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Annual Report 2011


AMREF Flying Doctors welcomed the third Cessna Citation Bravo jet to the fleet.

AMREF forms what will become a long time partnership with Kenyatta National Hospital, taking medical specialists by air to Wajir, Garissa and Mandera in Kenya.

In partnership with Phoenix Aviation, AMREF Flying Doctors begins to operate a Cessna Citation Bravo Jet.

On the foothills of Mount Kilimanjaro, AMREF Flying Doctors is founded by three reconstructive surgeons: Michael Wood, Archibald McIndoe and Tom Rees.

AMREF Flying Doctors Founder Sir Michael Wood receives a knighthood from Queen Elizabeth II.

Mobile Outreach Clinics are introduced to southern Kenya to treat nomadic Masai pastoralists.

AMREF Flying Doctors adds a second Cessna Grand Caravan to the fleet.

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19 5 7 19 5 7

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AMREF’s Outreach Programme is launched, initially servicing four hospitals in remote Kenya.

2000

19 8 5 19 9 6

2007 2007

AMREF Flying Doctors receives the ITIJ 2011 Air Ambulance Provider of the Year award.

2009 2007

2011 2010

The first Cessna Grand Caravan is introduced into the AMREF Flying Doctors fleet. AMREF Flying Doctors celebrates the opening of its Visitors Centre by founder Tom Rees.

AMREF founder Dr Michael Wood publishes his book “Go an extra mile”. Anne Spoerry, known as “Mama Daktari”, joins AMREF Flying Doctors.

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2003

AMREF Flying Doctors becomes the first operator outside of Europe to receive “Full Accreditation – Special Care” from the European Aeromedical Institute (EURAMI).

The hangar at Wilson Airport, Nairobi, is expanded to cater for our larger fleet

AMREF Flying Doctors acquires a third Cessna Grand Caravan.

AMREF’s Outreach Programme continues to expand, visiting 150 hospitals in Kenya, Tanzania, Uganda, Rwanda, Ethiopia, Somalia and Southern Sudan, training more than 6,200 doctors and nurses and undertaking over 26,000 consultations.


A small child is carried carefully from the aircraft by a Flying Doctors nurse (archive photo)


Vision

“To be the leading, most progressive and innovative aeromedical service, providing medical treatment to people in Africa and beyond, with the objective to strive for development based on the principles of quality, efficiency, integrity and humanity.”

Mission

“We remain committed to the principle of operating as an overall not-for-profit organisation. Focused on the comprehensive delivery of health services, we reach out to remote communities in East Africa bringing care, saving lives and giving hope.”

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Contents

12 Charity Evacuations

31 A Day In the Life of a Flying Doctor

18 Case Study: The African Challenge

34 ITIJ Air Ambulance Provider of the Year Award 2011

Fold out sections: AMREF Flying Doctors Timeline Air Ambulance Services - Nationalities Evacuated Full Contents Vision and Mission Statements From the Management Background Project Objectives Medical Advice and Communications Air Ambulance Services Charity Evacuations Assistance Services Aircraft Available Case Study: The African Challenge Medical Standby Coverage Case Study: Mogadishu AMREF Outreach Programme KATO Tourist Evacuation Scheme Australian Youth Ambassador for Development Placements Royal Flying Doctors Service Australia Marketing Volunteer Physician Programme A Day in the Life of a Flying Doctor Quality ITIJ Air Ambulance Provider of the Year Award 2011 Fundraising Activities Professional Partners Proud to support the work of AMREF Flying Doctors Accounts

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Dr Bettina Vadera

011 was an important year for the Flying Doctors, as it saw the official incorporation of the Emergency Services and Aviation Unit into a company, limited by guarantee, wholly owned by AMREF and registered as AMREF Flying Doctors. The company’s objective is to generate income to help AMREF achieve fundraising, financial and Outreach Programme obligations. This important step will enable us to grow and expand within the commercial industry of air ambulance and medical emergency services. It will also provide the necessary structure to develop new business avenues, strategic business partnerships and the possibility of franchising. Over the years, we have experienced a sharp rise in the demand for emergency medical evacuation services. With the new company, we are in a better position to offer affordable and quality emergency air ambulance services to a wider segment of the population and develop our own subscription schemes. As part of our expansion plans, we doubled the size of our 24-hour Control Centre, installing new computer and communication equipment, including aircraft tracking software, all of which has improved our performance significantly. Overall, 2011 has been the busiest year in the history of AMREF Flying Doctors, with evacuations increasing from 782 patients in 2010 to 1,254 patients in 2011. Particular support was given to Somalia during 2011, where the ongoing hostilities

Scott Griffin

s Chairman of the Board of AMREF Flying Doctors, it is my pleasure to report that Africa’s premier emergency evacuation and medical assistance service has just completed a record year by number of flights. AMREF Flying Doctors completed 932,714 hours of flying for a total revenue of US$981,922.76, which included evacuations from remote areas in East Africa to Nairobi and then on to South Africa, Europe and the Middle East. These flights included local flights in our two Cessna Caravans, and international flights in the four jets and the three King Air aircraft operated by our partner Phoenix Aviation. Customers included the United Nations, the Red Cross, travel agencies and the local population in East Africa. AMREF Flying Doctors provides air

From the Management

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between the Transitional Federal Government and the Al Shabab militia caused hundreds of casualties who we could safely evacuate from Mogadishu. Medical conditions ranged from blast injuries, gunshot wounds and burns, to infectious diseases and psychological trauma. Our commitment to evacuate patients free of charge from the most remote locations in Kenya is unchanged. In 2011, more than US$60,000 was spent evacuating the poorest of the poor, transferring patients at no cost to medical facilities where their lives could be saved. A particular highlight in 2011 was the International Travel Insurance Journal Air Ambulance Provider of the Year Award that AMREF Flying Doctors was honoured with at the ITIC conference in Lisbon in November 2011. We are also proud to celebrate the fifth year of successful accreditation by the European Aeromedical Institute (EURAMI), the European auditing organisation for professional air ambulance providers. The team at AMREF Flying Doctors are looking forward to another busy year with the launch of our new annual air ambulance cover, Maisha. We will be generating more funds to support our important humanitarian work through AMREF’s Outreach Programme and our Charity Evacuations. Dr Bettina Vadera Chief Executive Officer and Medical Director AMREF Flying Doctors

ambulance, ground ambulance, emergency first aid and aircraft maintenance services. The range of products offered has seen business expand in each of these areas and cover a wider geographical region than in any previous year. This improvement in service has not only resulted in our reaccreditation from EURAMI, but also saw AMREF Flying Doctors winning the International Air Ambulance Provider of the Year Award for 2011. I wish to take this opportunity to thank all stakeholders of AMREF Flying Doctors for their support over past year and to assure you of our continued determination to supply unparalleled service in the future. Scott Griffin Chairman of the Board AMREF Flying Doctors


Background

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TOP: Sir Michael Wood and a flight nurse offload a patient from an aircraft (archive photo) RIGHT UPPER: One of the first ‘under-the-wing’ clinics (archive photo) RIGHT LOWER: A mobile Outreach clinic (archive photo)

MREF Flying Doctors has committed itself to providing world-class medical services to the people of Africa for the past 55 years and remains Africa’s leading air ambulance service provider. Originally providing ‘under-the-wing’ clinics in the 1950s, AMREF Flying Doctors now provides emergency air evacuations with state-of-the-art technology, including an incubator to transport newborns. Operating a fleet of 14 aircraft, AMREF Flying Doctors pilots are well versed in navigating the rugged terrain that characterises the landscape of East Africa. The main areas of operation continue to be Kenya, Tanzania and Uganda, with

evacuation flights being more frequently carried out from neighbouring countries. AMREF Flying Doctors also provides medical escorts on commercial carriers worldwide and repatriates patients across the globe by private air ambulance. AMREF Flying Doctors currently employs one physician and 11 flight nurses on a full-time basis, who are cleared to be deployed at short notice. Additionally, 11 physicians are employed on an on-call arrangement to ensure that appropriate cover for emergency flights is available 24 hours a day, 365 days a year. The 24-hour control room at headquarters is staffed with qualified medical personnel at all times, who are able to provide emergency medical advice. AMREF Flying Doctors continues to ensure that their air evacuation services are available to people in disadvantaged and marginalised communities across East Africa. AMREF Flying Doctors provides emergency evacuations free of charge in special circumstances, with a number of emergency evacuation flights per year taking place on a humanitarian basis. AMREF Flying Doctors also provides medical and logistical assistance for international health insurance companies.

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Project Objectives

1 To respond to medical emergencies by providing professional advanced life support to East Africa and the neighbouring countries

4 To improve the prehospital care and provision of emergency medical services

“It’s been a hectic eight months since I joined AMREF Flying Doctors. The team here is amazing, very knowledgeable and committed! My role as CFAO, is to help the team and the company move to the next level as a commercial entity... and ensure good returns for AMREF Flying Doctors.” STEPHEN GITAU CHIEF FINANCE AND ADMINISTRATION OFFICER 8

7 To provide air ambulance services and medical advice to the members of the Flying Doctors’ Society of East Africa

2 To provide air ambulance services to remote areas within the East African region and beyond, where sufficient medical care is unavailable or non-existent

5 To provide high quality emergency medical care compliant with international aeromedical standards

8 To provide local support to international insurance and emergency assistance organisations

3 To provide emergency air ambulance services free of charge to people in East Africa who are in a life-threatening medical condition but are unable to pay

6 To provide international air ambulance and medical escort services on commercial carriers worldwide

9 To provide training in areas related to emergency medicine and pre-hospital care to help build a wider emergency medical capacity in the region


Medical Advice & Communications

“In a few words, working at AMREF Flying Doctors is challenging, exhilarating, rewarding and fulfilling, which is the reason I get up each morning to come to work.” JANE MUNYUA AEROMEDICAL COORDINATOR

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he Control Centre, located at Wilson Airport, Nairobi, is staffed at all times with qualified medical staff on hand to provide emergency medical advice. Once a call is taken about a patient requiring an emergency evacuation, staff start planning, with the assistance of the aviation team, the time for take-off and which aircraft to use, depending on the airstrip, weather and the patient’s condition. After collecting the patient, the pilot relays the medical report to the Control Centre. Control Centre staff book the hospital, ensure medical staff are briefed and make

sure an AMREF Flying Doctors ground ambulance is ready to transport the patient to a medical facility without delay. Health facilities in remote areas are also able to contact AMREF Flying Doctors Emergency Control Centre 24 hours a day for medical advice via radio or telephone. Medical advice is also given to rural medical centres, mission and district health facilities, and remote tourist lodges. Medical advice can be obtained at AMREF Flying Doctors’ Control Centre by anyone at no cost, irrespective of whether they are subscribed to our services.

TOP: Staff in the AMREF Flying Doctors Control Centre can monitor aircraft movement with satellite tracking BOTTOM: A nurse in the AMREF Flying Doctors’ Control Centre at Wilson Airport, Nairobi

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Air Ambulance Services

Evacuation Categories

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uring 2011, AMREF Flying Doctors provided a total of 86 long distance evacuation flights including 11 to destinations in Europe, 46 to Southern Africa, 16 to West and Central Africa, and 13 to the Middle East and Asia using the Citation Bravo jets. This represented a 52% increase in the figures for longer distance flights from 2010, and shows both a resurgence of demand from international insurance and assistance companies to offer their clients a choice of medical treatment areas, as well as an influx of international staff and workers who operate in Africa, but want their medical treatment in their home country. Nairobi continues to be a centre of medical excellence and there is a corresponding increase in flights bringing patients from other locations in Africa to Nairobi for treatment. In addition, AMREF Flying Doctors provided 12 international medical

111 Traffic accidentrelated trauma

escorts on commercial flights to South Africa, Europe, India and the US, which reflected the same number as 2010’s figures. AMREF Flying Doctors continued to work closely with leading European air ambulance providers carrying out a number of wing-to-wing rescue operations, whereby an air ambulance evacuation is provided by two air ambulance operators from different countries meeting together at a mutually arranged spot to transfer the patient to another carrier. A total of 12 such flights were carried out during 2010. The Air Ambulance Service continues to cover the countries of East Africa (Kenya, Tanzania, Uganda) stretching to countries such as Ethiopia, Eritrea, Rwanda, Burundi, Somalia and Democratic Republic of Congo, among others. Increasingly, the coverage has extended over the past few years to the whole of Africa, the Middle East, India, Europe and beyond.

93 Others

89 Other trauma

84 Infectious disease/malaria

72 Gastrointestinal diseases

70 Cardiovascular ailments 34 Cerebrovascular incidents

641 War/violence inflicted trauma

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32 Psych/Neurological disorders 21 Obs/Gynaecology cases 7 Animal attack-related injuries


Emergency Evacuations

Registered Client 425 FDSA Member 36 Paid Non-Member 240 Free Charity Evacuations 21

Assistance tasks 445

Tourist Scheme B 1

Night evacuations 222 0

100

200

300

400

500

UNSOA 687 0

150

300

450

45

2010

74

2009

64

2008

39

2007 0

20

40

60

748,051

2009

924,051

2008

0

100

1,269,070

2010

2007

80

932,794

2011

Flying Miles

750

86

2011

International Evacuation Flights

(x1000)

600

560,367 300

600

900

1,200

1,500

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Charity Evacuations

Under special circumstances, AMREF Flying Doctors provides a charity evacuation service, whereby AMREF Flying Doctors will evacuate a patient in a serious medical condition free of charge. A total of 21 charity evacuations were carried out in 2011, an increase from 16 in 2010. As described in the following accounts, the process is one that requires a rapid response and the provision of the high-level medical care that has become the cornerstone of AMREF Flying Doctors’ assistance services. Charity evacuations are supported by donations from various sources: internationally by the staff of IBM Sweden and AMREF Italia and locally by companies such as J.W. Seagon, a Nairobibased insurance company who donated more than US$6,500 to the programme in 2011.

Considerations and guidelines for granting a charity evacuation

1 Medical: Is the patient in a life-threatening condition? Does the patient have a good chance of surviving the evacuation flight? Is the prognosis for the patient likely to be significantly improved by air ambulance intervention?

3 Funding: Is the patient covered by insurance or do they have any other means by which the flight can be paid for by a third party? Does the patient or family appear to have adequate funds to pay for the flight in part or full? Will the patient be able to contribute to the cost of treatment at the hospital?

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2 Social: Is the patient a supporter of dependants, especially children? Will the patient have the means to return home after the treatment? Will the event of death at a location far from home create a large burden to the family and relatives?

4 Other: Does AMREF Flying Doctors have a suitable aircraft available? Does the weather allow an immediate response? AMREF Flying Doctors will not normally charter an aircraft for a free evacuation.


Charity Evacuations Case Study Moyale to Nairobi

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ohammed, a 27-year-old man, was diagnosed with periportal fibrosis, a chronic liver disease, in December 2010 as a result of schistosomiasis infestation. When he was admitted to hospital to stabilise the condition, his world crumbled. Once an active man, working as a labourer and a driver, this debilitating disease was taking its toll. His employers could not keep him on the demanding job of driving long distances as he had become so weak because of the effects of schistosomiasis. On this day, nurse Kilda was going about her usual duties at our Control Centre at Wilson Airport in Nairobi. Everything was running smoothly until 14:00 hrs. Nurse Kilda received a distress call from Sololo Mission Hospital

the airstrip by Mohammed and the nurse, who were so thankful that the team could make it. It took the AMREF team one quick look at Mohammed to know that it was the right decision not to postpone the rescue. Mohammed was weak and panting, especially when he attempted to walk. He was extremely pale and a look at his mucous membrane showed that he had lost almost all of his blood. The medical staff knew that he needed more blood, and quickly. With light falling, the AMREF Flying Doctors team raced against time to stabilise him and get him ready for the flight back to Nairobi. By 18:35 hrs, Mohammed and the team were ready for take-off, and with the aircraft being pressurised, they were not worried about the pressure changes that would affect the

requesting an urgent air evacuation of a young man with severe anaemia who had received three units of blood but was not improving. The medical team at AMREF Flying Doctors was informed that he had started vomiting and passing blood and required an urgent gastroenterology review in Nairobi. Flying to Sololo on a Caravan C208 was out of the question as it was too late in the day to land on the unlit airstrip. The only option to rescue this young man was to send a much faster and pressurised plane. However, Sololo airstrip is small and can’t accommodate this type of aircraft. The only option was for the patient to endure a torturous 1.5-hour drive to Moyale airstrip where the aircraft could safely land. The medical team contemplated postponing the mission to the next day when the Caravan could fly to Sololo, but abandoned this idea as they knew this case was time critical. With approval from AMREF Flying Doctors’ Medical Director, Dr Bettina Vadera, the team took off from Wilson Airport at 16:30 hrs for Moyale, landing there slightly after 18:00 hrs. The AMREF Flying Doctors team was met at

patient had the aircraft been non-pressurised. In-flight, Mohammed had been quite stable, but on landing in Nairobi, he vomited a significant amount of blood, which indicated that he was still bleeding internally. The team landed back in Nairobi at 20:00 hrs, and Mohammed was immediately taken in an AMREF Flying Doctors ambulance to Kenyatta National Hospital, the country’s national referral hospital. At the hospital, Kenyatta medical staff were ready to receive the patient, who was quickly taken into one of the acute rooms to be attended to by the resident doctor, who then called in the specialist doctor. At handover the next morning in the office at AMREF Flying Doctors, all the medical staff agreed that this was one man with nine lives. “With an extremely low haemoglobin count of 3 g/dl, medically, this would almost be considered incompatible with life, or if still alive, then one would require very high critical care support. But perhaps having been ravaged by the effects of drought, the body also develops some resilience and resistance to many afflictions,” said flight nurse Kitizo.

FAR RIGHT: A King Air being loaded with medical equipment to perform the Charity Evacuation from Moyale to Nairobi RIGHT: Flight nurse Kizito attending to the patient in a ground ambulance

PILOT: CAPT. ROB CORK DOCTOR: DR LUCY NG’ETHE FLIGHT NURSE: KIZITO OSUNDWA AIRCRAFT: 5Y-FDK (BEECHCRAFT KING AIR) TOTAL COST: US$8,315

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Charity Evacuations Case Study Illeret to Wamba

PILOT: CAPT. EMMANUEL WANYELA DOCTOR: DR JAMES MBAI FLIGHT NURSE: MILDRED ADHOLA AIRCRAFT: 5Y-FDC TOTAL COST: US$6,530

TOP: AMREF Flying Doctors staff loading the patient into the aircraft to evacuate him to Wamba Mission Hospital

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t was a bright sunny morning in September at 07:00 hrs when AMREF Flying Doctors received a distress call from nurse David at the Illeret Health Centre. David informed staff in the Control Centre that he had a patient who needed an urgent evacuation to a healthcare centre with better medical facilities in terms of an operating theatre, an intensive care unit, and qualified doctors and surgeons. The patient, a 46-year-old man called Adan, had been bitten on his left foot at approximately 20:00 hrs the previous evening by a snake while serving clients in his small shop. He didn’t see the snake clearly due to poor lighting, so he wasn’t in a position to describe it. He was in extreme pain, and the home remedies he used to try to manage the pain didn’t work, so his wife took him to the health centre to get more assistance. They arrived at the clinic at about 21:00 hrs. Adan was in severe pain and his vital signs were boderline. He was given 200 mg of hydrocortisone, gentamycine, painkillers and two vials of antivenom, and was connected to a drip. However, he didn’t improve, the pain worsened, he started having slurred speech and was spitting blood. AMREF Flying Doctors’ Medical Director, Dr Bettina Vadera, was asked if a charity evacuation was possible by staff at the Illeret Health Centre. After discussions, it was decided to transfer the patient to Wamba Mission Hospital, which was closer to Illeret where he would receive treatment by a team of highly qualified doctors. AMREF Flying Doctors staff contacted Wamba Hospital

to see if they were able to assist and they readily accepted. Immediately, the flight was authorised. The AMREF Flying Doctors medical team was activated and preparations commenced. The plane took off from Wilson Airport, Nairobi, at 11:15 hrs and landed in Illeret at 13:35 hrs. AMREF Flying Doctors’ medical team was met by Adan, along with his friends and family, as well as a nurse. Adan was pale and dehydrated. He was tearing excessively and complaining of a lot of pain all over his body. The bite site appeared darkened, but pulses on his limbs were present. The medical team put him on stretcher and lifted him into the aircraft. He was in obvious pain, as evidenced by his agonised face. His vital signs were fairly stable. Quickly, an intravenous line was put in to give him much needed pain medication and then fluids. After take-off, Adan’s oxygen saturation levels went down and additional oxygen was administered. His pain greatly reduced after receiving pain medication, and he remained fairly stable. The team touched down in Wamba at 15:50 hrs and was met by the Wamba Mission Hospital staff, and the patient was handed over safely. “We watched as he was being wheeled away into the hospital, with satisfaction that the poor man was going to get well and get to spend more time with his family. We had saved another life! And that feeling is very fulfilling,” said Mildred Adhola, AMREF Flying Doctors flight nurse.


Assistance Services

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MREF Flying Doctors provides various assistance services to international insurance and assistance organisations. This assistance includes: • following up medical reports for hospitalised patients • assessment of hospital bills • provision of transport for patients or relatives • booking of hotel accommodation or air tickets • guaranteeing medical or other caserelated expenses. AMREF Flying Doctors is able to make assessments of medical facilities on behalf of individuals, other medical facilities and insurance companies. AMREF Flying Doctors is also able to arrange repatriation

AMREF Flying Doctors staff giving initial treatment next to the aircraft

of patients to countries across the globe. These services are provided against a fee and are only rendered to clients with whom AMREF Flying Doctors has signed a Service Provider Agreement giving both parties a standing relationship. This year, the number of Service Provider Agreements signed with leading international insurance/assistance companies has reached a total of 182, under which many regional companies and subsidiaries are covered. Registration Agreements are also formed between AMREF Flying Doctors and larger NGOs, parastatals, or insurance companies. Registration Agreements include an upfront Guarantee of Payment for evacuation flights, consequently giving clients fast access to AMREF Flying Doctors’ air ambulance service.

Accommodation

To arrange hotel accommodation for the beneficiary in case of an unforeseen emergency such as an accident, illness, death or being the victim of a crime. The same can be arranged for the patient after discharge from hospital, or for the patient’s relatives.

Assistance with lost or stolen documents/ luggage

To assist the beneficiary with arrangement of local police formalities and renewal or replacement of documents.

Cash advance

To pay money to a beneficiary/patient in case of an unforeseen event such as an accident, illness, death or being a victim of a crime. This service is only available through contractual agreement with AMREF Flying Doctors.

Emergency returns

To make flight and taxi arrangements to the airport in case the beneficiary has to return to his/her home country due to an unforeseen event.

Funeral assistance

To arrange a local coroner/undertaker to organise a funeral (burial or cremation), including the arrangement of necessary documentation. Special arrangements linked to the religious/cultural background will be organised where possible.

Hospital guarantee

To guarantee payment of hospital charges and other medical expenses in Kenya. This service is only available through contractual agreement with AMREF Flying Doctors.

Repatriation of human remains

To make all necessary arrangements for the transport of human remains. This includes: • official documents • preparation of the body and coffin for transport • delivery to the airport.

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Aircraft Available

Cessna 208 B Grand Caravan

CAPACITY: 13 PASSENGERS OR 4 STRETCHERS

MAX RANGE: 1,700 KM SPEED: 260 KM/H

Beechcraft Super King Air B200

CAPACITY: 10 PASSENGERS OR 2 STRETCHERS

MAX RANGE: 2,025 KM SPEED: 420 KM/H

Beechcraft Super King Air B350

CAPACITY: 10 PASSENGERS OR 2 STRETCHERS

MAX RANGE: 2,400 KM SPEED: 475 KM/H

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Aircraft Available

Cessna 550 Citation Bravo

CAPACITY: 7 PASSENGERS OR 2 STRETCHERS

MAX RANGE: 3,750 KM SPEED: 690 KM/H

Cessna 560 Citation Excel

CAPACITY: 8 PASSENGERS OR 2 STRETCHERS

MAX RANGE: 3,750 KM SPEED: 750 KM/H

Eurocopter Ecureuil AS 350 B3

CAPACITY: 4 PASSENGERS OR 1 STRETCHER

MAX RANGE: 600 KM SPEED: 185 KM/H

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Case Study: The African Challenge Operating an Air Ambulance Service in Africa, with its long distances and geographical remoteness, poses special challenges. Medical facilities are few and far between. There are insufficient and inadequate treatment facilities in rural areas. A recent evacuation demonstrated some of the challenges that are so typical for the African environment and the flexibility we have to employ to get the job done.

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n employee of a mining company had been badly injured in a road traffic accident in rural Tanzania and was in a small hospital with very limited facilities. AMREF Flying Doctors was asked to provide air evacuation to a hospital where more advanced care could be given. The best trauma and neurosurgical facilities in the region are in Kenya, but the patient was a Tanzanian national with no

TOP: Crowd gathers as the helicopter lands RIGHT: Dr Raitt and the team taking the patient to the helicopter

travel documents. Additionally, his insurance only covered him within Tanzania. The option to take the patient to Nairobi therefore did not exist and the decision was made to transfer the patient to Tanzania’s capital, Dar es Salaam, for treatment. Our evacuations are usually carried out by fixed-wing aircraft. In this case, however, the dirt airstrip close to the hospital was unusable as the closure of the main road nearby had transformed the airstrip into a

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road diversion with heavy traffic. Limited communications with the rural hospital and little to no support from the local police force to clear the airstrip left only one option: to dispatch the medical team in a helicopter from Wilson Airport. Instead of 50 minutes flying time in a Beechcraft King Air to the patient’s location, the team was now looking at a two-hour flight by helicopter. Due to the patient’s critical condition and the level of medical support required during the flight, a further onward transfer to Dar es Salaam with a four-hour ride in the helicopter was not an option. AMREF Flying Doctors decided to position a fixed-wing air ambulance at Mwanza, an airport only 15 minutes by helicopter from the patient’s location, for a wing-to-wing transfer. The plan was that the medical team would stabilise and collect the patient from the rural hospital, then take him to Mwanza where he would be transferred with the same team onto the

the team had to consider carefully what equipment to carry in the helicopter

waiting Beechcraft King Air. Given the weight limits of the helicopter, the team had to consider carefully what equipment to carry in the helicopter and what to position in the King Air prior to departure from Wilson Airport. This was particularly challenging as details of the


peaceful from the air. To the crew’s surprise, when the dust cleared from the landing area, there were hundreds of local people who had gathered around to witness the helicopter’s arrival, which for them was probably the most

pilot confirmed via radio that the King Air had arrived in Mwanza and they took off on the 15-minute flight. The AMREF Flying Doctors Control Centre in Nairobi had organised for the helicopter to be permitted to land next to the King Air in Mwanza, and both air crew assisted the medical staff in transferring the patient onto the aeroplane. After a two-hour flight to Dar es Salaam, the team was met by a ground ambulance. In case of any problems during the transfer to hospital, all medical equipment had to be carried along to complement the rather basic equipment of the Tanzanian ambulance. The heavy rush hour traffic in Dar es Salaam provided a considerable impediment, but the driver was up to the challenge and most of the journey was spent on the wrong side of the dual carriageway, with lights and sirens on, swerving in and out to avoid oncoming vehicles. It was dark by the time the crew and patient reached the hospital, a full 24 hours after the accident had occurred. Not unusually, the hospital had misplaced the patient’s details and claimed that there was no agreement between them and the patient’s insurer. AMREF Flying Doctors had to make several phone calls to co-ordinate between the hospital and the insurer before

exciting thing that had happened all year. Initially, the crowd kept a distance, but soon, curious children were running perilously close to the spinning rotors, forcing the pilot to take off and land on the edge of a football pitch nearby, where the crowd could be controlled. In hospital, the patient was assessed and a head injury with possible spinal injury and a broken arm were diagnosed. After stabilisation and immobilisation, the patient was transferred to the waiting helicopter. The

the patient was finally accepted and handed over to the hospital team. Complex medical problems combined with logistical constraints and uncertain communications are a regular occurrence for AMREF Flying Doctors. The entire team, from Control Centre staff to medical crew, air crew and aircraft operations staff, all have to work together as a team, have confidence in each other and accept the fact that any plan is just something to amend.

patient’s condition were vague and the team needed to be prepared to provide intensive care, including mechanical ventilation. A schedule was worked out to ensure that the King Air would be on the ground in Mwanza in time to receive the patient. On arrival at the town where the small hospital was, the helicopter circled overhead to identify a safe landing spot. The crew could see the airstrip from above because of the traffic. A dirt field next to the hospital was identified for landing and everything appeared calm and

curious children were running perilously close to the spinning rotors, forcing the pilot to take off

TOP: Dr Raitt and the team transporting the patient ABOVE LEFT: Flight Nurse Charles Atemba and Dr Raitt in the helicopter on the way to collect the patient ABOVE RIGHT: Flight Nurse Charles Atemba with Dr Raitt in front of the helicopter before collecting the patient

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Medical Standby Coverage

East Africa Safari Classic

AMREF Flying Doctors provides medical support to various sporting events in the region that are considered as being of possible risk to participants. We make medical staff available at the events, able to provide treatment if someone is injured, as well as having aircraft on standby, ready to assist if needed. Funds generated from this standby coverage contribute to overhead costs for AMREF Flying Doctors.

AMREF Flying Doctors was on standby to provide medical evacuations as needed during the 2011 East African Safari Classic motor rally, which ran from 19 to 28 November 2011. The event is considered to be the toughest and most demanding motor rally in the world. Competitors drive classic rally cars, all pre-1978 vintage, for nine of the 10

days over the rugged roads of Kenya and Tanzania, with one day of rest in the middle of the programme. Two evacuations were completed, one for a participant who had sustained a back injury after their vehicle landed badly out of a jump, and the other was a spectator who had rolled their car. We are happy to report that both made a full recovery.

Horse Shows Gilgil Horse Show and Sanctuary Farm Horse Show showcase some of the best riders in the region. AMREF Flying Doctors was happy to provide medical standby coverage to these popular events.

Safaricom Marathon “I am very glad to be part of AMREF Flying Doctors team at this point of transiting to a commercial outfit. A historic moment wrapped with great success.� ESTHER WAKAHIA HUMAN RESOURCES AND ADMINISTRATION OFFICER 20

Held in the Lewa Wildlife Conservancy in Kenya last June, AMREF Flying Doctors provided medical support for the Safaricom Marathon. Through harsh terrain and weather conditions, more than 1,100 participants of varying fitness levels competed in the 21-km loop. The marathon raised US$500,000 for a variety of education, community, development, health and wildlife projects throughout Kenya. This was the third year that AMREF Flying Doctors attended, providing assistance to all participants on the day.


Case Study Mogadishu In 2011, for the first time in our history, we began evacuating mass casualties. The majority of these were from Mogadishu, Somalia. Medical conditions ranged from blast injuries, gunshot wounds and burns, to infectious diseases and psychological trauma.

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AMREF Outreach Programme

MAIN: AMREF Flying Doctors aircraft taking off in Tanzania after an Outreach clinic RIGHT: Mother and child being treated at an AMREF Outreach clinic

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he AMREF Clinical Outreach Programme takes essential medical and surgical services to remote hospitals and clinics to eight countries across East Africa. Originally visiting four hospitals in 1957, AMREF’s Outreach Programme now serves 150 hospitals across the region through three to five-day visits. Health clinics and hospitals in these areas are few and far between, often lacking the most

basic medical equipment. The Outreach Programme takes treatment to the hundreds of people who are without adequate healthcare and provides essential training to staff to increase their skills to better serve the health needs of their communities. In this reporting period, the Outreach Programme covered 150 hospitals, providing 7,906 major operations, 27,665 consultations and 1,584 joint ward rounds as well as a number of training workshops.

Outreach Achievements During 2010/2011 Periods

Number of Outreach Flights Made

“I have been around for eighteen years and I feel proud to be part of AMREF Flying Doctors’ transformation.” GEOFREY KHALAYI OPERATIONS OFFICER 22

2011

2010

137

146

Number of Hospitals Visited

150

150

Consultations Provided

27,665

26,184

Specialist Outreach

5,141

4,694

Surgical Outreach

388

432

Leprosy/Reconstructive Outreach

1,554

1,111

VVF & Safe Motherhood

823

1,201

Total Operations

7,906

7,438

Doctors Trained

1,542

1,519

Nurses & Clinical Officers Trained

4,893

4,756

Laboratory Staff Trained

301

303

Support Staff Trained

1,854

1,944

Joint Ward Rounds

1,584

1,632

Hours of Formal Training

1,785

1,437

Hours of Informal Training

9,617

9,226

Total Staff Trained

8,590

8,522


Goals of Outreach

1 To fly regularly to remote hospitals using light aircraft

6 To provide emergency surgical care to complicated cases

2 To provide specialised surgical services including endoscopic and urological surgery and vesico-vaginal fistula repair, to remote rural hospitals in East Africa through regular visits

7 To raise morale and provide psychological support to staff in remote hospitals through regular contacts by radio, telephone and email

3 To enhance the surgical skills of medical officers based in rural hospitals through training

8 To train postgraduate students from the University of Nairobi

4 To improve the skills of theatre staff and other hospital support staff in pre and post-operative management of surgical patients

9 To supply hospitals on the Surgical Outreach Programme with essential surgical supplies

5 To operate and provide advice on complicated surgical cases presented by the medical officers

10 To collaborate with the University of Nairobi Departments of Surgery and Obstetrics/ Gynaecology, Kenyatta National Hospital, KEMRI and Nazareth Hospital in training and operational research

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KATO Tourist Evacuation Scheme

RIGHT: AMREF Flying Doctors staff attending to a tourist prior to evacuation

“The past year been exciting especially working on our new product Maisha, which has now successfully been launched in the market and this will now on make air ambulance evacuation services affordable to all people. For me this was a great achievement.” CATHERINE OCHOLA SALES & MARKETING COORDINATOR AND PERSONAL ASSISTANT TO THE CEO 24

Kenya, Tanzania and Zanzibar

Cost

KATO and TATO Members

US$5 per person for 30 days

Non-KATO and TATO Members

US$10 per person for 30 days

Kenya, Tanzania, Uganda, Rwanda and Burundi

Cost

KATO and TATO Members

US$9 per person for 30 days

Non-KATO and TATO Members

US$18 per person for 30 days

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n 2010, AMREF Flying Doctors introduced our Tourist Scheme B for tour operators through Kenya Association of Tour Operators (KATO). This scheme allows KATO members to contact AMREF Flying Doctors directly in the event of a medical emergency. Tourist Scheme B provides peace of mind to tour operators and clients as subscribers can access 24-hour medical advice through our Control Centre. Tourists are covered for a period of 30 days, with the tour operator being invoiced at the end of every month. All that is required from tour operators is a list of the names of their clients, arrival

and departure dates, and the insurance details of the clients (if available at the time of registration). Tour operators that are not subscribed to the Tourist Evacuation Scheme risk delays in evacuations as AMREF Flying Doctors requires a 50% upfront payment prior to evacuation. Unutilised funds raised by this scheme help to support AMREF’s Outreach Programme and AMREF Flying Doctors’ Charity Evacuations. The Tourist Evacuation Scheme continued to expand in 2011, with 155 tour operators joining.


Australian Youth Ambassador for Development Placements (AYAD)

AMREF Flying Doctors was pleased to welcome two Australian volunteers to the organisation, funded by the Australian Government Aid Program, AusAID. The Australian Youth Ambassador for Development (AYAD) Program provides an opportunity for young professionals to work in a developing country, helping to build the capacity of host organisations and encouraging skills transfer.

Royal Flying Doctors Service of Australia

Clyde Thomson of the RFDS

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ridey Kerwick was with AMREF Headquarters for six months before transferring to AMREF Flying Doctors and taking up the role of Communications Officer. “Working at AMREF Flying Doctors was an unforgettable experience – each day bringing with it new challenges and adventures. I would never have dreamt that my year as an AYAD would see me flying to far reaches of Kenya on Charity Evacuation flights and forming life-long friendships with colleagues. I cannot speak highly enough about the vital

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MREF has had a very long and rewarding relationship with the world-renowned Royal Flying Doctor Service of Australia (RFDS). Since its inception in 1957, AMREF Flying Doctors has been able to call on the guidance, support and expertise of its Australian counterpart as it has developed into a fully fledged aeromedical service. With more than 80 years’ experience in Australia, the RFDS has been delighted to share the benefits of its experience with AMREF Flying Doctors and to also learn about the particular challenges faced in Africa. Over more than 50 years, this special relationship has evolved into one of mutual exchange and collaboration, and over the last eight years, the RFDS has assisted AMREF Flying Doctors in a variety of ways. These have included sharing of management techniques, fundraising ideas and

work that AMREF Flying Doctors undertakes, and cannot thank them enough for welcoming me into their family,” said Bridey. Rowena Harbridge joined AMREF Flying Doctors in November and will remain with the organisation as a Communications Officer for 12 months. “The sense of family here with the team is amazing and I feel very lucky to have the opportunity to work with these people for a year. They really are making a difference and are truly passionate about what they are doing,” said Rowena.

aeromedical advice. The Executive Director of the RFDS South Eastern Section, Clyde Thomson GM, sits on the Board of AMREF Flying Doctors and has also been able to assist in business planning and direction for the organisation. Most recently, in February 2011, AMREF Flying Doctors Chief Medical Officer Dr Bettina Vadera and Operations Manager Sean Culligan visited the RFDS South Eastern Section to learn more about their latest marketing and fundraising plans, health service delivery developments and operational capabilities. Funded by the Australian Agency for International Development (AusAID), the visit included time at two RFDS operational bases in New South Wales. The visit was highly successful, with many collaborative ideas and plans now being translated into operational reality. Clyde Thomson commented on the synergies between the two organisations: “AMREF Flying Doctors is based upon the same philanthropic principles as the RFDS. We share many similarities, including the isolation of our patients, and the RFDS wants to help in any way we can, so that people living in remote African communities can benefit from high quality aeromedical health services.”

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Marketing Media

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ur goal in the use of marketing and public relations is to raise the profile of AMREF Flying Doctors, to emphasise the quality of our services and to increase donations. There were a number of major media activities during the year. AMREF Flying Doctors was highlighted in a special news story on CNN. Several articles and profiles of various staff members appeared in international, regional and local media, sharing the stories of our life-

2012 will see the launch of the new AMREF Flying Doctors website which will have greater function to allow for easy online subscriptions, a newsletter, case studies and a comprehensive image library. We will also launch into social media.

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saving work with the world. AMREF Flying Doctors engaged a Kenyan communications firm to assist with raising the profile of AMREF Flying Doctors, rebranding our services as a commercial entity and to assist us with engaging with more people through digital, print and radio media. For the third time, a calendar was produced with a large format photo showing AMREF Flying Doctors in action for each month of 2012.


Marketing Media

International Travel Insurance Journal

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n order to be successful in the competitive world of travel insurance and international air ambulance activities, we need an acknowledged expert in the field to guide and support us, given our limited budget. The International Travel Insurance Journal (ITIJ) has been just that to us for the last 10 years. “As publishers of the flagship industry magazines ITIJ (International Travel Insurance Journal) and Waypoint AirMed & Rescue, we are immensely proud to have been working with AMREF Flying Doctors for more than a decade. “From the beginning, our relationship has proven to be both mutually beneficial and inspiring; whether we are publishing case studies on the incredible work performed by AMREF Flying Doctors, running features that draw on their expertise, or designing marketing campaigns to help them reach our worldwide audience, it has always been a pleasure to help them in any way we can,”

said Mandy Aitchison, title editor of ITIJ. In terms of international exposure over the years, ITIJ was key in creating AMREF’s increased reach in the repatriation market place. It allowed the organisation to be seen by, and then keep, the attention of insurance providers and medical assistance companies across the globe and draw specific interest in the high-quality service delivered under challenging conditions. ITIJ is the original and only dedicated monthly trade journal for the travel insurance community. With a global audience of more than 20,000 readers, the Journal continues to be used as a guide to the industry and as a key reference point for the foremost organisations involved in the design, delivery and implementation of travel insurance products. The readership covers the entire chain of travel insurance delivery, all the way from underwriters and intermediaries through to the air ambulance crews saving lives every day.

Waypoint AirMed & Rescue Magazine

W Contact: David Fitzpatrick Group Sales Manager Voyageur Publishing & Events Ltd. Phone: +44 117 925 51 51 Fax: +44 117 929 20 23 Email: dave@voyageur.co.uk Website: www.voyageur.co.uk

aypoint AirMed & Rescue is the world’s only monthly international trade magazine for the aeromedical and rescue communities. With more than 25,000 readers worldwide, Waypoint is the first publication of its kind to cover all forms of aeromedicine, from fixed-wing international patient transfers via commercial carriers and air ambulances, to HEMS, SAR and CSAR. Giving readers from across the globe a regular and comprehensive monthly digest of international developments in the aeromedical community, Waypoint also contains in-depth features, analysis and technical presentations.

The magazine is aimed primarily at both medical and flight personnel with an emphasis towards senior staff across HEMS, fixed-wing, military and public bodies. Hundreds of these readers will gather at London Oxford Airport, UK, this May to attend the magazine’s annual aeromedical air show, Waypoint AirMed & Rescue 2012. With static and live displays of fixed-wing and HEMS aircraft over two days by both private and military organisations, as well as an exciting educational agenda and exhibition, the two days in Oxford will host over 300 delegates from across the globe at Europe’s only annual event for the entire aeromedical community.

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Marketing Conferences

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s our international profile grows, it becomes increasingly important for AMREF Flying Doctors to market and promote the services we offer. In 2011, AMREF Flying Doctors staff attended a number of international conferences to raise awareness and support for AMREF Flying Doctors around the world. Conferences attended included the International Travel Insurance Conferences

TOP RIGHT: Dr Bettina Vadera speaking at ITIC Lisbon 2011 ABOVE: Dr Bettina Vadera with Dr Terry Martin of CCAT at the AirMed World Congress 2011 RIGHT: Sean Culligan posing a question during an ITIC Lisbon session

AMREF Flying Doctors also revised their 1½-minute movie showing the growth of the service and some of its current activities. It is available on our website:

www.flydoc.org 28

in Hong Kong and Lisbon, as well as the prestigious tri-annual AirMed Conference in Brighton, UK. Presentations were given by AMREF Flying Doctors staff to more than 600 delegates at a time. AMREF Flying Doctors was then invited to make similar presentations to staff of a number of European-based travel insurance and assistance companies. Local and regional marketing presentations were given to more than 100 organisations, who toured AMREF Flying Doctors at Wilson Airport during the year, including a number of international donor agencies, as well as international assistance and insurance companies on audit visits. These visits and presentations are important platforms for AMREF Flying Doctors for networking, strengthening international working relationships and participating in international discussions on standards and quality of air ambulance provision. Following the launch in 2010 of a dedicated Tourist Evacuation Scheme linked through the Kenya Association of Tour Operators (KATO), the scheme continues to grow. This partnership allows member operators or agents of KATO to contact AMREF Flying Doctors directly in the event of a medical emergency and provides peace of mind to tour operators and clients. Any excess funds raised by this scheme help support AMREF’s Outreach Programme and AMREF Flying Doctors’ Charity Evacuations. Various local and international safari and tour operators were shown the scheme at structured marketing events and presentations throughout the year.


Marketing Study Tours

OPPOSITE: AMREF Flying Doctors COO Sean Culligan and CEO and Medical Director Dr Bettina Vadera present the acting Director General of AusAID Catherine Walker with a photograph as a token of thanks for the outstanding support for AMREF Flying Doctors received from AusAID over of the past seven years

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RIGHT UPPER: Sean Culligan and Dr Bettina Vadera at RFDS Mascot Base, Sydney, NSW RIGHT LOWER: AMREF Flying Doctors and the staff of RFDS Broken Hill Base

n January 2011, Dr Bettina Vadera and Sean Culligan visited the Royal Flying Doctor Service of Australia (RFDS) South Eastern Section as part of a series of study tours funded by the Australian Government. This tour followed on from the previous AusAID-funded study tour undertaken by Dr John Wachira of AMREF’s Surgical Outreach Programme. In June and July 2009, Dr Wachira visited RFDS and a number of Australian Universities on a study tour focused on capacity and relationship building. The study tours enable AMREF Flying Doctors and RFDS to strengthen their ongoing relationship. The tours give AMREF Flying Doctors staff hands-on experience and allow them to witness how the RFDS has developed into the successful air

ambulance service that it is. Given the similarities between both organisations, AMREF Flying Doctors has a lot to learn from RFDS. A number of key operational and medical techniques were discussed at length between AMREF Flying Doctors and RFDS staff, including aircrew utilisation and operational manuals, aviation-based computer tools, financial and corporate governance, media guidelines, social networking strategies, training techniques, financial accountability, budgetary requirements, long-term financial planning, corporate support and use of donor funds. Information gathered in this study tour will be used by AMREF Flying Doctors for strategic planning and will provide considerable structural guidance to the organisation. RFDS assured AMREF Flying Doctors that we will have their continued support, particularly as we strengthen our organisational capacity in the areas of fundraising, communications and marketing. AMREF Flying Doctors personnel were also able to have a very productive meeting with AusAID, where then acting Director General Catherine Walker reconfirmed AusAID’s commitment to continue to provide support for AMREF Flying Doctors for future study tours.

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Volunteer Physician Programme The Volunteer Physician Programme provides an opportunity for highly experienced physicians from across the world to join the AMREF Flying Doctors team on one to three-month assignments. Volunteer Physicians are required to provide training sessions to AMREF Flying Doctors staff during their placement. This builds the capacity of medical staff by giving them specialised training as well as updates relating to emergency care practices. In 2011, AMREF Flying Doctors welcomed five Volunteer Physicians from Germany, Australia and the UK, some of whom completed more than one rotation. Upon their return home, Volunteer Physicians become important advocates for AMREF Flying Doctors, increasing awareness about the vital service we provide to people across East Africa and helping to raise much needed funds.

Dr Rhys Clayton

Dr Kirsten Bucher

Dr Holly Gettings

Dr Gerald Chitsunge

Dr James Raitt

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A Day in the Life of a Flying Doctor Dr James Raitt, Volunteer Physician

RIGHT: Dr James Raitt stabilising the patient before loading him into the aircraft and taking him to emergency surgery

D

r James Raitt completed two months of voluntary work with AMREF Flying Doctors in 2011. Dr Raitt, from the UK, flew on 36 missions, collecting 48 patients and landing in 15 countries. His missions took him as far as Germany and he also went to Mogadishu in Somalia. Dr Raitt mainly treated patients with seriously lifethreatening trauma. Volunteering as a physician with AMREF Flying Doctors gave Dr Raitt a different perspective on healthcare in Eastern Africa. “There really isn’t anything else like this in the world. It is a different experience of seeing East Africa,” said Dr Raitt. When talking about the best part of his two months, Dr Raitt was quick to answer: “The nursing staff that I worked with. They’re incredibly talented and experienced. It was a great pleasure working with them and having them by my side on all missions.” Dr Raitt was constantly working in a challenging environment, often performing initial medical treatment and stabilising patients under the wing of an aircraft. Dr Raitt’s most memorable experience was when he and the team flew to Laisamis, northern Kenya, to collect a patient who had been shot by bandits. Dr Raitt recounts this mission: “A 38-year-old man has been shot in the abdomen in Northern Kenya. He is being treated in a small clinic and they phone us to say he is deteriorating. Two hours after the incident, we are airborne heading north.” The following is an extract from the diary Dr Raitt kept whilst he served as a Volunteer Physician --------------------------------------------As we touch down on the dirt airstrip, a convoy of four-wheel-drives arrives and a number of heavily armed police and soldiers get out. Instead of securing the area, they gather around the aircraft and start taking photos on their phones. The patient is crammed into the back seat of a car and is in considerable pain. We give him some ketamine to ease his

suffering so we can move him onto the stretcher. There is an entry wound in the abdomen, but no exit wound. Despite having already received three litres of essential fluids, he has an unrecordable blood pressure and a heart rate of 170 – the normal resting rate is 60 to 100. Under the aircraft wing, we lay out the equipment to give an anaesthetic, so we can manage his pain and control his breathing. We needed every pair of hands available, so bystanders have been squeezing fluid bags as the pilots fetch oxygen cylinders, and the nurse and I connect the ventilator and pumps before loading up and setting off. The patient urgently needs a blood transfusion, so we radio ahead to the control room to get some blood waiting for us when we land. Whole blood is usually used in Africa, so there is no worry about requesting plasma, platelets and red cells. Halfway through the flight and two hours after meeting the patient, he has improved sufficiently that we can record our first blood pressure of 90/60. Arriving at the airport, the blood is waiting for us. We have arrived from Kenya, so there is no delay with immigration and 20 minutes later we are in the hospital.

“Each morning you don’t know where you’ll go, what situation you will be in, and what you will be treating. There really isn’t a standard day at AMREF Flying Doctors.” The anaesthetic consultant meets us at the front door and takes us straight to the operating theatre where, during the operation, they find that the bullet has traversed the stomach and gone straight through the liver and diaphragm before lodging in the left chest wall. Three hours later, the anaesthetist phones me to tell me that the operation has been a success and the patient is stable in the Intensive Care Unit. When we visit the next day, he is sitting up in bed awake and alert. Cases like this make me appreciate the difficult circumstances in which the AMREF doctors, nurses and aircrew operate on a daily basis and the teamwork that goes into making their work such a success.

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Quality

Professional Medical Training

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roviding emergency and primary healthcare onboard an aircraft and in remote areas requires specialised and exceptional medical skills. Every AMREF Flying Doctors medical staff member is required to have an extremely high level of education and experience before joining us. They are also required to continually undergo further training to ensure they are able to provide the best care possible, both on the ground and in the air. Advanced professional development is

an ongoing priority, and all AMREF Flying Doctors nursing staff underwent training this year in pre-hospital trauma life support and trauma nursing. Each year, two nurses are selected to attend the prestigious Clinical Considerations in Aeromedical Transport (CCAT) course in the UK. Taught by aviation physiology and retrieval medicine experts, the course is an intense six-day educational programme covering topics unique to the physical, physiological and psychological stresses of the flight environment.

First Aid Courses

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“I find great fulfillment and satisfaction working with AMREF Flying Doctors! Not only do we at AMREF save life but also give hope to the entire community especially where there is poor infrastructure and no medical facilities. Every day is unpredictable and exciting and presents its own very unique challenges.� MILDRED ADHOLA EMERGENCY FLIGHT NURSE 32

MREF Flying Doctors provides a three-day training course offering professional training for management and staff of organisations as well as smaller groups. The course covers the vital aspects of first aid to ensure safety in the work place, at home, and in the field. After three days of practical and theoretical studies, the course culminates in a two-part examination. Courses are available on request only.


Engineering

“I am clocking 32 years in AMREF Flying Doctors Aviation as an engineer and I love working in AMREF Aviation – it’s a family to me. I remember in the 1980s we used to have Landrovers as Mobile Clinics, wooden offices as the headquarters, small piston engine aircraft and very few staff. Today we have modern buildings, a large number of staff and Cessna Caravans.” STANLEY GAKURE AIRCRAFT ENGINEER

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MREF Flying Doctors has a highly skilled engineering team working in our hangar at Wilson Airport. The team, consisting of engineers, trades people, stores and technical records staff, not only service our aircraft to ensure they are in perfect condition, but also maintain private aircraft,

contributing to raising funds for AMREF’s charity work. Engineering staff work around the clock to ensure the safety for our staff and patients and conduct routine maintenance checks, major checks and, when needed, detailed overhauls based on the manufacturers’ recommendations.

Visitors Centre

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To arrange a tour, purchase AMREF Flying Doctors merchandise, or if you have any queries, please contact the Visitors Centre Tel: +254 20 699 2000 Email: info@flydoc.org. Visitors Centre opening hours Monday to Friday 09:00–13:00 and 14:00–17:00.

MREF Flying Doctors’ Visitors Centre showcases AMREF’s history and raises awareness and support for AMREF Flying Doctors with members of the public. Since its opening in 2007 by Dr Tom Rees, the last surviving founder of AMREF Flying Doctors, the Centre has attracted a large number of visitors, including more than 3,500 school children. The children are inspired by what has been achieved, and it often encourages many to consider a career in medical, engineering or aviation fields. Commencing with a 15-minute DVD, visitors follow the story of AMREF Flying Doctors from its foundation in 1957 to its impressive achievements today. Visitors tour the museum and then go to where the action takes place – the 24-hour Control Centre, where dedicated nurses take all of the calls. To finish the tour, visitors go into the hangar to view the aircraft. Tours must be arranged in advance and run for 45 minutes.

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International Travel Insurance Journal (ITIJ) Air Ambulance Provider of the Year Award 2011

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TOP: The team at AMREF Flying Doctors were thrilled to win the ITIJ Air Ambulance Provider of the Year Award in 2011 RIGHT: Dr Bettina Vadera, CEO and Medical Director at AMREF Flying Doctors with the ITIJ Air Ambulance of the Year Award

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MREF Flying Doctors was thrilled to be awarded the ITIJ 2011 Air Ambulance Provider of the Year Award. The ITIJ (International Travel Insurance Journal) yearly awards are voted for by the readers of the Journal and other stakeholders within the international industry, representing the global travel/ medical insurance industry, air ambulance providers, underwriters, assistance companies and cost containment entities. The companies with the most votes go through to be award finalists and each one submits a presentation to an independent judging panel, which decides on the ultimate winner based on achievements and outstanding performance throughout the year, as well as overall development, expansion and future vision. Each finalist also has to produce and submit a 45-second film clip that is presented at the prize-giving ceremony. The award was announced and presented at the Gala Dinner during the International Travel Insurance Conference in Lisbon, Portugal on 3rd of November 2011 and received on behalf of AMREF Flying Doctors by CEO and Medical Director Dr Bettina Vadera and COO Sean Culligan. In front of 600 delegates, representing 54 countries worldwide, the award to AMREF Flying Doctors was greeted with cheers and a standing ovation from the audience who appreciate the professionalism and respect the work carried out by AMREF Flying Doctors both regionally and internationally.


Fundraising Activities AMREF Flying Doctors is extremely appreciative of members of the community across the globe who fundraise for us so we can keep doing what we do best – saving lives.

RAI Team Cycles in Kenya Classic

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en Amsterdam Rijwiel en Automobiel Industrie (RAI) employees embarked on the Kenya Classic for a week in October with 90 other cyclists. This physically and mentally demanding challenge entailed a 360-km trek in the shadow of Mount Kilimanjaro, visiting projects organised by AMREF Flying Doctors in Kenya. AMREF Flying Doctors is one of the two

The team at RAI raised money for AMREF by completing the Kenya Classic

main charities to which Amsterdam RAI has been strongly committed for a number of years now. This gruelling bike ride was a chance for people from the RAI to witness first-hand what AMREF is doing to improve public health in Africa. The RAI raised some €85,000 for AMREF Flying Doctors with this project. In total, the Kenya Classic brought in around €600,000 of funding.

© Copyright Edwin Haan/Fiets

Hannah’s Story

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hile on safari in the Masai Mara with her family, Hannah Wright, a six-year-old girl from the UK, suffered a seizure. Being rescued by AMREF Flying Doctors and evacuated to Nairobi Hospital for specialist treatment in 2007 changed her life. “We are so grateful for the dedication and the care of AMREF Flying Doctors team who evacuated our daughter from the Masai Mara in April 2007. She was very seriously ill with a prolonged and intractable

fit. Without their fantastic service, the outcome for Hannah may have been very poor and possibly tragic – thank you so much,” said Anne, Hannah’s mother. Upon returning home, Hannah had a birthday party where instead of gifts from her friends, she asked for donations to go to AMREF Flying Doctors. “Thank you AMREF Flying Doctors for coming to help me when I was poorly, you saved my life and I am making the most of it,” said now 10-year-old Hannah.

Hannah raised money for AMREF Flying Doctors by asking for donations in lieu of gifts at her birthday party

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Professional Partners Phoenix Aviation

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hoenix Aviation and AMREF Flying Doctors have been working together for more than a decade. With AMREF Flying Doctors heavily involved in international air evacuations, we needed to partner with an aviation company just as committed to quality, safety and customer as ourselves. Phoenix Aviation, a charter company based in Nairobi, was a perfect match. They demonstrated their own commitment to quality by earning the distinction of the independently audited award of ISO 9001-2000. Together, Phoenix Aviation and AMREF Flying Doctors were able to equip the Phoenix fleet of four Beechcraft King Air aircraft, four Citation Bravo jets and one Citation Excel Cessna Citation Bravo jet

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with specialised modern aeromedical equipment including FAA approved Lifeport stretcher systems, monitors, ventilators and a neonatal incubator, allowing patients to receive intensive care whilst on the ground and in the air. Phoenix Aviations’ extensive fleet enables AMREF Flying Doctors to offer a professional 24 hour air ambulance service response locally as well as long range international transfers. The Phoenix fleet, combined with their 21 flight crew—who between them have flown over 250,000 hours—gives Phoenix the background, dedication and commitment to service that matches that of AMREF Flying Doctors. Together, this partnership allows the safe and speedy repatriation of patients to South Africa, Europe, Asia, the Middle East and beyond.

Contact Phoenix Aviation P.O. Box 49493-00100, Nairobi, Kenya Phone: +254 (020) 6005836 / 6005837 / 6004048 Fax: +254 (020) 6004049 24hr Mobile: +253 733 632769 Email: flightops@phoenixaviation.co.ke Website: www.phoenixaviation.co.ke


Professional Partnerships Private Safaris

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rivate Safaris (E.A), a premier safari specialist and event management company, covers Kenya, Uganda, Tanzania, Rwanda and Ethiopia. Our product range includes safari and beach packages, adventure tours, honeymoon packages, golf tours, incentive travel, conference and event management. We are committed to excellent service and satisfaction for every client with well trained staff and many years of experience. Our long standing relationships with suppliers ensures strong buying power, enhancing value for money without compromising on quality. We own a fleet of locally assembled vehicles (minibuses, 4X4s, and coaches), all comprehensively insured and fitted with two-way radio communication, binoculars, reference materials and real-time satellite tracking systems. We have a pool of multilingual staff with extensive knowledge of local culture, flora and fauna. Our safari drivers are carefully selected and highly trained in all areas, including defensive driving and first aid. As a responsible corporate citizen, we engage in four strategic areas with an objective to reduce the negative impact of tourism locally: protection of children and adolescents from exploitation and abuse; ensuring fair working terms and conditions within the industry; improving water supplies

in our destinations; and mitigating the impact of climate change. We also have a strong partnership with AMREF Flying Doctors that not only increases clients’ safety while on safari, but supports AMREF’s community development projects throughout Africa. AMREF Flying Doctors facilitates medical emergency care and evacuation services to all of our clients. Many top tourist destinations in East Africa are in remote regions where, in the case of an emergency, access to medical facilities is limited and presents a challenge. AMREF Flying Doctors is an ideal attribute to the existing safari tours in Kenya, Tanzania and Zanzibar, providing peace of mind in the rare event that something goes wrong on tour. The fact that AMREF Flying Doctors highly professional medical team are on call around the clock is a comfort to many clients, as well as the knowledge that they are contributing to Africa’s development in a sustainable manner.

Contact Private Safaris (E.A) Ltd Mobil Plaza Muthaiga P.O. Box 16913-00620 Nairobi, Kenya Telephone: +254 20 360 7000 Email: marketing@privatesafaris.co.ke Website: www.privatesafaris.co.ke

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Professional Partners ADAC Ambulance Service

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s the needs of AMREF Flying Doctors extend beyond the continent of Africa to North America, Australia and the Far East, an increasing number of wing-towing patient transfer services are needed. On a particularly long journey it can be of immense benefit in time and cost to carry a patient part of the way with one air ambulance company and then transfer the patient to another air ambulance company’s aircraft to complete the journey. It does mean, however, that both companies must adhere to a strict code of practice in both medical and operational procedures offering the same commitment to service, quality of patient care and flight safety standards. AMREF Flying Doctors is proud to be associated with ADAC Ambulance Service. World-wide patient transports ADAC Ambulance Service organizes and carries out patient transfers world-wide on ground and by air. The service ranges from the transfer by ground ambulances to the repatriation of intensive care patients in ADAC’s own ambulance jets. Highly qualified medical staff specialized in emergency medical assistance, intensive care and flight medicine accompany these transfers. The patients and their relatives are looked after personally and more than 40 ADAC physicians check the patient’s medical condition with local attending physicians. ADAC Ambulance Service assists about

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50,000 patients and transports more than 15,000 patients per year on ground and by air. Depending on the patient’s diagnosis, air-bound transport may also involve additional transport options such as stretcher, sleeper and PTC. The fleet The ADAC fleet comprises Dornier-Fairchild 328-300 jets, Beechcraft Super King Air A350 and several Lear jets. Equipped with state-of-the-art intensive care facilities, they are very quiet, stable aircraft with the highest hygiene standard specifically designed for patient transport. Thanks to their size and flexibility, particularly the Dornier-Fairchild 328-300 jets, they make it possible to transport not just the patient’s but also their next of kin.

Contact ADAC-Ambulance Service Phone: Fax: Email: Website:

+49 89 76 76 52 85 +49 89 76 76 50 70 info-ambulance@adac.de www.adac.de/ambulance

For urgent repatriation requests: Phone: Fax: Email:

+49 89 76 76 5005 +49 89 7439012 emergency@adac.de


Professional Partners Healix International

Integrated Travel Risk Management service supports employers’ duty of care At Healix, we have extensive global experience in the medical treatment, repatriation and evacuation of people taken ill or injured whilst overseas. With a team of doctors and nurses available on the phone 24 hours a day, 365 days a year, we are able to evaluate the gravity of a case from the very first call. To help employers fulfil their duty of care towards staff travelling and working abroad, Healix has partnered with a leading security company to develop an integrated travel risk management solution. By co-ordinating all services needed for travel, health and security risk management through one central point, Healix is able to provide a first class service, ensuring that all employees get the most appropriate support and protection. Communication is improved, employee compliance with policies and procedures can be monitored and employers have a central record evidencing duty of care for each employee. Furthermore, employees have the benefit of liaising with just one central access point, instead of having to deal with several different departments. A bespoke service is provided according

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to requirements. For example, we are the international medical healthcare provider for the UK’s Foreign and Commonwealth Office, as well as a number of other government departments. We’re responsible for over 17,000 employees and their families in over 190 foreign destinations including most African countries and provide primary & secondary healthcare management, prescription services and emergency evacuation support with the invaluable support of AMREF as local partner to help co-ordinate arrangements on our behalf. We are also involved in the Occupational Health assessment and preparation of FCO employees before they are posted abroad.

Contact Scott Sunderman Healix International Healix House Esher Green, Esher Surrey KT10 8AB United Kingdom Phone: +44 (0)844 854 0113 Email: scott.sunderman@healix.com Website: www.healix.com


Professional Partners REGA

O

ur partners help us out in so many ways. We receive a tremendous amount of support, advice and encouragement from one of the most professional air ambulance companies in the world, REGA Swiss Air Ambulance. Dr. Olivier Seiler, REGA’s Medical director for fixed wing operations says: “The history of good relations between REGA and AMREF has been going on for decades. In difficult to handle cases in the East African region we have always been very happy to rely on the services of our partner. Their knowledge and professionalism is essential when dealing with medical emergencies in remote areas of this part of Africa. In most cases we ask

AMREF to bring the patients to the nearest adequate hospital for first treatment and then organize their trip back to Switzerland by commercial airline together with our own medical escort if needed. In more time critical cases we have very successfully used the method of wingtowing operations; a delicate task that we will only perform with partners of the very highest quality. To this end, AMREF’s Special Care accreditation by EURAMI illustrates that quality and this allows us to confidently organise these wing-to-wing transfers which help to save precious time whilst safe in the knowledge that the patient is being taken care of by a professional medevac-team throughout the journey”

Contact Dr. med. Olivier Seiler, M.D. Swiss Air-Rescue (Rega) Rega-Center P.O. Box 1414 CH-8058 Zurich Phone: Fax: Email: Website:

+41 44 654 32 22 +41 44 654 33 22 Olivier.Seiler@rega.ch www.rega.ch

Professional Partners AIMS

I

n a constantly changing African Continent, Alliance International Medical Services (AIMS) consistently strives to live up to the mission statement “HUMANITY, DIGNITY, RESPECT” in the day-to-day dealings with our clients and their members who become our patients. Based in Johannesburg, AIMS is well positioned not only for assistance within South Africa but also a high percentage of the countries held within the SubSaharan Basin. Naturally, in order to do this well, one needs reputable professional associations which happily we have with AMREF Flying Doctors. Alliance International Medical Services and AMREF Flying Doctors have enjoyed a working relationship which over a period

of 10 years has grown from strength to strength and it is indeed comforting to know that once a patient is in the capable hands of AMREF Flying Doctors, our standard of “HUMANITY, DIGNITY, RESPECT” prevails.

Contact Bernadette Breton Managing Director Alliance International Medical Services Private Bag X5, Benmore Gardens, 2010 Johannesburg, South Africa Phone: Fax: Email: Website:

+27 11 783 0135 +27 11 783 2950 operations@aims.org.za www.aims.org.za

41


Proud to Support the Work of AMREF Flying Doctors

A HUGE THANK YOU TO YOU ALL AMREF Flying Doctors would like to say a very special thank you to all our professional partners and supporting organisations. With their help and generosity, we have been able to produce our most comprehensive annual report to date.

42


43


Accounts Air Ambulance Service 82%

Where the money comes from

2010/11 US$

Air Ambulance Service 11,679,516.55 -----------------------------------------------------------------------------------------------------------Assistance Services 1,200,538 -----------------------------------------------------------------------------------------------------------Internal Recovery 551,614 -----------------------------------------------------------------------------------------------------------Medical Escort 258,960 -----------------------------------------------------------------------------------------------------------Grants 174,117.03 -----------------------------------------------------------------------------------------------------------Aircraft Maintenance 201,148.18 -----------------------------------------------------------------------------------------------------------Medical Cover 118,359 -----------------------------------------------------------------------------------------------------------Interest From Bank 41,498.51 -----------------------------------------------------------------------------------------------------------Training Courses 8,590.00 -----------------------------------------------------------------------------------------------------------TOTAL 14,234,341.27

How the money is spent

Assistance Services 8.5%

Internal Recovery 3.8% Medical Escort 1.8% Aircraft Maintenance 1.4% Grants 1.2% Medical Cover 0.9% Interest From Bank 0.3% Training Courses 0.1%

2010/11 US$ HR & Administration 13.2%

Air Ambulance Service 9,385,062.15 -----------------------------------------------------------------------------------------------------------HR & Administration 1,755,949.93 -----------------------------------------------------------------------------------------------------------Assistance Services 1,206,373.57 -----------------------------------------------------------------------------------------------------------Finance Costs (Depreciation) 358,057.92 -----------------------------------------------------------------------------------------------------------Communication 90,897.27 -----------------------------------------------------------------------------------------------------------Charity Evacuations 106,243 -----------------------------------------------------------------------------------------------------------Emergency Services 151,837.98 -----------------------------------------------------------------------------------------------------------Travel Allowance 134,610.25 -----------------------------------------------------------------------------------------------------------PR & Marketing 40,713.65 -----------------------------------------------------------------------------------------------------------Staff Training 22,672.79 -----------------------------------------------------------------------------------------------------------13,252,418.51 TOTAL

Assistance Services 9.1%

-----------------------------------------------------------------------------------------------------------Surplus For The Year 981,922.76 -----------------------------------------------------------------------------------------------------------Air Ambulance Service 70.8%

44

Finance Costs (e.g. Depreciation) 2.7% Charity Evacuations 1.2% Communication 1% Travel Allowance 0.8% Emergency Services (e.g. Consumables) 0.7% PR & Marketing 0.3% Staff Training 0.2%


Dr Michael Wood in the first Control Centre talking to a Mission Hospital prior to take-off (archive photo)


Anne Spoerry known as ‘Mama Daktari, comforting a young child (archive photo)


Nationalities Evacuated 2011

CANADIAN

BRITISH

8

102

IRISH

NORWEGIAN

3

6

SWEDISH

FINNISH

9

2

DUTCH

BELGIAN

20

10

GERMAN

CHINESE

24

2

JAPANESE

4

SOUTH KOREAN

6

PAKISTANI

3

INDIAN

2

AMERICAN

ETHIOPIAN

65

9

FRENCH

20

SWISS

5

ITALIAN

15

SPANISH

8

GREEK

2

SUDANESE

7

RWANDAN

7

ZAMBIAN

3

SOUTH AFRICAN

34

ZIMBABWEAN

3

BURUNDIAN

TANZANIAN

339 21

KENYAN

136

UGANDAN

348

SOMALIAN

5

AUSTRALIAN

9


AMREF National Offices AMREF in Europe Contact Information ----------------------------------------------------

AMREF in Europe (continued) Contact Information ----------------------------------------------------

AMREF in Africa Contact Information -----------------------------------------------------

AMREF in Austria Gesellschaft fuer Medizin und Forschung in Afrika, inc Flying Doctors Service; Waagplatz 3; 5020 Salzburg Tel: +43 (0) 662 / 84 01 01 Fax: +43 (0) 662 / 84 01 01-13 Email: office@amref.at www.amref.at

AMREF in The Netherlands Haagse Schouwweg 6G, 2332 KG Leiden Tel: +31 71 576 9476 Fax: +31 71 576 3777 Email: info@amref.nl www.amref.nl

AMREF in Kenya PO Box 30125-00100 Nairobi Tel: +254 20 699 4000 Fax: +254 20 606 340 Email: info.kenya@amref.org

AMREF in Denmark Den Afrikanske Lægefond Gorrissen Federspiel Kierkegaard 12 HC Andersens Boulevard DK-1553, Copenhagen V Tel: + 45 33 41 41 41 Fax: + 45 33 41 41 28 Email: tf@gfklaw.dk www.amref.org/denmark.htm AMREF in France 134 Boulevard Haussman 75008, Paris Tel: + 33 (0) 1 71 19 75 35 E-mail: info@amref.fr www.amref.fr AMREF in Germany Mauerkircherstr. 155 D-81925 Muenchen Tel: +49 89 358050490 Fax: +49 89 358050477 Email: info@amrefgermany.de www.amrefgermany.de AMREF in Italy Via Boezio, 17 00193 Roma Tel: +39 06 99704650 Fax: +39 06 3202227 Email: info@amref.it www.amref.it

AMREF in Spain c/ Buganvilla, 5 - 1° C 298036 Madrid Tel: +34 91 310 27 86 Fax: +34 91 319 68 12 Email: amref@fundacionamref.org www.amref.es AMREF in Sweden Ostermalmsgatan 84 114 50 Stockholm Tel: +46 08 562 500 90 Fax: +46 08 660 02 43 Email: amref@telia.com www.amref.se AMREF in the UK Clifford’s Inn, Fetter Lane, London, EC4A 1BZ Tel: +44 20 7269 5520 Email: info@amrefuk.org www.amref.org/uk

AMREF in North America Contact Information ----------------------------------------------------

AMREF Milan Office AMREF Italia Sito della Guastalla, 3 20122 Milano Tel/Fax: +39 02 5410 7566 Email: milano@amref.it

AMREF in Canada 489 College Street, Suite 407, Toronto, ON M6G 1A5 Tel: +416 961 6981 Fax: +416 961 6984 Email: info@amrefcanada.org canada.amref.org

AMREF in Monaco Res. Les Saint Andre – 20 Boulevard de Suisse – 98000 Monaco Tel: +377 9777 0808 Email: info@amrefmonaco.com www.amrefmonaco.com

AMREF in the USA 4 West 43rd Street, 2nd Floor, New York, NY 10036 Tel: +212 768 2440 Fax: +212 768 4230 Email: amrefusa@amrefusa.org www.amrefusa.org

AMREF in Tanzania 11019 Ali Hassan Mwinyi Road, Upanga, PO Box 2773 Dar es Salaam Tel: +255 22 2116 610/2113673 Fax: +255 22 2115 823 Email: info.tanzania@amref.org AMREF in Uganda Plot 29 Nakasero Rd PO Box 10663, Kampala Tel: +256 414 250319 Fax: +256 414 344565 Email: info.uganda@amref.org AMREF in South Africa Hillcrest Forum 731 Duncan Street Hillcrest Pretoria 2000 Tel: +27 12 362 3127/35/36 Fax: +27 12 362 3102 Email: info.southafrica@amref.org AMREF in Ethiopia House Number 629 Kabele, 12, Wewda 16 Megenagna off Gebresellesie Road PO Box 20855, Code 1000 Addis Ababa, Tel: +251 11 6184751/6627851 Fax: +251 11 6627887 Email: amref@telecom.net.et

AMREF Flying Doctors 24 Hour Emergency Contacts Emergency Tel: +254 20 6992299 / 6992000 / 315454 / 315455 / 6002492 Fax: +254 20 344170 / 600665 Mobile: +254 (0)733 639088 / 736 0359362 / 722 314239 Radio Frequencies: HF: 9116kHz LSB / 5796 kHz LSB Email: emergency@flydoc.org

AMREF Report  

AMREF Report

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