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You’re in a foreign country, your child is critically ill, what do you do?

How Aetna International's CARE team can help you get the right treatment, in the right place, at the right time

When paediatric specialist, Dr Simon Swain*, moved his family from the U.S. to rural Tanzania, the stark differences in health care between the two countries quickly became apparent. In his first year on the job he recalls seeing “well over a hundred children pass away…”

"The surgical options in Tanzania are zero."

So when his ten-year-old daughter, Eloise*, began complaining of an earache, he paid close attention. Tests revealed the pain stemmed from an abscess in her skull. Dr Swain was only too aware of what that meant. “There was absolutely no way we could treat this without surgery,” he said. “And the surgical options in Tanzania are zero.”

Medical missionaries

Previously the Director of Paediatrics at a renowned medical centre in the U.S., Dr Swain and his family moved to Tanzania as part of a medical mission. Their new home would be radically different from their lives in Minnesota, and they were all looking forward to a life changing experience. But when Eloise fell ill, Dr Swain’s background meant he understood immediately how serious her condition was. Without the resources available to treat her at his clinic, they needed to urgently take her to a hospital that could offer them a higher level of care.

As Aetna International members, the family had access to medical evacuation benefits (available to all members) and Dr Swain made a call to the emergency assistance line. Although he’d already arranged Eloise’s transport to the Aga Kahn hospital in Nairobi, the Care and Response Excellence (CARE) team were able to provide him with clinical advice and support as they made the journey.

Emergency flight

On arrival, the hospital ran tests on the ten-year-old. It wasn’t reassuring news. The earache was caused by a mastoid sinus abscess, which was slowly spreading to her brain. She was already experiencing facial paralysis and needed emergency medical treatment.

“Doctors there were able to stabilise the girl… but she needed to fly back to the United States for the life-saving surgery”

In partnership with the CARE team, Dr Swain arranged an air ambulance to take his daughter from Nairobi down to the Red Cross Children’s Hospital in Cape Town. Collaborating with her father, doctors there were able to stabilise the girl with intravenous antibiotics. But they still lacked the expertise to perform the life-saving surgery she needed. For that, they’d need to take a long flight back to the United States.

Atlantic crossing

Drawing on his medical contacts, Dr Swain researched hospitals that were capable of performing the cranial surgery his daughter desperately needed, eventually securing a team at the Children’s Hospital UPMC in Pittsburgh. Almost a month after her initial diagnosis, the ten-year-old was strong enough to survive the flight across the Atlantic, and was admitted into hospital. The operation was extremely complex, but ultimately successful. Just days later, Eloise was discharged into the care of her mother, and continued her rehabilitation as an outpatient.

Already back in Tanzania with their other children, Dr Swain was acutely aware of how lucky they were in contrast to the people around them. “She's going to live through this,” he said. “But if it had happened to any other child in the country, they probably would not have survived.”

Clinical CARE

In this case, Dr Swain’s medical background meant he was able to do much of the organisation and planning himself, liaising directly with the treating doctors, deciding where Eloise needed to go and how she should get there, and prescribing her medicines directly. The CARE team was able to engage in medical conversations to support Dr Swain’s treatment decisions for his daughter but, just as importantly, operational support with transport, logistics, and handling their claims after treatment.

But for Aetna International members without a medical background, the knowledge that the CARE team can be called on 24/7 offers enormous reassurance, especially for those living or working in countries with poorly resourced health care systems.

If a medical emergency happens while one of our members is overseas, we’ll provide expert clinical assistance, advising on potential next steps over the phone, co-ordinating with treating doctors to ensure the best possible health care outcome and, if necessary, arranging transport to specialist consultants wherever they are in the world. And if, like Eloise, one of our members requires an emergency medical evacuation, the operations side of the CARE team can source transport, arrange admissions and direct settlements with health care providers, and help organise any required international visas.

Wrap around support

But the CARE team isn’t just there in the event of an emergency. For Aetna International members the team provide end-to-end support, from before they leave to set off on their new life abroad, to the moment they arrive back home. Pre-trip health care assessments allow the team to get an accurate picture of a member’s current health, so they can make sure their needs are met while they’re overseas. And if those tests identify any previously unknown medical problems, or if they have a chronic condition like asthma or diabetes, the team can arrange specialist support in country, or transportation of medicines directly to the member’s new location.

The aim is to have everything in place to support the member’s health care needs from the moment they land.

Extra help

Members also benefit from practical help while in country. Aetna International’s Employee Assistance Program (EAP) representatives are on hand to discuss or trouble-shoot issues that are causing members stress, provide counselling and mental well-being support while the member is settling into life in a new country. And if an emergency happens that isn’t medically related, such as a natural disaster or terrorist attack, Aetna International members with Aetna Pioneer cover in place, also have direct access to global safety and security experts, red24.

With a global network of highly experienced ex-military and law enforcement consultants, red24 are available 24/7 to provide assistance in an emergency, offering advice over the phone or, if necessary, organising a full-scale evacuation. The extent of the services available to members depends on the level of cover they, or their employer, has chosen.

Aetna’s international private medical insurance (iPMI) plans aim to give members the peace of mind that there’s always someone there to call on, whatever happens to you or your family. To find out more about how the CARE team works and the benefits of Aetna International plans, contact one of our expert sales consultants.

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*Names have been changed to protect the privacy of our members.

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