From Tokyo to Singapore: A Mission of Care
During this holiday season, our Aeromedical & Marine team has been travelling across the world carrying out international repatriation missions, supporting patients and their families when they need it most.
One of these recent missions took us from Tokyo to Singapore, where we accompanied a patient with a neurological condition caused by a degenerative disease.
The mission began in Tokyo, where we collected the patient directly from the hospital. All medical arrangements had been carefully prepared in advance, ensuring a smooth and well-coordinated transfer from the originating hospital to the receiving facility in Singapore, where the medical team was already expecting her arrival.
Throughout the journey, the patient was continuously assisted by Cesar, our Chief Nurse, and Robert, a technician, who ensured her comfort and medical stability during the repatriation.
As the year came to an end, we found ourselves welcoming the New Year in a very special way: onboard the aircraft, flying over Vietnam. Together with the flight crew and our patient, we shared New Year wishes at 35,000 feet, a quiet but meaningful moment that reminded us why we do what we do.
Holiday missions are always particularly delicate. During the Christmas and New Year period, some services that usually operate smoothly throughout the year may be reduced or limited. Despite these challenges, our team successfully completed the mission and safely delivered our patient to her destination.
She was deeply happy to be back home, reunited with her family, the true purpose behind every repatriation we perform.
Although our patient kindly authorized us to share her story, and the memories we captured together in photos, as an aeromedical company, we always prioritize and protect patient privacy.
This journey also marked an important step for Aeromedical, as we will soon have a presence in Singapore. This mission allowed us to make our direct contact with the country and further strengthen our international network.
After a brief and well-deserved rest in Singapore, our Chief Nurse Cesar was already preparing for the next mission, this time from Singapore to Canada. But that is another story…
Wherever we are in the world, even during the holidays, our commitment remains the same: to care, to accompany, and to bring patients safely home. We all wish you a very happy new year 2026!
Across Continents, With Care: CapeTown to Houston
At Aero Medical & Marine Training and Rescue International, every mission is a unique story of skill, coordination, and compassion.
In a recent operation, Dr. Alejandro Frola led the transfer of a critically ill patient from the ICU at UCT Netcare in Cape Town, South Africa, to the NeuroICU at Methodist Hospital in Houston, USA.The case was particularly complex, with a diagnosis of cerebral artery dissection and severe right hemiparesis, alongside urinary catheter care, nasogastric tube feeding, and tracheostomy management.
Thanks to the outstanding collaboration with the LatitudeAirAmbulance team, every stage of this intercontinental journey, from medical stabilisation to transoceanic transfer, was executed with expertise, precision, and compassion.
From the critical care unit in Cape Town to the specialised neuroICU in Houston, this mission demonstrated the power of teamwork, meticulous planning, and an unwavering commitment to patient safety.
These journeys remind us why we do what we do and why every mile matters.
One of Many Remarkable Missions: A Journey from Kilimanjaro to Denmark
At Aero Medical & Marine Training and Rescue International, we handle diverse and complex missions across the globe, each one with its unique challenges and moments of deep human connection.
One recent mission took us to Kilimanjaro, Tanzania, where a patient sustained serious injuries after a fall during a safari expedition. Thanks to the incredible expertise and dedication of Alexia Hartmann Fernández, who traveled from Spain to personally lead the repatriation, the patient and her family were safely transported to Denmark.
From remote terrain and cross-border coordination to detailed medical planning, this mission was a testament to the resilience of our team and the strength of collaboration. Every procedure, every detail, every mile handled with care, precision, and compassion.
This is just one of many stories that remind us why we do what we do.
Bridging Borders in Crisis: Inside the World of Medical Evacuations and Repatriations.
Dr. Manu Krishna, MD
Global Case Manager | Specialist in Global Health & International Operations
Introduction: Health in Motion
In an increasingly interconnected world, medical crises do not respect borders. Whether a tourist is injured abroad, a migrant needs specialized treatment, or a seafarer falls ill mid-voyage, medical evacuations and repatriations are vital in ensuring that no one is left behind, no matter where they are (1,2,3).
This article examines the real-world operations of Aero Medical and Marine Training and Rescue International (TRI SL), a specialized aeromedical service provider based in Spain, and reflects on how such organizations contribute to the broader landscape of global health, emergency preparedness, and cross-border patient safety.
What Is Medical Repatriation and Why Does It Matter in Global Health?
Medical repatriation refers to the safe transportation of patients back to their home country or to a specialized medical facility, typically under medical supervision. This process is not limited to emergencies alone—it spans acute medical incidents to long-term care transfers (1,2). In the context of global health, repatriation is often overlooked but crucial. It intersects with:
- Health equity – ensuring continuity of care regardless of location.
- Cross-border coordination – involving embassies, hospitals, and airlines.
- Public health risk management, especially during infectious disease outbreaks.
- Humanitarian response – assisting vulnerable travelers or migrant workers.
Medical repatriation and evacuation are essential for patients who require ongoing treatment or specialized care, or simply wish to be closer to their support networks during recovery. These services are vital for travelers, expatriates, and workers at sea or remote locations, where access to advanced healthcare may be limited (1,2).
Inside the Work of AeroMedical and Marine TRI SL
At the heart of this complex process is Aero Medical and Marine Training and Rescue International (TRI SL), headquartered in Spain, with additional operational hubs and affiliated companies in Dubai and the USA (Miami). The organization specializes in:
- Medical escort services, with trained doctors and nurses accompanying patients on commercial airlines.
- Coordination with global insurance companies, embassies, and health facilities to ensure seamless patient transfers.
- Full logistical management, including flight bookings, medical clearances, visas, and equipment preparation.
- Training programs in aeromedical care and crisis management to build capacity for future medical emergencies.
Aero Medical and Marine TRI SL’s multidisciplinary team includes full-time case managers and a vast network of freelance doctors and nurses, who can be mobilized on short notice to fly around the world (3,4). Their operations are supported by partnerships with air ambulance providers in Europe and beyond, ensuring global reach and flexibility.
Real-World Example:
In January 2024, the team successfully repatriated a 20-year-old Colombian student from Slovakia to Colombia after he suffered a spontaneous brain hemorrhage. The mission involved meticulous planning, collaboration with airlines and local authorities, and providing intensive care during the 26-hour journey. The patient was safely delivered to a local hospital, accompanied by his family—a testament to the organization’s commitment to compassionate, safe, and efficient medical transfers (1).
Beyond Borders: The Humanitarian and Operational Impact
Aero Medical and Marine TRI SL’s work extends beyond traditional patient transfers. They also conduct high-seas medical assessments and collaborate with national authorities to evaluate the health of vulnerable individuals, such as stowaways or crew members in distress. These missions require sensitivity, professionalism, and a commitment to humanitarian care and operational efficiency (3.2). Under Dr. Mònica Fortea—an experienced trauma surgeon and flight doctor—the organization’s leadership emphasizes a holistic approach to patient care. Dr. Fortea’s background includes years of service with Spanish Helicopter Emergency Medical Services (HEMS) and extensive experience managing complex international patient transfers (1,2,3).
Training, Preparedness, and the Future
Aero Medical and Marine TRI SL provides emergency medical transport and is a leader in training the next generation of aeromedical professionals. The organization shares its expertise through lectures, hands-on courses, and international collaborations and helps build a more resilient global health infrastructure (2,3).
Their involvement in disaster response, humanitarian missions, and health security initiatives underscores their role as a cornerstone of emergency preparedness and cross-border patient safety.
Conclusion
Medical evacuations and repatriations are complex, high-stakes operations that require meticulous planning, robust coordination, and swift action. Organizations like Aero Medical and Marine Training and Rescue International are essential in bridging borders during crises, ensuring that patients receive the care they need, no matter where they are. Their work is a testament to the power of collaboration, innovation, and compassion in global health.
(Dr. Monica Fortea)
References
1. https://air-marine-int.com/
3. https://www.linkedin.com/company/air-marine-int/posts/?feedView=all
4. https://air-marine-int.com/provider-profile-aeromedical-marine-training-rescue-international/
Medical Repatriation Mission Carried out from the Philippines to the United States
We are pleased to share this informative video featuring Dr. Alexia Hartman, a physician and valued member of the Aeromedical and Marine TRI team. In this clip, Dr. Hartman walks us through the step-by-step process of a medical repatriation mission carried out from the Philippines to the United States.
She explains the key stages of the operation offering insight into the complexity and precision such missions require.
🌍 At Aeromedical, we are proud to have a medical team with extensive experience in critical care and aeromedical transport. Every mission is handled with technical excellence, rapid response, and deep human empathy.
🔹 Our commitment to professionalism, safety, and high-quality medical care is what allows us to operate successfully even in the most challenging international contexts.
How Is a Critically Patient Transported From One Country to Another?
¿Alguna vez te has preguntado cómo se traslada de forma segura a un paciente en estado crítico de un país a otro? En este Día Internacional del Trabajador, queremos tomarnos un momento para destacar uno de los servicios más complejos y esenciales en la atención médica global: la repatriación médica en avión ambulancia.
En Aeromedical and Marine, nos especializamos en organizar y ejecutar traslados médicos internacionales para pacientes que requieren atención urgente o continua. Estas misiones implican una planificación minuciosa, aeronaves especializadas equipadas como unidades de cuidados intensivos voladoras y personal médico altamente capacitado, todo trabajando en perfecta coordinación para garantizar la seguridad y el bienestar del paciente.
Desde la recogida en la cama del hospital en el país de origen hasta la coordinación fluida con hospitales y equipos médicos en el destino, cada misión de repatriación se adapta a la condición y necesidades del paciente. Es un poderoso ejemplo de lo que sucede cuando la medicina, la aviación y la logística se unen.
Hoy, mientras celebramos a los trabajadores de todo el mundo, reconocemos especialmente la dedicación de nuestros equipos médicos, tripulaciones aéreas y coordinadores que hacen posibles estas misiones que salvan vidas.
¡Disfruta de este breve video documental realizado por nuestra fantástica compañera, la Dra. Alexia Hartman sobre un proceso de repatriación!
Have you ever wondered how a critically ill patient is safely transported across borders? On this International Workers’ Day, we want to take a moment to shine a light on one of the most complex and crucial services in global healthcare: medical repatriation by air ambulance.
At Aeromedical and Marine, we specialize in organizing and executing international medical transfers for patients who require urgent or continuous care. These missions involve meticulous planning, specialized aircraft equipped as flying intensive care units, and highly trained medical personnel — all working in perfect coordination to ensure the safety and well-being of the patient.
From bedside pickup in the origin country to seamless coordination with hospitals and medical teams at the destination, each repatriation mission is tailored to the patient’s condition and needs. It’s a powerful example of what happens when medicine, aviation, and logistics come together.
Today, as we celebrate workers around the world, we especially recognize the dedication of our medical crews, flight teams, and coordinators who make these life-saving missions possible.
Enjoy this short video document made by our fantastic colleague Dr. Alexia Hartman about a repatriation process! (in Spanish)
Happy International Workers’ Day!
#MedicalRepatriation #AirAmbulance #EmergencyMedicine #GlobalHealth
Medicina a 10.000 metres d’altura: la vocació de Mònica Fortea
The Trauma Surgeon Balancing Work at the General Hospital with Leading a Pioneering International Air Medical Transport Company
A Colombian young man, about 20 years old, fell into a coma after suffering a cerebral infarction due to hemorrhage while studying aerospace engineering in the Czech Republic a few months ago. The student insurance he had contracted stopped covering his hospital expenses, and his chances of survival were very low.
In this context, Dr. Mònica Fortea, a trauma surgeon from Sant Cugat and founder of a leading air medical transport company in Spain, stepped in. The embassies of both countries contacted Fortea to coordinate the young man’s repatriation. Thanks to a complex journey involving both ambulance and air transport, he was able to return to Colombia.
This is just one example of the missions carried out by Aeromedical and Marine Training and Rescue International, a company born from the passion of a Sant Cugat doctor that completes around 200 missions worldwide each year.
A Project Born from Experience
Fortea is an orthopedic trauma surgeon who currently works at the Hospital General de Catalunya, heading the international department. Her experience beyond the hospital began two decades ago when she treated sailors from around the world in Spain and then arranged their return to their home countries.
“I started asking myself questions and realized that airborne medicine needed to exist with a different set of characteristics,” she explains. Motivated by this concern, she pursued further training—first as a HEMS (Helicopter Emergency Medical Service) instructor, then in the aeromedical transport of patients via commercial and air ambulance flights.
Having worked for both national and international companies, assisting private patients and insurance providers, Fortea eventually decided to establish Aeromedical and Marine Training and Rescue International four years ago.
“It’s a 24/7 job, every day, every night. It requires deep commitment and a strong medical mindset because we always have to be there,” she emphasizes.
A Service That Spans the Globe
So, what exactly does the company do? From its headquarters in Sant Cugat, the team coordinates emergency air transfers, medical transports on commercial flights, and private medical escort services.
“We handle everything: finding flights, arranging the right type of escort, booking taxis and hotels… We oversee the entire process, from the moment the medical escort (a nurse, doctor, or both) departs to reach the patient, assess their condition, determine if they are fit to fly, and accompany them until they arrive safely at their destination.”
Major insurance providers from Europe and North America rely on their services to ensure that patients in complex medical situations can return home safely. Recently, the company expanded its operations by establishing bases in Miami and Dubai, enabling faster response times to global emergencies.
Fortea highlights that the key to the company’s success lies in meticulous preparation and adaptability. “Without dedication, this would be impossible,” she states, emphasizing the commitment of her colleagues.
The company has a core team of about 15 people who regularly fly and manage operations. “Additionally, we have up to 50 professionals in our reserve pool—highly skilled aeromedical experts who work on a case-by-case basis,” she explains.
Flexibility is crucial: “We are professionals with a degree of flexibility. Without it, balancing this job with the rest of our professional and personal lives would be impossible.”
A Passion-Driven Career
Many of these professionals combine this work with their stable jobs. “I work onsite at the hospital until noon, then continue remotely from the office,” says Fortea. Passion is essential: “It’s in our blood.”
Despite her demanding hospital duties and running a business, she still actively participates in missions, admitting that flying remains her greatest passion.
Aiming for Long-Term Success
“This is a lifelong project. I want it to last forever and become Spain’s leading air medical transport company, setting an international benchmark,” Fortea asserts.
She also underscores the strong presence of women in the company. “This is a company with a lot of women, both Catalan and Spanish. It’s not always easy to gain international recognition, but we’re making it happen.”
A Year Later: A Remarkable Recovery
We are thrilled to share an uplifting update on the young patient we repatriated from Zilina, Slovakia, to Bogota, Colombia, in January 2024. According to his family, after a year of dedicated rehabilitation and care, the 20-year-old has made significant strides in his recovery.
You can read the original article here
The patient, who faced immense challenges following his initial condition, is now in much better health and spirits. His family reports that he has regained considerable strength and functionality, and his determination to improve has been truly inspiring. With ongoing therapy and support, he has been able to rebuild aspects of his life, and he now looks toward the future with hope and excitement.
We are deeply touched by the heartfelt gratitude expressed by his family. Their kind words reaffirm the importance of the work we do. Knowing that our efforts helped bring him home and contributed to his recovery fills us with immense pride and joy.
This story is a testament to the resilience of the human spirit, the unwavering love of a family, and the collective dedication of all those involved in his transfer and care. It is an honour to have been part of his journey.
How was the repatriation now a year ago? We remind you here:
Home at Last!
On January 28-29, 2024, Aeromedical and Marine successfully transferred a 20-year-old Colombian patient from Zilina, Slovakia, to Bogota, Colombia. The patient, a university student with no prior medical history, suffered a spontaneous intraparenchymal hematoma (HIPE) in October, requiring neurosurgical intervention. Prolonged care in a neurocritical unit left him with quadriparesis and mixed aphasia.
Preparation for the Transfer
The process began in early January when the patient’s mother sought assistance. The Aeromedical and Marine team undertook a detailed planning process that included gathering medical reports, designing the safest and most efficient route, and securing logistics with airlines and governments. Air France was selected for its capability to accommodate stretcher-bound patients, and ground ambulances in Slovakia, Austria, and Colombia facilitated transport to and from airports.
The Transfer
The patient travelled on a commercial flight in a specially equipped medical section, assisted by a team of intensive care specialists. The journey involved meticulous preparation, including sedation to manage the patient’s neurological symptoms, and was monitored in real-time by Aeromedical and Marine’s ground team. Despite minor challenges, such as reconfiguring the final disembarkation in Bogota, the patient was safely delivered to a local hospital, accompanied by his family.
A Successful Repatriation
After 26 hours of travel, the patient arrived home, completing a complex yet smoothly executed mission. This effort underscores the dedication of Aeromedical and Marine in providing compassionate, safe, and efficient medical transfers.
A Year Later: A Remarkable Recovery
We celebrate his recovery and wish him continued success and happiness as he moves forward. This story reminds us why we do what we do, and we couldn’t be happier to see such a positive outcome.
A New Challenge Successfully Solved: ASWAN-GRANADA
The transfer was requested by one of our clients. It involved a man who had suffered an accident during his holiday, resulting in a vertebral fracture and a fractured finger.
He was hospitalized in a private hospital in Aswan.
The challenge was that the patient had limited mobility due to the vertebral fracture, requiring him to remain lying down as much as possible, although he was able to move and walk for hygienic purposes.
Another difficulty was his home city, Granada, which has no direct flights to Egypt. A combined air and ground transfer route was proposed: Aswan-Cairo-Madrid by commercial flight, followed by Madrid-Granada by ground ambulance.
I contacted the patient in the early morning hours; he was accompanied by his wife. After consulting with the hospital’s medical team and conducting my own assessment, the FIT-to-Fly was approved. The patient was able to travel in Business Class with his seat adjusted to its most horizontal position.
The repatriation began with a transfer to Aswan Airport by ambulance, and we completed the boarding process using the airport’s liftcarbox. I ensured the patient was comfortably seated, maximizing the seat’s recline and using the footrest to allow him to lie as flat as possible. We then embarked on the first flight, Aswan to Cairo.
At Cairo Airport, with the assistance of the passenger support service, we transferred to the next plane and began the flight to Madrid.
Throughout the flights, the patient was closely monitored. I ensured his vital signs were stable, watched for any signs of neurospinal issues, and maintained his prescribed medication regimen.
Once in Madrid, and with the help of the passenger support team, the patient was transferred to the stretcher in the ambulance for the final leg of the journey to his home in Granada by road. During this segment, he remained lying down on a vacuum mattress secured to the ambulance stretcher.
Finally, we arrived at the patient’s home without any incidents. He expressed his gratitude for being brought back home so quickly.
From the time the mission was planned to the moment the patient arrived home, less than 72 hours had passed.
