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 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 travellers 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 travellers, 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 physicians 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/ 

2.https://www.airmedandrescue.com/latest/long-read/provider-profile-aeromedical-marine-training-res cue-international

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/

¿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

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.

Aeromedical and Marine TRI recently undertook a delicate mission at sea, demonstrating its commitment to providing comprehensive care in complex situations. The mission involved the assessment of two stowaways who had clandestinely boarded a vessel during its journey across the Atlantic.

Upon the ship’s arrival at the coast, the Aeromedical and Marine team worked in close collaboration with the National Police, Port Authority, and Immigration Services to evaluate the individuals. A thorough examination was conducted to assess their physical and mental health, ensuring their well-being after the long voyage.

Fortunately, both stowaways were found to be in good physical and mental condition. Following standard protocols and in coordination with the authorities, arrangements were made for their safe return to their country of origin aboard the same vessel.

This mission reflects the professionalism and sensitivity required to handle situations involving vulnerable individuals, balancing humanitarian care with operational efficiency. Aeromedical and Marine TRI remains steadfast in its dedication to providing specialized medical services in challenging environments.