By Private Jet to Helsinki

An important lesson about travel insurance.

For some of my overseas trips, I have taken out medevac insurance; if ever this coverage was necessary, it was during my recent trip to Uzbekistan.

After waiting for the landing of Uzbekistan Airways A300 flight from Bangkok, the twin engine private Cessna Citation CJ2+ jet accelerated smartly down runway 8 Left of Tashkent Airport. After quickly becoming airborne, we made a sharp right turn, then left Tashkent behind and headed for Helsinki. I was the only passenger on board for the seven-hour journey through the icy December evening. Arrival in Helsinki was just after 2 am, in unfriendly weather as the small jet battled with strong crosswinds and cold sporadic rain at the airport. This could have the makings of an exciting and interesting journey out of Uzbekistan but my left leg was in pieces (more properly termed a periprosthetic fracture of the left femur) and I was tightly strapped to a stretcher in the Med Flight Finland aircraft. My destination was the Orton Orthopaedic Hospital in Helsinki where, hopefully, my leg would be put back together.

My trip to Tashkent began uneventfully a few weeks’ earlier with the early morning arrival of Turkish Airlines’ A320 aircraft from Istanbul. Arrival at Tashkent airport can be one of the worst travel experiences, with hundreds of pushing/shoving passengers, each trying to be first in the immigration line. They then get their bags and form in mobs in front of each of the three or four customs inspectors, where each bag is subject to x-ray inspection and the passenger is interrogated by surly customs officials. Surprisingly, I found the arrivals area of Tashkent airport to be smooth running and I passed immigration and “baggage control” quickly, with the customs officials even showing a smile. From the back seat of the taxi from the airport, in the cool November morning the city became once again familiar to me as this was probably my tenth trip to the country. At first the driver was unfamiliar with the location of my hotel, a new establishment, opened only a couple of years ago. But soon we found our way and I walked up its shiny polished marble entrance and steps for registration. These steps would be covered with ice in a few weeks.

My work in Tashkent went well for the first five weeks, with most meetings held and needed information obtained. Then by early December the weather turned snowy and ice became a feature of my daily commute to the office and to meetings in the city. One early December morning as I stepped out of the hotel doorway, feeling confident that I had just obtained the correct hotel receipt needed to claim my expenses, my feet found the smooth icy steps and I was propelled horizontal landing hard on my left leg, shattering the bone. The fact that my left foot just dangled uselessly, was my first indication that the lower part of my leg was no longer connected to the upper part. Helpful hotel staff tried to lift me but I could only cry out in stabbing pain with every well – intentioned touch.

A rough wooden stretcher was found and I was painfully placed on this device as a local ambulance delivered me to the trauma unit of the city’s main hospital. The ambulance took the route using the roughest roads in the city, compounded by potholes hidden by the snow and a rock-hard suspension system on the vehicle.

Of the health care system in Uzbekistan the United States Department of State, Bureau of Diplomatic Security has the following comments on their web site:

“The health care system is not adequate to meet the needs of many serious emergencies. There is a lack of basic supplies and little modern equipment. Emergency medicine is very basic. The Tashkent International Medical Clinic (TIMC) meets Western standards. TIMC telephone number is 998-71-291-0142/0726. There is a physician on-site during the day and on-call during non- working hours. TIMC has basic diagnostic equipment, and has the ability to handle some trauma emergencies. More severe injuries require air evacuation”.

With this information in mind, it was a no-brainer to use the medevac insurance policy I had fortunately bought for the trip. After a couple of hours in the public hospital, I made a call to the TIMC and was soon transported to that welcome haven of (relatively) modern medical services. After a quick examination at the clinic they confirmed that my shattered leg could only be repaired overseas, my decision to invest in a medevac insurance policy suddenly was one of the best decisions of my life. The clinic quickly called the emergency telephone number in the United States, received approval for an emergency flight to an overseas medical facility. Within 12 hours, I received confirmation by telephone that a private jet was on its way from Helsinki to Tashkent to take me to Helsinki’s Orton Hospital for emergency surgery. Just over 24 hours after the accident, I was in another ambulance on my way to the Tashkent airport to meet up with the medevac jet. With departure documentation taken care of efficiently by the TIMC staff, my exit stamps were soon in my passport and I was at the airport gate and moving on the tarmac to the waiting jet.

Acquired through living in the UK with her British husband for seven years, Satu-Carita Lingwood’s accent was definitely British but the trauma nurse who would accompany me on my flight was part of the Med Flight Finland crew, now arranging for me to transfer for the last time to their stretcher that I would ride while on board the flight. The tricky part of my “boarding” the aircraft was inserting the stretcher (with me strapped aboard) through the narrow aircraft door. In order to fit the stretcher on which I was lying, through the door of the small jet, it had to be twisted about thirty degrees of vertical; I was told not to put out my hand when this happened. The Finnish crew assured me: “don’t worry; you will not fall…do not put out your hand when the stretcher is twisted to the side”.  As the crowd of Uzbeks and one or two

Finns had their hands on the stretcher, lifting it above their heads, shoving it through the aircraft door at a 30 degree bank, I desperately stretched out my arm to grab anything to keep me from falling. In spite of all of this, they managed to insert me into the narrow body of the aircraft. Inside there were eight seats, several of which had been removed to make way for my horizontal position.

The nimble jet would fly to Helsinki via Samara, in southern Russia, for refueling. In total the trip would take just over seven hours, promising a 2 am arrival in the Finnish capital. The flight was uneventful, even with the forty-five minute refueling at frigid Samara, with outside temperatures far below zero, and the Russians did not even demand to see my passport. Russian immigration officials reluctantly wandered out to our aircraft and asked the crew: “nationality of the patient?” With the response of “US” they were satisfied and retreated into the warmth of the airport building.

Cold wind driven rain greeted my arrival at Helsinki and the jet quickly taxied to an empty hanger. I was twisted out of the aircraft and soon into a waiting modern ambulance for the last few kilometers to the Orton Hospital. As the insurance organization and Med Flight Finland had organized everything with the hospital before my arrival, I was immediately rolled to a private room on the 5 th floor and awaited the arrival of the surgeon. Dr. Manninen, soon greeted me and assured me that soon after detailed x-rays were taken, he would perform the necessary to put me back together. Later, in the x-ray theatre, I saw him and his fellow surgeons studying the images of my leg on the remote screens, ordering additional views and angles as necessary. Within three hours, I was on the operating table and soon lost consciousness.

I spent ten days at Orton Hospital for my initial recovery, finished my final report for my Tashkent assignment before returning to the US on Finnair’s non-stop flight to Miami. It is now six months since the surgery and I walk without any support. I just need some more exercising the left leg to rebuild the damaged muscles, but for the most part, the ordeal is over.

But, it could have been much worse; that $100,000 could have come out of my own pocket. Before the trip I took out a medevac insurance policy (bought on line) that paid for virtually all costs. I travel frequently for my business and I don’t always buy this insurance for each trip; but this trip taught me the hard lesson. So, here is the accounting totaling $100,000: $64,000 for the aircraft; $33,000 for the surgery and 10 days in hospital plus $3,000 for medical expenses in Tashkent. I learned the tough lesson that it is essential to have enough insurance and a good medevac policy to take care of the unthinkable, which sometimes happens. The $160 premium turned out to be the best investment of my life.

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