An Indian woman who needed an emergency surgery was airlifted from the United States to her home country this week in one of the longest aeromedical evacuations in recent years here. The flight lasted 26 hours and stopped three times on the way — once in Iceland and twice in Turkey — before reaching the southern Indian city of Chennai (Madras) early Tuesday morning. The woman is now awaiting surgery at the Apollo Hospital in Chennai. A hospital spokesperson told BBC Hindi that her condition was stable. "She was in the ICU in the US with a heart valve problem. The family was in touch with our cardiologist Dr Sai Satish from 5 July. They came here to get the heart valve repaired," a hospital official said. The 67-year-old woman - whose identity has not been disclosed - was staying with her children in Portland, Oregon, when she developed the problem. Her family felt it would be better for her to be treated at home and contacted the International Critical-Care Air Transfer Team (ICATT), an air ambulance service based in the southern Indian city of Bangalore (Bengaluru), where the woman is from. "We used two planes to reduce the mandatory fuelling and maintenance time at airports to fly her to Chennai, where she is set to have her surgery," says Dr Shalini Nalwad, co-founder and director of ICATT. The flight time, Dr Nalwad says, beat the company's previous record of an 18-hour-long journey from Johannesburg in South Africa to Chennai with a cancer patient - this was done during the peak of the Covid lockdown in 2020, when flight services were curtailed. The air ambulance market is still at a nascent stage in India - industry experts say it is currently growing at around 6% every year and has high potential for expansion. Most Indians are unable to afford the high costs of private air ambulances, but operators say demand is growing. In May, a federal minister told India's parliament that there are 49 air ambulances in the country, run by 19 operators. In the past three years, about 4,100 patients have been moved in air ambulances in India. In the recent case, a medical team from ICATT reached Portland two days before the scheduled flight to make the arrangements and get the patient ready. The team included critical care physicians and two perfusionists (who operate heart-lung machines). They first flew in a Challenger 605 plane - which has been converted into a "flying ICU" - to Reykjavik in Iceland, where the plane was refuelled. Then they went to Istanbul, in Turkey, where the patient was shifted to another plane which had a new crew. They then stopped once more for refuelling in Diyarbakir in Turkey, before flying to Chennai. The aircraft was changed, Dr Nalwad says, to reduce the time taken for mandatory checks every time a plane stops for refuelling. "It is also mandatory for the pilots to rest after eight hours of flying, so the crew was also changed," she added. ICATT, which was set up in 2017, has 25 doctors and 25 perfusionists. It owns two aircraft in India - one is usually parked in a southern city while the other is in the eastern city of Kolkata in West Bengal state. The second plane was shifted from the capital, Delhi, to Kolkata because of high demand from patients in north-eastern states, Dr Nalwad said. Many patients from the north-eastern and northern states use these services to travel to hospitals in the south, where medical infrastructure and facilities are better. A medical staff checks on a ventilator of an intensive care unit at a newly inaugurated hospital by the Tamil Nadu state during a government-imposed nationwide lockdown as a preventive measure against the COVID-19 coronavirus, in Chennai on March 27, 2020.Image source, Getty Images Shifting the plane to Kolkata has cut costs, she said - while earlier, a patient would pay 1.4m rupees ($17,500; £14,690) to fly from Kolkata to a major southern city, now they would be charged only about half that amount. The recent flight, from Portland to Chennai "was expensive", Dr Nalwad says, without giving the number. But news reports have estimated that the journey cost around 10m rupees. ICATT, Dr Nalwad says, airlifts about two-three patients every day. They also airlift organs for transplant and surgical teams. — BBC
