In case of emergency

By Shaan Bajaj

One look at your Instagram or Facebook will inform you that travel is (mostly) back to normal, as are our usual, overseas-travel prep-work: the mums among us will create a medication pouch “just in case” their children fall sick, you start to restock any medication that you may be on, and you check with doctors to see if you need any vaccinations for the country you are visiting. However, there will always be things that we miss, and the one thing we often forget or don’t pay enough attention to is our travel insurance policy. While no one wishes for a medical emergency, they do happen, and having travel insurance can significantly affect your chances of survival. To learn more about staying healthy while travelling, I spoke to Dr. Kanwar Singh, internist and aviation medicine specialist at Bangkok Hospital, who has an in-depth understanding of the importance of travel insurance, as well as all the other ways we can be prepared for unseen medical emergencies while travelling.

Born in Bangkok and raised in Amritsar, Dr. Kanwar completed his education at St. Francis School, Amritsar. Encouraged by his grandfather and family, he pursued his education in Medicine at Sambalpur University. He was then offered the opportunity to complete a postgraduate degree in Thailand, where he studied and worked for an army
hospital within the field of tropical medicine. Looking for a change, Dr. Kanwar then settled in Bangkok Hospital as an internal medicine specialist, where he’s been for the past 35 years.

During his tenure at Bangkok Hospital, and ever-eager to gain more experience, Dr. Kanwar came across a French doctor who was the Medical Director of Europ Assistance in Paris. He was invited to train in aviation medicine for three weeks, and, he tells me, he immediately loved it and subsequently trained as a specialist in aviation medicine. Shortly after, he joined International SOS as a young advisor, and retired as a senior
medical advisor, after a 30-year career with them. I was fascinated to learn that as an aviation doctor, Dr. Kanwar carried out a tremendous amount of medical evacuations via air ambulance from many different parts of the world, helping save lives by getting people to better facilities. “My most frequent destinations were all over Europe, China, Japan, Korea, Vietnam and Cambodia,” he recalls; an impressive list at a time when the world seemed much bigger than it is now.

In an exclusive interview with Masala, he shares his extensive knowledge on aviation medicine, and how travel insurance can save your life.

How did your education as an internist inform your current specialty?
Medicine on the ground versus medicine in the air is very different. While the background is the same, the approach differs due to physiological differences. Without proper training in medicine, you cannot practice aviation medicine.

What exactly is an aviation doctor, and what are some common misconceptions about this field that you would like to address?
Many people don’t know what an aviation doctor is, or that it requires a lot of training. Only an aviation specialist can tell a patient whether they are fit to fly, how they should fly, and what equipment they might need. Aviation doctors need to anticipate the complications that may arise because of the change in pressure and oxygen. We’re also needed once a patient needs to be transported or evacuated. I’ve done a lot of evacuations from remote parts of the world. Basically, without aviation doctors, we wouldn’t be able to save a lot of lives.

What kind of cases or diagnoses did you often witness? Any interesting cases?
As an internist, I have treated a lot of tropical diseases, including fevers, malaria and typhoid. As an aviation doctor, I have dealt with a lot of trauma cases; people who needed urgent and immediate evacuation. I did evacuations from all over the world, bringing them to a hospital with proper facilities from countries or cities that had none. Around 30
years ago, we’d bring people out of places where the medical facilities were extremely poor, and nothing like they are now; it was almost like bringing someone out of a rat hole.

A lot of these evacuations were of young travellers who experienced sports injuries or had drunk accidents, or of terminally-ill elderly patients. Often the target was to reach home. I have also worked with embassies; I helped American soldiers in Vietnam, and even received a certificate from The White House Medical Unit for supporting President George W. Bush during his visit to Bangkok.

While it’s impossible to prepare for every medical emergency one may face abroad, what can community members do to prepare before they travel?
The first thing I would suggest is, do not leave your country without proper insurance. You might think you won’t need it if you’re rich, however, without insurance companies, you will end up at a standstill as making arrangements for repatriation is a complicated process. When choosing your insurance, please read the fine print and small clauses. It’s tempting to buy the cheapest option before you read the policy, but reading your policy can be the difference between life and death. If you do find yourself in a medical emergency, call your insurance immediately and they will sort it out.

If you are a frequent flyer, keep your underlying diseases in mind before flying, while ensuring that you have a sufficient amount of any medications you may need. After the age of 60 and over, you need to start taking care of your health more, and assessing your mobility before you travel, as the risk is higher.

What are the current trends and advancements within aviation medicine?
Repatriations are easier to perform as some new planes have proper equipment for an ICU. Some of the facilities available in these planes are even better than local hospitals. When I had started, we had to turn over the seats to create an ICU on an ordinary plane, nowadays all you need to do is walk in.

Any final medical advice to the community?
Stop treating hospitals like shopping centres. Time is incredibly precious, so you need to allow your doctors the time to find the proper diagnosis and treatment without having to start from scratch. Let doctors complete a diagnose before you go shopping for the next;
this way you’ll get the best care that you need.