Why Global Rescue?

Global Rescue provides worldwide advisory, field rescue and evacuation services, in both medical and security emergencies. 

  • Field Rescue from point of illness or injury, no matter how remote
  • Evacuation to the home hospital of choice
  • Services provided up to $500,000
  • 24/7 advisory services from medical and security specialists
  • Medical oversight from specialists at Johns Hopkins Medicine
  • Paramedics deployed to member's bedside
  • Memberships start at $119

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Global Rescue News

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Snakebites – Who Gets Bitten and Who Dies

  
  
snake

Many people dread snakes – so much so that they actually avoid going outdoors to fish, hunt, hike, or picnic. Others, out of a misplaced fear, will kill every snake they see. This is unfortunate because it’s fairly easy to avoid direct encounters with snakes.

Snakes are reptiles, and like their relatives, lizards and crocodiles, are covered with scales, are legless, cold-blooded, can swim and have been around for millions of years. All snakes eat other animals, while some snakes even eat other snakes. But snakes, even venomous ones, are important to the environment and help to control populations of rodents and other pests.

Snakebites are Rare

As an outdoor enthusiast, it’s really only a matter of time before you will encounter a snake in the backcountry. But contrary to popular belief, snakes are not in the business of looking for people to bite. Despite their sinister reputation, snakes are more afraid of you than you are of them. Most snakes do not act aggressive toward humans without provocation. Although many harmless snakes will bite to defend themselves, usually their bite produces nothing more than simple scratches.

Venomous Snakes

Only about 400 of 3,000 snake species worldwide are poisonous. These venomous snakes are most prevalent in temperate and tropical climates, with April-October being peak snakebite season.  About 25 species of poisonous snakes are found in North America.

The Risks of Dying from a Snakebite

The chances of dying from a venomous snakebite in the United States is nearly zero, because of the high-quality medical care in the U.S. Fewer than one in 37,500 people are bitten by venomous snakes in the U.S. each year (7-8,000 bites per year), and only one in 50 million people will die from snakebite.

In North America, approximately 10-15 people die per year as the result of a venomous snake bite. The risk of dying from a venomous bite increases when multiple bites are involved and when the bite occurs in the very young, old, or in persons with underlying respiratory or cardiovascular problems.   

Compare this with the 11,000 reported deaths that occur in South Asia each year, accounting for over half of estimated snakebite deaths worldwide. Poor, rural areas that lack appropriate medical care and the correct antivenom contribute to this high number of snakebite fatalities.

Who Gets Bitten By Snakes?

In the United States, a significant number of people who are bitten are the ones who handle or attack snakes. The majority of poisonous snakes in the US are pit vipers.  Rattlesnakes, copperheads, and cottonmouth (water moccasin) snakes are in this family, known as Crotalidae.  Typically, pit viper victims tend to be young males, 11-19 years old, who are bitten on the hand while trying to pick up the snake. People attempting to take a “selfie” with the snake are at high risk of being bitten. Alcohol has also been shown to be a common factor in these incidents.

For Venomous Bites: Antivenom is the only proven therapy for snakebite but only when it is specific for the snake involved.  

DO NOT try to kill or capture the snake for identification purposes.  

Dead snakes, even several hours later, can reflexively bite injecting venom causing either a second bite or biting another member of the group.  Use your smartphone to get a picture of the snake instead.

Follow Up

As with any deep puncture to the skin, infection is a concern. The wound should be irrigated and cleaned at a hospital emergency department or emergency health clinic. The person who is bitten by a snake may need a tetanus shot. Tetanus boosters should be given every 10 years.

Take Global Rescue with You

Wherever you travel, Global Rescue encourages you to study of your destination and research the native flora and fauna that might be harmful. Be prepared and expect the unexpected. And it you travel to a remote area, take a Sat Phone with you.

Read the story: Global Rescue evacuates a man bitten by an African Cobra

World Malaria Day: What you should know

  
  
world malaria day, Global Rescue

In recognition of World Malaria Day (April 25), the Global Rescue Medical Operations team would like to share some important reminders about prevention and treatment of this life-threatening disease.

Malaria is found most often in Africa, Southern Asia, Central America, and South America, and is relatively rare in the United States. The disease is caused by a bite from a parasite-infected mosquito. Symptoms of malaria can include fever, chills, sweats, body aches, and muscle pain. Fever that goes away and returns is fairly common. Nausea, vomiting, abdominal pain, backache, and dark urine are also possible symptoms. More severe forms affecting mental status and organs typically require hospitalization.  Left untreated, malaria can be fatal.

1.       How do I know if malaria is an issue where I’m traveling?

For updated information on countries with malaria, use the resources available through either the Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO).  Both of these organizations have maps with malaria risk levels indicated by country, and for regions within countries as well.  Global Rescue members can contact Global Rescue for specific malaria advice, or can access country-specific information using the Global Rescue Mobile App. It is important to consider the time of year of your travel.  If a country has malaria, there is usually some seasonality to it. Typically malaria follows the rainy season, and is particularly active in the middle to the late part of the rainy season when water is pooling in areas; standing water allows malaria-carrying mosquito larva to populate. Additionally, the more rural your destination, the higher the likelihood of malaria being a concern.

2.       Who is at greatest risk?

Anyone who is not native to an area certainly faces an increased susceptibility to malaria.  There is a level of tolerance that develops over time in those who are born and live in areas with malaria.  A look at global statistics shows that greater than 75% of people who die from malaria are children under five years old. Weigh carefully any decision to travel with children to malaria-prone areas as they are the group that is most at risk for negative outcomes if malaria is contracted. The elderly are the next at-risk population, and the third class of traveler at an increased risk is pregnant women.

3.       How can I protect myself?

Take precautions such as wearing long sleeves, using DEET repellants to ward off mosquitoes, and sleeping under netting. Most countries typically have mosquito nets in stores and even supermarkets, but if you’re concerned that you won’t be able to find them, it is a good idea to buy them in advance. The insecticide treated nets are best. People sometimes pre-treat their clothing, too. There are anti- malarial prophylactic medications (preventative therapies) that one can take. It is important to note, however, that none of these treatments is 100 percent effective.  Seek advice from your regular healthcare provider, or a provider experienced in travel medicine to help decide which of these medications might be best for your individual health profile.

Again, it is always a good idea for travelers to check in with their primary care provider or a travel medicine professional before traveling for a detailed discussion of their risk for malaria.

Global Rescue’s own to run Boston Marathon

  
  
Bryan Ody, Global Rescue, Boston Marathon

Global Rescue’s Bryan Ody will be running the 2016 Boston Marathon on April 18, 2016, in support of the Martin Richard Foundation.

Bryan wrote on his fundraising page, “I am running the Boston Marathon this spring as part of TEAM MR8 for the Martin Richard Foundation. Martin was the 8 year old boy killed in the 2013 terrorist bombing of the Boston Marathon. Many can appreciate how terrorism and indiscriminate violence towards civilians has impacted our lives. As a retired veteran, this rings true more than most. I have chosen to fight against this violence by raising money in Martin's name. Martin had a message of ‘No more hurting people. Peace.’ I will carry that message to the finish line.”

Bryan, a U.S. Army veteran who ran his first marathon in Taji, Iraq, is honored to represent the foundation and be part of one of the greatest marathons on earth. To learn more or to donate to the Martin Richard Foundation, please go to http://www.firstgiving.com/fundraiser/bryan-ody/bostonmarathon2016.

Bryan Ody, Global Rescue, Boston Marathon

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An Italian motorcycle emergency

  
  
Julie Cook, Global Rescue, medical evacuation, motorcycle accident

Julie Cook with Global Rescue Senior Specialist paramedic Justin Romanello (l) and Supervisor Kyle Bertrand (r).

The roads of Italy lead through thousands of years of history, presenting spectacular views and faithfully following the contours of rugged mountain terrain, while providing the ultimate challenge and potential for peril to motorcyclists.

“We knew going on this trip that those were the most dangerous roads to ride on in the world,” recalled Julie Cook.  “That’s why we purchased Global Rescue. Thank God we did.”

It was the summer of 2015. Julie and her husband Eric were enjoying a tour through Europe on a new BMW R1200R as part of a small group led by a European motorcycle tour, where Julie is employed. “It’s a nice job perk, having the chance to take a tour that the company runs all over Europe. This year, we were riding through Slovenia, Czech Republic, Germany and Italy,” Julie said.

Then, on one of Italy’s tiny, winding roads, Julie and Eric’s motorcycle adventure took a sharp turn for the worse. Eric was driving and Julie was seated behind. It took only a split-second and suddenly the motorcycle fell off the road and flipped down the mountainside.  

“I knew instantly that my leg was broken,” said Julie. “I could feel it and I heard it. I heard it break. I couldn’t move at all. Eric was able to move around – although he was in pain.”

Help on the way

The tour leaders acted swiftly and called for a local ambulance. “Eric pulled his membership card out of his jacket and called Global Rescue,” Julie said. He told them that both he and his wife were being transported to a hospital in Tolmezzo, Italy, for evaluation.  “Both Eric and I immediately thought, ‘Thank God we have Global Rescue.’”

Upon initial assessment at the hospital, Julie was diagnosed with a lower right leg fracture. She was admitted to the hospital and scheduled to undergo a surgical repair of her leg the following day.

“It was difficult not being able to speak any Italian,” recalled Julie. “Once we were able to speak with Global Rescue, we knew that they had checked out the hospital and were doing everything possible to take care of us. It was such peace of mind.”

Global Rescue immediately deployed two paramedics to Julie’s bedside.

I remember Eric saying that Global Rescue would be here soon and would begin to figure out a plan to get us home. Knowing that two Global Rescue people from the States were coming to help us get through this really helped me stay strong.”

When Global Rescue’s paramedics arrived, Julie greeted them with smiles and tears.

“It was a very happy moment,” said Julie. “All of my worries and all of the unknowns disappeared. The Global Rescue team took control of the situation and started making a plan to get me safely and comfortably back home. I will never forget how wonderful they were and how much they did to make my transport comfortable.”

Julie continued, “I felt so much relief once they explained how everything was going to happen, from beginning to end. They were on top of everything, including coordinating with hospital medical staff and sending my medical records to the Global Rescue medical team. When you’re injured, you just can’t deal with everything on your own. There’s no way my husband, who had torn ligaments in his knee, could have dealt with everything that happened.”

Global Rescue, Italy, Julie Cook

Julie with the Global Rescue team in Italy

Distraction by iPad

Boredom set in quickly for Julie with no landline in the hospital room, no international calling plan, no TV in the room and no air conditioning.

“When you’re going through that type of pain and you don’t have any way to distract yourself, it’s very difficult. One of Global Rescue’s paramedics said, ‘I have my iPad and I have some movies on it.’ He lent me his iPad, which was just the nicest thing. I was able to watch movies and take my mind off of everything for a while. If those Global Rescue guys had any way to help, they were there to help. They did everything they possibly could.”

The Global Rescue team accompanied Julie and Eric home.  “I was happy to learn that I wasn’t going to have to fly home in a normal seat. They upgraded me to first class,” said Julie.

Back home

Once at home in New York, Julie faced a long recovery following multiple surgeries. She was instructed not to put any weight on her leg for three months.

“I had broken my tibia, my fibula, and I had a rod going down my leg and pins and screws holding it together.  I had broken off the right hand side of my knee.”

Although confined to a hospital bed in her living room, Julie maintained a positive outlook. “I’m typically super healthy and active. Nothing gets me down. I’m always on the go and considered the healthy one. We have a wonderful family that keeps me company and brings me coffee.  I’m feeling better now that this last surgery is over, knowing that I’m finally on my way to healing and getting better.”

Julie is unsure if another motorcycle trip will be in her future. “My husband probably would go,” she said. “We knew going on this trip that those were the most dangerous roads to ride on in the world. That’s why we purchased Global Rescue. Thank God we did. I’d probably still be in Italy because there was no way we could have afforded to be transported the way we were. We were lucky that we’d asked ourselves beforehand whether coverage was worth it.  You just never know what can happen.”

“I cannot imagine how much pain and how many problems we would have had to endure without the help of Global Rescue,” said Julie. “We are so happy with Global Rescue. I will be recommending Global Rescue to all of our motorcycle tour clients.” 

 

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Thin Air Park City: Innovation in Peak Human Performance

  
  
Thin Air, Global Rescue, Dan

(Photo courtesy of Veristride)

Global Rescue CEO and Founder Dan Richards shared his views on the topic, “Teams Operating on the Edge of Human Performance” during Thin Air Park City in early April. Richards was part of a panel of elite athletes and executives discussing ways to optimize team dynamics and support to enable the full potential of human performance.  The session followed opening remarks by Under Armor CEO and Founder Kevin Plank and Fortune Magazine’s Managing Editor Adam Lashinsky.                                                              
Joining Richards on the panel were Tiger Shaw, CEO of US Skiing & Snowboard Association; Paul Winsper, Vice President of Performance at Under Armour; Luke Bodensteiner, Executive VP of Athletics for USSA; and Richard LePage, Director of Coaching and Performance at Cirque du Soleil.

With a 2016 theme of “Innovation in Peak Human Performance,” Thin Air Park City gathers groups of inspired people to Park City, Utah, each year to solve business challenges and foster innovation.

 

"If it weren't for Global Rescue, I probably wouldn't be here."

  
  

Melissa Corn, Global Rescue, medical evacuation, South Africa

Global Rescue Associate Director of Medical Operations Devon Davis, MD (l), Geoffrey Corn, Missy Corn, and Global Rescue Supervisor of Medical Operations Patrick Longcore.

On safari in the Eastern Cape Karoo region of South Africa in January 2016, Global Rescue members Missy and Geoffrey Corn were having the time of their lives. It was their fourth trip to Africa and the couple was looking forward to creating memories of a lifetime. Little did they know that Missy was about to suffer a potentially life-threatening stroke on the first day of their trip, thousands of miles from home.

Global Rescue received a call from the outfitter for the Corns’ trip. The caller urgently stated that Missy was suffering from signs of a stroke -- facial drooping, left arm and leg weakness, confusion, and speech difficulty.

With time of the essence, Missy was immediately transported to the hospital via ambulance after an evaluation by a local physician.

Preparing for the worst

Global Rescue Operations personnel immediately contacted the hospital, liaising with Missy’s physician there to discuss treatment. The company deployed one of its physicians and a critical care paramedic to Port Elizabeth to Missy’s bedside to oversee her care and later evaluate her stability for a flight back to a hospital close to home.  

Upon arrival at the hospital, Missy underwent radiological studies showing an ischemic stroke and large arterial clot in the right brachial artery.  She was admitted to the intensive care unit for care and observation. Subsequent radiology revealed progression to a hemorrhagic stroke but no other new brain injury.

While in South Africa, Global Rescue’s medical personnel helped to obtain Missy’s medical records for Global Rescue doctors to review.  Through a consultation with Johns Hopkins Medicine, with which Global Rescue has an exclusive relationship, physicians there agreed with the Global Rescue medical team’s assessment and guidance on continuing medical care.

The Global Rescue team evaluated transport options. Determining Missy’s case to be critical, the team initiated an air ambulance to conduct medical repatriation back to her home hospital.

An unexpected delay

Then, a further complication: radiological studies of Missy’s lungs showed the presence of multiple pulmonary emboli, including the main pulmonary artery. The critical nature of her condition required cancelling the air ambulance evacuation based on the possibility of it proving fatal (the jet had traveled from Europe and was refueling in Namibia at the time the mission was scrubbed).  With the presence of new clotting, an anticoagulation medication was needed. Yet, due to the previous discovery of bleeding in Missy’s brain, this medication could potentially cause further bleeding and also prove fatal. 

 With no other option, anticoagulation was initiated and she was transferred to the ICU for close observation.

After spending the weekend in the ICU and developing no new issues with the medication, Missy was transferred to the general ward. Over the next two weeks, she worked with physical therapy and our deployed personnel as she prepared for her return to the U.S. 

Based on improvement in her condition and the physician’s recommendations, Missy was finally determined to be fit to withstand the long flight home after [another week] of rehab and stabilizing care. Global Rescue medical personnel identified a comprehensive stroke center in the Denver area, the closest suitable facility to the Corns’ residence.

Missy was discharged from the hospital to the care of Global Rescue paramedics, who accompanied her from the South African hospital to the facility in Denver, Colorado. 

MissyCornresized resized 600

Missy Corn

A personal touch

Missy praised the Global Rescue paramedic who was at her bedside for weeks in South Africa.

“He knew everything that was going on medically with me and would explain it to me,” she said. “When I ended up back in the ICU, he came every day and kept track of me. He talked to my sisters and knew everything about my care and my doctor. When I didn’t know what was going on, he just handled it. Then when my husband left and I was there by myself, it was even more important to have him there.

She continued, “Anything I needed, he got it for me. He smuggled in blueberries because I was losing weight and couldn’t eat the food in the hospital.  I broke out in a horrendous rash from the soap they washed me with, and he went and got me little bars of soap so I wouldn’t break out. He held my hand when I needed it.

“He was amazing, all that he did for me.  If it weren’t for Global Rescue, I probably wouldn’t be here,” said Missy, emotionally.

Recovering back home

Upon arrival at the Denver hospital, Missy was transferred to the neurological unit for evaluation. 

After a successful transport home accompanied by two members of Global Rescue’s transport team, Missy was able to continue her recovery. Following an evaluation in Denver, she was transferred to an inpatient rehabilitation facility in Kansas. In March, she was discharged to her home.

“I’m working therapy five days a week and I can walk without a cane now,” said Missy. “The fine motor skills in my left hand are coming back slowly. It’s not where I need to be yet, but I’m trying to get back into my daily routine.”

Missy is on track for a good recovery. In fact, she and her husband already have plans to return to South Africa in September if she is well enough. Once again, they will head out on safari.

“I tell all my friends and family that if they’re doing any travel, I recommend Global Rescue highly,” said Missy. “We purchased annual Global Rescue memberships this year and it was worth every penny.”

 

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Zika virus: Will it come to the U.S.?

  
  
Zika, Global Rescue, medical advisory services

Will Zika come to the U.S? Global Rescue Intelligence and Medical Operations teams provide our members with the update below regarding the Zika virus and the potential for locally-acquired cases in the U.S.

Overall, the local spread of Zika in the U.S. remains a possibility, particularly in Southern states, given the established populations of Aedes mosquitoes and the warming weather due to the approaching summer season.

Read on for full details.

United States

Thus far there have been no documented cases of mosquito-borne transmission of Zika virus in the continental US. However, cases have been confirmed in people who have traveled to Zika-infected countries or acquired it through sexual transmission. According to the Centers for Disease Control and Prevention (CDC), between 1 January 2015 and 30 March 2016, at least 312 cases of travel-related Zika virus have been confirmed in the continental US, with the highest number of cases reported in Florida (74), New York (46), Texas (27), and California (17). Of the 312 travel-associated infections, 27 were in pregnant women, six were sexually transmitted, and one had Guillain-Barré syndrome.

Although it is impossible to predict whether the virus will spread to mosquitoes in the continental US, sporadic small-scale outbreaks of dengue and chikungunya—similar tropical mosquito-borne diseases spread by the Aedes mosquito—have been reported in the past in south Florida and southern Texas. For example, in 2014 Florida reported 12 locally acquired cases of chikungunya. Some cities in the southeastern and eastern coastal regions of the US might be more prone to Zika transmission due to established populations of Aedes mosquitoes. However, in order for local transmission to take place, the Zika virus would need to be introduced by an infected traveler or infected mosquitoes and become sustained in an established population of Aedes mosquitoes.

Both the Aedes aegypti and the Aedes albopictus species of mosquitoes are known to spread Zika. The two species need warm and relatively stable temperatures to survive and standing water to reproduce. According to a National Institute of Health (NIH) study, about 200 million citizens—more than 60 percent of the US population—reside in areas of the US that might be conducive to the spread of Zika virus during summer months due to the presence of Aedes mosquitoes. According to the CDC, populations of at least one of the two Zika spreading mosquitoes are found in 38 states from California, southeast to Florida, and northeast to Maine (see map below). The southern and southeastern regions of the U.S. from California along the Gulf Coast and up the eastern coast to Connecticut contain both the Aedes aegypti and the Aedes albopictus mosquitoes.

Meteorological conditions favorable for the Aedes mosquitoes are not present in the US during winter months from December to March, except for south Florida and southern Texas. However, weather conditions become more suitable for Aedes mosquitoes during peak summer months from July to September. A March 2016 study conducted by the National Center for Atmospheric Research (NCAR) and the University Corporation for Atmospheric Research (UCAR) simulated climate data and other information such as mosquito populations, air travel from Zika-affected countries, and poverty to investigate the likelihood of Zika spreading in 50 US cities. According to the study, by mid-July meteorological conditions in southeastern cities will be suitable for “high abundance” of the Aedes, eastern cities will be suitable for “moderate-to-high abundance”, and cities in western US are suitable for “low-to-moderate abundance.” Nine of the cities studied could have a “high abundance” including New Orleans, Mobile, Tallahassee, Tampa, Miami, Orlando, Jacksonville, Savannah, and Charleston. According to the study, US cities most at risk are Miami, Orlando, Savannah, and Charleston. US cities with moderate risk are New York, Philadelphia, and Washington, D.C.

Outlook

Overall, the local spread of Zika in the US remains a possibility, particularly in Southern states, given the established populations of Aedes mosquitoes and the warming weather due to the approaching summer season. However, public health experts say that any US outbreaks are expected to be small and short-lived due to the vastly different conditions from countries that are experiencing widespread transmission. Many countries that have experienced a rapid spread of Zika are poorer and lack adequate public health response capabilities, limiting their abilities to contain and combat the virus. For instance, in countries where air conditioning is not commonly used and/or screens are not widely used on windows and doors, people are exposed to open air (and thus mosquitoes) for longer periods of time, allowing the virus to spread more easily. Conversely, in the US, well-built homes, screened windows, air conditioning, and access to mosquito preventative products are likely to limit or even prevent the spread of the virus.

  Zika mosquito, Global Rescue

Background

Zika virus is an acute viral illness that is primarily transmitted through the bite of an infected Aedes species mosquito that has previously fed on a person infected with the Zika virus. Zika can also be transmitted from mother to fetus, through blood transfusion, and through sexual contact. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis. However, symptoms are usually mild and only last from several days to a week. About 80 percent of people infected do not experience symptoms. There is growing evidence linking the disease to birth defects and neurological complications. There is currently neither a vaccine nor a cure.

Prior to 2015, local transmissions of Zika virus had largely been confined to Africa, Southeast Asia, and the Pacific Islands. Zika was first discovered in Uganda in 1947 and only 14 cases were confirmed from 1947 to 2007, all of which occurred in West Africa and South Asia. In 2007, the first outbreak was reported in Oceania when over 185 cases were confirmed in the Yap Islands, an island chain in the Federated States of Micronesia. The virus then appeared in October 2013 in French Polynesia.

In May 2015, an outbreak of the virus began in Brazil and by 1 April 2016, 34 countries and territories in the Americas have reported local transmission of the virus. The recent outbreak of Zika has been strongly linked to birth defects, including microcephaly, an abnormal smallness of a newborn’s head associated with incomplete neurological development. The incidence of Zika has also been correlated to an increase in cases of Guillain-Barré syndrome, a syndrome in which the body's immune system attacks part of the peripheral nervous system, causing paralysis.

In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infection in Brazil and on 1 February 2016, the World Health Organization (WHO) designated the Zika virus as a global public health emergency requiring a coordinated response, placing the disease in the same category of concern as Ebola. It is expected that Zika virus transmission will increase throughout the region increasing the incidence of infection in returning travelers and the possibility of local transmission in the US.

To stay up to date on Zika virus developments, visit our landing page. It is updated regularly with the countries that have reported locally transmitted cases of the virus and the latest information available.

Questions? Contact us at 617-459-4200 or memberservices@globalrescue.com. 

State Dept. travel alert for Europe: Is it safe to go?

  
  
Paris, travel alert, Arc de Triomphe, Global Rescue

The US Department of State (DoS) issued a Travel Alert to US citizens on 22 March warning of potential risks of travel to and throughout Europe due to the threat of terrorism following recent attacks.

What does the alert mean for those considering European travel? Global Rescue Intelligence and Security Operations personnel offer the following assessment of the alert and advice.

Background

According to the Travel Alert, terrorist groups are continuing to plan attacks in the near-term in countries across Europe, particularly targeting large sporting events, tourist sites, restaurants, and transportation. The Travel Alert is scheduled to expire on 20 June 2016. In the Travel Alert, the DoS does not advise against travel to Europe, though it encourages all US citizens to exercise caution in the coming months and to avoid crowded public areas.

The DoS Travel Alert was issued following the coordinated terrorist attacks in Brussels, Belgium on 22 March that killed at least 31 people and injured 230 others. At least 11 of the fatalities were caused by two explosions at Brussels Zaventem Airport (BRU), and at least 20 were the result of a third explosion at Maelbeek/Maalbeek metro station, near the headquarters complex of the European Union Commission. The Sunni terror group the Islamic State (IS) has claimed responsibility for the attacks.

Also, on 23 March the Associated Press (AP) reported that IS has trained at least 400 fighters to target Europe in a wave of attacks. The AP cited unnamed European and Iraqi intelligence sources, in addition to a French lawmaker. It remains unclear whether this is directly linked to the DoS alert.    

In addition to the latest attack in Brussels, there have been other mass casualty terrorist attacks in Europe in the past 12 years, including:

·         13 November 2015 – Paris, France: 130 people were killed in a series of coordinated attacks across the city, including at the Stade de France, the Bataclan concert hall, and a number of restaurants and cafes. IS claimed responsibility for the attacks.

·         7 January 2015 – Paris, France: 12 people were killed in a series of attacks that began with a shooting at the Charlie Hebdo offices. The terrorist group al Qaeda in the Arabian Peninsula (AQAP) claimed responsibility for the attacks.

·         7 July 2005 – London, United Kingdom: Multiple suicide bombings targeted the London Underground and a bus, killing 52 people and injuring hundreds of others. Al Qaeda claimed responsibility for the attack.

·         11 March 2004 – Madrid, Spain: Coordinated bombings on commuter trains and stations killed 19 people and wounded more than 1,800 people. Al Qaeda claimed responsibility for the attacks.

Assessment

The terrorist threat in Europe differs in some respects to the terrorist threat Americans face at home. As demonstrated with the November 2015 Paris attacks and the latest attacks in Brussels, which both required a degree of planning, terrorist cells have successfully been able to coordinate with one another across borders to plan attacks. These networks can be (and have been) cross-national, further complicating coordination between intelligence and security agencies. In addition, the mass migration from the Middle East to Europe, which has represented the greatest movement of people in Europe since World War II, has continued to present immense security challenges to European governments. In the United States, however, most recent attacks have been “lone wolf” style where one or two individuals become radicalized and carry out less sophisticated attacks without a command structure or larger conspiracy. This is how the attacks in San Bernardino, California transpired in December 2015, as well as the Boston Marathon bombing in April 2013.

While travelers to Europe should take the DoS alert into account while traveling, it should not necessarily deter travel to Europe in the coming months. The threat of terrorism is not new to Europe, which has been dealing with a variety of terrorist organizations for decades. The probability of being affected by a terrorist attack when traveling abroad (and even at home) remains very small, and travelers should not necessarily let this latest threat disrupt future plans. Travelers to Europe should, however, maintain awareness of any possible future or more specific alerts and warnings put out by the government agencies.

Advice

The most important piece of advice for travelers will be to practice patience and account for longer wait times at airports and train stations.  In order to reduce these wait times, and reduce the amount of time travelers will spend outside of security, travelers should:

·         --Arrive early during non-peak times and avoid rush hour. 

·         --Conduct early check-in, if available.

·         --Only pack enough luggage that can be comfortably carried or rolled.  If possible, try to pack carry-on only.

Prior to travelling, always conduct research on your destination.  Most governments offer up-to-date travel alerts and restrictions on their foreign office’s website or Twitter feed. Many offer an email alert subscription as well. Register your travel with your embassy’s travel notification program so you will be kept informed of any alerts.

While traveling within a city, consider using taxi or ride sharing services (such as Uber) to reduce exposure to crowds and large gatherings. Always have local currency and an ATM or credit card available. This will allow you to pay for transportation and other needs in the event of an emergency. Also, always have a paper map available to use in the event cellular and/or internet connection is limited and you need to navigate across the city. Ensure your travel companions are using the same map. Local maps are often provided by hotels.

Have a plan to communicate with someone back home, in case of emergency or in the event of a crisis or attack.  Cellular networks can become quickly overwhelmed, as was the case in Brussels and Paris immediately following the attacks, so having alternate means of communication is a must. 

·         --A satellite phone is a great option.

·         --Utilize an internet connection to communicate via email, messaging app, or social media.

·         --Leave an itinerary and hotel information with someone back home, and communicate any changes to travel plans.

·         --Establish and review a rally point with your travel companions each day (such as your hotel). If you are separated for whatever reason and cannot communicate with one another, meet at that location.

Lastly, if travelers should find themselves in a dangerous situation, remember to move away from the area as quickly and safely as possible. Follow all instructions from emergency personnel, and do not attempt to return to the scene to help or gawk. Remember that your life is not worth recovering luggage or capturing a cellphone video. 

 

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Trouble in Kamchatka: “I might lose my arm, or it might kill me if the infection gets to my heart.”

  
  

Sirles mike2 resized 600Scott Sirles in Kamchatka before his trip was cut short by a dog bite

Global Rescue member Scott Sirles traveled to a remote region of Russia in search of one thing: The perfect fly fishing spot fully stocked with king salmon and rainbow trout.

“I was going to Kamchatka to go fly fishing in the Ozernaya River. It was a beautiful setting,” said Sirles. “Everything was wonderful -- absolutely superb fishing, almost a fish every cast. There were no roads within 200 kilometers of us. The only way to get to it is to helicopter in. It’s truly wilderness.”

Accompanying Sirles and his group was a Russian Laika, a breed of hunting dog used to scare off any grizzly bears that could wander too close to the camp.

One morning as Sirles went to breakfast, he noticed the camp dog sitting in front of the building. “I reached over and scratched its ears and he was fine,” said Sirles. “He had a bunch of mosquitoes on the top of his nose. I thought I’d do him a favor and brush those mosquitoes off. Well, as soon as I did that, the dog latched on to my wrist!”

The dog’s bite left an inch long and ¾ inch deep gash in Sirles’ wrist, damaging one tendon but luckily missing any arteries.

Two doctors in the fishing camp used an iodine-based solution to clean out the wound before wrapping Sirles’ hand in gauze. They later treated him with antibiotics when his wound became red and swollen after another day of fishing.

Two days after the incident, Sirles woke to find his entire forearm red and swollen. “I wasn’t really terrified. I’ve had incidents in the past where I ran a stick right through my hand when I was hunting years ago. My hand got infected and I walked into the hospital with the streaks going all the way up my arm. They put a few bags of antibiotics in an IV and sent me on my way. This time, I’m thinking to myself that I’m out here in the middle of nowhere and need to get some bags of antibiotics. I knew if I stayed here, it was going to get worse. I might lose my arm, or it might kill me if the infection gets to my heart. I didn’t have any other choice. I had to call Global Rescue and get evacuated out. So that’s what we proceeded to do.” Using a satellite phone, Sirles called Global Rescue.

Global Rescue’s Operations team spoke with Sirles about his condition, then quickly arranged for his evacuation to Petropvalovsk-Kamchatsky -- the nearest city with a suitable hospital.  The Operations team obtained Sirles’ medical reports while he was examined at the hospital, and maintained constant contact with the hospital’s doctors to ensure that Sirles received proper care.

Sirles had developed a serious infection.  “If not for Global Rescue, I might have had a much worse infection or lost an arm,” he said.

After conferring with Global Rescue medical personnel, doctors at the hospital sedated Sirles and operated on his hand to fully clean out the infection.

Following a brief hospital stay, Sirles flew back to his home in Oklahoma, where he made a full recovery.  He is back to work and to traveling. “Everybody was super at Global Rescue. They were always contacting me when they said they would and did everything they could,” said Sirles. “The cost of the extraction would have been almost prohibitive without the coverage. I wouldn’t go anywhere remote again without Global Rescue.” 

 

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Giraffe attack!

  
  

 

Video of the giraffe that attacked Daniel Core, seconds before the incident

“I saw the giraffe pick up his right hoof and I thought, ‘he’s going to kill me.’”

While driving to their hotel inside Zimbabwe’s Mosi-oa-Tunya National Park, Daniel and Laura Core’s guide spotted two giraffes walking near the path. “The guide told us that it was OK to get out of the cart and take pictures,” said Daniel. “We were just filming the giraffes, didn’t get too close, and out of the corner of my eye is a really big giraffe coming from the opposite direction.”

An experienced veterinarian, Daniel was familiar with the signs of a hostile animal. “He didn’t lay his ears back, didn’t stomp, didn’t blow or anything like that. He just walked his way slowly up the game trail,” Daniel recalled.  

Laura, Daniel’s wife, began filming the bull giraffe as it approached.

Run!

When the giraffe was 20 yards away, Daniel’s guide picked up a branch and waved it in the air to scare it away. “About 30 seconds after that, I walked up to see what was going on. I heard our guide scream ‘Run!’” remembered Daniel. “In Africa, when your guide screams ‘run,’ it’s bad.”

Bull Giraffe Attack

The giraffe took one more step and swung its head “like a wrecking ball,” catching Daniel in the chest. The impact lifted Daniel into the air and threw him onto a pile of rocks. “I’ve been hit by bulls and kicked by horses, and I played football all through college. But, I’ve never been hit that hard in all my life,” he said.

Ten feet away, Laura was lying on the ground, “playing dead” so the giraffe would not attack her. “I saw the giraffe pick up his right hoof and I thought, ‘he’s going to kill,’” Daniel recalled. “Fortunately, my wife had dropped her purse about a foot and a half away from her torso. What the giraffe had his eye on was the poor purse. He came down on it and it just exploded.”

Daniel scrambled to his feet, grabbed his wife, and rushed to the cart. The guide gunned the engine and the three raced down the path.

After escaping the giraffe, Daniel took stock of his injuries. “I had about a three inch cut on my head and I could tell big contusions and bruises were coming.”

An Emergency Call to Global Rescue

Daniel and Laura went to the game reservation’s clinic to get patched up. With basic medical facilities and a registered nurse as the only healthcare options, Daniel turned to Global Rescue. He took pictures of all his injuries and emailed them to the Global Rescue Operations team.

Global Rescue’s medical team immediately reviewed his injuries and provided medical advice. Global Rescue’s team of physicians determined that there were no broken bones, no blood in his lungs, and no symptoms of a head injury. Daniel lucked out. He was bruised, but he’d be fine.

The Cores took another cart to their hotel room. “Right before we arrived at the hotel room, guess who’s standing there, straddling the path? The giraffe.” Fortunately, this time the Cores were able to pass by the giraffe without any conflict.

Everything Ends Well

“I was very happy and pleased with the way Global Rescue handled my case. I’m a small animal veterinarian and I deal with bad stuff all the time, but I don’t know everything. I felt like I was in good hands and that, if I needed anything, Global Rescue would be able to handle it.  Everything ended well.” said Daniel.

Undaunted by the giraffe attack, the Cores continued their vacation through Africa. “Everywhere we went, people would ask, ‘did you hear about the American couple that got attacked by the giraffe?’” Daniel recalled. “We’d say, ‘yes, we’re intimately associated with them.’” 

Giraffe attack, Global Rescue

 

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