Medical services in the sky

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During First World War we began to use airplanes, both as a weapon and as a medical service. In 1917, a British plane evacuated a solder with a broken ankle. This is the first recorded aerial rescue. In the next ten years, British, French, and Germans had all used military air ambulances to evacuate war-casualties. However, no such ‘air medical service’ was available for civilians. There are numerous stories of explorers, service-men, or natives who perished – just because medical care was too far away. This was to change.

John Clifford Peel was an Australian medical student and an airman. In 1917, he wrote a letter to his pastor Rev John Flynn, and floated an idea that airplanes can be used as an ambulance. While Peel died in an air-crash the next year, Flynn kept the thought alive. John Flynn was working for Australian Inland mission, and had an interest to serve far-flung communities.

Royal Flying Doctors Service(RFDS)

In 1920s Flynn contacted Alfred Traeger, who in 1926 developed a radio-device. Remote communities could now contact Flynn, in case of need. This was a necessary step, for a successful flying service. Two years later, in 1928, Flynn managed to lease a small-plane, and on 15th May 1928, Australian Aerial Medical Service was born. This was the first airborne medical service for civilians.

In event of a medical call, Flynn his pilot and a doctor would travel to remote locations in a small airplane. They would carry supplies, often treat locally and fly-back. Initially, this was doctor visit to treat, rather an evacuation. After initial years of struggle, this service became hit. In 1942 the service was renamed as “Flying Doctor Service of Australia”. In 1954, when Queen Elizabeth visited Australia, a prefix of Royal was added to the name.

Today Royal Flying doctor service (RFDS) has a fleet of 79 aircraft. RFDS provides on-site emergency care, evacuation, primary health, Telehealth, and even inter-hospital transfers. Moreover, its website, also showcases all current airborne flights. It is supported both by government and private philanthropy. Its success in Australia led to an air ambulance network, that was later set up in Scotland (1936), Canada (1945) and US (1947).

Flying doctors of Africa

In 1957 three plastic surgeons-Sir Archibald McIndoe, Dr. Michael Wood, and Dr. Thomas D. Rees, formed African Medical and Relief Foundation (AMREF). They started ‘The Flying Doctors Service of Africa and in 1971 established a Society (FDSA)to support their work. There are many dramatic FDSA stories about sorties, missions, field surgeries, and lives saved. The group would fly-in to conduct difficult childbirths, caesarian sections, reconstructive surgeries, evacuate trauma victims, and even treat medical conditions.

Today FDSA is engaged in outreach medical services, evacuations, and an air-ambulance service. Their fleet of five aircrafts is largest in Africa.

From aircraft to a helicopter

Helicopters do not need a runway. They can take-off and land vertically. While, we had our first helicopter in 1942, it was only in 1950s that we improved their design for a more widespread use. Its early medical usage for civilians was in 1960s, to evacuate victims of road traffic accidents in US. However, first dedicated medical helicopter, for civilian use started in Munich, Germany in November 1970. Over next five years, there were more than 10 hospitals in Germany, that had their own helicopter air-ambulances.

Today, many cities, governments and hospitals in Europe and North America have helicopter-based air ambulance or rescue services. The global air ambulance services market is projected to grow from $5.79 billion in 2022 to $10.30 billion in 2029. In 2015, there were about 1045 dedicated medical-helicopters in the US.

The road ahead

Air medical transport provides numerous advantages over ground transport. These include speed, ability to manoeuvre, and with helicopters, ability to land in proximity to an emergency. It however remains expensive. In India, this sector is only about fifteen years old, currently run by privately owned companies. As we continue to expand our road-ambulances, dedicated medical air-ambulances in the public sector may not be far away.