Emergency evacuation and repatriation
Emergency evacuation and repatriation: repatriation is the process of return of employees to their homes. In most cases, it happens at the end of the assignment. However, it may occur in unexpected circumstances and lead to premature termination of the mission.
Contrary to repatriation that may be planned, evacuations are by definition, unplanned, unexpected and urgent. It does not imply a return of the expatriates to their home country but a transportation to a “safer” place.
Evacuation in case of crisis
Thus, emergency evacuations and repatriations occur in a situation of crisis. While definitions of crisis may differ greatly, Lerbinger (2012) distils eight generic characteristics of a crisis event:
- first, the event is sudden, unexpected and unwanted;
- also, it is of high impact and low probability;
- it has great ambiguity regarding cause, effect and resolution;
- one can note that it interrupts normal operations of an organisation;
- it hinders goals and threatens the firm’s profitability or survival;
- it requires fast decision making; then it may cause problems if no action is taken;
- and it creates significant psychological stress.
Evacuation and expatriates
Multinational companies are increasingly managing expatriates (and other staff) in countries and regions that present substantial health, safety, and security risks. Reports of violence, kidnapping, terrorism, and murders that target international assigees are common. Triggers for evacuation include natural disasters, irregular man-made crises, e.g. kidnapping, and regular man-made crises. Accidents and health problems fall into the category of regular man-made crises (table 10).
Evacuating international assignees incurs large direct and opportunity costs for firms, and can be traumatic for those involved. While data on the actual number of evacuations is unavailable, one global medical assistance firm reports overseeing 18,000 evacuations in a single year. And a recent study of international aid workers in 18 countries reported that more than 20% required evacuation over a 12-month period.
Medical evacuation and repatriation
Worldwide, when the needs of injured or ill patients exceed what local clinics and hospitals can provide, urgent evacuation to the nearest well-equipped medical facility becomes the key to preserving function and saving lives.
The evacuation of patients with less severe conditions is required when they need hospitalisation and adequate facilities are not available. Hospitalisation in facilities with no adherence to universal precautions (e.g., where sinks and gloves are unavailable), where hygiene is a low priority, or expertise or special
equipment is absent (e.g., orthopaedic hardware for larger patients) can create unnecessary complications that can be avoided by travel to a comprehensively staffed and stocked centre.
Because blood is not an export commodity in any country, the early transfer of a patient at risk of bleeding (e.g., from an ectopic pregnancy) to a facility with a replete and reliable blood bank can avert a tragedy. This is a special concern in sub-Saharan Africa, where the safety of blood supplies may be suspect, and in Southeast Asia, where Rh-phenotype blood is not always available.
Evacuation is also warranted when critical drugs are substandard, prone to being counterfeited, or unavailable owing to supply disruptions, government regulations, or practice standards.
Medical reasons for evacuation
For international evacuation, the most common conditions include:
- neurologic and orthopedic sequelae of road trauma,
- acute coronary syndromes,
- infections unresponsive to available therapies,
- infectious diseases, like malaria,
- and complications of pregnancy.
A study in the energy, mining and infrastructure industry25 indicates that the overall incident rate for medical evacuations and repatriations was 7% of all assistance cases within a population of 5,057 employees in the examined 40 companies within the segment. Within the entire population the three main reasons for emergency medical evacuation were:
- 28% accident and injury,
- 14% cardiovascular disorders,
- and 14% gastro-intestinal disorders.
The cost per case in a high risk country is double the amount as compared to a moderate risk country where risk is quantified by geography, economy, stability and local healthcare.
⇒ Download the study on prevent.be
Source: Yann Meunier, Globalization: health challenges for multinational corporations (2007)