In past, numerous local victims and tourists have been airlifted from distress site alive but did not make it to the hospitals. Some breathed their last inside the helicopter and others at the TIA heliport in the process of transfer or waiting for the ambulance. It is therefore a huge shy of relief that patients can be accompanied by medics to and from the hospital helipads. In lifesaving missions, saving time matters and quick response with a complete medical team is possible with hospital helipads.

Having Helipad within the hospital premises has its advantages. First and foremost, it saves transfer time of the patient in need of critical care. In other words, this is exactly what we need in critical lifesaving Medical evacuation missions in Nepal, given its geographical complexion. Bringing patients by vehicle may take hours and days from remote areas where medical facilities are not at the same level as some of the hospitals in Kathmandu.

At present, Karuna Hospital in Chunikhel has built a surface helipad and they are ready for the operation. There are three Major Hospitals with Serviceable Rooftop Helipads; Nepal Mediciti in Bhaisepati, HAMS in Dhumbarahi and Grande International Hospital in Dhapasi. There are surface landing facilities in TUTH Teaching Hospital and Gangalal Hospital but they need major face-lifting and renovation for safer operation.

The conditions of rooftop helipad and facilities should be monitored and analyzed at least twice a year by authorities to ensure safer operations. Approvals to operate helipads are not perennial endorsements or blanket authority and are subject to strict compliance to the regulatory requirements. Such regulation caters to safer operation.  

Having helipad allows immediate Medical Rescue Mission operation but also raises several safety concerns at both Surface and Rooftop Helipad are medical evacuations are daily affairs these days. Keeping patients, crew and personnel assisting patient transfer safe is the highest priority and we can achieve this by implementing some of these simple points:

1. Consultation with aviation professionals, operators, and officials of Civil Aviation Authority of Nepal (CAAN) by Hospital Management prior to the commencement of Helipad construction and operation whether it is a rooftop or surface. Guidelines from officials other than CAAN or Google may not be sufficient or in compliance with CAAN regulations.
2. Routine Check and Maintenance of Hospital Helipad including firefighting capacity, official documents and contacts of relevant Hospital officials (HLO) responsible for the helipad by CAAN Authority.
3. Continuous Training and Development Program in Helicopter Marshaling and Handling by authorized and experienced professionals.
4. Continuous Training and Development Program in Helicopter and Hospital Firefighting by authorized and experience professionals.
5. Effective Communication between the Operator and Hospital Staff every time a mission is activated.
6. Reporting of condition of helipad and surrounding areas, unusual behavior or practice of Hospital staffs that compromises safety by Pilots to their Safety Managers and Authority if required.
7. Reporting by Hospital management to Operators of visible obstacles, Foreign Object Debris (FOD) in and around the actual landing and surrounding area, weather, wind and state of the surface of helipad to ensure it’s not slippery.
8. Safety nets should made by professionals from tested materials/ ropes in rooftop helipad.
9. Keeping wind socks or wind direction Indicator with a visible light of aviation grade in excellent condition.
10. Proper and enough signage to warn of dangers throughout the Helipad Area.
11. Understanding the nature of Helicopter Operation and the risks involved through interaction and information sharing with operators.
12. Emergency Response Plan and Flowchart familiarization.

During the operation or flight missions of past, accidents have happened and lives were lost. And in some cases, helicopters were completely destroyed. Luckily some very fortunate flying crews managed to escape with minor injuries and managed to save passengers onboard. These lifesaving operations can start from a mark helipad to unmarked and unguarded landing areas with people and animals in the surroundings and as such, it is important to be aware to protect self and others. Accidents and incidents do not send alert message or ring bells, it just happens.

The number of Inter Hospital transfers, Medevac/ rescue flights are on the rise and so is the risk, specifically in the Hospital helipads. No one should get injured or lose life in the process of saving lives so keeping the Hospital Helipad safe is very important.

Hospital Management cannot take for granted with “once and for all and done” attitude once the construction process ends and approval to operate obtained from CAAN authorities. Just satisfying authorities’ requirement for the purpose of operation initiation is nothing but a short term solution. Routine maintenance, development of SOP, continuous training and orientation of Helicopter operations is the key component ensuring safety and stability of the rescue process system and its longevity.

Hospital helipads are the best alternative to saving time in critical medical evacuations. However, their numbers should not just increase in quantity but also in quality satisfying all the parameters for safer Medical Evacuation operations. Hospitals premises and the infrastructure should exist to treat and heal people, not to turn into an unsafe location to trigger unfortunate events or accidents causing injury or deaths.   

Suraj Paudyal is a long time Helicopter Industry acquaintance and Sr. Rescue Coordinator/ Consultant with Simrik Air and contributed to write this article. He has given consultancy to Nepal Mediciti, HAMS, and recently advised and aided Karuna Hospital in their process of Helipad constructions, operation and maintenance. Suraj cares about everyone involved and advocates for safer operational practice and safe culture.