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How a single phone call can save a life

How a single phone call can save a life

By Eric Vo · May 2016

The call to Aetna International’s Care and Response Excellence (CARE) team* in Farnborough, United Kingdom, came in at 2 a.m. GMT. The caller said that her sister, a member of one of Aetna International’s global health insurance plans, was very unwell in a hospital in Mozambique and that her condition was rapidly getting worse.

The clinical experts within the 24-7-365 CARE team immediately sprang into action, gathering the background information on the member’s case, assessing the details and working closely with emergency evacuation colleagues as the situation unfolded.

The team discovered that the member had been living and working in Mozambique when she began experiencing increasingly severe stomach pains. She was admitted to a nearby hospital, where medical staff discovered a stomach abscess. They began operating on the member to drain the abscess. During the procedure, however, doctors discovered a second abscess. Unsure of how to proceed with this unusual turn of events, they patched her up with gauze and left her in the hospital. Meanwhile, her stomach was still effectively wide open. The member’s condition weakened in a matter of hours, which is when her sister called Aetna International for help.

“This was one of the worst cases I have come across from a medical point of view,” said Dr Mitesh Patel, medical director of Aetna International. “If the sister hadn’t called us when she did, things would have ended badly. Her call enabled us to act immediately and get the patient the care she needed."

After evaluating the member’s case, the CARE team determined that she needed urgent care from a specialist facility. The situation was time critical and in less than 12 hours, the CARE team had arranged for a medical evacuation by air, and the member was taken to Sunninghill Hospital in Johannesburg, South Africa. During the trip, the member received appropriate medical assistance and on arrival in Johannesburg, she was immediately admitted into Sunninghill’s Intensive Care Unit. From there she underwent several surgeries, including a bowel resection to remove the infected abscess.

The woman spent a total of five weeks recovering in Sunninghill hospital, South Africa. During this time, her case was continuously monitored by a dedicated team of Aetna International staff. After a successful recovery, the woman returned to Mozambique where she is living and working in complete health. The CARE team’s rapid response allowed the woman to receive the appropriate treatment and avoid a potentially fatal situation. After recovering, the woman’s husband sent a message of gratitude to the CARE team : “We want to thank all the Aetna International personnel we have dealt with since that day, during the admission in Sunninghill Hospital and back to Maputo after more than a month, for their attention, kindness, efficiency, and mostly their professionalism."

More about the CARE team

The CARE team serves as a single point of contact, helping Aetna International plan members access the care they need. They cover all aspects of the assistance process, including providing advice from medical experts, arranging admittance to hospital, identifying specialists and arranging ambulances as well as organising the approval and payment of treatment.

The team also arranges evacuation of members for critical and non-critical conditions, where medically necessary, if adequate treatment cannot be provided locally. Our in-house medical team and remote working panel of registered practising physicians ensure that our members receive the highest professional standards of medical treatment whilst helping to challenge overtreatment and the inconvenience and cost of unnecessary medical investigations.

*The CARE team handles our members’ clinical and emergency evacuation needs outside the U.S.

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