destination of choice.

One thing to keep in mind is that most MEDEVAC firms are not insurance companies. If you are not contracting them through your insurance provider, you most likely will be required to contract with them prior to any emergency, or be prepared to pay a significant fee up-front.   If you do contract directly with the MEDEVAC provider, make sure you and the insurance provider understand your coverage.  Appropriate preparation, including well thought standard operating and effective emergency procedures, will ensure that when a medical crisis occurs and a staff member becomes injured or ill, problems in seeking treatment will be mitigated.

In the stability operations industry, it is incumbent on companies to provide quality care to their staff.  Companies ask them to work in dangerous environments, often at considerable risk.  It is part of the industry’s responsibility that people are cared for adequately, even when the unforeseen occurs.