An Interview with AIMS medical escort, Glen Orritt

Paramedicine, also known as emergency medical services (EMS), involves the provision of immediate medical care to people who are experiencing a medical emergency. Paramedics are trained medical professionals who are equipped to respond quickly to emergency situations, often arriving on the scene in ambulances or other emergency vehicles. Their primary goal is to stabilize patients and provide
life-saving interventions, such as administering medications, performing CPR, or providing oxygen.

AIMS often works with paramedics when they required to help facilitate the repatriation and transport of a patient either from South Africa to their home country or from remote regions in Africa to locations with better equipped medical services. Paramedics are a core component to AIMS care and services who work to ensure that that patients receive the best possible care in emergency situations and during
repatriation.

We sat down to interview one of our newer medical escorts, Glen Orritt, to discuss his profession in Paramedicine as well as his experience working with AIMS. Glen shared his insights into what it is like to be part of a commercial repatriation, the challenges paramedics face and what it takes to make his part in the process of commercial reparation successful.

Tell us a bit about yourself and how you got into paramedicine?

My name is Glen Orritt, I am 36 years old and reside in Benoni, Johannesburg’s East-Rand. My EMS journey started in 2011 as a Basic Life Support medic which I did part-time. From there my passion for pre-hospital emergency care grew and I went on to obtain a higher qualification where I qualified as a Critical Care Assistant (CCA) in 2016.

I have covered work in road-ops, fixed-wing and rotor-wing flights and worked with companies such as ER24 from Basic Life Support (BLS) to Intermediate Life Support (ILS), then Netcare911 as an Advanced Life support (ALS). I have also worked aboard in countries such as the Ukraine, Dubai and Morocco, on a contract basis.

What are the actual realities of what you do as a medical repatriation
professional, and what does that entail?

It depends on the mission. The call is received into the Network Operations Centre (NOC). The Network operations centre (NOC) will then give the pilots, my team, and myself the details the mission. Activation time varies as it’s shorter with the helicopter and longer for fixed-wing flights. We are then sent to retrieve the patient or escort the patient to the hospital.

With AIMS, I have currently done four commercial repatriations. Firstly, I would receive details about the patient and the care the patient needs. Then details on the mission including the destination and flight times. This all happens the day before I am requested to go and visit the patient and introduce myself. The majority of the time, the patients are foreign speakers, and AIMS provides a translator, or they are
able to speak some basic English.

After I introduce myself, I conduct my own physical assessment of the patient. I take a good look at the patients’ medical history and current list of medication. In some cases, it’s needed to request that certain medical procedures are done prior to the flight, such as urinary catheter or prophylactic medication. I then update my case handler or the operations staff at AIMS and give them my findings. From there the
decision is made as to whether or not the patient can fly home, and usually the green light is given.

Depending on what time the flight has been booked, I will go into AIMS House for a briefing of the mission and be taken to either the hospital to travel with the patient in the ambulance, or to the airport if we are bringing a patient back. Sometimes I am flown to the country the patient would need to be repatriated from back to their home country.

What exactly goes into a repatriation, tell us a bit about the mission from
start to finish?

A repatriation involves a great deal of detail. All paperwork, visa applications, and so on will be handled by the AIMS case handler or operations team. I am advised on the potential mission and its destination, so visas can be obtained (if needed). I then get a medical history and information about when the patient is scheduled to fly home. It can be a tiring 24 to 48 hours. I am in good hands with AIMS, however my primary concern is the patient’s well-being while in my care.

What’s the most challenging case that you’ve come across?

In our industry a lot can be challenging. One AIMS case that stands out occured while I was still working with Netcare911 helicopter.

We were required to airlift a brother and sister from a hospital 400km north of Johannesburg. Both helicopters took off and landed simultaneously to collect the injured siblings. Their mom and dad were to be transferred via road ambulance as the children needed the most medical attention.

On arrival, I met a 12-year-old girl who was previously involved in a motor vehicle accident (MVA) whilst on holiday with her family in South Africa. My colleague and I met with the treating physician, outside the cubical of the young girl’s room in ICU. We received a handover from the treating doctor and as we both suspected, the girl would be paralysed from the waist down. She had not yet been informed of this and
would be told once in Johannesburg with the appropriate councillors and family members present. I requested that the nursing staff bring both parents into the ward so they could see their children prior to departure. They said goodbye to their children and assured them that they would see them in Johannesburg later that day.

This was a challenging case as there is always that deeper empathetic response with children, this case in particular was closer to home as she was the same age as my niece and her brother the same age as my nephew. The hardest and most difficult part, was knowing she would not walk again, without her being told yet and having her whole life ahead of her. I do believe that this will allow her to succeed in
other aspects of her life and that her difficulties she was going to face were not be a burden.

On the commercial repatriations, the language barrier is almost always a difficult one. I recently assisted in getting a Romanian national back to Bucharest, and the gentleman was so excited to be returning home that he had quite a lot of questions. Once he realised that I had been involved in his initial treatment he had a lot more questions. He had suffered a severe stroke, therefore his higher cognitive function was not fully back to his original baseline, so this also added to making the basic
explaining of questions or answers a lengthy one.

What’s the most bizarre or frustrating situation you’ve come across
regarding travelling with a patient?

Luckily it hasn’t been too bad with the repatriations from AIMS so far, as majority of my cases were walk-on’s. One that does stand out is when I was on a repatriation from Maputo to a European country and the patient was transported to the airport by ambulance. It was an extremely hot summers-day and the airport did not have any air-conditioning. I left the patient inside the ambulance with a paramedic while I went inside to deal with the baggage check-in. The airline crew then informed the traveling patient, that was waiting inside the ambulance, that he would be picked up by a prearranged wheelchair as soon as everything was ready.

This created a 2 hour wait, luckily, we arrived 3.5 hours prior departure. The more I tried to convince the airline that the wheelchair was unnecessary and that he could fully mobilize without it, the more they refused. They kept explaining that because the ambulance was present, this was necessary. They wouldn’t let him leave the ambulance without the wheelchair and then they had to consult with the airline’s
main office, which was in another country. This opened an entirely different discussion about his medical history and so on. It was uncomfortable, and the heat inside the airport was unbearable.

What’s the worst and best medical facility or hospital that you’ve ever had to
collect a patient from?

We are spoiled for choice when it comes to hospitals in Johannesburg, despite the fact that South Africa is considered a ‘third-world country’ by some, our medical facilities and practitioners are first-world, and our patients receive excellent care.

I’d have to say that there are places in Africa that I’ve visited that don’t have the same luxuries in terms of budget and expertise that we have in South Africa and are accustomed to.

During the repatriations have you ever clashed heads with a medical
professional overseas?

Once, when I landed in Paris with a patient, the medical team that was retrieving the patient had come to meet us from Canada. We had discussed the patients care inflight and before finalising our patient handover and I wanted to move the patient in a manner I thought was the safest option for the patient. The Canadian team did not agree with the way I wanted to move the patient onto their equipment and this led to a short, heated debate. That added a lot of frustration to a mission well done but, in
the end, I managed to move the patient successfully, and the handover of the mission was completed.

What has been one of your favourite countries or cities you have done a
repatriation to?

I would definitely have to say Paris, France. What an incredible city. After the repatriation was completed, I had some time to explore Paris, which is another great benefit of being able to travel to new places while doing what I enjoy as a job.

What do you enjoy about doing commercial medical repatriations?

I enjoy that on most missions, I am taking a patient home. Seeing how excited they are brings me so much joy or, if I am bringing them into South Africa, knowing they are going to receive the best care possible. Saving lives, it makes me feel like I am doing great things in my career and fuels my passion for what I do.

Finally, how has your experience been working for AIMS on these missions?

Without a question, the level of professionalism from the AIMS team from start to finish on all missions is outstanding, it is often lacked around the world these days.