Europ Assistance doctors are concerned about the evolution of Belgian behavior on vacation: “The files are more and more complex”

This summer, how did the medical activity of Europ Assistance evolve?

The number of medical records increased by 20 % compared to last year. However, when it had already increased from 15 to 20 % compared to the previous year. However, It is not trivial.

What are the main destinations concerned?

The majority of files come from Europe: France, Italy, Spain … Nevertheless, But for several years. Consequently, we have observed that travelers are leaving further and further, towards countries little or not medically equipped, sometimes in poor health or to practice sports at risk. Moreover, This complicates our work. Nevertheless, Since I was in office – almost six years -. Meanwhile, I have noticed a complexification of files: difficulties in obtaining medical reports, lack of collaboration of certain local doctors, heavier pathologies, europ assistance doctors concerned about …

Can you give a concrete example?

A patient with COPD (chronic obstructive bronchopneumopathy. Meanwhile, editor’s note) may seem stable in Belgium, but in Thailand, with a warm and humid climate and exposure to unknown bacteria, he risks decompensation. Similarly, In Bangkok, hospitals are excellent, sometimes even better equipped than with us. But apart from large cities, infrastructure is insufficient. In some cases. we must organize rapid europ assistance doctors concerned about transfers by helicopter or plane, with all the medical reasoning risks/benefit that this implies.

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What destinations are the most challenges?

Indonesia, for example: in some islands, there is nothing. No hospital, no decompression box for divers. Cape Verde is also a vogue destination. The hotel offer is excellent. but the medical infrastructure is very limited: a scanner that works once a week, no hyperbaric box … In the event of an accident. the only rescue is the plane, which must be pressurized at sea level – rare and expensive equipment.

Are travelers aware of these realities?

Not really. When we reserve a vacation, we think of the positive, not the medical risks. People are often surprised. In Egypt, for example, there are only two hospital structures that europ assistance doctors concerned about can be described as acceptable, in Hurghada. We also had to manage crisis situations, such as the sinking of a boat, where Belgians were involved last year. The survivors were first hospitalized in unworthy conditions, and it took close collaboration with the embassy to evacuate them.

Your team is made up only of emergency doctors and anesthetists. Why this choice ?

Because the emergency room is the “Swiss knife” of medicine. He knows all the pathologies, can manage very varied files and decide on the methods of repatriation. Hyper-specialists are not suitable for this type of regulation. Our job is to ensure secure repatriation. However. putting a patient on an airplane is never trivial: there are pathophysiological constraints, IATA standards, and sometimes formal contraindications (sinusitis, otitis, infection, hemoglobin too low …). Airlines also require their medical agreement, which takes time.

Beyond the medical, there is the financial question of repatriations. How is it managed?

A Thailand to Brussels health plane costs around 180,000 euros. In the United States, one night in intensive care costs 30,000 dollars, without even counting care. Many travelers underestimate these amounts and are bad. For example, temporary insurance capped at 250,000 euros may be enough in Europe, but not in the United States or Japan. Annual contracts, often better suited, cover europ assistance doctors concerned about up to 1.2 or 1.5 million euros.

Concretely, how are repatriation decisions made?

With us, it is the doctors who choose, depending on the interest of the patient. We favor safety and efficiency. The most crucial is to work quickly and properly to avoid gigantic costs. For example. we have developed, with Air France, the possibility of repatriating intubated and ventilated patients on regular flights, by installing a real mini-unit of intensive care on board. This reduces the cost from 180,000 to 35,000 euros, while remaining perfectly secure.

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Beyond the technique. there is also a strong human aspect …

Absolutely. During repatriations, we are often the first interlocutors in the patient’s language. We are not just monitoring medicine: we psychologically support traumatized people, sometimes in europ assistance doctors concerned about mourning, sometimes terrified. I. for example, accompanied a father who was to announce to his daughter that his mother died in an accident in Thailand. Or an entire family, survived by a helicopter crash in Africa. These situations are of enormous human intensity, and that is what motivates our team.