By Dr. Dinesh
Critical patients after a severe injury, cardiac arrest, stroke, or other life-threatening event from the islands deserve a seamless air-evacuation system not a battle with bureaucracy. In a medical emergency, every minute counts. For a critical patient in the Andaman Islands, those minutes often determine the line between life and death. Yet, for too many families, the so-called “golden hour” is being squandered not in medical indecision but in negotiations with airlines over stretcher approvals and flight clearances.
When a patient from Sri Vijaya Puram needs urgent transfer to a tertiary hospital in Chennai, one would expect the system to move with precision. Instead, calls to airline offices, delayed permissions, and unclear medical protocols turn a rescue operation into an administrative marathon or worse, a systemic void.
A dedicated counter (single window system) with internet facilities and minimum required infrastructure and staff to coordinate with patient parties, airlines, and mainland hospitals is the need of the hour. The patient attendant is often unable to cope with the stress and strain of arranging both logistics and financial matters during a crisis.
Commercial airlines differ in their approach to carrying stretcher-bound or critically ill passengers. Some, like Air India, have established provisions for medical evacuation on scheduled flights; others decline such requests outright, citing technical, safety, or operational constraints. The reasons are not entirely unreasonable, a stretcher installation requires reconfiguring the cabin, additional crew coordination, and medical supervision.
However, the lack of a uniform national protocol means that each emergency devolves into a fresh round of persuasion and paperwork. In the process, the patient’s most precious resource time is lost.
The cost of delay,
Doctors speak of the “platinum hour,” that fleeting window during which swift treatment can prevent irreversible organ failure or death. On the islands, that window is narrowing further because the air evacuation process is fragmented and unpredictable. The absence of a dedicated coordination cell or pre-approved agreements with airlines forces local officials and families to start from zero each time an emergency arises.
It is an unacceptable irony that while India has made rapid strides in civil aviation and emergency medicine, a patient’s survival can still depend on the discretion of an airline call centre.
The remedy is neither complex nor costly. What it requires is foresight and coordination.
Establish a 24×7 Aero-Medical Coordination Cell (AMCC) at G.B Pant Hospital and Srivijayapuram airport, empowered to communicate simultaneously with airlines, hospitals, and air-ambulance operators.
Sign standing Memorandums of Understanding (MOUs) with willing carriers, defining fixed tariffs, medical criteria, and guaranteed response times for stretcher patients.
Designate at least one flight per day as “medevac-compatible,” ensuring that equipment and staff are prepared in advance.
Adopt a standard medical triage form, approved jointly by the Directorate of Health Services and airline medical officers, to avoid repeated queries about patient fitness.
Create a small contingency fund under the Lt. Governor’s (A & N Administration) to subsidise urgent air transfers when commercial negotiations fail.
Policy beyond the Islands, the Ministry of Civil Aviation and the DGCA should now consider framing a national medevac policy. This should make it mandatory for airlines to declare their stretcher-handling capacity, designate a medical desk, and respond within a fixed time frame to emergency requests. Incentives such as fee waivers or recognition under CSR obligations could encourage cooperation from private carriers.
This is not about special privilege for one Union Territory, it is about establishing a humanitarian standard across India’s skies.
For the islanders, lives before logistics, an aircraft is not just a mode of transport, it is often a lifeline. To lose that link to indecision or red tape is a failure of both policy and empathy. In the twenty-first century, when India aspires to world-class healthcare and aviation infrastructure, no patient should die waiting for an airline’s consent.
Saving the golden hour must become a shared national priority, because in the air, as in medicine, delay is the deadliest diagnosis.
The right to emergency medical care is not merely an ethical or humanitarian concern, it is a constitutional right, which guarantees the right to life. In the Andaman skies that connect the islands to the mainland, compassion and policy must fly together.