HEMS, Disaster Relief Operations and Equipment Pre-Positioning

The UK’s Midland Air Ambulance Charity (MAAC) have developed and implemented a new concept in Extending Day and Night flying Operations for Helicopter Emergency Medical Services (HEMS) that could have major implications, not just for HEMS operations but for disaster relief operations right around the world.

They call them Community Emergency Lit Landing Sites or ‘CELLS’.

West Midlands is one of the largest regions of the UK with population 5.6 million and has a mixture of rural and urban territory including the UK’s second largest city, Birmingham.

The question for MAAC was how they could increase night flying and poor visibility HEMS operations (especially to rural areas with poor local infrastructure) safely and at an affordable cost.

Well, the first obvious question for night operations is why not simply use night vision goggles?

After  carrying out a study, they concluded that the initial outlay on equipment is very expensive, critical golden hour time must be taken to plan ad-hoc night missions and a requirement for ongoing training for pilots and crew, means ongoing recurrent expense. So, NVG’s were rejected.

The concept they came up with instead was CELLS; which are pre-designated and pre-surveyed helipads operated by local people. These CELLS are strategically sited across the entire region to ensure maximum HEMS coverage day or night with maximum operational safety but at minimal cost.

The idea is that local people such as volunteer groups co-ordinated by the emergency services, respond to emergency calls to mark out the pre-surveyed ‘Landing Zone’ with portable lights so helicopters can land safely. Local road ambulances are directed to the CELLS where the patient is transferred from the road ambulance to the helicopter for fast transfer to an appropriate emergency unit.

Landing sites are chosen for their geographic distribution using analysis of emergency calls, as well as other criteria such as population density and transfer times to Trauma and Cardiac units (in this case anything over 40 minutes).

Consequently, CELLS are mainly in rural areas with limited road networks, and can be located anywhere, such as hospitals without emergency facilities, health clinics, doctors’ surgeries, police and fire stations, power stations, football clubs, sports centres, theme parks, schools and public parks.

It was an important requirement that CELLS needed to be independent of critical infrastructure such as power, terrestrial communications, roads etc. and need minimal training for operators.

The company chosen for the development of the equipment CELLS required was FEC Heliports Equipment.

FEC have a track record of delivering portable helipad lights as well as other helipad equipment to air ambulance, government agencies, the military and bodies like the UN.

For this project, in addition to their portable helipad lights, FEC developed a lockable case that can be wall or pole mounted with inbuilt charging stations for the lights. They also developed an illuminated wind sock and obstruction light all of which can be powered by wind or solar power, so that the station is independent of local power supplies and infrastructure. They called it the HEMS Station which serves as a secure cabinet for the storage and charging of up to ten portable helipad lights keeping them ready for immediate deployment. The whole installation is fenced with access for volunteers via a key pad.

CELLS are now in operation right across the West Midlands and more are being rolled out as funds become available. Other regions around the UK are also planning to adopt this approach.

So, what are the implications for disaster relief operations?

Pre-positioning of equipment is not a new concept. The American military have been doing it for years. It means having all the equipment you need to achieve your military objective is pre-positioned in bases at geopolitical hot spots around the world. Maintenance of the equipment is carried out by the minimum number of personnel. All you need is to turn up with your combat troops as and when the need arises. Obviously, that’s a massive over simplification but in principal, that’s how it works.

Well, the same principal could and should apply to disaster relief operations. Time and again when natural disasters strike, isolated rural communities are cut off from communication and vital help for days, sometimes even weeks. Local resources are overwhelmed and whole communities must wait for additional resources to arrive from overseas governments and NGO’s before rescue and relief missions can be mounted.

Often it is only when the first helicopter arrives in the area that the authorities and the outside world get any idea of the scale of the local casualties and are then able to assess what sort of supplies and help are required. Depending on how degraded the local infrastructure is, it is helicopters again that are key to delivering initial relief supplies, rescue equipment and evacuation.

What is clear from experience is that in almost any type of disaster, whether it is flooding, earthquake, tsunami, forest fires, dam collapse or something man-made, in the initial phase helicopters are critical to the immediate response.

Therefore, it makes sense to build emergency response and resilience around helicopter operations. Day and night!

That’s where the MAAC CELL concept comes into its own. By carefully selecting and surveying CELL sites for those communities most at risk and co-locating emergency relief supplies and equipment at a CELL site, not only can you provide local communities with daily HEMS coverage for their more routine emergencies, but you equip them with the means to help themselves in the event of a major disaster. The same CELL equipment can be used as marking an air strip for fixed wing aircraft, space permitting.

And it doesn’t have to be expensive. Everything you need is available commercially off the shelf and at affordable prices. All you would need is a HEMS-Station (£20,000), 40ft shipping container/s (between £4,000 and £6,000 each) the relief supplies to go in it and enough fencing to surround it.

Of course, none of this matters if you can’t communicate with the outside world in the first place. But again, recent developments in mobile communications make this much more doable and affordable. Everyone has a mobile phone today, even in most of the world’s poorest countries the number of mobile phones per head of population is in the high 80’s and 90’s percent. But of course, those mobile phones are useless if the GSM infrastructure, which is very vulnerable, goes down.

Companies like Thuraya produce what they call a Satsleeve (£480), which turns most common mobile phones into a satellite phone or the Satsleeve hotspot that you simply connect your smartphone via Wi-Fi to the satellite unit. The sound is now routed through the smartphone, allowing users to make their calls directly from the smartphone or phones.

US company make the goTenna Pro (£380 per unit), which provides the portability and accessibility of traditional voice radios, but instead of voice, it focuses on offering digital communications for smartphones and their applications. It creates long-range multi-hop wireless networks without any infrastructure for smartphones. It provides text communication only via free apps like WhatsApp or messenger and can be used for group communication or between individuals. But importantly it provides geolocation of every member of the network, which is vital for rescue operations.

Then of course you fill the rest of your container with all the things you need to keep people alive until help arrives like first aid kits, emergency generators, fuel, tenting, thermal blankets, water purification kits, dried and tinned emergency rations, solar chargers, batteries, work gloves, crank radios and torches etc.

Obviously, the CELL site locations, the mix of equipment and supplies will depend on local conditions and perceived threats, but it is not inconceivable to envisage everything you need to deliver a CELLS in a container for not much more than around £50k. A small price compared to delivering the same supplies after the event.

But the real beauty of this approach is that CELLS can make a tangible difference to the everyday lives of people in isolated communities by providing that safe day and night landing zones and landing strips for aircraft, as well as an emergency lifeline in times of major disaster.

(NB all prices are approximate)

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