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hotline
International SOS Worldwide Journal
20 ANNIVERSARY OF INTERNATIONAL SOS
TH
1985-2005
Contents
04 A PASSION FOR QUALITY
CARE AND SERVICE
International SOS founders, Dr Pascal
ELCOME to this special edition of
W Hotline. To mark the 20th
anniversary of International SOS, this
Rey-Herme and Arnaud Vaissié,
talk about the genesis of the company
and the changes they have seen over
20 years.
07 A DOUBLE SUCCESS
Dr Rey-Herme remembers a day in 1985,
issue is devoted to a review of just some which stretched International SOS
resources to the limit.
of the milestones in the company’s
08 A 20-YEAR PARTNERSHIP
history. It looks back at a few of the more A focus on BP, with whom International
SOS has been working for 20 years to
dramatic events from the past 20 years. provide a duty of care to its employees,
their families and local communities
throughout the world.
There are memories of International SOS
10 HOSPITALS IN THE AIR
in the early days, of individual clients and A look at the vital work played by
International SOS’s global fleet of
members, and recollections from air ambulances around the world.
International SOS people who have played
a key role in the company’s development.
It also highlights more recent initiatives,
which today support the delivery of
services to the millions of
clients and members that
International SOS is proud
to serve around the world.
2 INTERNATIONAL SOS
18
04 08 10
12 PIONEERING A NEW 22 THE WORLD AT YOUR FINGERTIPS 34 WIDENING THE NET
SERVICE CULTURE A close-up of how International SOS’s A spotlight on SPIN - the tool for
Personal memories from Dr Inggriani clients can harness the power of accessing International SOS’s 24-hour
Gandha of the opening of the very first technology to provide a global duty network of medical and other providers.
International SOS clinic. of care.
35 SAFETY IN THE SKIES
14 ALL HANDS ON DECK 24 A VITAL 20 HOURS The story of how one Lufthansa passenger
Recollections of the early days at International SOS medic Patrick Deroose received vital medical care on a long-
International SOS’s first alarm center, recalls a mass medical evacuation from Bali. distance flight.
and the rapid response they provide
today. 26 ANYWHERE IN THE WORLD 36 SUPPORTING PATIENTS
How International SOS is delivering IN A NEW WAY
17 STRAIGHT FROM THE TOP healthcare services in some of the A look at the new service provided to
How International SOS’s most senior remotest regions on earth. patients who need to take prescribed
medical team is involved in delivering medication long term.
front-line care. 30 A CHANGE OF GEAR IN
OCCUPATIONAL HEALTH 38 ADDING VALUE
18 EVERYBODY OUT A conversation with Dr David Cook about How International SOS’s logistics
The dramatic events that unfolded during the importance of occupational health expertise is helping clients to deliver
Indonesia’s civil unrest in 1998. services and how they have changed over premium services to their customers.
the years.
21 MORE THAN AN 39 KNOWLEDGE IS POWER
EMERGENCY SERVICE 32 WHERE OTHERS FEAR TO TREAD Innovations in technology mean that
How one International SOS doctor views An insight into the work undertaken by patients can now be monitored in real
the importance of membership. International SOS for governments and time, irrespective of where they are in
NGO’s in some of the world’s hotspots. the world.
Designed by Andrew Kellard Associates +44 (0) 1483 549095.
26 38 HOTLINE - ANNIVERSARY EDITION 3
INTRODUCTION
4 INTERNATIONAL SOS
A passion for quality
care and service
Since they founded the company in 1985, Dr Pascal
Rey-Herme and his childhood friend Arnaud Vaissié have
seen the company rise from humble beginnings to become
the world’s leading provider of medical assistance,
international healthcare and security services.
How did the company begin? open-pit coal mine in Kalimantan, Borneo, and
Pascal: I was working in Jakarta as Medical our remote site services began. Today we run over
Attaché for the French Embassy and observed how 200 such operations, with hospitals and clinics,
medical care in Asia was very much based around taking care of tens of thousands of people
the hospital. I felt that there was a big opportunity including both employees and the local population.
to bring in a European model of ‘pre-hospital care’,
including a medical rescue service. Arnaud was Arnaud: We were very small at first, with just two
based in San Francisco at the time and I persuaded small clinics in Singapore and Indonesia, and 14
him to join me in setting up this new venture. staff. But we saw tremendous growth from day
one. Although at first we only had small pieces of
Arnaud: I was told that you should never go into business, they were with large clients such as BP,
business with your friends – but we’ve proved that Schlumberger and Alstom, with the potential to
it can work! We gave each other support and grow. I’m delighted to say that all our clients from
fortunately our styles are complementary. our early days are still with us today, as are many
Naturally we have our differences but when it of our original employees.
comes to the major decisions, we have always
been in agreement. Essentially our early vision Pascal: Our first plane was a small Beechcraft
was the same as it is now – to offer complete that we had to convert ourselves by ripping out
healthcare solutions to organizations and seats. On one of our first evacuations out of
institutions – firstly in Asia and now globally. And Dacca, we had to stop in Rangoon without
from day one we have both been passionately permission and were promptly arrested! Our nurse
committed to quality service – something that will was actually on her first ever flight and must have
never change. wondered what she was getting into. We now have
a fleet of ten state-of-the-art air ambulances, and
How did the business develop in the at any point in time at least one of our planes will
early days? be in the air.
Pascal: We started with medical evacuations and
clinic services, with most of our patients being Arnaud: Having clinics wasn’t part of our original
expatriates working in Indonesia and Vietnam. idea, but we soon realized that this gave us a base
However, as many of these people were working in to employ and train specialists, which is now one
remote locations and employing large local of our core strengths. Now we have 24 clinics
populations, it was a natural progression to move around the world, but they all stay true to the initial
into broader healthcare consulting services. Then concept of 24/7 pre-hospital and emergency
Rio Tinto told us it was building an enormous services.
HOTLINE - ANNIVERSARY EDITION 5
INTRODUCTION
Tell us about some other key milestones
Arnaud: In many cases we’ve simply been
responding to client demand. Security
services are a good example of this natural
evolution. During the 1998 crisis in
Indonesia we had to carry out a large-scale
evacuation of foreigners from Jakarta. At
that time we weren’t openly offering
specific security services but having proved
our capabilities we have integrated this into
our portfolio. By bringing in security
specialists we utilize our existing global
infrastructure, and the majority of our
clients now use both security and medical
services. We are always looking to improve
existing services and grow new ones – in
fact 40% of our existing business is with
services developed in the past five years.
We also encourage our operating units to
be innovative. Our Australian office developed
a patient compliance service with Roche,
offering support to patients on long-term
therapies, and this has been so successful that
we’ve now rolled it out worldwide.
Arnaud and Pascal relaxing on the Great Wall year, this speeds up our service and radically
Pascal: Our online services really proved having obtained the right to open an improves the quality of our decision-making.
their value during the SARS epidemic, International SOS clinic in Beijing in 1989
where there was a huge need for accurate, Pascal: It also allows us to stay true to our
practical information on a daily basis. Our initial ideas – where a customer will always
general attitude is: “if it needs to be done, reach a trained professional who can
we’ll find a way to do it”. This was amply understand his or her situation and quickly
demonstrated during the recent SARS pass the caller onto a medical or security
epidemic. We were told that we couldn’t professional.
evacuate patients due to the risk of infection,
so our team lead by Dr Roger Farrow, Arnaud: To achieve the global reach that our
quickly developed a Portable Medical clients demand, we have had to expand
Isolation Unit (PMIU). quickly, and acquisitions have played a big
part in achieving this. Of course the biggest
What are the main challenges now single addition was the purchase of
that the company has grown so large? International SOS Assistance in 1998, which
Pascal: We have to sustain the same culture Laurent Sabourin speaking at the inaugural meant we became a global rather than a
and values that have driven us from the start: ceremony of the office in Taipei predominantly Asian company, with a far
a medical heritage and a passion for patient bigger US presence.
care. Now that there are over 4000 people,
we have to work harder to achieve this, and What about the future?
recruitment and training have a very big role Pascal: My main aim is to ensure that we
to play to ensure we maintain quality control. continue to offer the highest quality service
Arnaud: Logistics is a key development area, “40% of our to our clients. To achieve this we need to
attract a new generation of dedicated
as we serve more and more clients and professionals. Arnaud and I were 30 when
individuals, and IT plays a central role. We
have recently invested millions of dollars and
existing business we started the business and we want to bring
in talented 30 year olds to keep driving the
thousands of man-hours into a new global
case management system called Magellan.
is with services organization forward.
This means that anyone dealing with a
patient’s case from an alarm center will see developed in the Arnaud: Innovation is the key: providing
unique new services and as Pascal said,
the same details in real time, enabling us to attracting the best talent in the world. I
create virtual coordinating teams with
doctors from around the world. When you
past five years” spend a lot of time interviewing, and see this
as my number one responsibility – to ensure
consider that we handle over 600,000 cases a ARNAUD VAISSIÉ we all get the very best people to join us. s
6 INTERNATIONAL SOS
FIRST EVACUATION
A challenging flight
Unfortunately the landing field at the mission
was too short for the HS 748, so we arranged
for a light aircraft belonging to the
missionaries to meet our incoming team at
Banjarmasin and take them and whatever
equipment they could fit into the small
aircraft on to the mission.
From Jakarta we contacted the Indonesian
authorities to get landing clearances at
Banjarmasin airport at sunrise (the airport
had no facilities for night-time take-offs or
landings).
The pediatrician, the mother and her
premature baby were squeezed into the light
aircraft and taken to Banjarmasin, then
transferred to the HS 748. The head of
immigration was waiting at the aircraft with
the necessary travel documents, and the
A double
mother and baby were rushed to Singapore.
Weighing just 1.9kg, the baby was taken
straight to hospital where I’m pleased to say
both mother and baby recovered well from
success
their ordeal.
Another emergency
At the same time as we were harnessing our
resources to save the baby, another request
came in, this time from Malaysia. An
American oil worker had been transferred
from an offshore platform to his company
clinic in Kerteh. Suffering from a heart
We asked Dr Pascal Rey-Herme to tell us about some condition, he needed urgent transfer to
hospital in Singapore. As the HS 748 was
of the first medical evacuations he was involved with already being used to transport the baby, the
for International SOS. Here he remembers one only aircraft available to us was a much
smaller plane called a Queen Air.
afternoon in 1985 when his team received two With our Singapore escort team already
flying to Indonesia to care for the baby, I went
simultaneous calls for help. on the journey to Kerteh to escort the patient
to Singapore. On arrival I discovered that he
was 1.95m tall and weighed over 140 kg.
(These days it’s standard procedure to check
Vital help and support
A JAKARTA-BASED church which ran a
small remote mission in Kalimantan,
Indonesia, heard that the wife of a foreigner
Through the night an obstetrician and
pediatrician in Singapore gave vital help and
this type of information before a flight.) With
considerable difficulty we got the patient, the
pilot and me on board. We then flew back to
working in the area had arrived at the support to the mission’s health officer by Singapore where we landed at the same time
mission’s medical center in premature labor. phone while the baby was delivered and then as the baby. I will always remember one of
At that time, the only way to communicate resuscitated. At the same time, we were our Singaporean nurses exclaiming at the
with the mission was by radio. We already assembling a pediatric team from Singapore time: “So, you put the big patient in the small
had an arrangement with Singapore Radio and equipping an HS 748 aircraft to fly out plane and the small patient in the big plane!”
(which supported shipping fleets in that part to Kalimantan as soon as possible. After carefully extracting the patient from
of the world) whereby we could patch our Our team in Jakarta managed to contact the small plane, we transferred him safely to
telephone with their radio. In this way, we the head of immigration in Banjarmasin at hospital. Facing many challenges, we had
were able to establish a radio link with the home that night to convince him to issue a successfully completed two evacuations at the
mission. travel document for the new-born baby. same time. s
HOTLINE - ANNIVERSARY EDITION 7
FIRST CLIENT
A 20-year the managers who was using our clinic. He
was invited to visit the site, undertake a
partnership
survey and set up protocols for malaria. He
also arranged an evacuation service using our
clinics and alarm centers in Jakarta and
Singapore.
“The relationship with BP is ongoing. I
think the reason why we’ve been successful is
because we have common goals: we were
able to provide them with locally based
International SOS has been working with BP for 20 services. Local knowledge is so important. If
you break your leg in Singapore, there’s no
years. Sandy Johnson who joined the company in 1985 big problem because medical services are
available. If on the other hand, you’re with a
recalls that right from the start, she saw the geo-thermal crew in Sumatra and you break
your leg, it’s a completely different situation.
importance of combining international standards with It’s not possible to undertake night flights on
helicopters. We had to develop detailed plans
local knowledge and experience. for BP to evacuate people by road ambulance
to a point where the aeromedical evacuations
could be done by fixed wing.
“Over the years we’ve maintained an
unwavering, uncompromising commitment to
“I WAS BASED in Singapore in 1985 and
met two charming French gentlemen
through a friend of mine who was a nurse and
PARTNERING WITH BP
quality. I’ve always been absolutely sure that
we would get the job done. Arnaud and
Pascal lead from the front and there is
had done medical evacuation work for them. accountability through every layer of the
They were looking for somebody to “Our relationship with International SOS organization. I call the company a diamond –
communicate with American and Western has been successful because they it has many facets, with a core integrity.”
clients operating in Singapore and Jakarta. understand our business needs and our
Having grown up in Texas and with the oil culture. International SOS teams can Assistance in partnership
industry, I was very aware of the importance work seamlessly with our staff in the International SOS has been working with BP
of medical evacuations and was fascinated by field and provide specialist skills, advice for 20 years, helping to ensure the well-being
the work that Pascal and Arnaud were doing. and experience where needed. of employees, their families and local
“I joined as Director of Marketing in July International SOS has the global reach communities throughout the world.
1985. At that time there were many European we need combined with vital local As one of the world’s major energy
and North American companies operating in knowledge. Its network of alarm centers companies, BP is committed to meeting its
Indonesia who were drilling for oil and gas in and family-based clinics is a very useful corporate responsibilities to the environment,
the area, as well as organizations providing resource for BP worldwide.” to its people, and to the communities in
support services to them. It was natural for us Dr Alison Martin, Health Director, which it operates. It’s an ethos that
to work with these companies because they Exploration & Production, BP International SOS readily understands and the
had a specific need we could help them with. two companies have worked closely together
“We also worked extensively with “The security of our employees across the at a global and local level.
embassies, insurance companies and private globe is of paramount importance. In
citizens who were looking for real-time local, order to assure ourselves of our ability to Work on projects
medical support. Unlike the European relocate any of them in times of crisis, International SOS’s relationship with BP
assistance companies at the time, who had no we have contracted on a long-term basis started in 1985, when Dr Pascal Rey-Herme
physical presence in Asia, we had people on with International SOS to take advantage was asked to assist with a malaria outbreak at
the ground and had developed very strong of their expertise and capability to effect one of BP’s remote sites. International SOS’s
relationships with doctors and hospitals in the such emergency relocations, and have involvement with BP’s anti-malaria programs
region. tested that capability in a real situation still continues today.
“Our first client was BP. They had with great success.” Since then International SOS has been
operations in Sumatra and at the time had a Nigel Carpenter, Deputy Head, Group involved with many of BP’s largest projects.
problem with malaria on one of their remote Security, BP International SOS is often there right from
sites. Pascal heard about this through one of the start – delivering primary and emergency
8 INTERNATIONAL SOS
FIRST CLIENT
Security services
Four years ago, the Global Membership
Agreement was broadened to include security
assistance services, which International SOS
provides to BP on the same partnership basis.
Again, International SOS teams are organized
to align with BP’s own security divisions.
24-hour security advice and evacuation
assistance is available to BP employees
abroad, and International SOS experts work
on BP’s projects providing advice and support
on security and risk management.
In just one example, an International SOS
team provided security consultancy to BP’s
contractors and sub-contractors in Baku,
Azerbaijan. Having carried out a detailed gap
analysis of current procedures and systems,
they made recommendations for effective
security risk management and contingency
plans that met BP’s standards and requirements.
In Kuwait, International SOS was responsible
for the evacuation of 65 BP employees just
before war broke out in Iraq in February 2003.
Medical services support
International SOS’s medical services support
Picture courtesy of BP
some of the largest energy and exploration
projects in the world today. International
SOS is currently providing a full suite of
project-based medical services to a number
of BP projects across the globe including the:
care services to workers on site. As each Namconson Liquefied Natural Gas (LNG)
project develops, employees’ families join project in Vietnam, Tangguh LNG project in
them and local people are hired. So the Papua region of Indonesia, various BP
International SOS broadens its service to projects in the Caspian region and new
include the full spectrum of healthcare in the ASSESSING THE HEALTH OF ventures in Russia, including Sakhalin Island
community, including family and in far east Russia.
THE LOCAL COMMUNITY IN
occupational health services.
TANGGUH, INDONESIA Growth and evolution
Global agreement The partnership between BP and
In 1999, after a number of highly successful Among the many projects International International SOS has grown from the close
projects, BP and International SOS SOS has been involved in, is one for BP involvement of one doctor to the fully
recognized that a more strategic approach was in Tangguh - the development of a structured corporate response service it is
needed. They developed a Global large liquefied natural gas (LNG) today. Martin Dennett is Business
Membership Agreement which put in place facility. Development Director for Energy, Mining
consistent mechanisms for looking after the As part of BP’s environmental and Infrastructure at International SOS: “By
health of all BP’s personnel when they were impact assessment, International SOS aligning ourselves closely with BP’s
outside their home countries. developed and carried out a baseline business, we can deliver comprehensive
The agreement means that International health survey in the local area, Bintuni solutions to help provide a duty of care to its
SOS can work closely with BP in a consistent Bay. This work assessed the state of employees and their families. BP takes its
and structured way. International SOS’s health of the community, so that BP corporate responsibilities seriously, and in
medical teams are aligned with BP’s own could review the potential impact on partnership with them we can help to ensure
medical divisions, and its global network of the health of its employees and the that medical and security risks to employees,
alarm centers and clinics are accessible to BP project overall. their families and local communities are
employees when they’re working abroad. managed effectively.” s
HOTLINE - ANNIVERSARY EDITION 9
Hospitals in the
International SOS’s air ambulances are a vital three dedicated aircraft, we make over 100
medical transports a month between our
link in providing ‘bed-to-bed’ care for patients. resources based in South Africa, Botswana
and Namibia. We have been as far afield as
the Maldives, Ascension Islands, Canary
Islands and Diego Garcia. Overall, more than
A SIX-YEAR-OLD child was lying in a
hospital bed in Abidjan in the Ivory
Coast following a snake bite. International
the rest of Africa,” explains Dr Fraser
Lamond, Regional Medical Director Southern
Africa. “Logistically our jet air ambulances
two thirds of all the patients brought into
South Africa for medical care are handled by
International SOS.”
SOS doctors in Johannesburg were can access anyone up to fifteen degrees north
monitoring his condition, but one vital piece of the equator. We are also supported by our A growing fleet worldwide
of information was missing: what kind of air ambulances based in Europe which can From the early days it was a real challenge
snake had bitten him? They decided it was also overlap this area into sub-Saharan Africa getting quick access to suitable aircraft for
too risky to wait. thereby allowing us to efficiently cover the the medical teams operating out of Jakarta
It was June 2000 and the newly entire continent.” and Singapore. This prompted the company to
commissioned Falcon 10 air ambulance was And the demand for evacuations to South think seriously about investing in its own jets.
about to make its first medical evacuation. Africa has spiraled in recent years: “With Since the Falcon 200’s maiden air
Within hours the boy had been picked up and ambulance flight from Singapore in 1997,
flown, with the unidentified snake in tow, to a International SOS has expanded its fleet to
modern hospital in Johannesburg, where he ten, making it one of the world’s largest air
was placed in intensive care. ambulance service providers. With bases in
It turned out that the bite came from the Germany, Russia, South Africa, Namibia,
potentially deadly West African Carpet Viper Botswana, Singapore, China and Papua New
and would probably have proved fatal in this Guinea. The speed and range of the aircraft
child. The boy was given the appropriate enables International SOS to reach patients
serum but also needed to be on a ventilator. virtually anywhere in the world. There are a
He made a full recovery and was able to variety of aircraft including Learjet, Falcon,
return home a few weeks later. Hawker and even turbo props that can land in
“With its high quality of medical facilities, particularly difficult terrain where there may
South Africa – and Johannesburg in particular be no proper airstrip.
– is very strategically placed in relation to The aircraft are quite literally ‘intensive
10 INTERNATIONAL SOS
AIR AMBULANCES
air MAKING A DIFFERENCE
”FROM the moment we arrive on the scene,
we’ve upgraded the quality of care”, says
woman in Mozambique with 60% burns. We
had a very bumpy ride due to bad weather
Dr Tyrone Richards, Deputy Medical Director, and we had to use a tube to get oxygen into
care units in the sky’, carrying everything International SOS, South Africa. “Medical her lungs.
necessary to cope with a medical emergency, facilities are virtually non-existent in many “On landing in Johannesburg we rushed her
including resuscitation equipment, oxygen, parts of Africa, so we can offer real hope for to a preferred hospital. It was touch and go
infusion pumps and a full range of drugs, the patient. but fortunately she pulled through and three
fluid and supplies. “Each day is a new adventure; you never months later was back home, working again.
“All our medical staff is fully trained in know where you may end up. One of our most It’s so satisfying to know that you’ve made a
aviation and emergency medicine and has dramatic rescues involved a fifty-year-old difference.”
extensive medical evacuation experience,”
says Dr Arnaud Derossi, International SOS’s
Regional Aviation Medical Director for the alarm centers manage all the logistical helicopters, and communication with staff at
EMEA region. “They can manage adults, aspects of an evacuation. The nerve centers clinics and hospitals to prepare them for the
neonatal and pediatric cases, with the most are the four regional aviation units in patient’s arrival.
common conditions being cardiac conditions, Frankfurt, Johannesburg, Singapore and
traumas, infectious disease, head and spinal Philadelphia. Bed-to-bed care
injuries. Dr Derossi explains some of the key “It’s capability, continuity and quality of care
“Medical missions need to be flown by challenges in creating an integrated support that distinguishes our service,” Dr Fraser
pilots who are expert in air ambulance structure: “Access and landing permits are Lamond tells us. “We offer a high standard of
processes and knowledgeable about the critical to the success of a mission and our medical care and attention throughout the
medical team’s requirements. They also need centers can obtain landing clearances and transportation process. And every detail
to have the experience of dealing with the coordinate the complex set of activities counts: we deliver a safe reliable service to
logistics of flying in and out of remote sites required at destination airports”. those who need it.
where conditions may be rudimentary. And when every minute can literally mean “The integrated nature of International
“Although the vast majority of flights are the difference between life and death, local SOS’s local, regional and international
on our own jets, we also have access where knowledge and contacts can help get you network means that from the very first call,
necessary to a range of other aircraft through customs and immigration quickly. we can manage just about any logistical
including executive jets, helicopters and even “We recently evacuated a seriously ill patient challenge and deliver medically appropriate
military aircraft or wide-body aircrafts.” from Tajikistan to London, which required services and support.
clearance across seven different countries’ air There are many decisions to make during
Sophisticated logistics space.” an emergency: finding the quickest and best
Whilst the pilots and paramedics on board are The coordination activities also involve the transportation should not have to be among
at the sharp end, the aviation specialists in the utilization of ground ambulances and them.” s
HOTLINE - ANNIVERSARY EDITION 11
FIRST CLINIC
Pioneering
to work at the clinic.
“What Dr Rey-Herme emphasized right
from the start was that the patient was at the
center of any decision that was made”, says
Dr Inge. For her, this was perhaps the most
important aspect of the clinic at that time.
“We were teaching our doctors to see their
a new service culture patients as customers. This was a very
different ethos for clinical services in
Jarkarta – and is still the foundation of every
International SOS clinic today.”
Dr Inggriani Gandha joined AEA Growth and change
As the years passed, the number of clients
International, now International SOS, in and members visiting the clinic grew
steadily. “At the first clinic we saw around
1985. She was part of the team that 900 expatriate patients and the numbers just
went up. By 1991 we needed new premises
opened the first clinic in Jakarta. to accommodate our growing client base and
we opened our second clinic – where we’re
still based today.”
Increasingly the client base grew to
R INGGRIANI Gandha (known locally As well as delivering primary healthcare include local people as well as expatriates
D as Dr Inge) trained as a doctor in
Indonesia. She spent 11 years in Germany,
services to expatriates and their families, the
clinic pioneered emergency care to patients
and eventually the balance tipped. “These
days we see around 6,500-7,000 patients
studying in Aachen and specializing in before they were evacuated, often to hospitals every month”, says Dr Inge, “With around
gynecology. In 1983, she returned to in Singapore. “We have always been strong 60% of them coming from the local
Indonesia and joined AEA International (now on our emergency response capabilities. Back population”.
International SOS). In 1985 she was part of when we first started, the type of service we
the team that opened the first clinic, in offered was virtually unheard of in The clinic today
Jakarta. Indonesia.” Today’s busy clinic has around 300 staff,
including 40 doctors on site. “We see patients
First beginnings Changing the culture of all ages, and many of the children at the
“We set up the first clinic in 1985 in Jakarta As well as pioneering new services, the International School in Jakarta come to us”,
because we needed a place where patients clinic was forging a new, more service- says Dr Inge. The range of services has
could be stabilized before being evacuated”, oriented culture among healthcare expanded over time to include a dental
Dr Inge explains. “At that time, there were professionals. Dr Pascal Rey-Herme practice, a pediatric practice, a diabetic clinic,
24-hour clinics in the city, but they were recruited and trained a team of local doctors a well-woman clinic and a weight-control
staffed by operations people who would ring
a doctor only if they decided it was
necessary. With around 31,000 doctors and a
population of 180 million in Indonesia,
getting to see a doctor could be difficult.
Ours was the first clinic to offer direct access
to a full clinical team, around the clock.”
Establishing services
Opening the new clinic was fraught with
practical difficulties and challenges. “We
struggled even to get a telephone line
installed,” she remembers. After just a few
months, and with a small medical and
operations team in place, the clinic opened its
doors.
“In the early days, a large proportion of
our clients were international oil and mining
companies”, says Dr Inge. “They came to us
because they knew their people would get
access to international standards and
procedures they recognized.”
12 INTERNATIONAL SOS
FIRST CLINIC
INTERNATIONAL SOS clinics operate in
countries where medical care of an
international standard is unavailable, or
where cultural and language barriers make
it difficult to receive appropriate care.
Each clinic offers primary care,
diagnostic care and 24/7 emergency care.
Services include family practice
consultations, pediatrics, ophthalmology
Reception of the International SOS clinic in Jakarta and occupational health programs. Clinics
are well equipped with the facilities
needed to stabilize a critically ill or injured
clinic. “We also do a lot of medical check-ups healthcare services on every continent. She person before evacuation. Many clinics
for companies as part of their employee speaks six different languages and have international-standard pharmacies,
healthcare programs. Of course the percentage understands cultural differences in the laboratory services and diagnostic services.
of emergency cases is small – but we provide delivery of healthcare around the world. Many are also equipped to offer x-ray and
dedicated intensive care,” she says. “My time in Germany was instructive in ultrasound tests, dentistry, physical
“Our clients today still value international terms of getting experience of international therapy and counseling.
medical training and standards. While standards”, she says. “I’ve learned about the There are 24 International SOS clinics
English language capabilities are critical, the differences in emphasis and expectation in worldwide in the following locations:
spectrum of nationalities among our staff is different countries. And of course sometimes
wide, including Australian, South African, you have to adjust your approach to your Angola: Gamek
American, Malaysian, Philippine, French, environment. But international standards of Ilha
German and British.” medical care are essentially the same Azerbaijan: Baku
everywhere – and that’s what we are here to
Cambodia: Phnom Penh
International standards provide. Whether you’re in Moscow or
During her career, Dr Inge has traveled Beijing, the standard of care you’ll receive is Chad: N’Djamena
extensively and gained experience of the same.” s China: Beijing
Nanjing
Shekou
Tianjin
“Dr Rey-Herme Indonesia: Jakarta (2)
Bali
emphasized right Kazakhstan: Almaty
Atyrau
from the start that Mongolia: Ulaanbaatar
Myanmar: Yangon
the patient was at Nigeria: Lagos
Port Harcourt
the center of Warri
Russia: Moscow
any decision that Vietnam:
Yuzhno-Sakhalin
Hanoi
was made” Ho Chi Minh City
Vung Tau
DR INGE, INTERNATIONAL SOS
HOTLINE - ANNIVERSARY EDITION 13
hands on alarm center
Allfirst International SOSdeck
at the
Dr Roger Farrow has been with International SOS since 1987. He first
started on a locum basis when he was Commanding Officer at the
New Zealand Military Hospital in Singapore and is now Chairman of
the Corporate Assistance Department.
F OR 18 YEARS, Dr Farrow has been
closely involved with the development of
the International SOS alarm center network.
mobile phone. It was huge, and the networks
weren’t great, but even then we were leading
edge in terms of telecoms and technology.”
they are today, but we were doing frequent
medical evacuations so the level of expertise
was high and the process very efficient. We
Here he looks back at the early days, at what learnt right from the start about the
has changed – and what has stayed the same. Early days importance of harnessing the
“Back when we first started, it was all Sharing and swapping apartments and complementary skills of both expatriate and
hands on deck”, he says. “Arnaud [Vaissié] traveling between Jakarta and Singapore, Dr national staff – just as we continue to do
and Pascal [Rey-Herme] were involved with Farrow and Dr Rey-Herme were on constant globally today. This mix of expertise has
every case, with Pascal and I always on call call at the Singapore and Jakarta alarm been a key element in the company’s
to give medical assistance to clients and centers when in 1989 the Hong Kong alarm success.”
undertake medical evacuations. This was in center opened and additional medical staff Zaleha Hassan also worked at the
the days before mobile phones, when we came on board. “There were a lot of mining Singapore alarm center in the early days.
each carried pagers and bags of 10-cent coins and infrastructure companies in Asia, and a “Back then we did everything ourselves”, she
ready to rush to the nearest public phone. I large population of expatriates and families. remembers. “We rushed to embassies to apply
remember sharing our very first Ericsson Medical facilities were certainly not what for visas, picked up medication, filled up
14 INTERNATIONAL SOS
FIRST ALARM CENTER
oxygen tanks locally, and went to the airport
to check in patients ahead of repatriation.” “The soul of the sophisticated medical equipment available
today, we had to take the utmost care to
monitor the patient to make sure he remained
Pioneering evacuations
Modern aviation has made the medical
company, its stable through each stage of the flight.”
On another occasion, a Singaporean boy
transportation of patients faster and less
stressful. Roger Farrow continues: “I
humanity and had to be flown back urgently from Kota
Kinabalu, where the airport was already
remember in 1988 we completed a
pioneering evacuation of an extremely sick compassion, have closed. Dr Pascal Rey-Herme asked Lisa Tan,
who was the only Malaysian in the company
patient by air ambulance from Singapore to a at that time, to talk to the Malaysian
hospital in London. This was before the
advent of the non-stop long haul 747 400
been preserved” authorities to convince them to open the
airport especially for the mercy flight. The
aircraft and when there were few air ROGER FARROW, INTERNATIONAL SOS airport authorities readily agreed to do so
ambulance aircraft available. We used a Lear once the urgency of the situation was
36 to make the transcontinental flight, explained.
stopping at Madras, Abu Dhabi and then
Lanaka in Cyprus before finally landing at Soul of the company
Heathrow. Stopping in the middle of the The years since have seen the rapid growth
night, while the aircraft was being refueled of International SOS, with hundreds of new
needed careful planning. With little of the staff joining and new alarm centers and
clinics opening throughout the world. This
might have meant a lot of change –
particularly for longer-serving members of
the team. Dr Farrow doesn’t agree. “Yes,
SERVING INTERNATIONAL SOS’S today’s alarm centers are incredibly efficient
JAPANESE CLIENTS AND MEMBERS operations, with systems and technology that
we wouldn’t have recognized even 10 years
ago. But the heart of what we do is the same.
INTERNATIONAL SOS delivers services Jakarta, Hong Kong and Brisbane to audit our The soul of the company, its humanity and
specifically designed and tailored for its operations. We were able to demonstrate our compassion, have been preserved.
Japanese clients and members. consistency of approach. More importantly, “I always liken Pascal and Arnaud to the
Lisa Tan joined International SOS in 1988. we demonstrated our understanding of Asia queen bee in a bee hive. Just as the queen
She spent two years setting up and and the Japanese market, and showed bee affects and directs the behavior of the
upgrading International SOS's alarm center intimate local and cultural knowledge. The whole hive, so in the same way Pascal and
operations in Seoul and Hong Kong. In 1991 key win for us was our geographically Arnaud’s strong medical and personal ethics
she returned to the Singapore alarm center balanced network, which met the and their passion for excellence have shaped
as Operations Manager. She remembers how expectations and requirements of Tokio this company and the people who work in it.
the International SOS Japanese Desk first Marine in Asia Pacific at that time. Today, we I’ve been strongly influenced by them both
came about. provide services to Tokio Marine on a global since the day I first met them. And in turn
"Our Japanese clients and members have basis. those longer serving members of the
always been important to us. They were the "In 1993, we set up the Japanese desk at company are passing onto those who joined
first clients in Asia willing to invest in our the Singapore alarm center, dealing later, the same values and standards.
services despite medical assistance being exclusively with assistance to our Japanese
almost unknown in this region in the late clients and members. This was the start of A hands-on approach
1980's", she explains. "Both AIU Insurance the fully-fledged Japanese service department “What is so important and so unusual for a
Company and former Mitsui Marine & Fire that has continued till this day in Tokyo, large company like ours, is that Pascal and
Insurance Company, now known as Mitsui serving more than 90% of Japanese non-life Arnaud are still directly involved in medical
Sumitomo Insurance Company, were the first insurers and all our global members from and operational decision making. There is no
Japanese insurance companies to show a Japan. serious medical case which senior
keen interest in including medical services "International SOS has always believed in management are unaware of. What we all
to give added value to their insurance the importance of providing services to value – and the reason so many of us stay
products. Both companies have grown to customers in their own language and in with International SOS – is the opportunity
become key clients and our business accordance with their own customs and to work for a compassionate, medically
partners in many ways. traditions, even when they're overseas. The driven, ethical company.
"In 1992 we reached another milestone attention to detail and commitment we “In another 20 years we’ll probably look
when Tokio Marine chose us as their demonstrated to our Japanese clients in the back at 2005 and say that what we’re doing
appointed assistance company for Asia early days is still fundamental to the service now was pioneering. It’s all a question of
Pacific. Before choosing International SOS, we offer today, even though we have grown perspective. But it is extraordinary to see
Tokio Marine sent teams to Singapore, such a lot in the past 20 years." just how far we’ve come in such a relatively
short time.” s
HOTLINE - ANNIVERSARY EDITION 15
FIRST ALARM CENTER
A TYPICAL CASE FOR THE ALARM CENTER TEAM
Patient calls International SOS An Australian lady, Sue Williams, lives in Inner
and speaks to Mongolia, China, with her husband, who is
Operations Coordinator working on an Australian aid project. At home
one day she falls and hits her head. As well as a
bump to her head she receives a black eye, but
chooses not to visit the local doctor. Over the
Patient speaks to Intl. SOS doctor course of the next few weeks she suffers
frequent fatigue, nausea and vertigo. Finally after
ten weeks, when her condition worsens and she
experiences debilitating earache, headache and
dizziness, she calls the International SOS alarm
Doctor calls Beijing AC center in Sydney.
Expert response
After talking at length with Mrs Williams, an
Beijing AC recommends International SOS doctor determines that she
admittance needs neurological investigations and treatment.
to hospital in Hong Kong He contacts his medical colleagues at the Beijing
alarm center to discuss suitable medical
facilities. Having completed their research, they
identify Hong Kong as the nearest center of
excellence in this field.
Because of her medical condition, the
Intl. SOS doctor calls
International SOS Intl. SOS arranges International SOS doctor recommends that she
patient to make
calls insurers flight and escort travels on commercial flights from Yinchuan to
recommendation
Hong Kong with a medical escort. This
recommendation and a quotation is provided to,
and approved by, Mrs Williams’ insurer.
The International SOS alarm centers in Beijing
Intl. SOS stays in and Hong Kong work together to arrange all
contact with Intl. SOS stays in logistical aspects of the transportation, including
insurers contact with her medical escort and Mrs Williams’ admission
patient to hospital in Hong Kong.
Throughout, International SOS staff keep in
constant contact with Mrs Williams to keep her
fully informed and reassured. They also maintain
communications with the underwriter.
Patient discharged On being discharged from hospital, Mrs
from hospital and Williams asks International SOS for help to make
contacts Intl. SOS her hotel arrangements before flying back home
to Inner Mongolia. International SOS not only
arranges and pays for the hotel, but also
arranges taxis within Hong Kong.
Intl. SOS arranges A safe conclusion
hotel and taxis
On her safe return, Mrs Williams contacted
International SOS to express her gratitude for
the service provided.
“I wish to commend all the staff I had contact
with, from my initial telephone contact in
Patient arrives
Sydney, to the staff in Beijing and Hong Kong.
home safe
Everyone was concerned and professional. I
and well
cannot praise your organization too much.”
16 INTERNATIONAL SOS
CORPORATE ASSISTANCE DEPARTMENT
Straight from the top
Dr Neil Nerwich is Deputy Group Medical Director and Regional Medical Director for
International SOS, EMEA. When we spoke to him about the approach to medical and
operational decision making, and the role of the Corporate Assistance Department
(CAD), he echoed many of Dr Roger Farrow’s comments.
“O UR OVERRIDING aim is to
consistently provide medical duty of
care at the very highest levels”, he says. “The
• the condition of a patient deteriorates
while they are being evacuated
• a major medical or security incident
International SOS service delivery model requires a crisis response
puts the best people with the right expertise
at the front end. That’s why we have full-time “Ever since the company started, senior
medical teams – not medical consultants – on medical staffs have provided round-the-clock
duty in all our alarm centers. They provide support to members of assistance teams,”
real-time medical advice, direction and explains Dr Nerwich. “But as the
reassurance to our members and patients. organization grew, we realized we needed a
Their skill is to listen to what’s being said, more formalized approach, and in 2000 the
assess and interpret in the context of the Corporate Assistance Department was
individual’s situation, and then to respond formed. The Department ensures there is
appropriately.” total transparency and that any element of
“The decisions taken will depend as much medical or security risk is dealt with
on the condition of the patient as on the proactively. This is particularly important in a
implications posed by the local environment. crisis situation.”
In consultation with our other medical teams In response to the most recent Bali
around the world who are experts in their bombing in October 2005, Dr Philippe
region, we decide on the best local solution, Barrault, a fellow CAD member, poignantly
or alternatively evacuate them if local commented that International SOS had
resources are insufficient. learned so many lessons from previous
“And when a situation is particularly bombings that this time the decision was
challenging, all our staff know they have the taken to proactively launch mercy medical
Corporate Assistance Department to call on.” “Ever since the evacuation flights. “One of the lessons was to
mobilize as quickly as possible,” says Dr
Expert advice and opinion
The Corporate Assistance Department
company started, Barrault. “As soon as we realized that help
was needed, our largest air ambulance left
(CAD) comprises a global roster of senior
medical directors with the knowledge and senior medical Singapore in the early hours of Sunday
morning.”
experience to deal with the most complex or “Our processes ensure that clinical need is
challenging cases. On call 24 hours a day,
seven days a week, they make decisions on a
staffs have provided put first,” continues Dr Nerwich. “Patients
are in direct communication with medical
real-time basis in the best interests of the
patient and the client. A strict set of
round-the-clock staff right from the outset, so their access to
a doctor is in real time. The ethos of
operating procedures ensures that they are
always contacted in scenarios where: support to members International SOS comes from the very top.
Through the Corporate Assistance
Department we make sure that our collective
• there is a complex case involving
evacuation across continents or where
of assistance teams” experience is applied where it matters most –
responding to our members when they need
technical difficulties need to be resolved DR NERWICH, INTERNATIONAL SOS our help.” s
HOTLINE - ANNIVERSARY EDITION 17
Indonesians demanding
the resignation of
President Suharto
SECURITY EVACUATIONS
Out
Everybody
International SOS evacuated 4000
members from Indonesia during the civil
unrest that followed President Suharto’s
resignation in May 1998. Jim Williams
was at the center of the drama.
B
Y EARLY 1998, President “It was absolute mayhem. I remember
Suharto’s thirty-year grip on power hearing of people driving their cars to the
in Indonesia was loosening. With airport and abandoning them or selling them
the economy in crisis, on the spot”, recalls Jim Williams, who was in
demonstrations, violent clashes and riots charge of International SOS’s Indonesian
erupted on the streets. By May 21st the
pressure on the leader had grown to such an
extent that he was forced to step down.
Appointing his Vice President as successor did
little to stop the strife.
Not surprisingly expatriates, as well as
local citizens, were desperate to leave the
country, but it was virtually impossible to get
a flight on a commercial airline from Jakarta
or other airports. The situation was considered
so dangerous that the US government advised
all its citizens to leave the country as soon as
possible.
HOTLINE - ANNIVERSARY EDITION 19
SECURITY EVACUATIONS
operations at this time.
“Once the phones started ringing they
never stopped, so we immediately set up a
crisis center in our alarm center and mobilized
all our team. People expected International
SOS to be able to help them and we were
determined to justify this faith.”
A triumph of logistics
Within the first few hours, we established a
plan of action that was on the scale of setting
up an airline. One room was set up
specifically to track the 15-20 aircraft that
International SOS could call on to make
evacuations. All employees helped out no
matter what their normal jobs were.
Every detail for each passenger’s flight
needed to be covered. Our staff had to do
everything from schedule the aircraft and
crews to assign passenger seats, deal with
immigration paperwork and help them pay the ourselves. This enabled our members to go
exit tax. “At the airport most people were through the system in a fraction of the time,”
waiting eight hours in a government line to explained Jim. The Singapore operations
pay the exit tax. We took the situation into our provided all of the reception services. They
own hands and agreed to a new procedure were tasked with arranging ground
with officials to help with the paperwork transportation, travel arrangements and hotels
for the members we evacuated.
Organizing the evacuation of so many
TOWARDS RISK MANAGEMENT people in such a short time was an enormous
logistical operation. In spite of this we
“INTERNATIONAL SOS is no longer just and other hostile regions. managed to launch several medical
helping organizations respond to events,” “It’s all about knowing the risks you evacuations with our own air ambulance. One
says Richard Culver, Senior Director, Security face, managing those risks and making of these was a neonatal case.
Services, EMEA/CIS. “In an uncertain world, informed decisions. In 2004 a construction During an intense three-day period, over
we’re increasingly being asked to look at client needed to establish business four thousand people were successfully
the complete security infrastructure to help operations in Afghanistan. We embedded a airlifted out of the country. “Overall many of
reduce the risks of terrorism or crime. We security consultant with their project team, us in Jakarta and Singapore didn’t sleep for 56
also help clients manage the consequence and as an integral part of the client hours. When members are in trouble, they
of crisis, not just the incidents themselves, structure assisted in the management and immediately call International SOS. Our job is
through the provision of holistic crisis reduction of risk to enable the business. We to help them, whatever their needs.” s
management services.” supervised security provider selection, and
“We can evaluate site security, travel deployed with the client advance party to
policies and the quality of security firms
used. We can also provide a full-time or
ensure that their security management in-
country was up to the standards required.
“I remember
seconded security manager to oversee all a
client’s activities and prepare crisis
That client is still successfully operating in
Afghanistan, and our
hearing of people
management and emergency evacuation
plans.
plans and procedures
have assisted in the driving their cars to
Clients can access our comprehensive prevention of death
web services, giving security updates and
other useful information. They can also call
and injury to their staff
on a number of
the airport and
into our alarm centers 24/7 and receive
immediate advice and assistance from our
occasions.” abandoning them
on-call security specialists. “Our security
specialists typically have a military
Richard Culver,
Security Services, or selling them on
background with further experience in EMEA/CIS
consulting and corporate security. They’re
all accustomed to working in war zones
the spot”
JIM WILLIAMS, INTERNATIONAL SOS
20 INTERNATIONAL SOS
MEMBERSHIP
More than an
emergency service
Dr Rene de Jongh has worked for
International SOS since 1992. He’s a
passionate believer in the importance of
membership – and he’s at the end of the
phone when members call for help.
S INCE he started working for
International SOS back in 1992,
Regional Medical Director for Assistance,
got her examined at the nearest International
SOS clinic. She had in fact a significant
previously undiagnosed neurological
International SOS in an emergency. “I’m not
interested in just sticking to the bare facts,”
says Rene. “I want to give people proper,
Dr Rene de Jongh has seen the benefits of problem, so we arranged to evacuate her by detailed advice on how to manage
membership time and time again. “People commercial flight to London so that she themselves while they’re traveling. If
aren't always clear what membership really could immediately receive the care she someone is a diabetic planning a trip to
gives them,” he says. “I think the value of needed to make a recovery.” China, they’ll want to know where they can
membership is two-fold: Members have buy needles, where they can keep their
access to myself or any of my physician Managing risk insulin cold during flights, and whether they
colleagues day or night should they have a Of course membership isn’t just there for can get their needles through customs. We
medical concern, and as medical emergencies. Members have access to travel give them the whole nine yards.”
professionals, we have the opportunity to get and security advice to help keep themselves
to know a little more about them. Knowing and their families safe while abroad. “It’s Clinical need
our members' background and situation human nature to get excited when you’re For Rene, membership is about much more
helps us to deal more effectively with issues going on a trip. People tend not to think than just a fast service. “The first person
or emergencies when they arise. What’s about what might go wrong,” says Rene. “I you’ll speak to when you call is a trained
more, membership ensures that don’t want to take the fun out of traveling; I customer service executive. The second will
administration and payment is already just want to help people manage the risks.” be a medical professional who will already
sorted. When you’re dealing with someone One International SOS member was have an idea of who you are, what your
who’s had a serious accident, the last thing starting a mine site survey trip to Africa and problem is, and at least a partial solution
you want to talk about is who’s going to foot called Rene on the suggestion of a already in place.”
the bill.” colleague. He outlined his plans and the This reflects a principle that attracted
Sometimes International SOS helps vaccinations he’d been given on the advice Rene to International SOS in the first place.
members with problems that they didn’t even of his GP. It soon became clear that he “The service we give our members when
know they had. “I remember one lady who would pass through countries where it is a they travel is unique,” he says. “Every
had been a member for some time,” says requirement to have been vaccinated against decision is based first and foremost on
Rene. “I was delighted to get a call from her yellow fever. “If you’re not covered, quite clinical need – even before they’ve stepped
telling me that she and her husband were apart from the risk of the disease to you off the plane.” s
expecting a baby – I knew they’d wanted a personally, you may either be deported or be
family. But during our conversation, she told given a jab there and then at the airport, Dr de Jongh is a New Zealand citizen who
me she’d been experiencing nasty headaches. which won’t always be safe,” explains Rene. joined International SOS in 1992 and is now
She presumed these were a normal symptom During their phone conversation Rene Area Medical Director for SOS’s operations
of her condition and had been suffering advised his client to re-route in order to have in the South Asia Region. His specialty is in
bravely because she didn’t want to take any the yellow fever vaccination, take time to hospital-based emergency and intensive care
painkillers. As she was talking I realized that develop immunity and collect documented medicine. He is also qualified in pre-
these headaches weren’t just another side proof to take with him. hospital emergency care, advanced cardiac,
effect of pregnancy. They sounded much Getting this kind of advice reduces the pediatric and trauma life support and was
more serious. Speed was important, so we likelihood of ever having to call on awarded a MSc in Travel Medicine.
HOTLINE - ANNIVERSARY EDITION 21
ONLINE
pages each, available in English, French,
The world at your Spanish, Japanese and Chinese. You can find
out all you need to know about health,
security, climate, culture and customs. And
information is constantly updated 24/7 to
fingertips
keep users fully informed.”
Towards full interactivity
Customers are always searching for ways to
help manage risk more effectively: “The idea
for our ‘Traveler Locator Service’ came
following a client discussion shortly after
9/11. Tragically, the company had had
employees on one of the hijacked planes, and
Hi-tech online solutions help mitigate the risks of wanted a system that could track every
traveling member of staff anywhere in the
international travel. world.
“Traveler Locator takes data from travel
management systems and travel agencies to
give an instant snapshot of the movements of
O NE OF THE downsides of living in the
‘Information Age’ is data overload.
This is particularly true for international
International SOS’s website and associated
online services the only places you would
ever need to look,” says Tim Daniel, Chief
employees. You can track individuals by
region, by country, by flight number or hotel
booking. It also lets you assess the risks
companies with hundreds or thousands of Operating Officer, International SOS Online. facing these people and gives automatic
employees traveling or working abroad. From humble beginnings in 1997, the main medical and security alerts if they’re likely to
With so many sources of information, it’s International SOS members’ website has face dangers or hazards.
virtually impossible to access the specific developed into a comprehensive guide to “The service is web-based and accessible
details they need to help keep staff safe and traveling and working around the world, as from anywhere in the world, yet also highly
secure. Tim explains: “We now have more than two secure with restricted users. As you would
“The aim from the start was to make hundred country guides of around 25-30 expect, the amount of data processed is
22 INTERNATIONAL SOS
ONLINE
enormous, with 120,000 travel itineraries management, it asked International SOS to
entered every day.” create a dedicated portal. This contains action
Over the past few years a number of other plans and procedures, relevant local
online services have emerged, such as information such as fire, police and
‘Automated Travel Advisories and ‘Travel ambulance services, and details on all
Ready’. These help travelers prepare for the employees, including scanned copies of
next trip, giving up-to-date information on passports.
destinations through email alerts, making sure If there is a crisis, management can act
they have the right vaccinations and even quickly, contact all relevant parties and make
letting them know the status of visa evacuations or close facilities. There are even
applications. detailed maps helping to locate expatriate
workers.
Customized services Renault in France has chosen to provide a
As with many International SOS offerings, similar service to its employees and decided
the client is often the trigger for to incorporate a customized medical section
improvements. For example, when IKEA into the site. Daniel Mahé, General Manager
wanted to improve its global crisis of the International Mobility Department
succinctly summarises the benefits: “This is
an additional risk prevention tool for our
company. This new online tool contributes to
“This new online tool contributes to our our employees’ awareness of the importance
of maintaining their health and of the services
employees’ awareness of the importance of our company provides in this field.”
“The future of online services is all about
maintaining their health and of the services getting the right information to the right
people in real time,” says Tim, “Whether it’s
epidemics, natural disasters or political
our company provides in this field” unrest, the use of email alerts, websites and
portals will give clients the tools they need to
DANIEL MAHÉ, RENAULT take important decisions and mitigate risk.” s
HOTLINE - ANNIVERSARY EDITION 23
A vital
20 hours
Memories of the first International SOS mass evacuation.
Combining resources
P ATRICK Deroose is General Manager at
International SOS’s Corporate Assistance
Department. A trained nurse, he has been
seriously, and several people were killed.
Local services arrived at the scene as quickly
as possible and took the injured passengers to
The operations team at Singapore quickly put
together a plan that combined the resources of
with International SOS since 1993. the local hospital. three International SOS alarm centers:
Soon after he joined, Patrick was part of a As soon as they were informed of what Singapore, Jakarta and Bali. The Singapore
team sent to care for the victims of a serious had happened, the French insurance company and Bali teams would triage the patients (that
road accident on Bali. Here he remembers contacted International SOS and the is, determine their injuries in order to decide
how events unfolded. Singapore alarm center was immediately the order and urgency of treatment) ready for
“A couple of weeks after I started work alerted. repatriation. The Jakarta team would provide
with International SOS there was a terrible Knowing that local medical facilities the necessary equipment and personnel for
crash on Bali. A group of elderly French and would not be sufficient to deal with the the aircraft.
Belgian tourists were traveling in a situation, our mandate was to bring the One of our Bali-based doctors was
mountainous area when their coach tumbled patients to major trauma centers in Singapore immediately sent to the hospital in Bali to
into a ravine. for treatment and repatriation. assess the situation. Understandably,
Many of the passengers were injured, some conditions at the busy emergency room of
24 INTERNATIONAL SOS
FIRST MASS EVACUATION
“20 hours from the time of the first
call, the patients had arrived safely
in hospital in Singapore”
this Government hospital were crowded, with to us. We quickly organized for the least Offloading the patients in Singapore was
staff struggling to cope. The doctor carefully injured patients to go first, with the most easier because there were 14 ambulances
and sensitively explained the plan that critical patients following last so that they waiting to transport them to the casualty
International SOS had put in place. would spend as little time as possible out of departments of Singapore General Hospital,
Meanwhile a medical team was sent from hospital. the National University Hospital and other
Singapore to Bali, comprising myself, Dr Meanwhile, our logistics team were sorting private hospitals in the city. Allocations were
Roger Farrow and Dr Peter Heron. With the out passports and the necessary papers in made by the Singapore alarm center to ensure
necessary language capabilities between us, collaboration with the insurance company and that each patient received the treatment they
we took with us the medical equipment we the relevant consul on Bali. needed.
would need, including 15 stretchers. 20 hours from the time of the first call to
Safe arrival in Singapore International SOS, the patients had arrived
Directing triage The patients were flown out of Bali on a safely in hospital in Singapore where the 15
One of our Bali team met us at the airport Fokker aircraft, which had been prepared by most seriously injured remained until being
and took us to the hospital. Dr Farrow the Jakarta team, including medical staff, repatriated for treatment or rehabilitation.
directed the triage and we prepared the monitoring equipment and enough food and Out of the five people with more minor
patients for transport out of Bali to drink for the patients. injuries, three went home and the two others
Singapore. 15 were seriously injured and Once the aircraft was loaded, we called the stayed in Singapore to be with their loved
another five had more minor injuries. Singapore alarm center with our arrival time ones who were being treated in hospital. All
A lack of ground transport in Bali meant so that ambulances would be waiting on the the uninjured were flown home within 24
that there were only five ambulances available tarmac at Singapore airport. hours.” s
HOTLINE - ANNIVERSARY EDITION 25
Any
REMOTE SITE SERVICES
where
IN THE WORLD
Taking healthcare to some of the world’s most remote regions.
O
RGANIZATIONS working in oil, gas, day healthcare, as well as provide preventative
mining and construction operate in treatment for malaria and other tropical diseases.
some of the harshest, hostile and most “What began with just one doctor in a single
inaccessible environments, with clinic has now grown into a complete medical
employees carrying out dangerous work, often in infrastructure operation incorporating a small
extreme weather conditions. Whole communities hospital, outpatient and emergency facilities, and
can spring up around these sites, and keeping satellite clinics with occupational health
employees and their families healthy is a major programs and award winning public health
challenge. programs,” explained Dr Myles Neri, Group
International SOS first became involved in Medical Director for International SOS’s Global
this field in 1988, when a French airport Medical Services.
construction company was commissioned by the
Indonesian government to build Jakarta’s new A natural development
international airport. The company was eager to Fast forward to 2005 and International SOS now
offer a high standard of care to their construction manages around 200 remote sites across five
teams at a site that was three hours’ drive from
the city. After consultation, Dr Pascal Rey-Herme
recommended creating a field clinic offering the
same emergency and primary care services as his
city center operation. The doctor not only
designed and equipped the clinic, he also
supplied and supervised local medical staff.
Some time later a senior mining company
executive asked International SOS whether it
could help develop medical services for a huge
coal mine that was being built in Kalimantan in
Borneo. With the mine employing 300
expatriates and 2000 local Indonesian workers
and their families, the company needed to be able
to make medical evacuations and manage day-to-
HOTLINE - ANNIVERSARY EDITION 27
REMOTE SITE SERVICES
“The occupational health
program aims at prevention,
detection and surveillance of
occupational illnesses and
injuries on the site”
DR DAVE KNIGHT, INTERNATIONAL SOS
continents, from
the new tarsand oil
fields in Canada to
gold mines in Papua
New Guinea; from
pipelines in Chad and
Cameroon to
petrochemical plants in
China. Dr Neri continues:
“Companies take their duty of
care towards employees very seriously,
and they’re looking to achieve a high
standard of medical service for all their
operations. These facilities may range from a
simple first aid station to 120-bed fully
managed hospitals.”
Over the years, International SOS has
developed its services to encompass the full
spectrum of health care specialist services
from primary and emergency care to
occupational and public healthcare. And
having gained an intimate understanding of
remote site medical needs, it also offers
expert consulting advice and guidance to its
clients.
Dr Neri continues: “Our first step
typically involves a site survey, looking at
everything from local living and working
conditions to the availability of medical care
and accessibility of emergency transport.
From here we work with the client, the local
health authorities and local resources to
define the appropriate scale of medical
services.”
The oil and gas fields on the island of
Sakhalin, off the easternmost coast of
Russia, present a different challenge
altogether. There are 16 field sites scattered
around the island, where the severe winters
can last for up to 7 months. International
SOS provides doctors and paramedical staff
for all these sites and has nine permanent
clinics on the larger work sites, plus a
doctor, medic and health and safety adviser
28 INTERNATIONAL SOS
Water sampling as part of
a malaria control program
Large, remote sites of occupational illnesses and injuries on the
site. The dual aim is workers’ health
protection as well as health promotion.”
not only create their In recent times governments and aid
agencies have called upon International SOS
own communities, to provide similar services to them in areas
of reconstruction, following conflict
they also impact (Iraq/Afghanistan) or devastation
(Aceh/Pakistan). The emphasis is on rapid
deployment, quality medical services,
upon the wider medical evacuation capacity and local
staffing, training and development.
local population. Companies, governments and aid
organizations will continue to operate in
remote areas, to respectively extract raw
material and energy, develop the
infrastructure or to help the local population.
And in extreme heat or arctic cold, in deserts
or offshore, International SOS will be there
with them, helping keep the workforce – and
their families – healthy. s
on the huge offshore platform that supports HAIR-RAISING SURGERY
a crew of 132 people.
DR Patrick O’Neill, who worked as Chief into the site clinic, where visiting plastic
Helping the wider community Medical Officer at the Kaltim Prima coal mine surgeons involved in a company public health
Large, remote sites not only create their own in Indonesia when International SOS first set surgical program for cleft lip repair, were on
communities, they also impact upon the up its on-site operation, remembers the many hand to sew it back on. After a difficult
wider local population. International SOS is challenges of those early days. period of readjustment the orang-utan was
active in helping clients build health In addition to carrying emergency finally released back into the wild with both
capacity with their neighbouring operations out in remote jungle clinics, and hands fully intact.
communities by providing programs to riding 90 minutes by boat to transport
monitor, treat and prevent diseases, improve patients to the nearest local hospital (before
sanitation and manage and counter sexually a hospital was built on site), he also had to
transmitted diseases (including HIV), TB handle patients of a hairier variety!
and malaria. One day an orang-utan managed to find
Dr Dave Knight, International SOS its way into the site and severed its thumb in
Medical Director at Batu Hijau, Indonesia a conveyor belt. The unfortunate animal was
told us: “The occupational health program sedated with tranquillizers and then taken
aims at prevention, detection and surveillance
HOTLINE - ANNIVERSARY EDITION 29
’D SPENT YEARS delivering general
“I medical services on remote sites
around the world”, he says. “And it was
clear that what was increasingly critical was
occupational health. Where there are
employees, it’s not just a question of
delivering primary healthcare. You need to
ensure that there’s an appropriate fit between
employer work and employee – that the job
doesn’t cause ill health, and that ill health
doesn’t affect the health and safety of
anyone in the workplace.”
David was given the remit to develop
occupational health services globally for
International SOS, working in the UK and
supporting its network of occupational
health professionals at its regional centers
worldwide.
David, what does occupational
health mean?
There are two types of occupational health.
There are occupational health services in
first-world countries like the UK and US.
These countries benefit from a good medical
infrastructure, resources, training and
research, and full health and safety
legislation that is enforced. Here
occupational health focuses on prevention of
work-related ill-health, promotion of
wellness and on managing health and safety
programs in the workplace.
Then there’s occupational health in
A change of gear emerging countries where there is little
medical infrastructure, where medical
training can be variable and resources scarce.
Classic industrial diseases – like lead
poisoning, dust induced lung diseases and
in occupational hearing loss – may prevail and public health
problems are far more prevalent, for example
HIV, tuberculosis, under-vaccination, and so
on. Services are often delivered at remote
health sites and include employment screening and
health and safety management, with disease
management an inevitable component.
What occupational services does
International SOS offer?
Dr David Cook was originally Chief Medical Officer International SOS offers services across the
whole occupational health spectrum. We’re
in Burma for International SOS between 1996 and second to none in terms of resources –
medical, intellectual, transport,
1997, working in Jakarta, Singapore and Papua communications, and security.
Remote sites are usually in emerging
New Guinea. After 10 years working abroad he countries, where International SOS delivers
returned to the UK to pursue occupational health occupational health services along with
general medical services in places where
as his specialty in 2003. employees don’t have ready access to a GP
or a local A&E. We also develop
comprehensive occupational health programs
30 INTERNATIONAL SOS
OCCUPATIONAL HEALTH
designed to suit a particular company’s Can clients access GO-Care? – a quality system and a quality service. We
needs. We can deliver fully managed A very important component of GO-Care is call it quality, quality, quality. That was our
occupational health services on behalf of the online statistics and reports that it can mantra back in the 1990s and it hasn’t
clients. generate. As GO-Care is web-based, some of changed today.
We are the only company in the world our clients can access it to generate and
that can offer consistent levels of care – download their own reports. So it’s a tailored What new developments are there in
globally. And that’s a capability that’s service, with tailored data recording and occupational health?
becoming increasingly important for many reporting. And employees with some of our International SOS is continuing to develop
of our clients. clients can download their own paperwork new occupational health services. At the
(while individual medical records remain moment, we’re working on an evidence-
How has occupational health confidential). based service to manage sickness absence
changed over the years? GO-Care is all about quality management for our clients in Europe. Believe it or not,
Occupational health has always been in
place. More recently the emphasis has
changed towards preventative medicine and
public health, not just general medical
health. Companies recognize that LOOKING AFTER THE WELL-BEING
occupational health directly affects safety
and productivity. OF WORKERS AT TOYOTA AUSTRALIA
We are also moving towards evidence-
based occupational health. Companies are TOYOTA Motor Corporation is one of return to work after ill health, including
keen to meet their corporate responsibilities, Australia’s leading car manufacturers. It has primary first aid, diagnosis, support,
to improve the health, safety and over 4,500 employees in Australia, spread treatment planning, active support and
environment of local employees and to make over six locations with 90% based at its two advice. Staff assess and advise on a wide
a positive contribution to communities. main sites in Port Melbourne and Altona. range of health issues, and provide stability
and familiarity for workers visiting the
What is evidence-based Objectives for Toyota Australia centers.
occupational health? Toyota’s key objective is to ensure that ‘every We also carry out pre-employment and
It’s about developing management and employee is treated as an elite athlete and employment assessments, monitoring,
reporting systems that enable organizations the best treatment possible is rapidly sourced reporting and education. Recent health
to manage risk proactively and coherently. so that they can be returned to their education initiatives have included healthy
Specific initiatives can be designed to workplace as soon as possible.’ eating and keeping hearts healthy.
combat particular issues that are identified Back in 2003, with concerns about costs To raise awareness of healthy practices in
based on evidence. It’s also about spiraling, its own health services not widely the workplace, we are working closely with
implementing coordinated systems and used, and work injuries (particularly Toyota Australia to identify workplace
processes to ensure that employees are musculoskeletal injuries) increasing, Toyota concerns and put in programs to minimize
treated consistently, wherever they work. Australia needed a more proactive approach risk of injury.”
International SOS delivers a thoroughly to managing the health of its employees. It
researched, evidence-based medically driven wanted its Health Centers to be the first port Measuring progress
service, comprehensively thought through of call for any employee with a health International SOS carries out detailed
and comprehensively delivered. concern, whether work-related or not. monthly reporting against key performance
Toyota Australia needed an expert partner indicators agreed with Toyota Australia. Data
How is evidence generated? who understood its business and had the is used to target healthcare and education
Data reporting and measurement is critical capability to deliver a full range of healthcare initiatives. Key measures this year include a
to effective occupational health services. It asked International SOS to work in fall in the number of musculoskeletal injuries,
management. partnership with its occupational health and and a reduction in the cost of third-party
At International SOS we have developed safety team to design, deliver and monitor a medical providers.
our own occupational health tool called GO- comprehensive occupational health Paul Furtado is Health Support Advisor on
Care (Global Occupational Care). Its management program. Toyota Australia’s Occupational Health and
backbone is a bespoke piece of software, Safety Team. “The Toyota/International SOS
which is fully integrated with the other How International SOS has helped relationship is now over 12 months old. In
International SOS systems. We use GO-Care Philippe Arnaud, Group General Manager this time a strong relationship has been
to manage a complete suite of occupational GMS Development explains International established and quality health outcomes are
health services for our clients. SOS’s approach: “We have delivered a fully being delivered.
These include comprehensive fit-for- integrated occupational health program in Toyota looks forward to continuing to
work programs and vaccination programs. partnership with Toyota Australia. work with International SOS in the important
We also use GO-Care to manage and Our medical teams run Health Centers at area of employee health to ensure that we
support our occupational health consulting Toyota Australia’s two main sites. They offer a retain our competitive advantage both locally
services and our occupational health staff full range of services to promote employees’ and globally.”
on-site.
HOTLINE - ANNIVERSARY EDITION 31
OCCUPATIONAL HEALTH
£13.2 billion is lost annually in the UK
through sickness. There is plenty of
evidence that employed people who stay in
work are healthier, get better faster and to a
greater degree if sick or injured, compared
to those who are unemployed or stay out of
the workplace too long. As I always say,
work is good for you!
Is that something that companies in
other parts of the world would
benefit from?
When we develop a service in one region,
we always look for opportunities to apply it
in other regions where appropriate. Our
network of occupational health practitioners
regularly meet to share interesting cases and
learning – and to cross-fertilize ideas. This
exchange is crucial for delivering
international-standard services to our
clients. s
NEW GLOBAL PUBLIC
HEALTH CHALLENGES
AS anxieties increase over the spread of
the avian influenza virus, International
SOS’s most senior medical staff has been
working over the last 18 months to
thoroughly research the implications of a
Where others
potential influenza pandemic and to
develop pandemic preparedness plans.
The concern is that if the current virus
Non-governmental organizations (NGO’s) often arrive
mutates and gains the ability to spread
easily from person to person, it may
in a country when everyone else is leaving. So who can
emerge as the cause of the next they turn to in time of need?
influenza pandemic.
Dr Doug Quarry, Medical Director,
International SOS Online, is a member of
the International SOS Avian Flu and
Pandemic Preparedness team. “As well as
N ON-GOVERNMENTAL organizations
(NGO’s) often arrive in a country when
everyone else is leaving. So who can they turn
monitoring the situation 24/7 and to in time of need?
making the latest information available Whenever there is a war, famine or
through our dedicated website, we environmental disaster, most people’s first
wanted to give our members practical reaction is to get out of the area as quickly as
guidance so that they could put possible. But for organizations like the UN,
contingency plans into place for their Red Cross, WHO, Oxfam, Save the Children
businesses,” he says. and Medecin sans Frontières, this is typically
“After extensive research, we have where their work is just beginning.
developed nine chapters of protocols Like any large international concern, NGO’s
and over 120 pages of information to and indeed government agencies also need to
ensure employers have the key safeguard the health of their employees.
documentation they need to develop a Emmanuel Chevron, head of Sales and
company- and employer-specific Marketing in International SOS’s Geneva office
Banda Aceh – chaos and destruction caused
Pandemic Preparedness Plan.” explains: “With the ever-present threats
by the Tsunami
surrounding them, our clients need to be able to
32 INTERNATIONAL SOS
GOVERNMENTS & NGO
AGAINST ALL ODDS
DR Jean-Bernard Carbonnel, who has been landing permit 2 hours before arrival in
with International SOS since 1992, recalls an Kinshasa.
urgent medical case that he coordinated for On reaching Geneva a large ambulance
the Red Cross: was waiting to take the patient to the
“In March 2002 we received a call in our intensive care unit in the Cantonal Hospital,
Geneva alarm center about a four year old where a successful operation was followed
girl with severe hepatitis in Kinshasa, by a full recovery. This project was a triumph
Democratic Republic of Congo. She was the of logistics, with our team arranging visas,
daughter of a Red Cross delegate in the landing clearance, ambulances and hospital
country and needed an urgent liver facilities.”
transplant.
We decided that the best place to get a
quick operation was Geneva, despite it being
11 hours away, and commissioned a long
distance jet. We took a chance in sending
the plane immediately and only received a
fear to tread
get medical assistance at a moment’s notice, employees are essentially no different to those out over 100 evacuations.
anywhere in the world. Thanks to our global of a commercial corporation.” Mike Penrose was also seconded to the
coverage, we have been able to help a number Having previously worked in a number of WHO for six weeks to help set up disaster aid:
of government bodies provide high levels of NGO’s in war and disaster zones around the “In an environment with so much suffering and
primary medical care to employees in different world, Mike is only too aware of the dangers. a totally traumatized population, it’s very
parts of the world.” Indeed, he was once kidnapped by Chechen difficult to coordinate the aid effort.
rebels for two months. “When planning their International SOS’s experience in similar
Security climbs up the agenda security, NGO’s must be very conscious about situations helped us put together appropriate
With the breakdown of former political how they are perceived. Surrounding yourself strategies and assist the Indonesian Ministry of
structures and the rise in religious with bodyguards may be counter-productive Health to re-establish its own structure.” s
fundamentalism, security is also an issue. and only serve to alienate local groups; it’s
NGO’s are not always seen as neutral more important to project an image of absolute
organizations and may get labeled as ‘tools of neutrality.”
the west’, leaving them increasingly vulnerable. TSUNAMI AID APPEAL
Security has consequently become a far higher Tsunami: helping when disaster strikes
priority and a number are turning to With its global infrastructure and experienced THANKS to the generosity of customers
International SOS for advice on protecting staff staff, International SOS can offer much-needed and staff, International SOS has been able
and facilities and minimizing the risk of advice and on-the-ground support to both to raise over $330,000 dollars to help
terrorism, kidnapping and crime. governments and NGO’s. Following the 2004 victims of the disaster in Banda Aceh.
“Where NGO’s may once have been seen as Tsunami that devastated Sri Lanka, Indonesia, These funds are being used to sponsor 80
a group of well-meaning amateurs they are now Thailand, Maldives and Malaysia, it gave young Indonesians from Aceh over the
large, established, professional organizations valuable logistical aid to the UN and AUSAID next four years to become nurses, so that
with full time staff,” explains Mike Penrose, (the development wing of the Australian they can actively participate in the
Regional Security Manager, International SOS. Government), providing a team of 20 medics rebuilding of their community.
“The security and medical needs of their on the ground in North Sumatra, and carrying
HOTLINE - ANNIVERSARY EDITION 33
GLOBAL ASSISTANCE NETWORK
Widening the net
Thierry Watrin, Corporate Director, Global automatically. It is also integrated with our
case management system, to ensure that the
Assistance Network, joined International process of dealing with each individual case is
as smooth and efficient as possible.
SOS in 1998. He has been responsible for For a small number of our largest clients,
we’ve developed tailor-made provider
developing the global network of medical networks, available via the Internet. In
particular, we can make details of key
and other providers that International SOS providers available to members through our
online country guides.
can call on anywhere and at any time.
Into the future
The Global Assistance Network, which now
“W HEN I joined International SOS
there was already a strong network
of providers established in Asia, with more
tool used daily by our GAN managers and
coordinating doctors for managing the quality
of service delivered by our worldwide
includes a team of more than 40 dedicated
personnel based in all our alarm centers, is set
to develop – not only with the numbers of
informal networks in place in other regions. network, from assessing and credentialing providers and preferred providers growing, but
Years previously, the company had providers, to ensuring smooth payment and with the depth and quality of information
sometimes relied on the co-operation and administration when help is needed. continuing to improve. Key areas, like China,
resources of our correspondents to record When someone from International SOS are expanding quickly, and new parts of SPIN,
information about medical providers in visits a provider, they use SPIN to record for example a whole new function for provider
different parts of the world. All cases were details about its organization and services. credentials, is being released.
handwritten or typewritten, and to search for This helps us make the right choices on Thanks to the energy and dedication of the
individual cases required a trawl through behalf of our clients and means we can Global Assistance Network team, we have
stacks of physical files. develop a set of preferred providers. SPIN managed to formalize our network rapidly
The big change came when an important also holds comprehensive records about while continuing to meet the urgent needs we
client, the insurance company Tokio Marine, providers, including licenses to practice, deal with every day.
asked us to establish a cashless network of medical qualifications, terms and conditions, The network is the backbone of
medical providers for its clients worldwide. and site audits. International SOS and a vital part of the way
Timothy Yee and Dr Doug Quarry at our we deliver services to our clients. There is still
Singapore alarm center established a system Widening access much to do, but the last three years have seen
to document assessments and details of As a web-based tool, SPIN is accessible a lot of progress in our development of such
medical providers onto a database and to set worldwide and updates are available an unique resource.” s
up guarantees of payment with providers as
part of our service. This was the genesis of the
vast Global Assistance Network (GAN) that
we have today. The other strong building
block was to develop a whole team of Global
Assistance Network managers able to develop
our network anywhere we have a case.
About SPIN
Launched in November 2002, the Service
Provider Information Network – or SPIN – is
the key means of accessing our Global
Assistance Network and spans every country
in the world.
SPIN is a powerful on-line database and
search tool that pinpoints a particular
provider according to the criteria that our
staff choose, for example by location, medical
specialty or type of agreement.
But it’s much more than that. SPIN is a
34 INTERNATIONAL SOS
IN-FLIGHT SERVICES
Safety in the skies
emergency medical treatment procedures,
When a Lufthansa passenger suffered a heart attack which includes simulation exercises.
on a long distance flight, he was in the safe hands – Serving the aviation industry
of a doctor hundreds of miles away. “The development of our services to the
aviation industry can be traced back to the
1980’s, when we provided medical assistance
to members of SIA’s frequent flyer program,
I N FEBRUARY 2003 a middle-aged man
suffered a myocardial infarction whilst his
Lufthansa flight was passing over Siberia.
procedures. Our doctors will calm everyone
down and help the captain decide whether a
diversion is necessary.”
Priority Passenger Services (PPS),” Kasey
Khaw, Regional Director, Global Accounts
Asia, explains. “The airline was impressed
This was cause for serious concern. International SOS offers in-flight services with International SOS’s ability to provide
Fortunately the pilot was able to contact a to Lufthansa, Singapore Airlines (SIA) and a remote medical care and assistance. We had
German-speaking International SOS doctor number of other carriers, as well as successfully carried out some medical
by satellite phone at the Frankfurt alarm supporting several fleets of private jets for evacuations for individual customers whilst
center. The doctor assessed the patient’s multinational corporations.Training is on business and personal trips. Offering in-
symptoms and concluded that it was provided for the airline flight crew in flight services was just a natural progression,
imperative to get him to a hospital as soon as where we combined our on-board medical
possible. Having checked the database, he experience with our geographical knowledge
confirmed that the nearest appropriate
facilities were in Almaty. The pilot agreed to
“It’s the closest of appropriate medical providers and
facilities. Our in-flight medical assistance
land at the local airport and the patient was
rushed in for emergency treatment. thing to having a teams are all aero-medical specialists trained
in aviation medicine.”
“In-flight medical assistance is a highly Today, International SOS is also working
specialized service requiring an in-depth
knowledge of emergency treatment and an
doctor next to you” with airlines’ medical departments to help
reduce the risk of medical incidents by
understanding of how patients react when at MR YAP KIM WAH, SIA SENIOR providing pre-flight screening for both
35,000 feet,” says Dr Michael Weinlich, VICE-PRESIDENT MARKETING passengers and crew. Whilst you’ll never be
Medical Director International SOS Germany. able to guarantee that there’s a doctor on
“You have to know the nature of on-board SERVICES, TALKING ABOUT THE every flight, a ‘virtual’ medical team is the
conditions and be familiar with flight TELE-MEDICAL SERVICE next best thing. s
HOTLINE - ANNIVERSARY EDITION 35
PATIENT SUPPORT
Supporting
patients in a
new way
With help from International SOS nurses and specialists,
patients on prescribed medication are benefiting from a
new service provided by International SOS.
T HE PROBLEM of non-compliance has
been plaguing the healthcare sector for
years. In some cases as many as 80% of
the treatment and make necessary behavioral
changes.
have. We talk to them about their lifestyle and
for certain treatments, the importance of a
healthy diet. Many people expect a quick fix,
patients fail to finish their course of treatment Holding their hands so we also have to manage their expectations
or take their medication correctly. This can “We’re there to provide ongoing support to the and educate them on the long term nature of
have very serious consequences for the patient, holding their hands through the the benefits.”
patient’s health, as well as costing the health journey,” says Ben Connor, International SOS Patients enrol voluntarily, usually after
service the time and expense of re-admissions Operations Manager, Pharma Services. “Our hearing about the program from their doctor
and further treatment. aim is to give patients a better understanding or pharmacist. International SOS will then
There are many reasons why so many of the medication and what effects it may work to a contact plan, calling at critical
patients seem unable to follow dosage regimes
or make lifestyle changes. For some it’s
simply a matter of poor motivation, whilst
others don’t really believe they’re ill, Reasons given by patients for ceasing antidepressant therapy
especially when the symptoms are hidden,
such as with high cholesterol. While poor 60
compliance is often attributed to simple 50
forgetfulness, in fact, the majority of patients 40
can articulate their reasons for ceasing 30
therapy. In a bold move, doctors, pharmacists, 20
health managers and the pharmaceutical 10
0
industry have joined forces to combat non-
r
ts
ce
s
y
gs
ns
tte
ug
ac
compliance, with the additional help of
en
ru
en
tio
fic
Dr
Be
Ev
tD
nd
uc
Ef
th
International SOS.
ng
pe
rse
str
ou
of
wi
eli
De
ith
In
ve
ck
e
Fe
The Patient Support program offers patients
Ad
W
GP
bl
of
La
rta
ve
ar
fo
on specific medications a support network of
Fe
ol
tS
m
co
us
healthcare professionals who can guide them
Un
M
through the weeks and months of their
therapy. Primarily telephone-based, they Ref: K. Demyttenaere et al. Compliance with antidepressants in a Primary Care Setting, 1:
receive a combination of information and Beyond Lack of Efficacy and Adverse Events; J Clin Psychiatry 2001; 62
encouragement, helping them to understand
36 INTERNATIONAL SOS
PATIENT SUPPORT
“Non-compliance with prescribed
medication continues to be a significant
and widespread problem. The idea of
providing proactive telephone support to
patients is looking increasingly promising.
We support the development and
evaluation of these schemes to establish
what works and what doesn’t, for the
benefit of patients.”
Geraldine Mynors, project manager for
Medicines Partnership
points, during a prescribed period. This can patients, echoes Ben’s sentiments “We get so approach: the patient improves his or her
vary between three and six months depending much positive feedback from patients. One condition; the health service saves time and
on the therapy. woman recently told me she had just got out money; and the pharmaceutical company
The level of attention is a vital factor, of her wheelchair and hung the washing up for benefits from longer treatment regimes,
according to Maggie Butler, a registered the first time in fourteen years, after helping them establish their therapies.
nurse who works on one of the programs: successfully losing weight. Whilst another One client reported that the average
“Doctors just don’t have the time to talk to improved her health and became pregnant, and treatment duration has subsequently more than
patients at length, and sometimes it can take rang to tell me that I had changed her life.” doubled, with patient satisfaction with the
days to simply get an appointment. We’re on program running at over 85%. Importantly, the
the other end of the phone any time they want Win-win concept has the blessing of health
to call us.” Patient Support is proving increasingly organizations who realize the benefits of a
popular, with International SOS working with healthier population. Indeed the UK
Highly rewarding pharmaceutical companies across Europe, Department of Health is so concerned with
Patient support is relevant for a wide range of Asia and Australasia. It’s essentially a win-win non-compliance that in 2002 it set up The
longer term or chronic conditions such as Medicines Partnership, a task force aimed at
cardiovascular conditions, diabetes, high helping patients get the maximum benefit
cholesterol, multiple sclerosis, osteoporosis,
.
obesity, rheumatoid arthritis and HIV Ben
“This is the most from their medicines and therapies.
Patient Support is an intrinsic
Connor continues: “We have nurses, exercise
physiologists, nutritionists and a range of rewarding job I’ve element of this initiative
other specialists who have developed an in- The last word goes to Ray Rowden1, an
depth understanding of the various treatments
we support. Most importantly, we can give
ever had, knowing adviser to the UK Health Service, who
believes we need: “...to create a generation of
patients all the time they need, whether they’re
concerned about side effects or merely want
that I can make a patients who are empowered to take action,
with the health professional caring for them.
some encouragement. In over twenty years of
working, this is the most rewarding job I’ve real difference to Patients will receive the support to take more
control of their own health and treatment and
ever had, knowing that I can make a real to make more appropriate use of health and
difference to people’s lives.”
And International SOS nurse Maggie
people’s lives” social services.” s
Butler, who provides support to obese BEN CONNOR, INTERNATIONAL SOS 1. Rowden R. The Expert Patient, Pharmaceutical Field, April 2002.
HOTLINE - ANNIVERSARY EDITION 37
SPECIALTY SERVICES
technological infrastructure gives our team
the ability to search for solutions quickly.”
Personal service
‘Concierge’ services are being offered to
customers across a number of industries as a
way of adding value to the core product or
service. Just one call will put you in touch
with a dedicated team of personal assistants,
who can sort out birthday presents for a loved
one, find you tickets for the latest top show or
even get you prices for a private helicopter!
“A number of card issuers ask us to deliver
concierge services for them because they
know they can trust us with their most
valuable customers,” says John, “At our
Sydney alarm center we offer seven different
languages 24/7, and people who have the
right answers at their fingertips.”
Adding value
Since International SOS first started
managing such services for Visa’s premium
customers in Asia-Pacific in 1997, they have
added a range of other offerings including
domestic tradesmen (for home insurance
customers) and emergency medical assistance
International SOS is using its remote servicing skills to mobile phone users.
Expectations are high, says John: “Our
and logistics expertise to help clients deliver premium clients want comprehensive feedback on who
is making the calls and how quickly and
services to their customers. effectively their customers are dealt with. Our
management information systems - initially
developed to manage complex medical cases
E VERY DAY a team of skilled car
mechanics arrives at International SOS’s
alarm center in Sydney. But they’re not
premium services to help clients around the
world differentiate themselves from the
competition. “One of our core competencies
- are able to give the kind of detailed reports
they’re looking for. But above all, they have
the confidence of knowing that International
wearing overalls and they won’t be getting is highly skilled and trained specialists who SOS is always fully committed to keeping the
their hands dirty. Their job is to take calls are determined to solve any caller’s problem.” customer happy - no matter what they’re
from worried motorists, talk them through John Jessup continues: “Our sophisticated demanding.” s
their concerns and if necessary arrange to
send a breakdown vehicle.
This is part of a specialized service “SUBARU has entrusted International SOS to technicians as operators who have a real
provided for drivers of new Saabs, Ferraris, provide Premium Assistance Service to our understanding of the customer’s needs
Maseratis, Alfa Romeos, VW’s and other top customers across Australia since February 2002. together with a focused account
marques. “Because the mechanics really Customer interaction and high quality management team.
understand the cars, one in three calls gets service is a vital part of our business, and we Subaru’s philosophy is based on doing the
resolved without having to send out a have found International SOS to be a highly common things uncommonly well and
breakdown truck,” explains John Jessup, valuable and professional partner. From a flat International SOS is a key part of that
Managing Director, International SOS, tyre to an accident, International SOS strategy.”
Australasia. “With our expertise, we can provides assistance and peace of mind.
handle calls on behalf of our clients and help They understand our business, our culture Derek Ashby
offer something extra to their customers.” and our customers. They have proven to be Subaru National After-Sales Manager
‘Auto Assist’ is just one of a number of flexible and provide skilled automotive Subaru Australia
ways in which International SOS is providing
38 INTERNATIONAL SOS
GLOBAL SYSTEMS
W
Knowledge is
HEN International SOS members get
sick or injured, they may well have to
be passed through more than one medical
power
facility and possibly be evacuated across
hundreds or even thousands of miles. In
such situations it’s vital to keep a constant
watch on the patient’s progress and have a
full medical history to hand.
A fully integrated system
International SOS’s new global ‘case
management’ system (codenamed Magellan)
which is currently being rolled out to all of
its 28 alarm centers, provides full, regularly
updated details for doctors monitoring cases
around the world. Advanced technology lets International SOS globally
“If a patient is moving between time
zones, then doctors in different alarm centers monitor a patient’s condition in real time.
will all view the same information on
screen, letting them discuss the case more
efficiently. All details are entered directly on
to the paper-free system which already
contains the patient’s medical history,”
explains Mark Crawford, Global Systems
Development Director.
“This innovative technology is fully
integrated with virtually all our other
systems across the organization, helping us
to reduce administration and speed up data
entry, giving the doctors more time to focus
on the patient’s needs.”
And with the digital age well and truly
upon us, information such as x-rays and
scans can be attached and viewed from any
of the centers, greatly aiding the decision-
making process.
Invisible life support
So, when a patient calls from Nigeria with
chest pains, the coordinating doctor, taking
the call from International SOS’s alarm
center in Paris, is immediately able to access
the man’s details, arrange transport to the
nearest approved hospital and automatically
generate a Letter of Guarantee to cover any
medical expenses. When the patient is
evacuated to South Africa, the case can be
simply and seamlessly taken up by the alarm
center in Johannesburg.
“This whole system has been two years in
the making, involving millions of dollars of
investment and a tremendous effort by a
team of over 100 people. It is an invisible
life support system for our members. Our
doctors are delighted with this new
development as it helps them deliver a better
quality of care.” Mark continues: “This
software effectively lets us watch over a
patient twenty-four hours a day from
anywhere in the world.” s
Hotline, International SOS, Landmark House, Hammersmith Bridge Road, London, W6 9DP, United Kingdom
Phone: +44 20 8762 8000
Fax: +44 20 8762 8400
