Collaborative medical and security approach to a crisis in Yemen
A crew member of a cargo ship sailing through the Gulf of Aden collapsed. Due to a lack of medical personnel on board, the ship was forced to sail to the nearest port, which happened to be Aden. Yemen has been in a state of Civil War since 2015, with most international companies and embassies warning against all travel to the country. However, with the patient’s condition worsening, the ship’s captain felt they had little choice in the matter. Healix stood up a joint medical and security Incident Management Team (IMT) to plan the operation.
Challenge
There were several complications in this case. Yemen is in a state of civil war. The Houthi rebel movement controls the capital Sana’a, while the internationally recognised government is based in Aden. While the Houthi rebels in the north enjoy the support of the Islamic Republic of Iran, the government in Aden is backed by an international coalition that controls the airspace and conducts regular air raids against Houthi positions in the north. In this case, it meant that any charter air evacuation options would need to be approved by the coalition.
Secondly, the city had been targeted by several terror attacks, which were perpetrated by al-Qaida’s most dangerous franchise, al-Qaeda in the Arabian Peninsula (AQAP). Only a day before the request, the security forces had prevented a suicide bombing. The country is an exceptionally complex operating environment with EXTREME security risks across the board, including terrorism, crime and kidnapping.
The patient was an Indian national, but his country did not have any diplomatic representation in Yemen, as the Indian embassy in Sana’a had relocated to Djibouti.
An additional challenge we faced was finding a suitable hospital that had the necessary medical facilities (including a cardiology unit), was safe to reach from the port and had an available bed for our patient.
Even though options were limited, with the help of our local assets we chose a hospital nearby that – having opened just two months before – did not have a presence on the internet. We were fortunate that Aden had a functional international airport, conveniently located near the port. This allowed us to keep the option open for a medical evacuation by air.
Approach
The ship docked at the port of Aden, where a convoy of two vehicles (an ambulance and a support vehicle with armed personnel) was waiting at the bottom of the gangway for the patient. While passing through customs, the patient was required to surrender his passport; the DAC’s contacts at the port authorities ensured that it was kept in a secure location.
The ground transfer from the port to the hospital took about twenty minutes. During this time, our IMT provided real-time updates to the client’s organisation and the ship’s captain. As soon as the patient arrived, he was admitted to the emergency department for medical consultation. While the patient was hospitalised, a low-profile armed escort remained with him all the time, providing constant updates to the IMT.
While the patient was in the hospital, there was a protest in Aden’s Crater area with dozens of people denouncing power cuts. The demonstrators burned debris and tires. Meanwhile, the patient was undergoing treatment, and his condition was improving, so an air evacuation deemed unnecessary. The IMT began preparations for returning the patient to the ship and settling his medical fees.
Outcome
Less than a week after he collapsed, the patient had recovered sufficiently and was able to re-join the ship. The ground team, comprised of two vehicles with armed personnel and a local fixer, departed from the hospital at 12h05 (local time). By 13h15 the patient had proceeded seamlessly through the port authorities and was boarding the ship.