Meet ER24 Global Assist Agent Andiswa Ngwena

ER24’s Global Assist services operate throughout Southern Africa, Africa and the surrounding islands.

As a Global Assist Agent for ER24, Andiswa Ngwena ensures local and international patients who need an air ambulance and medical assistance are processed efficiently and receive the appropriate care. She is responsible for all the Flight Desk paperwork and administration.

“We serve public and private clients, such as governments, medical insurers, and the energy and mining industry, who require access to international medical care,” she explains. “We have a number of aircraft at our disposal that we can use to evacuate and transport patients who need medical care.”

These include a fleet of fixed-wing aircraft (called Air Ambulances), Medical Escort services using commercial flights (for those who aren’t well enough to travel without medical assistance), ICU road ambulances (known as Critical Care Retrieval Services CCRS), and ER24’s various ground ambulances.   “A CCRS ambulance is an ICU-equipped ambulance designed for neonates, critically ill patients, and those needing high-flow oxygen over long distances,” Ngwena explains. We also outsource Helicopter Emergency Medical Services (HEMS).

ER24’s Global Assist has been managing international evacuations for over 20 years. “While we used to outsource additional services – such as organising transport and accommodation for family members, plus recommending facilities and translators – these now officially fall under our Medical Assistant Services (MAS),”  Ngwena explains.

Daily duties and responsibilities

One of three Global Assist Agents – and the only woman – Ngwena says her previous experience at ER24 helps in her current position. “I worked as an Emergency Resource Officer at ER24’s Contact Centre before becoming a dispatcher,” she says. “This has helped me understand the urgency of every call. Communication must be extremely clear, and I also need to display empathy when the person on the other side of the phone is frustrated.”

Most of Ngwena’s daily duties involve client communication, paperwork and administration. The Global Assist Agent forms the central point for all communication between the client, the aircraft operator, the medical team, the ground ambulances involved in the referring, the receiving country and the patient’s destination point. “We first have to gather all the patient’s clinical information and check the designated hospital has capacity,” she explains. “Once we have all those details, we liaise with the clinical coordinator and medical officer on call who decides which level of care and what method of transport is required. The aircraft captain also weighs in as the final decision is both medical and operational.”

Before a patient can be moved between countries, ER24’s Global Assist Agents must gather all the necessary travel documents and permissions. These include the patient’s passport, medical reports, vaccination certificates, acceptance letter from the receiving hospital or treating doctor, and approval from the South African Port Health and the Civil Aviation Authority (CAA).

Fixed wing air ambulances and helicopters

Global Assist’s fleet of fixed-wing aircraft includes long-range jets such as a Falcon 50, capable of flying to Europe with a single technical stop for refueling. The Falcon 20 and Hawker 800 are commonly used for medevacs in Sub-Saharan Africa and the surrounding islands. While these aircraft can also be used for flights to Europe, they require more technical stops en route for refueling. The King Air 200 is used for flights to neighbouring countries such as Botswana, Lesotho, Mozambique, and Namibia, as well as for local medevacs that a helicopter cannot reach. The maximum distance a helicopter can reach is about 350km so the King Air 200 would be used for patients from the regions who require specialist care in centres of excellence such as Gauteng or the Western Cape.

‘Depending on the country, obtaining all the permits for fixed-wing flights can take between four and 36 hours,” Ngwena explains. “If a call comes in for a helicopter evacuation, it always takes priority as the patient is in need of emergency medical care. We assess each case and determine the best mode of transport for the patient.”

She adds that while some might think HEMS is always the quickest and best option, it isn’t always the case. “Sometimes it is faster and more appropriate to use a road ambulance. In most cases, the ground ambulance is already where the patient is and can start transporting the patient immediately. In areas like Mpumalanga and Limpopo, the helicopter is often dispatched from Johannesburg and still needs to be refueled, as it can only reach a certain distance.”

Global Assist Agents also co-ordinate medical escort services on commercial flights. “This occurs when a patient isn’t critical but still needs medical attention during a flight,” Ngwena explains. “It entails a lot of administration because the airline must approve the patient’s clinical condition and anticipated medical needs during the flight, the medical equipment that is required for flight and planning, and provision for the patient stretcher and on-board oxygen.”

Aviation training

Ngwena renews her CAT 138 course every year and knows the capabilities of each Global Assist aircraft. CAT 138 training refers to the technical standard of operation that all air ambulance operators need to provide safe and efficient aero-medical services. The training entails the operation of the aircraft, the medical interior, the loading and unloading of patients and equipment, medical principles, and industry best practice with a major emphasis on safety.

“It’s a wonderful feeling when a mission goes smoothly and you get confirmation that a patient has been safely handed over,” she says. “It’s very rewarding playing a key part in someone’s medical journey to recovery.”