Setting: Ambulance in the Southern Highlands province of Papua New Guinea
Position: Chief medical officer for Chevron
I am in an ambulance on my way to pick up a patient who needs to be evacuated for surgery in the general hospital of Port Moresby. As I drive up a hill to the helipad, the nurse sitting next to me learns by radio from the base camp that the chopper carrying the patient is on its way and will meet us in five minutes. We transfer the patient into the ambulance and proceed in haste to the airstrip at Moro. After about 40 minutes on the winding dirt road, I can see the Citation plane on the tarmac waiting for us. We reach the makeshift air-control tower and I run up the stairs and say hello to the controllers, who seem to be in a bad mood. I am glad to see that the pilot is in the room, although he, too, looks angry and starts a tirade. “I have been waiting for you guys for more than 15 minutes. Where have you been?” he says. I know that he is worried about his daily flight schedule. He also asks me, “Do you know the hourly rental rate of this plane?” I cut the discussion short, which is easy to do because everyone is focusing primarily on the task at hand.
As soon as the plane takes off, I start an investigation into the confusion over the timing of the helicopter and plane flights. The patient would have been at the airport sooner if the chopper had flown directly there. I discover that the source of the problem is the absence of a radio link between fixed-wing aircraft and helicopters in Papua New Guinea. Further discussions reveal that about two years earlier the helicopter company was unsuccessful in trying to set up a bilateral working scheme. I restart the process immediately, but this time including the PNG government (with national security and political advisors), helicopter and airline companies, radio technicians and Chevron medical department representatives. A few weeks later, we have worked out an agreement that establishes the first national radio network for emergency medical services in Papua New Guinea. Chevron is allocated three frequencies. The agreement will raise safety levels nationally as well as locally. Moreover, it carries minimal costs because the specialized network does not require the creation of new frequencies and no additional equipment will be needed for its implementation.
Lessons for the doctor: An efficient and reliable communication network is crucial for saving life and limbs, so do not accept the status quo when it falls short of best practices, particularly for emergency situations. Also, including all the partners at the table increases the likelihood of reaching an agreement.
Yann Meunier, MD, is the health promotion manager for the Stanford Prevention Research Center. He formerly practiced medicine in developed and developing countries throughout Europe, Africa and Asia. Each week, he will share some of his experiences with patients in remote corners of the world.