Transforming air ambulance services across Africa

In this exclusive interview, Capital sits down with Stephen Gitau, the Chief Executive Officer and Accountable Manager of AMREF Flying Doctors. With over four years of leadership experience, Stephen has been instrumental in advancing the company’s strategic objectives, driving operational excellence, and fostering innovation to enhance client experience. Prior to becoming CEO, Stephen served as Chief Finance Officer at AMREF Flying Doctors, where he managed financial operations, executed strategic initiatives, and oversaw key administrative functions. He holds a Bachelor’s degree in Economics from the University of Nairobi and an MBA in Finance and Strategic Management from Strathmore Business School. Additionally, he is a certified public accountant with extensive expertise in financial management and corporate governance. Under Stephen’s guidance, AMREF Flying Doctors continues to strengthen its position as Africa’s leading air ambulance service, committed to delivering exceptional medical care and support across the continent and beyond. In the interview, he shares insights into the economic contributions of air ambulance services, the historical journey of AMREF Flying Doctors, and the company’s ambitious plans for the future.

Capital: What economic contribution can air ambulance services bring to the countries where they operate in?

Stephen Gitau: The air ambulance industry is a significant global economic contributor, playing a vital role in enhancing healthcare access and creating specialized jobs. By providing rapid medical interventions, especially in remote areas, this industry strengthens healthcare infrastructure and directly supports economic growth. In Africa, countries like Kenya and South Africa have established strong air ambulance services that not only improve public health outcomes but also generate substantial revenue through cross-border medical evacuations. These countries have positioned themselves as regional leaders in emergency medical services, attracting both regional and international investments.

The economic benefits of robust air ambulance services extend beyond healthcare. By ensuring quick and safe medical evacuations, these services boost confidence among tourists and international visitors, who are reassured that they will receive immediate and effective care in the event of an emergency. This, in turn, promotes tourism a key revenue stream for many African economies by enhancing the country’s reputation as a safe and reliable destination. Moreover, the success of air ambulance services in countries like Kenya has sparked interest from neighboring markets such as Ethiopia where there is growing demand for similar services. By showcasing the effectiveness and economic benefits of these operations, countries are not only attracting international investments, but also inspiring the development of similar services across the region. This ripple effect leads to broader economic productivity, as improved healthcare access directly correlates with a healthier, more capable workforce.

Capital: Historically, how did AMREF Flying Doctors start operation as air ambulance service provider in Africa? How is your company connected to Amref Health Africa?

Stephen: AMREF Flying Doctors is at the core of what Amref Health Africa, the leading international health organization in Africa, is built on: providing quality healthcare to communities across the African continent. It started its journey as an air ambulance service provider in Africa 67 years ago, in 1957. The service was originally founded by three surgeons – Sir Michael Wood, Dr. Tom Rees, and Dr. Archibald McIndoe – who saw the critical need for medical care in remote areas of East Africa. Using light aircraft, they pioneered what would become Africa’s first air ambulance service, reaching patients in areas where access to healthcare was limited by challenging terrain. And just like Amref’s Health Africa’s thoughtful expansion over the years, AMREF Flying Doctors grew to be an essential player in addressing critical gaps in healthcare in Africa. It was incorporated and officially registered as a social enterprise in 2011. This incorporation allowed us to expand our services and operate as a fully-fledged, internationally recognized air ambulance provider. The corporation remains a whole entity of Amref Health Africa.

Capital: You mentioned expansion. Tell us more about how AMREF Flying Doctors has expanded

Stephen: To give you context, we have gone from operating light aircraft to now operating fleets specially designed aircrafts capable of both short-field operations and long-distance transfers. Instead of servicing a few patients within just East Africa, we now evacuate over 1,200 patients each year within Africa, Europe, Asia, the Middle East, and the rest of the world. I should mention that we have not only expanded the breadth of our reach, but also the depth—we operate modern, sate-of-the-art aircrafts equipped with advanced medical technology, ensuring top-notch intensive care during transport. On each aircraft we include a highly trained team of doctors, nurses, and paramedics specializing in aeromedical care. The innovation of combining a commercially successful life-saving emergency air ambulance service with the non-profit arm of Amref Health Africa is one reason why we are seen as the go-to health partner in Africa.

Capital: What does air ambulance service entail and how different it is from regular service? Walk us through the process.

Stephen: Air ambulance services differ significantly from regular transport services in that they are specifically designed to provide life-saving medical care during transit. Our aircrafts function as flying intensive care units, equipped with advanced medical technology and staffed by highly trained medical professionals. This capability enables us to transport critically ill or injured patients quickly and safely over long distances, including international borders, where ground transport would be inadequate. What makes air ambulance services superior is their ability to bypass geographical barriers and deliver immediate care in time-sensitive situations, greatly increasing the chances of patient survival. For instance, imagine a tourist who travels to a remote area in Africa and is struck with a dire health emergency that requires immediate attention. Our aircrafts can quickly reach remote or challenging locations, providing essential, time-sensitive in-transit care in emergencies where ground transport would be inadequate. Once we reach the patient, our air ambulance service uses advanced aircraft equipped with cutting-edge medical technology, acting as mobile intensive care units. Of course, the most important part of the system is the highly trained medical and aviation team that ensures continuous, high-quality care and safety throughout the journey.

Besides emergency events, we also address patients who need medical treatment unavailable in a town, city, or country they live in. AMREF Flying Doctors steps in to provide transportation to advanced health facilities nearby or even abroad. We work closely with hospitals around the world to seamlessly transfer patients to get the help they need. In the event that a patient can fly a commercial airline, we can provide medical escort services.

In addition to our commercial services, however, we conduct humanitarian evacuations at no charge to support emergencies. For example, we recently provided free emergency evacuations in response to the mass casualty involving Kenyatta University students. This is part of our corporate responsibility obligations we take seriously, and also an extension of our organizational ethos of “Ubuntu”—I am because you are.

Capital: When did you start flying patients from Ethiopia? Who are your main clients in Ethiopia?

Stephen: Amref Flying Doctors has a long and proud history of providing air ambulance services in Ethiopia dating back to the early 1980s. Over the years, we have conducted numerous life-saving evacuations from Ethiopia, including the evacuation of renowned photographer Mohammed Amin, who lost his left arm during an ammunition dump explosion in Ethiopia during the political unrest in the early 1990s. This particular mission underscored our commitment to delivering world-class medical care in some of the most challenging environments.

Our main clients in Ethiopia are as diverse as the country itself. We serve a wide range of organizations and individuals, including non-governmental organizations (NGOs), multinational corporations, embassies, and tour companies. Additionally, we provide vital services to expatriate individuals and families, ensuring they have access to rapid medical evacuation when needed. Our ability to provide a variety of services—emergency medical evacuations, medical assistance, medical repatriation, medical escort services, Emergency Life Support Training, etc., makes us a standout entity in Ethiopia, covering the needs of individuals, corporations, governmental and non-government organizations, with some services tailored to meet exact needs.

Capital: How can new clients in Ethiopia access your services?

Stephen: Quite easily. In the earlier example I cited, ideally, that tourist would have already subscribed to Amref Flying Doctors’ Maisha Membership—a subscription-based service that offers comprehensive coverage for air medical evacuations. Of course, the subscription is not limited to just tourists. Anyone who feels compelled to take extra precautions and be proactive about healthcare can subscribe to our medical evacuation services and health insurance packages needed during the evacuation through our annual Maisha Membership.

But even if one doesn’t have a subscription, AFD offers a competitive fee-for-service for immediate needs. In either circumstance, help is on the way. We also have robust corporate partnerships for organizational-wide plans through a Maisha corporate membership plan or customized fee-for-service arrangements. And finally, individuals both national and expats can access our services through insurance providers if their policy includes evacuation coverage.

Capital: Do you operate in partnership with other similar aeromedical service providers in Africa? What kind of partnerships are they?

Stephen: You said the magic word: partnership. As with the larger Amref Health Africa tradition of operational excellence, we have been intentional about building strong and thoughtful partnerships that enhance and scale up our work. In AFD’s case, we collaborate with various world-class aeromedical service providers both in Africa and internationally for medical evacuations. For “wing-to-wing” evacuations, we coordinate with local and global partners to ensure uninterrupted transitions between aircraft and continuous patient care throughout the journey. This includes aligning flight logistics, medical support, and handling all necessary protocols for a smooth transfer. Our complex network of partners includes airports, hospitals, high-tech communications companies, major airlines, as well as international insurance enterprises. Because we adhere to the highest standards of medical care and safety that are backed by various accreditations and certifications, we are a trusted entity in this highly specialized industry.

Capital: Recently, you signed an agreement with the African Union Commission (AUC). What does that agreement entail and how do you want to bring other organizations onboard to use the services?

Stephen: Our agreement with the African Union Commission moves us to a higher playing level. As an African-led organization, it was natural for us to connect the dots with an existing African organization. The agreement involves providing high-quality medevac services to AU staff and their dependents across the African continent. The service is available on request from the AU’s medical team. It is gratifying to know that we have engendered the trust and confidence of an important body like the African Union Commission. It reinforces our relentless pursuit of excellence, innovation, and compassionate, people-centered healthcare. You stated earlier about the AMREF Flying Doctors’ affiliation with Amref Health Africa.

Capital: What is the economic return of your services for the non-profit arm of your organization?

Stephen: Amref Flying Doctors is fully owned by Amref Health Africa and plays a key role in advancing our broader mission. As a social enterprise, it is another way we fund our health programs that have been making transformative changes in the lives of Africans. With surplus revenue generated from our medevac services going back into supporting our health programs, we are also building sustainable ways to independently fund some of our programs. We strongly believe in the private sector playing a part in finding local solutions to local problems. So, it is exciting to be at the forefront of incubating ideas and businesses that wil help bring lasting health change across Africa.

Capital: What are the challenges this sector mainly faces? More specifically, what were the most challenging experiences AMREF Flying Doctors underwent during these years of services?

Stephen: Just like any other business, challenges are inevitable. The air ambulance sector faces numerous challenges, from high operational costs to regulatory hurdles, and by the very nature of the unpredictability of emergencies. Political uncertainty in various countries also presents unique difficulties for aviation operations. Maintaining a fleet equipped with advanced medical technology and staffed by highly trained personnel is costly, particularly in regions like Africa. Balancing affordability with high-quality care is crucial, especially in underserved rural areas.

AMREF Flying Doctors manages these challenges through cost-efficient operations, strict regulatory compliance, continuous investment in advanced medical technology and skilled personnel, proactive political risk mitigation, affordability initiatives like the Maisha Medical Evacuation Plan, and strategic partnerships that enhance service delivery and resource sharing.

The COVID-19 pandemic presented an unprecedented set of challenges, leading to increased demand for medical evacuations under stringent health protocols. This spike for critical care transport, combined with strict health protocols, required us to adapt quickly. We responded by implementing key measures, including specialized isolation units, enhanced safety protocols, and telemedicine integration, facilitating the safe transfer of over 500 patients during the pandemic.

Now, with the emergence of the Mpox outbreak, AMREF Flying Doctors is once again at the forefront of the response. Mpox, caused by the monkeypox virus, has posed a unique set of challenges due to its contagious nature and the need for specialized care during transportation. Leveraging the lessons learned from the COVID-19 pandemic, AMREF Flying Doctors has developed comprehensive protocols to handle Mpox cases.

Key measures include: Specialized Training Programs: Staff have undergone extensive training on Mpox-specific protocols, focusing on the identification, handling, and care of infected patients during air evacuations. Enhanced Collaboration with Health Authorities: AMREF is working closely with international and local health authorities to stay updated on the latest developments in Mpox treatment and containment, ensuring the highest standards of care. Rapid Response Capabilities: Building on the agile logistics developed during the COVID-19 pandemic, AMREF has established rapid response teams ready to deploy at a moment’s notice, ensuring timely and efficient evacuations. With these strategies in place, AMREF Flying Doctors is well-equipped to meet the challenges posed by the Mpox outbreak, continuing its mission of providing equitable and life-saving care across diverse and remote regions. We have been at this for 67 years, so we have managed to learn from setbacks, quickly pivot, adapt, and move ahead. What has remained consistent is our focus on equitable healthcare. It’s Amref’s signature move.

Capital: What is your aspiration in the future?

Stephen: As always, our future plans are ambitious and further rooted in our commitment to improving healthcare access across Africa. We envision establishing physical offices in most African countries to expand our reach and ensure that our services are available to those who need them. By working closely with different governments, we aim to integrate our medical evacuation services into national health systems and make them more accessible and affordable. Additionally, we are committed to expanding our fleet of aircraft, and elevating our training programs to meet the evolving needs of our communities. Africa is rising, and we are happy to be part of that journey.

Article first published on https://www.capitalethiopia.com/2024/09/16/transforming-air-ambulance-services-across-africa/