What types of medical emergencies are common among Canadians in the Caribbean?
Cuba, the Dominican Republic, Jamaica, the Bahamas, and Aruba are all islands in the Caribbean that typically receive thousands of North American tourists year-round. Consequently, the hospital emergency departments on those islands see Americans and Canadians weekly, if not daily.
The most common conditions are treated and resolved locally within a few days. More serious cases lead to a trip interruption and eventually medical repatriation to Canada for follow-up treatment.
Heart problems and strokes are quite common among Canadian holidaymakers. It is believed that the tropical weather aggravates pre-existing conditions, the excessive exposure to the bright Caribbean sun, and the sudden change in daily routines.
Injuries are also far too common. Like anywhere else, trips and falls can happen at any time. The islands are also extremely popular for adventurous outdoor activities like watersports, off-road trips by a quad racer, or horseback riding, leading to broken bones, concussions, etc.
Most Canadians who need to be transported back home with medical assistance do so by commercial flight. Some are unfit for commercial travel and need the services of an air ambulance.
Where are the best hospitals in the Caribbean for Canadian patients?
In the event of a medical emergency while visiting the Caribbean, know that the level of care available varies between islands, and it all depends on where exactly you are.
While the ABC-islands (Aruba, Bonaire, Curacao), Barbados, the Cayman Islands, Martinique, and the Bahamas have an excellent reputation for their modern facilities and high standards of care, the situation can be very different on most of the smaller islands in the East of the Caribbean, leading to a more urgent need for medical repatriation. The sharp contrast between private and public hospitals can be quite impressive on the larger islands like Jamaica, Cuba, and the Dominic Republic.
Typically, Caribbean islands have small populations and limited resources. In the same way that Northern communities in Canada rely on large hospitals in the cities, most community hospitals in the Caribbean are only equipped for first stabilization until the patient gets medical transport to somewhere else. For that reason, permanent residents of the islands who need advanced medical treatment are flown year-round to larger centers in, for example, Puerto Rico, Florida, or Colombia.
When a Canadian visitor ends up in the same Caribbean hospitals, it is up to the insurance company to arrange a medevac to the nearest appropriate hospital, often in Florida. If no insurance is involved, family and friends can contact a medical repatriation company with the request to fly the patient back to Canada and continue the treatment in the home province.
What care is available in case of a medical emergency on a cruise ship in the Caribbean?
Medical emergencies are quite common onboard cruise ships. That’s not a surprise if you consider that the average cruise ship carries between 3,000 and 6,000 passengers plus the crew. That is comparable to the crowd of a small town, except that the average cruise ship in the Caribbean will be hosting a relatively high number of seniors.
Whenever a severe medical emergency happens onboard a cruise ship, the patient is first brought to the onboard medical center, where ship doctors and nurses will start treatment.
Cruise ship medical centers are generally well-equipped for a first assessment. There are several beds, a pharmacy, a lab, and x-ray facilities. Hospital-like treatment can be provided onboard for several days while the ship is sailing the Caribbean waters. Still, as soon as the next port of call is reached, the patient is offloaded and transported by ambulance to the local hospital on the island.
For the islands that house the larger hospitals in the Caribbean, it is quite common that several patients are offloaded from the same cruise ship simultaneously and brought to the local emergency department.
Depending on the situation, arrangements will be made for the patient to be picked up by an air ambulance or a medical escort if flown in to accompany the patient on a commercial flight back to Canada.
It’s important to consider that even if the patient is insured, most emergency medical bills will have to be paid out of pocket, with the prospect of filing a claim later. While the cost of the ship’s medical center is usually billed to the passenger’s account, local hospitals and ambulance companies in the Caribbean typically require a cash deposit upon admission and full payment by the time the patient is discharged.
When is commercial airline medical transport the best way to bring a patient back to Canada?
A medical transfer on a commercial flight is only sometimes an option. Sometimes a medevac must happen as soon as possible to save the patient’s life or minimize long-term disabilities. The patient might also need critical care that an air ambulance team can only provide during the flight. In all these cases, it takes only a few phone calls before an air ambulance takes off.
A fully equipped medical team can land on the island within hours to pick up the patient.
Suppose the patient is first stabilized in the local hospital and transferred on a commercial flight days later when the critical phase is over. In that case, the medical transport is considered non-urgent or a so-called ‘non-emergency medical transfer.’
There might still be a need for medical treatment as soon as the patient arrives in Canada, but traveling on an airplane is not expected to have a negative effect on the patient’s condition. For example, the patient might have a leg fracture in a cast splint that requires orthopedic surgery upon arrival. In those cases, a fully equipped medical escort can safely transport the patient to Canada with a commercial airline for a fraction of what an air ambulance would cost.
How to transport a Canadian back home after a mental health crisis in the Caribbean?
Unfortunately, each year, Canadians get stranded in the Caribbean due to a mental health crisis, be it a psychotic event, a suicidal act, or a severe relapse of anxiety. Whatever the background, a situation arises that warrants the response of the police and EMS, followed by admission to a psychiatric hospital on one of the larger islands or, if unlucky, a lockup at a local police station.
First, the patient needs to be stabilized on medication, and the treating doctor needs to be satisfied that the patient will not cause a problem on the flight. It can take a while before the patient can be medically cleared to fly back to Canada. Being locked up on a Caribbean island, far away from family or friends, can be an extremely frightening experience.
The language barrier, culture shock, and many unknown factors lead to high-stress levels. The quickest way out of the situation is to contact a Canadian medical repatriation company and request a psychiatric nurse to escort the patient back to Canada on a commercial flight. The company will contact the hospital on the island and start working on a plan to evacuate the patient as soon as a fit to fly certificate can be issued.
What is the cheapest way to transport a patient from the Caribbean to Canada?
If a patient is fit to fly and does not need critical care interventions on an air ambulance, the cheapest way to get home is to fly back to Canada on a commercial flight with a Canadian medical escort. The cost will be between $10,000 and $20,000 Canadian. This type of air medical transport is called commercial airline medical repatriation.
At JET COMPANION, the aeromedical approvals can be processed within 24 hours. A medical escort with all necessary medical equipment and supplies will fly from Canada to the Caribbean the next day to take the patient to the hospital.
They’ll then travel together on the first available flight to Canada. That can be with WestJet, Air Canada, Caribbean Airlines, or through the US with United, Delta, or American. Depending on the patient’s exact location, traveling through Latin America with Aero México, Avianca, Copa Airlines, or LATAM Airlines might make sense. This will be the case if the patient is offloaded in cities like Cartagena, Panama City, Belize, or San Jose, Costa Rica.
Some remote locations require a short medevac trip by boat or float plane before a commercial flight can be boarded. In any case, the same Canadian medical escort will stay with the patient until the final destination is reached and the patient is in the care of a Canadian hospital.
How can I get a medical flight from the Caribbean to Canada without insurance?
Patients stranded in the Caribbean can only sometimes rely on the insurance company to arrange a medical flight back home. Uninsured, underinsured, insurance-declined patients and those who are insured but have exhausted their maximum allowance for emergency medical expenses can find themselves in a position where they have to pay out of pocket for the cost of medical repatriation to Canada.
Medical transport companies like JET COMPANION work with families, employers, consular offices, and other organizations to help Canadian patients find the most cost-effective way to get medical transport from the Caribbean to Canada.
Tips to keep in mind if you need repatriation services from the Caribbean to Canada:
- Ask the hospital to issue all medical documents in English. Most hospital physicians in the Caribbean speak English, but the default language in the hospital could be Spanish, French, or Dutch.
- In case of a language barrier, remember that JET COMPANION has Spanish-, French- and Dutch-speaking case managers and medical escorts on staff.
- If uninsured repatriation is planned, get the ball rolling as soon as possible, even if the patient won’t be ready to fly for several days. Some preparations take time, for example, if a travel document is lost and an emergency must be issued.
- Many flights from the Caribbean to Canada and the USA leave in the afternoon and arrive in the evening, meaning that a patient connecting to a city other than Toronto or Montreal might reach the final destination at midnight or the following day after the layover.
- Commercial airline stretchers are not available from the Caribbean to Canada. A patient transported on a commercial flight must be able to sit in a business-class seat.