Medical aviation, a branch of general aviation, is a lifeline for patients that must transit or travel. We sit down with Doctor Vika Cokronegoro, Founder and CEO of FlyDoc Indonesia to learn about medical aviation and how it has been affected by COVID-19.
Please introduce yourself in 2-3 sentences.
Hi, my name is Vika, I am an Indonesian female flying doctor, and Founder and CEO of medical aviation organisation, FlyDoc Indonesia. I am an aviation medicine specialist working in the aeromedical evacuation field.
What is medical aviation?
Aviation medicine is a branch of medical science-based in aerophysiology: the changes that take place in human bodily functions in an aviation environment. In-flight, we face health risks such as low oxygen concentration (hypoxic hypoxia) in-cabin, gas volume expansion, acceleration-deceleration force, radiation, and others. This is nothing to worry about for someone in good health as flight can be tolerated by the normal human body. However, for certain passengers or patients, there are some precautions that need to be taken to ensure a safe transfer.
How has medical aviation been affected by COVID-19?
Aviation medicine, commercial aviation, and business and general aviation are hugely affected by COVID-19. The pandemic has created a lot of additional steps, compliance issues, and processes to follow including screening, border controls, and quarantine. This creates a stressful and challenging environment for a patient in transit. As a medic, it is my job to ensure the patient is safe, comfortable, and that we reduce the stress of being in transit between locations.
Aviation is, even in normal circumstances, a highly regulated industry. Through COVID-19, there is a longer and more complicated administration process, as we need to coordinate with port health authorities at the start and finish of the flight and report to the COVID-19 task force. For international Medevac flights, additional approvals must be obtained, including from the ministry of health. Before COVID-19, this process could be completed in a few hours, now it may take several days or weeks to collect all the documents required.
Additional challenges include a strict patient selection process which is needed to determine infectious status. Infectious patient transfer requires the proper Personal Protection Equipment (PPE) and a smaller team to minimize contact. In some cases, the patient must be put in a special chamber (to contain the virus).
We need to consider the complete patient journey from start to finish, including the provision of care at their destination hospital. Although I am responsible as a medic for their transit only, it is vital and I also ensure their safe arrival and care at the destination hospital. During COVID-19, most hospital beds were occupied across Southeast Asia. Often, we had to spend days searching for a suitable facility to care for our patients upon arrival at a certain destination.
Where do you fly?
We fly locally (short flights), mid-distance domestic flights, and internationally.
During the pandemic, most countries closed their borders. In this situation, we began implementing a “tarmac transfer” system whereby our medical team escorts the patient to the destination airport, and the receiving hospital’s medical team pick up the patient from the airport and take them to the hospital. Ordinarily, I would stay with my patient until they are safely situated in the destination care facility. Through COVID-19, this has not been possible, meaning communication between medics is fundamentally important.
What does a typical day look like for you?
I manage and monitor the medical teams, ground ambulance,s, and air ambulance movement, and also liaise with hospitals at both ends to make sure everything goes to schedule and the patient is transferred safely.
Whenever a case is called, I complete a medical assessment, collect required documents, prepare medication(s), medical equipment, and form the appropriate team of medics. I coordinate with the operations team regarding air ambulance availability, ground ambulance, and administration matters. When all preparations are complete, I go to the airport, fly, pick up the patient from the hospital, complete the medical information transfer from the originating hospital, carry out inflight monitoring, care, and treatment, escort the patient to the destination hospital and complete the medical handover to the new hospital for the continuation of therapy. I then fly back home!
What proportion of women (estimated) work in your field?
For medical teams(doctors and nurses), it is probably around 50%. There is a good balance of female and male doctors in medical aviation. That said, there are almost no males in typically “female” roles including nursing. In addition, there are no female pilots in Indonesia’s Air Ambulance service. I see this as a challenging industry but one that is open to both genders.
What do you think needs to change in medical aviation to make it more attractive to women?
Support from family and society for women to pursue careers in science, STEM, aviation. This is an incredibly challenging profession, expensive to train for, and support is an important key to more women choosing this career.
You work with business aviation operators. Is their knowledge sufficient to carry out medivac or do you need to provide training?
All our aircraft operators are very well informed regarding medivac. They have safety departments to manage the aircraft’s requirements to perform safe medevac flights. We work together to ensure flight safety, including oxygen on board, medical equipment in flight, and patient loading and unloading process.
Describe your profession in 3 words.
Life-saving, quick-response, team-work
Thank you for reading!