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Rapid evacuation and long-term care — One expat’s road to recovery after a stroke in Antigua

This is the story of Kumar, an Indian national living in Antigua who suffered a life-threatening stroke.

The severity of the episode also pointed to an immediate need for lengthy, specialist rehabilitation unavailable in Antigua.

Read Kumar’s* story to find out how we help our members recover from an emergency anytime, anywhere.


Kumar and his family relocated to Antigua for work, when, in August 2018, he suffered a stroke. He required urgent treatment and was rushed to a nearby hospital.

Kumar’s stroke left him severely weakened down the right-hand side of his body, and without the ability to speak or swallow. After a few days in hospital, the doctor told his family that he would require further urgent treatment followed by an extended period of rehabilitation.

Through their international private medical insurance (iPMI), Kumar’s wife was immediately able to contact Aetna International’s CARE team and request emergency medical support.

Urgent treatment, lengthy rehab

Kumar’s case was picked up by Shamsa and she became their primary point of contact. A clinical case manager with many years of diverse care experience, including surgical expertise Shamsa also speaks four languages fluently: Hindi, Urdu, Punjabi and Arabic. As a member of the CARE team, Shamsa provides one-to-one nurse-led support for members to help them make informed decisions about their care and manage their acute or chronic conditions, helping to ensure the best possible health outcome. It’s an industry-leading approach to member care, not least because our clinicians are trained in motivational interviewing techniques and cultural sensitivity.

Shamsa spoke with Kumar’s treating doctor to understand the nature of his condition. She agreed with the doctor — Kumar would require further urgent treatment and lengthy rehabilitation – so set to work finding the best care solutions. She quickly discovered that there weren’t any facilities in Antigua that could offer the level of care that Kumar needed and they would need to look further afield.

Evacuation to America

Shamsa liaised with Kumar’s family (his wife in Antigua, a daughter in the UK and another daughter in Germany) and the U.S. legal authorities to arrange the logistics.

This meant organising U.S. visas and travel itineraries as well as evacuating Kumar and his family to the closest centre of medical excellence — in Florida some 1,400 miles away. Time was a factor but Shamsa was able to make all the necessary arrangements within just two days.

The family hadn’t been in Antigua long so were uncertain how to navigate its health care system. Of U.S. health care they knew even less. Shamsa was therefore able to reassure them and answer their many questions and address any concerns they might have — round the clock.

Homeward bound

While Kumar’s condition was being stabilised in the hospital, his family wanted to return to India as quickly as possible so they could be at home while Kumar underwent rehabilitation.

The treating doctor, Shamsa and Kumar’s family agreed upon a course of action. Kumar would stay in the U.S. moving from the hospital to rehab until he was well enough to join his family in India and continue his rehab there.

The plan was set in motion and once his initial treatment was complete and successful, Shamsa arranged the hospital discharge paperwork and Kumar was transferred to the U.S. rehab facility.


During rehab, Kumar suffered significant further medical episodes and complications and he was readmitted to hospital for treatment which lasted 50 days. Finally, he reached a level of health where his condition was no longer critical and doctors agreed he could be discharged.

It was a nerve-wracking time for the family, especially as, like most people, they were unfamiliar with the workings of international private medical insurance (iPMI). With Shamsa always at the end of the phone or email she was able to talk to the family, explain technical terminology and walk through new processes.

Kumar was discharged but remained very weak and rather than risking exposure to infections in a hospital environment, it was agreed that he should be transferred to a specialist nursing facility.

Rehab revisited

The next task was to locate a quality rehab facility that could cater to Kumar’s complex and demanding medical needs. Shamsa contacted 20 specialist facilities, but none would agree to take Kumar. Eventually, she found a skilled nursing facility within network that could accept and effectively look after him.

And so, Kumar took up residence in the facility where he received the rehab treatment he needed as well as recovering from several infections he had picked up during his stay in hospital. Throughout his ordeal, Shamsa helped the family with everything from finding accommodation close to the hospital and facilities to arranging visa extensions for everyone.

Two weeks later, Kumar was pronounced fit to fly. Shamsa arranged his transport home to India via commercial airliner with the support of medical care throughout his journey and he and his family arrived home in India in a stable condition. Once at home, the family arranged ongoing rehabilitation so Kumar could take his time to recover in the comfort of his own home.

It had taken more than 200 emails, 50 phone calls between medical experts and daily calls with the family, but Kumar was finally and firmly on the road to recovery.


We believe in being there, no matter what.

In the event of a medical emergency (prescription refill, illness or accident), contact the CARE team by calling the number on the back of your membership card.

For more information about the CARE team and the other benefits and services available through your plan, login to (or register for) the Health Hub.

Are you an employer? Find out more about how Aetna International’s CARE team can help you support your international employees and help to keep them healthy, happy, safe and productive.

* Name changed to protect the identity of the member

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