Airlines deal with 12 serious medical issues daily - now there is help on hand, writes Gerry Byrne
EVERYONES WORST nightmare is getting killed or injured in a fiery wreck, but you are more likely to die in your seat during an uneventful flight.
That's what happened a 24-year-old Italian au pair en route to an Irish family in September 2006 when she was suddenly taken ill aboard a Ryanair flight. A 40-minute struggle by two nurses and a doctor on the flight failed to save her and she died of a suspected cerebral haemorrhage.
The aircraft diverted to Charleroi but she was dead on arrival. Later a row broke out when the nurses accused Ryanair of having an inadequate first aid kit. Ryanair strongly refuted this.
More recently, Carine Desir died of heart disease aboard an American Airlines flight from Haiti to New York, leading to accusations that the oxygen bottle used to treat her was empty, charges the airline dismissed as being without foundation.
Whatever the truth of the two controversies, there is little doubt that an aircraft is an inadequate place to treat the sick but, warns Edel Mannion of Mondial Health Insurance, simply diverting to the nearest airport may not be the correct solution. Mondial has launched a service for airlines where it will provide a doctor to discuss a sick passenger's symptoms over the radio with the pilot or crew.
Having arrived at a probable diagnosis, he/she will advise the crew on how to keep the patient stable while searching his/her database for a suitable clinic or hospital where the passenger can be treated. Mannion says Mondial can provide access to a doctor within 30 seconds, and a diagnosis 10 minutes later.
It marks an extension of Mondial's Marco Polo travellers health insurance scheme where clients who fall ill are booked into the best local facility which can treat their symptoms. Sometimes, says Mannion, they have already been admitted to hospital but they often insist on moving them because Mondial is unhappy with the facilities.
"For every million people who take a flight, at least 100 will fall ill en route," she says. "Throughout the world, airlines deal with 12 serious medical issues a day."
Most in-flight emergencies are minor, and fainting accounts for almost half. Stomach problems represent 14 per cent of cases and, while most are minor, there is the occasional case of E coli or salmonella poisoning.
The infection is often contracted on board. In 1984 a total of 186 cases of salmonella were reported on 20 transatlantic flights. First-class travellers were worst affected; budget travellers rarely fell ill. The cause was traced to prawn cocktails on the first-class menu stored at the wrong temperature.
More recently, Health Canada discovered total coliform bacteria on 65 out of 431 aircraft it surveyed. In four cases it found the even more harmful E coli in toilets and, in one alarming case, in the galley. In 15 per cent of the aircraft surveyed, total coliforms were found in the water tanks, and in 1.2 per cent, E coli was also found in the water.
Aircraft are blamed for other health issues. The close confines mean that bugs can easily be spread between passengers and frequent travellers are found to catch more colds and other respiratory tract diseases than people who spend all their time on the ground.
One reason may be that the drier air being breathed at altitude evaporates the protective fluid mucus on our airways leaving us susceptible to infection.
The rapid spread of Sars was blamed on air travel and deep vein thrombosis is another illness associated with air travel.
One in-flight medical case in 12 is heart-related and there is a surprisingly high incidence of neuropsychiatry which accounts for 6 per cent of cases.
After diagnosis, the next problem is deciding what to do. Sometimes, says Mannion, the decision is made to do nothing because the passenger is stable and can wait until reaching their destination to receive treatment. But if the crew is confronted with a serious situation, quick decisions are needed.
Sometimes an immediate landing at the nearest airport is counterproductive, warns Mannion, as the correct facilities may not be available, especially in less developed countries.
Mondial has developed a database of the medical facilities near 160 international airports and can advise the crew where the nearest suitable airport within reach of a good hospital is.
"We are drawing on our experience of being the largest travel insurer in Europe. We handle some 400,000 medical files annually."
Since 2003, Mondial claims its doctors have visited 143 hospitals in 120 countries and graded them, along with the medical facilities in 161 airports. Their best grade is reached by less than 9 per cent of facilities and only 70 per cent in total offer correct medical structure. Eight per cent are not recommended under any circumstances.
So, far, says Mannion, no airline has signed up for its new service, but negotiations are underway with several carriers.