“Do I have to be an American citizen to join Global Rescue?” It’s one of the questions we hear often. We thought it would be helpful if we regularly highlighted a few of these frequently asked questions (FAQs) along with the answers. Here is the first post in the series.
Q: Do I have to be an American citizen to join Global Rescue?
A: Global Rescue membership is available to anyone, regardless of his or her country of citizenship. We have thousands of foreign national members who enjoy the exact same benefits as U.S. citizens.
Q: Why do I need Global Rescue when I have travel insurance?
A: Because no other service provides the resources, expertise and boots-on-the-ground capabilities of Global Rescue. If you’re concerned about lost luggage, cancelled trip, or don’t have medical insurance, we are an excellent complement and improvement on standard travel insurance. Global Rescue advises and helps manage your medical or security emergency while you are experiencing it. However, with travel insurance you must manage the emergency by yourself, and later submit receipts to get expenses reimbursed.
Global Rescue is a membership organization that provides medical, security, advisory, intelligence, and evacuation services for members who require inpatient hospitalization more than 160 miles from home.
Members pay a flat membership fee up front, and all costs associated with advisory services or an evacuation from the point of injury or illness, to the home country hospital of choice (or home country, in the event of a security evacuation), are included in the cost of membership. Since a Global Rescue membership is not insurance, there is no out of pocket payment or deductible. It should be noted that Global Rescue does not cover medical bills, trip cancellations, baggage loss, delayed flights, etc.
Q: Do you have restrictions on where I can travel? On elevation/altitude? On activities?
A: The standard Global Rescue membership is in effect anywhere other than the polar regions -- below 60 degrees South latitude and above 80 degrees North latitude. We do not have altitude or activity restrictions for Global Rescue members. We strongly advise climbing members to educate themselves on preventing acute mountain sickness (AMS). It should be noted that helicopter options above 20,000 feet are limited and evacuations above 20,000 feet can be
time-consuming and difficult.
Do you have a question about Global Rescue membership? Add it in the Comments below.
Over the past decade, Global Rescue has been very active in the Himalaya, advising and evacuating hundreds of our members who have faced severe illness and injury while climbing Everest and other peaks.
Recently, however, in addition to the perilous nature of the climbs themselves, climbers and trekkers have faced another danger: the threat of forced or coerced evacuations in non-emergencies as part of fraudulent practices by some in the Nepalese helicopter industry.
We posted about this issue first in June 2013 and again in December 2013, with advice on how to avoid being victimized by this corruption.
For several years, Alpine Rescue Service has been working diligently to put an end to this fraudulence. Climbers and trekkers will be pleased to know that progress is being made. ARS wrote in its June newsletter that its effort to suppress fraudulence “is gaining rapid momentum through collaborative efforts of our insurance partners.” These insurance partners have been investigating questionable cases that resulted in evacuations and visiting the offices of the service providers who initiated these evacuations. ARS writes that it is “hopeful that this initiative will ensure that fraudulence is minimized significantly and emergency medical assistance for travelers to Nepal will ultimately foster with genuine cases demanding the same.”
With the spread of the Ebola virus in West Africa, many organizations are seeking guidance on how to best protect their employees in the region. The majority of questions have been about the risk of travelling into the affected and nearby countries: Is it safe to travel? Should there be suspension of employee travel to certain countries? If so, for how long?
Global Rescue recommends evaluation of the best course of action for your organization within a range of possible options and your decision-making process.
The World Health Organization (WHO) declared an international public health emergency on August 8th, signifying the outbreak of the Ebola virus as an extraordinary event with possible international consequences if the virus continues to spread. The situation on the ground is very fluid, with new cases and deaths being reported daily in the three primary affected countries (Sierra Leone, Liberia, and Guinea). In addition, there have been 13 cases, including two deaths, identified in Nigeria as of August 11th. Health screenings have been implemented at airports and border crossings in the region, and multiple airlines have ceased their activities to and from the three primary affected countries. Authorities in the affected areas are implementing strict screening and quarantine measures, and movement of people across borders, with illness symptoms similar to those found in Ebola (fever, vomiting, diarrhea) will likely be impossible. Despite these control measures, the outbreak is expected to continue for a period of at least one or more months.
Three alternatives exist for travel policy as current choices for organizations doing business in the geography impacted by Ebola:
Option #1: No restrictions on travel
This choice provides for corporate travel into the impacted area with the understanding that the risk to your employees is very low --- assuming they are not engaged in direct healthcare activities, preparations of remains for burial, or ingestion of infected animal products. It assumes that your employees can aggressively and consistently adhere to the recommended avoidance and protection practices recommended by the WHO and the Centers for Disease Control and Prevention (CDC). It also assumes your employees will monitor alerts and other travel warnings in their region, and that they will be able to take action to adjust their travel and movement as needed to minimize further risk.
There are indeed many organizations and corporations which are currently employing this strategy (within the affected areas), particularly if their work is mission-critical, and unable to be interrupted.
Risks to consider with this option:
--Travel may become limited or restricted further, i.e. employees may not be able to move out of the country when they need or want to.
--Limited access to safe and adequate health care in local or nearby facilities. There is no way to guarantee that a facility will not have Ebola cases in house. Transmission within the hospital setting is a very real concern in the affected areas.
Option #2: Restriction of travel to business critical
The second option is a curtailment of travel to business critical trips only. The CDC has recommended against all non-essential travel to Liberia, Sierra Leone, and Guinea. This strategy prohibits non-essential travel to these areas, as well as recommends strong consideration for removing personnel currently in these areas. An organization’s management would need to be able to define what activities and projects are “business critical,” both in terms of requiring on-the-ground presence and that the activity cannot be deferred until the outbreak is over.
Global Rescue has a number of clients that are adopting this strategy for the three affected areas as well as Nigeria.
Option #3: Banning travel
The highest level of protection for employees is a complete ban on corporate travel to one or more of the affected countries. This approach also includes consideration of facility shutdown and potential removal of all employees currently in the named country.
While providing the highest level of protection against possible exposure to the Ebola virus, this option severely limits an organization’s ability to continue business-as-usual in these areas, and may require shifts in project timelines and resource allocation. This kind of restriction can be very disruptive, but is sometimes chosen in very high risk situations.
There are a number of corporations and/or organizations that have adopted this strategy in response to this current Ebola outbreak, despite the disruption to business activity. For example, the Peace Corps has temporarily removed its volunteers from Liberia, Sierra Leone and Guinea.
Only an organization’s management can decide what is their best approach given the risks to their employees. Global Rescue is available to provide guidance, information, training and support to our members regarding travel to West Africa and other countries of concern. Stay informed with alerts from GRID, the travel risk product from Global Rescue. Contact us at 617-459-4200 or visit www.globalrescue.com for assistance in developing your corporate travel advisory policy and for additional recommendations on employee education and pre-travel procedures.
After a fall during a motorcycle trip in Alaska, Global Rescue member Mike Sonderby shared a detailed account of his rescue together with dramatic photos of his medical evacuation by Global Rescue:
“On a motorcycle trip in Alaska between Coldfoot and Deadhorse on the Dalton Highway, one afternoon I lost control of my bike due to unforeseen loose gravel in the roadway. The bike took me off the roadway and flipped me off. My back and foot were injured to the point where the EMTs immobilized me and I was helicoptered to Deadhorse (Prudhoe Bay) for a medical evaluation.
“Due to my injuries, I was put on a medevac jet plane and immediately flown to Anchorage, Alaska, where I was admitted to Providence Health Services Hospital. Further evaluation determined that I had broken my T6 vertebrae and four ribs. My left foot had also suffered a gash and required stitches.
“Two days later, surgery was performed on my broken vertebrae, with titanium rods fused to vertebrae T4 to T8, stabilizing T6. After surgery, my pain level was quite high. Global Rescue spoke with me about getting to my home in Lewes, Delaware, with the doctors estimating that I would be ready to travel within a few days. Global Rescue found a first class seat for me to Philadelphia. I left the hospital early one evening and was at my door step the following day at noon. The Global Rescue team made all of the arrangements for wheelchair attendants at the airports, including a plane change in Chicago. Global Rescue coordinated limousine service from the hospital to the Anchorage airport and from the Philadelphia airport to my home in Delaware approximately two hours away. The trip was relatively quick by reason of the efficient routing, and all wheelchair and limousine service was executed without flaw. Prior to my departure and upon my arrival at home, Global Rescue was in contact with me.
“I was completely satisfied with Global Rescue’s level of service in handling all of the logistics around my trip from Anchorage to my home. In the future, I will buy Global Rescue coverage for my trips, particularly those that are adventures and in remote areas of the world. It was a great buy!”
The growing Ebola crisis prompted the U.S. Centers for Disease Control and Prevention to issue a warning on July 31 against non-essential travel to Guinea, Liberia, and Sierra Leone, the West African countries experiencing the outbreak. Also on July 31, the government of Sierra Leone declared a public health emergency to ensure a proper response plan was being implemented to handle the outbreak of the Ebola virus. Additionally, the Ghanaian government announced on July 31 that enhanced medical screening in the form of body temperature scans will take place for those arriving at border crossings as well as at Kotoka International Airport (ACC) in the capital, Accra. Quarantine areas will also be set up at ACC and the country’s border crossings.
Global Rescue is advising our members to closely adhere to the World Health Organization guidelines:
· Infection by the Ebola virus is by contact with blood or body fluids of an infected person or animal, or by contact with contaminated objects:
- Contact with blood or bodily fluids of a person or corpse infected with the Ebola virus.
- Contact with or handling of wild animals, alive or dead or their raw or undercooked meat.
- Having sexual intercourse with a sick person or a person recovering from Ebola virus disease (EVD) for at least 7 weeks.
- Having contact with any object, such as needles, that has been contaminated with blood or bodily fluids.
- Symptoms include fever, weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, rash, and in some cases, bleeding.
- Persons who come into direct contact with body fluids of an infected person or animal are at risk.
- There is no licensed vaccine.
- Practice careful hygiene and other preventive measures:
- In case of a passenger presenting with symptoms compatible with EVD (fever, weakness, muscle pain, headache, sore throat, vomiting, diarrhea, bleeding) on board of an aircraft, the following measures should be immediately considered, in accordance with operational procedures recommended by the International Air Transport Association (IATA):
- Distancing of other passengers if possible from the symptomatic passenger (re-seating); with the ill travelers preferably near a toilet, for his/her exclusive use.
- Covering nose and mouth of the patient with a surgical facemask (if tolerated).
- Limiting contacts to the passenger to the minimum necessary. More specifically, only one or two (if ill passenger requires more assistance) cabin crew should be taking care of the ill passenger and preferably only the cabin crew that have already been in contact with that passenger.
- Hand washing with soap after any direct or indirect contact with the passenger.
- Immediate notification of authorities at the destination airport in accordance with procedures promulgated by the International Civil Aviation Organization (ICAO).
- Immediate isolation of passenger upon arrival.
- Avoid all contact with blood and body fluids of infected people or animals.
- Do not handle items that may have come in contact with an infected person’s blood or body fluids.
- Avoid contact with wild animals. Do not eat primate meat (“bushmeat”).
- Practice good hand washing.
- If you have stayed in the areas where Ebola cases have been recently reported, seek medical attention if you feel sick (fever, headache, achiness, sore throat, diarrhea, vomiting, stomach pain, rash, or red eyes).
- The incubation period of EVD varies from 2 to 21 days. Person-to-person transmission by means of direct contact with infected persons or their body fluids/secretions is considered the principal mode of transmission. In a household study, secondary transmission took place only if direct physical contact occurred. No transmission was reported without this direct contact. Airborne transmission has not been documented during previous EVD outbreaks.
The following link can be accessed for more information: http://www.who.int/ith/updates/20140421/en/
Call Global Rescue immediately at 617-459-4200 if you are a traveling Global Rescue member and have questions, symptoms, or concerns about your health.
For the first time in their extensive travels, Lorne and Mary Liechty purchased a Global Rescue membership. For the first time, they needed it. On only his second day in Zimbabwe, Lorne found himself with an eye irritant that felt as if someone had stuck a needle in his eye. Four hours from the nearest medical facility, Mary turned to Global Rescue.
“We were trying as hard as we could to do what we knew to do,” Mary explained. She had attempted to flush the piece of debris out twice after Lorne complained that it felt as if it were poking into his cornea. “We talked to his personal ophthalmologist and then to his specialist. He has macular degeneration, and the specialist assured us it had nothing to do with the MD, and that it was likely something foreign in his eye. He said, ‘put the drops in, if it hurts don’t keep using them.’ So, we put one drop in and it was extremely painful, excruciatingly painful, so we didn’t put anymore in,” Mary said. In the midst of these attempts to ease Lorne’s pain, Mary called Global Rescue.
“I hadn’t even remembered to call you until I prayed and I just really felt like that was my answer for that moment, to be able to be at ease with what we were doing,” Mary continued. She spoke with several Global Rescue operations personnel over the course of multiple calls using a satellite phone from their remote location amidst connectivity issues.
The next morning, when Lorne’s condition had not improved as they had hoped, Mary packed up all their belongings in case they needed to be evacuated, and drove to Bulawayo to see an optometrist and an ophthalmologist. “The doctor put some kind of dye in Lorne’s eye. Everything that was damaged showed up red in his eye. It was more than a third, I would say close to half of his entire cornea that had been injured,” Mary said. “It was pretty amazing to me how much damage a little speck of nothing could do.”
Next a nurse at the facility professionally flushed Lorne’s eye. “Immediately he felt better,” said Mary. “He sat up and opened his eyes without pain for the first time in 24 hours.”
Mary theorized that the foreign object was a small piece of thatch from their cabin roof. Once the situation was resolved, the couple stayed over in Bulawayo for the night before returning for the remaining seven days of their trip without further incident.
Praising the affordability of Global Rescue membership, she continued, “I saw it as a good financial investment in my peace of mind for this particular trip. I told my husband it was very nice to have someone I could turn to when I was completely at my wit’s end, someone to share the unknown with.”
Mary continued, “More than anything else, I think Global Rescue gave me an opportunity to feel that there was an ‘out’ for this – that there was a way to handle our problems and not feel like I was on my own there in the middle of Africa, four hours from the closest doctor. Talking with Global Rescue gave me the confidence and assurance that, even if I am handling this on my own, I am not alone.”
The Avalon’s departure from Geraldton in Western Australia on June 11, 2014 (Photo courtesy of Ocean Row Events)
Following Global Rescue’s successful rescue last week of a rower in the middle of the Indian Ocean, Ocean Row Events managing director and ocean rower Leven Brown shared his gratitude:
“I would thoroughly recommend Global Rescue to all seafarers. We had a crew member with severe burns during a rowing expedition and we were literally in the middle of the Indian Ocean. Global Rescue not only gave us medical advice which helped us manage these burns but also arranged a quick and efficient evacuation for the crew member. If you are going anywhere adventurous and it carries risk, Global Rescue is the essential partner as it is for us.” Leven Brown, Ocean Rower, Managing Director - Ocean Row Events
Avalon crew member Shane Usher (in light blue) with crew of the Nordic River (Photo courtesy of LPGC "Nordic River" "K" Line Ship Management Co., Ltd. [Tokyo, Japan])
Nordic River launch boat (R) evacuates injured rower from Avalon rowboat (L) during Indian Ocean rescue led by Global Rescue on July 11. (Courtesy: LPGC ”Nordic River” “K”Line Ship Management Co., Ltd. [Tokyo, Japan])
Global Rescue has coordinated the rescue of a rower from the middle of the Indian Ocean after he sustained severe burns.
Ocean Row Events (ORE) crew member Shane Usher was successfully evacuated to the 590-foot K Line bulk carrier Nordic River on the morning of July 11. Earlier in the week, Usher had accidentally scalded himself while preparing food on the ORE rowboat, Avalon.
Global Rescue’s medical team confirmed that Usher’s burns were significant enough that an evacuation was necessary to secure proper treatment. The six-man and one woman Avalon crew was rowing non-stop across the Indian Ocean, having departed Geraldton, Australia, on June 11.
Global Rescue led the rescue and coordinated with the Australian Maritime Safety Authority (AMSA) and the Australian Rescue Coordination Centre to identify a vessel in the vicinity of the Avalon. Global Rescue led the operation from its operations centers in Massachusetts, New Hampshire and Thailand.
The Nordic River responded to the request to go to the aid of the rowboat. The carrier reached the Avalon successfully and transferred Usher by launching a rescue boat. The challenging operation, which was conducted in the open ocean, lasted nearly two hours.
K Line carrier (Courtesy: LPGC "Nordic River" "K" Line Ship Management Co., Ltd. [Tokyo, Japan])
Once Usher was on board the Nordic River, Global Rescue’s medical team managed the treatment of his burns, liaising with the Nordic River’s crew to oversee his care. The ship is expected to reach Australia on July 18.
The current Ocean Row Events mission is to row from Western Australia to Durban, South Africa, through nearly 5,000 miles of open ocean. The Avalon sustained only minor damage after the rescue and is en route to Africa.
Ocean Row Events' Avalon in the Indian Ocean (Courtesy: LPGC "Nordic River" "K" Line Ship Management Co., Ltd. [Tokyo, Japan])
MERS-CoV, or Middle East Respiratory Syndrome Coronavirus, belongs to the large family of coronaviruses which have been known to cause illness in both humans and animals. In humans, the coronaviruses can cause mild respiratory illness like the common cold to severe life-threatening illness such as MERS-CoV or Severe Acute Respiratory Syndrome (SARS).
MERS-CoV was first reported by the World Health Organization on 22nd September 2012; since then, all the associated cases globally have been linked back to the Arabian Peninsula. The disease first emerged in Jordan in April 2012 and was retroactively attributed to MERS later that year.
It is suspected that the primary source of transmission is from infected animals to people working closely with the animals, with limited human-to-human transmission. Camels are suspected to be the main animal source of infection but this has yet to be confirmed by health authorities and investigations regarding the source are ongoing. The incubation period is 2-14 days.
Countries with Lab-confirmed MERS cases
Countries in or near the Arabian Peninsula with cases:
--United Arab Emirates (UAE)
Countries with Travel-associated cases:
--United Kingdom (UK)
--United States of America (USA)
*Two patients were transferred to Germany for care
Who is at risk:
--Anyone visiting farms, markets, barns or places where camels are present
--Recent travelers to the Arabian Peninsula
--Anyone in close contact with an ill traveler from the Arabian Peninsula
--People with diabetes, kidney failure, chronic lung diseases or weakened immune systems
--Healthcare workers caring for infected patients.
Signs and symptoms:
--Shortness of breath
--May have gastrointestinal symptoms such as diarrhea, nausea or vomiting.
It should be noted that not all infected individuals will exhibit symptoms. Those who have traveled to the Arabian Peninsula should be cautious, regardless of their activities or outward symptoms.
There is no specific treatment for MERS-CoV infection. The current treatment regimen involves supportive care to alleviate symptoms and provide support to vital organ functions.
1. Observe good personal hygiene at all times.
2. Practice frequent hand-washing (before handling food or eating, after going to the toilet or when hands are soiled). Use alcohol-based hand sanitizer if soap and water are not available.
3. Avoid close contact with persons suffering from acute respiratory infections.
4. Cover your nose and mouth with a tissue when you cough or sneeze, then throw the tissue in the trash.
5. Avoid touching your eyes, nose and mouth with unwashed hands.
6. Avoid contact with camels and other live farm/wild animals. If there is contact, wash hands thoroughly with soap.
7. Adopt good food safety practices and avoid consuming unpasteurized milk and uncooked meat.
8. Get vaccinated against influenza and meningitis. While there is NO vaccination against MERS-CoV, vaccinations against influenza and pneumococcal infection can help prevent these common infections that have symptoms similar to MERS-CoV.
9. If you are traveling to the Arabian Peninsula and have pre-existing chronic conditions, consult your doctor prior to your travels for medical travel advice.
10. Should you become unwell with fever and cough during or after your recent travel (within two weeks) to the Arabian Peninsula, put on a mask and seek medical attention immediately.
Temperature surveillance of passengers at airports
Airports around the world have begun temperature monitoring and health surveillance checks of passengers upon arrival.
To our knowledge, a number of major international airports have installed and implemented infrared temperature monitoring:
1. Middle East International Airports - Riyadh, Jeddah, Dubai, Abu Dhabi, Kuwait City and Bahrain
2. Australia – Sydney, Melbourne, Perth, Darwin
3. New Zealand
5. Hong Kong
6. Malaysia – Kuala Lumpur
7. United Kingdom
8. Turkey – Istanbul
These infrared temperature machines will detect passengers with a high body temperature as they pass through the checkpoints. This helps the health officials at the checkpoints to quickly screen incoming passengers with fever (one of the signs and symptoms of MERS-CoV). However, not all MERS-CoV infected individuals will exhibit symptoms, much less a fever, rendering the temperature scanners not entirely effective. Nonetheless, temperature scanners are the method that health authorities are employing as a first line of screening. Passengers with a higher than normal body temperature will be further screened by health officials. In addition, the passenger may be asked to complete a questionnaire detailing recent travel histories and activities. Depending on the reply, the passenger may be required to be seek immediate medical attention at one of the airport clinics before being allowed to enter the country.
For anyone who has symptoms of fever, cough or shortness of breath prior to travel, it is advisable to seek medical consultation to obtain a fitness to fly memo or certificate. The memo or certificate should indicate any recent travels.
National Center for Immunization and Respiratory Diseases, Division of Viral Diseases
Page last updated: June 12, 2014
Centers for Disease Control and Prevention
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
Division of Global Migration and Quarantine (DGMQ)
Page last updated: May 21, 2014
Ministry of Health, Singapore
Page last updated: May 16, 2014
David Koo at Everest Base Camp
In our “Meet the Team” series, we profile the people who make Global Rescue what it is. David Koo, based in Global Rescue’s Bangkok Operations Center, offers a glimpse into his role as an Operations Manager, the business culture in Asia, and his time in Tibet.
What is your role at Global Rescue?
I am working in the role of Operations Manager. I ensure that the Operations Center is operationally ready and runs smoothly. This includes ensuring the readiness of our Asian teams and providing case direction and oversight for active operations, assisting the Directors in making decisions, and providing leadership to the team.
What do you like most about your job?
My staff! I work with a talented multinational team. We learn from each other and from the experiences that each of us brings to the table. Furthermore, this job is unpredictable. Every request that comes in is different and sometimes you really have to think creatively to develop solutions.
Give an example of a recent mission you’ve handled.
Our Operations team recently managed a commercial stretcher transport from Doha (Qatar) back to the U.S.A. This transport involved coordination across cultures, and very long transport durations. A Global Rescue Senior Specialist paramedic was at the member’s side during the hospital stay, and then was with her all the way to her home hospital. The team handled the logistics from start to finish.
You are based in Thailand. What do you think is the greatest benefit to Global Rescue members in having a Global Rescue operations center in Bangkok?
I think it is very important for Global Rescue to have a presence in Asia. The business culture in Asia is very different from the West. We place a strong emphasis on first developing a relationship before a business deal. We like face-to-face meetings over a meal and having multiple interactions before we get down to business. For example, the annual deployments of Global Rescue staff in Nepal is a great example of how having “boots on the ground” helped to foster relationships and to ensure the best possible operational handling of cases.
What is the coolest place you’ve traveled to and what made it interesting?
I really treasured my three years in Tibet during which I trekked across the region, rode on top of a delivery truck from Tibet to Chengdu, stayed overnight in a nomadic tent, trekked to Advance Base Camp, and stood in awe of mount Everest with only one thought in mind: “People must be out of their mind to try to summit Everest.” Now I oversee the coordination of rescues from the mountain. Sometimes we circle back to where we started.