Air evacuation in the Amazon Basin

POSTER 20 AIR EVACUATION IN THE AMAZON BASIN Elizabeth DeMond, SkyMed Transport University of Nebraska Medical Center 42nd & Dewey, Omaha, NE. 68105 Off the eastern slope of the Andes mountains in Ecuador, South America, lies over 20,000 square miles of tropical rain forest sparsely populated by indigenous tribes of Jivaro, Waorani and Achuar Indians. There are no roads here. Electricity and plumbing are unknown. Travel is by foot or by air in small STOL planes capable of landing on the short dirt airstrips hacked from the jungle. The only medical facility in the area is a 35 bed mission hospital at the town of Shell, si te of an abandoned U. S. petroleum base. For critically ill or injured Indians, unable to make an overland trek of days to weeks through dense jungle, air evacuation is the only chance for survival. This service is provided by the MAF (Mission Aviation Fellowship), a church sponsored organization that provides the only link to the outside world for much of the region. Last year their six pilots flew some 275,000 miles using a Cessna 180, three C-185's and a C-206. Approximately 700 flights or one third were air ambulance transfers to the Shell hospital where 35% of the patients arrive via MAF. Emergency air evacuation operations in this primi ti ve and isola ted area are a world apart from the sophisticated hightech aeromedical programs we take for granted in the developed world. Medical equipment is rudimentary at best and often improvised. Stretchers are apt to be two stout sticks and a blanket on the floor behind the pilot. Communication is via old battery powered radios. The range of medical emergencies requiring air evacuation includes snake bites, spear and arrow wounds, burns, infections, malaria and difficult or premature births. Medical control and personnel depend upon whether someone can be spared from the hospital. More often than not it is up to the pilot and villagers at the scene to stabilize and prepare the patient for transport. Payment can take the form of a wild pig, several chickens or a blowgun. Inhospitable geography, primitive conditions, lack of support services and a shoestring budget, not to mention over 20 feet of rainfall per year, lend some unique problems to aeromedicine in the jungle. A look at how such obstacles are being overcome in this little corner of the world can lend a new perspective to the challenges and problems we all face in our own programs wherever they may be. The Journal of Air Medical Transport • October 1989

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