Medical Evacuation in Libya by FEMERAID International Air Rescue Service
On the 6th January 2020, Femeraid International Air Rescue Service together with Femeraid International Ambulance Service – the recently established department of FEMERAID International, the health service institution of the Sovereign Order of Saint John of Jerusalem, Knights of Malta, Federation of the Autonomous Priories (KMFAP) dedicated to provide Medical Care and Humanitarian Assistance to the needy and to critical patients – have received a dramatic request for help from a family that – either mistakenly or not – was bombed at their farm near Tripoli, Libya.
The bombardment resulted in severe injuries in 5 children between the ages of 6 and 17. One of the children died on the spot and the others were evacuated to a clinic in the Libyan capital.

Due to the political and military situation, very few Air Ambulances accepted this request, but our Air Rescue Unit did and we proposed that 3 of the less seriously injured children would be evacuated by ground ambulance to Tunisia and the most serious case, a 16-year-old teenager should be evacuated by our Air Ambulance to Istanbul.
On the 7th January, the most serious case was submitted to a dramatic surgical intervention due to a piercing of the intestine by metal fragments and an amputation of the left hand in order to save his life.
Our team planned to take off in the early hours of the 8th January, and when they were already on the plane for take-off to Tripoli, the airport and the surroundings have been bombed, making the flight unfeasible, at that point.
I was in Rome on an official mission and was asked to return immediately to Malta to make this flight but to a city 250 kilometres from Tripoli, where our Libyan team could take the patient by ambulance for the “rendez-vous” with the Air Ambulance.
After verifying the immediate security conditions on the 9th January, we took off to Libya properly coordinated by the Alarm Centre, so that our time on land would be as little as possible. Upon arrival to Libya the military situation seemed to be calm, which allowed us to receive the patient, who was in a critical condition with signs of infection, intubated and connected to the ventilator to maintain his vital functions. The patient was transferred to our Life Support unit, we changed the medication and the parameters so that the flight would be safe for the patient. After 1h30 on the ground preparing the patient we could successfully stabilize and load him in our Air Ambulance, a Falcon 100, and we took off for a flight of about 3 hours, during which the patient remained relatively stable despite having spikes of fever and some difficulties in adapting to the ventilator, which led us to change medication and to sedate and paralyse him even more deeply. The patient arrived at the intensive care unit in Istanbul safely and stable and within a few hours he underwent a new surgical procedure due to abdominal infection.

Today this 16 years old patient finds himself out of the ventilator but with a still difficult recovery and not yet out of danger of life.
The boy’s father accompanied us throughout the mission and asked me to write this summary so that world wakes up to atrocities that are happening right now, next door in Libya...

14th January 2020

Sir Dr. Nuno Cosmelli
Director of Femeraid International Air Rescue Service
Medical Director of Femeraid International Ambulance Service