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ASSISTANCE CASE STUDY

10/10/2013
Evacuation in Republic of Yemen
 
On August 29th, the Princeton Operations Center received a call from an insurance client in the
United Arab Emirates who reported that a member and his family had been traveling in the Marib
province in Yemen and were involved in a motor vehicle accident on August 23rd. The father, mother
and three children had all sustained injuries including a concussion and a variety of fractures and two
minor children were unharmed. The client also informed us that the family had been hospitalized
following the accident. The Operations Team immediately contacted an older son, who was not
involved in the accident but had also been traveling with the family and explained Assist America’s
services.

The Operations Team began assessing the capabilities of the hospital and possible evacuation plans.
Due to the inability to communicate with the medical team at the hospital, the Operations Team
consulted with the son and concluded that all of the injuries to the family members were beyond the
care available at the Marib hospital.

Direct contact with the hospital continued to prove difficult as the staff rarely answered the phone and
when they did answer, they refused to allow us to speak with the treating physicians. After persistent
efforts, however, the Operations Team spoke to the treating physician the evening of the 29th and
the doctor advised that most of the patients had been x-rayed but care had not progressed beyond
that point. He did not provide any further details about their condition and requested the Team call
back the next day. On August 30th, the Operations Team sent the hospital a written request for a
medical update via fax, as well as explained to the son the continuing difficulty we were experiencing
getting in contact with the hospital and obtaining medical reports.

Although the patients were not in critical condition, the ongoing communication issues, technological
limitations of the hospital, combined with the substandard medical reports and ongoing care, Assist
America determined that an evacuation was necessary. The Saudi German Hospital in Yemen’s
capital of Sana’a was the closest facility but its capabilities were only slightly better than the treating
hospital and it was not going to provide long term adequate care/treatment. Accordingly, the
Operations Team focused on an evacuation plan to return the patients and family to the UAE with
routing through Sana’a and the Saudi German Hospital for stabilization.

Assist America arranged for a provider to pick up the patients on September 2nd; however, the
provider could not obtain flight clearance and arrange a ground ambulance service. Assist America
confirmed with nine of its providers in the region that the problem impacting each provider was the
absolute unavailability of ground ambulance service over the road that connects Marib to Sana’a.
This road had been previously closed due to protesting Yemenis and general tribal fighting. No
provider was willing to provide ground ambulance services to evacuate our members. With no option
for ground transport due to tribal fighting, road closure, fear of carjacking and personal safety issues,
the Operations Team utilized its SecurAssist team to coordinate the ground ambulance portion of the
mission.

Assist America, working in connection with its security advisors, devised a mission that included high
level security measures to ensure the successful transport of the family through a mountainous and
dangerous region. The detail included four security vehicles with armed personnel carrying high
powered automatic weapons, together with two ambulances. The convoy was flanked by lead and
rear security vehicles deployed at an effective distance from the ambulances to provide advance
warning of any potential threats during the four hour journey.

The ground transport was planned for September 5th but was delayed for a full day due to continuing
tribal warfare in Marib. This conflict forced the closure of all roads in and around the hospital and
prevented the convoy from completing the mission on the 5th. Rather than facing an indeterminable
delay in the transport, the security team brokered a temporary truce with the tribal leaders allowing
for the movement of the caravan/ambulances to and from the hospital. The mission was delayed
until late in the day on the 6th but the caravan left in time for travel during day light and one of the
vehicles actually transported a tribal representative for a part of the trip to ensure safe passage. The
transport was completed without incident.

Upon arrival, the Saudi German Hospital admitted the patients and medical staff evaluated their
condition. Assist America continued to monitor the treatment until discharge on September 9th.
Assist America arranged for ground ambulance service from the hospital to the airfield and air
transport via air ambulance for the entire family from Sana’a to the UAE. Upon arrival in the UAE,
Assist America arranged for ground ambulance to take the patients to the local hospital for further
treatment.