India’s nascent HEMS market holds large potential for global service providers
Atul Chandra
The Indian Helicopter Emergency Medical Services (HEMS) sector is in its infancy with only a handful of helicopters configured for this role. The global HEMS sector is a key market for helicopter manufacturers, along with Search and Rescue (SAR), and will remain a driver for future growth as markets like China and India begin to acquire more such helicopters. An estimated 30 per cent of the helicopters currently flying worldwide are outfitted for medical and other similar roles. Global helicopter manufacturers such as Airbus Helicopters, Bell Helicopter, AgustaWestland, Sikorsky and Russian Helicopters are keenly awaiting growth in this sector in India, with an estimated market for 50 helicopters by the end of this decade. Post 2020, the demand for air-medical helicopters is expected to grow substantially.
A helicopter configured in the air-medical evacuation role with trained crew can quickly stabilise a critically ill or injured patient (on the ground or inside the helicopter), and then have them transferred to a hospital. India lags behind in offering this important emergency medical service compared to other developed countries, where the usage of helicopters for such roles is well established. The increasing urbanisation of major Indian cities marked by rapid and unplanned growth, along with high traffic density, makes the need for HEMS even more urgent. A helicopter can travel at approximately two miles per minute and surmount challenges such as natural obstacles, traffic snarls, and slow movement of traffic on narrow roads, which cannot be overcome by ground ambulances. It is important to note that HEMS is not a substitute for ground ambulances, it only offers an enhanced capability and must for be used for emergencies only, and not when a ground ambulance can perform the same task. For many in India, the sight of the armed forces being deployed to provide air evacuation during natural disasters and other emergencies, is a familiar one. The helicopters are often mobilised from nearby units and have to be flown down and are configured only for transport and not equipped with the specialised medical equipment available on a HEMS configured platform. These operations also consume precious flight hours on expensive military assets. The solution is to have air-medical helicopters available for such roles.
There are a host of other issues which also need to be tackled to enable the growth of this vital service, and the task is acknowledged as ‘difficult but necessary.’ Regulatory requirements also require to be changed and the Directorate General of Civil Aviation (DGCA) has been made aware of the requirements for the growth of HEMS in India. The time taken to receive clearance after filing the flight plan needs to be reduced, as this is vital to the quick response to an emergency call by an air-medical helicopter. Airspace availability also needs to be looked at, and according to industry observer, “opening up the airspace is vital to the growth of helicopter operations. Opening up air-space below 5,000 feet should be seriously considered for growth of HEMS in India.” China has taken the lead with regards to the setting up of HEMS and last year saw the delivery of the first fully equipped air ambulance helicopter in China, an EC135 P2e, delivered by Airbus Helicopters. It is the country’s first rotorcraft outfitted for dedicated HEMS missions, delivered to the 999 Emergency Rescue Center which is a Beijing Red Cross Foundation subsidiary. “The relaxation of China’s low-altitude airspace augurs well for the development of HEMS which is very much needed in a country of such geographical and population size,” said Norbert Ducrot, President of Airbus Helicopters China, on occasion of the delivery in October last year.
HEMS operations can be divided into three distinct types:
• ‘Primary response’ – transport of medical personnel and equipment direct to the scene (or nearby) of an incident / accident (e.g. road traffic accident, fall, train derailment etc.) and the rapid transport of patient(s) / victim(s) to hospital. (Most people recognise HEMS in the ‘primary response’ role)
• ‘Secondary response’ – direct to a designated site1 to meet road ambulance(s) coming from either a hospital or incident site to facilitate rapid on-carriage of patient(s) by helicopter to a hospital
• ‘Tertiary response’ – planned urgent and rapid transfers of critically ill patients requiring specialised care between hospitals (inter-hospital transfers – often referred to as ‘air ambulance’).
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