Memorable medevacs

This post contains images that may upset.

The bulk of the flying that we do in Timor is medevacs, and some of those flights are more memorable than others. At one extreme is my first ever medevac, during my training, where the patient passed away en route. Others have been more routine and I haven’t been too worried about the patient (especially when they are able to get themselves in and out of the aeroplane). After a while the different flights start to blur into one another. But I thought it was time to share some of the more memorable flights I have done.

1. Viqueque

During my training with Marcus we were called on to pick up two patients in Viqueque: a person on a stretcher and a child. When the aeroplane is set up in the medevac configuration, we have the front passenger seat, three additional passenger seats in the cabin, and the stretcher. This means that on solo pilot operations it is possible to take two patients (if one is sitting, or a child under 2 who can sit on an adult’s lap), one medic and two family members. However with Marcus on board we were one seat short. We arrived in Viqueque and loaded the stretcher patient, who was an older man. The child patient, a boy about 3 or 4 years old, was being held by an older lady who was quite vocal. I got her into the plane and strapped her and the boy in. He was very floppy and hot to touch (his medical notes, which I glanced at later, had a diagnosis of epilespy/meningitis). Another younger lady, who was most likely the boy’s mother, was also gesturing towards a seat in the aeroplane. But with the old man’s family member on board, Marcus, and the medic, there were no more seats. I stood by helplessly, watching as the medic explained to the lady that she could not come. She seemed in shock, just standing there, not saying anything, shaking her head slightly. After we closed the doors of the aeroplane, started the engine, taxiied and took off, Marcus and I prayed for the old man, the boy, and the lady we had to leave behind.

2. Viqueque

About six weeks ago we were asked if we could transport two patients on stretchers from Viqueque. They were two young men who had been involved in a motorcycle accident. We told them that we could only transport one stretcher patient at a time, so to get both of them to Dili it would be two flights. 10 minutes later as I was preparing to jump in the plane, we had another call to confirm the flight. They told us that one of the men had died, so there was now only one patient to bring to Dili. I left straightaway, and at Viqueque was able to get him into the plane and then take-off again quickly, but he was obviously in a lot of pain. It was quite a bumpy flight as well, which wouldn’t have helped. The last 10 minutes or so as we were coming in to Dili he was yelling and calling out almost constantly. I knew I just had to concentrate on flying the aeroplane and landing as smoothly as I could. We landed in Dili less than 3 hrs after the accident happened.

3. Baucau

Late one afternoon we were called to Baucau (30 mins flight time from Dili) for a young man in his 20s with a head injury. He was practically unconscious but was trying to pull out his IV line and oxygen line, so the medics had tied him to the stretcher by his wrists and ankles. They had to untie him and then tie him onto our stretcher before we could load him into the aeroplane. It was really hard to watch, seeing how much he was struggling and the force the medics needed to use to restrain him. After we arrived in Dili and had helped everyone get out of the plane, his mother took my hand and pressed her nose to it. In Timorese culture this is a sign of deep respect and gratitude, usually performed by children towards their parents or grandparents, or greeting someone like a bishop or the Pope. I can only imagine how terrifying it must be for people to come with us in the aeroplane, and consequently the sense of relief that they have at being on the ground again.

4. Same

About two weeks ago we had an early morning call for a patient in Same. All that Aldo could tell me was that the medic would come with me from Dili and that the patient had been ‘chopped’. I wasn’t entirely sure what he meant by that, but like most of the medevac descriptions we are given, I figured I would find out.

When we arrived in Same there was a big crowd of people. It turned out that our patient was a doctor in the village, so he was well-respected and a lot of people knew him. He had been attacked with a machete by his mentally unstable brother, with his worst injuries being to his face. The medic and I loaded him on the stretcher as quickly as we could, and along with three family members (since we had seats available) we took off and headed back towards Dili. I was turning around every few minutes to check with the medic that things were ok; he spent most of the flight applying pressure to the man’s wounds. The family members didn’t seem to be too distressed, until we were descending into Dili and my front seat passenger started rummaging for a sick bag. Trying to concentrate on landing an aeroplane while the person beside you is vomiting is pretty hard, but not the first time I’d had to do it. After we landed and I opened the rear cabin door I was taken aback by what I saw. It didn’t quite look like a machete attack had happened in the aeroplane, but it was close. Thankfully the ambulance had already arrived and they were able to whisk the man away to hospital, leaving us to clean up.

Ameu cleaning the plane

Local news (in Tetun). The headline reads 'Doctor Estevao receives chop from his own brother'