Assisting friends Ebiye and Raniya on their trip from their homes near San Francisco, CA to the Diamond Jubilee Ismaili Conference in Atlanta, GA.
With the help of a flight nurse and private flight charter service, what seemed like a distant dream became reality for couples Nadir and Ebiye R. and Siraj and Raniya A. as they set their sights for the Diamond Jubilee in Atlanta, GA in March 2018.
Years in the making, the event would feature a historic visit from Ismaili spiritual leader Mawlana Hazar Imam, also known as Prince Shah Karim Al Hussaini, Aga Khan IV, during the 60th (Diamond Jubilee) year of his reign. This would be a once-in-a-lifetime opportunity and as devout Ismaili Muslims, neither couple wanted to miss the chance to see him in person, especially with Ebiye and Raniya’s declining health in recent years.
At the time, Ebiye lived at home in Concord, CA, where her husband, Nadir, cared for her around the clock with the help of an in-home caretaker. Meanwhile, twenty minutes away in Vallejo, CA, Siraj visited his wife Raniya daily at the nursing home where she lived. The couples were long-time friends.
Both Ebiye and Raniya struggled with dementia in addition to a host of other health concerns: Ebiye with Parkinson’s disease and cardiac stints and Raniya with diabetes and chronic kidney disease.
Fortunately, both Nadir and Siraj were retired physicians who understood well the level of care their wives would need to travel, but how would they get to Atlanta?
By the year of the conference, Ebiye could no longer speak or sit up for even short periods and Raniya had lost all use of her legs. Finding tickets on an airline that could support both of their needs for a cross-country flight seemed like a daunting task.
A team of dedicated volunteers from the Ismaili community made it their mission to reach out all across the United States to assist would-be travelers to the Diamond Jubilee. It was through this channel that Dr. Fatima R., Ebiye and Nadir’s daughter, reached out to see whether the trip could become a possibility for her parents after all.
Due to Ebiye’s medical condition, the task of finding appropriate travel conditions for Ebiye fell to one of the organization’s medical case managers, Madia A., who reached out to Sky Nurses.
During Madia’s initial phone conversation with Chloe, a logistics coordinator from Sky Nurses, it became clear that though securing a flight nurse for the trip would not be an issue, making flight arrangements for someone in Ebiye’s condition would not be as easy as she had hoped.
Because Ebiye could not sit up during take-off and landing, a traditional airline seat would not be appropriate, as even lie-flat Business Class seats need to be in the upright position during the 30 minutes it takes for the plane to reach cruising altitude and for 30 more minutes during the plane’s landing. Chloe also advised that a stretcher service on a commercial airline would not be an option, as stretcher services are not offered on North American carriers.
With this in mind, Madia considered an air ambulance service for the trip, but the cost reflected in the resulting quotes seemed prohibitively high to Ebiye and Nadir. With Ebiye not in emergent condition, neither Fatima nor Nadir could justify that expense under their current budget.
While Ismaili organizational medical case manager Madia was gathering quotes from Air Ambulance companies for Ebiye’s trip, Sky Nurses logistics coordinator Chloe was doing some research of her own into chartering a private plane.
Though the idea of chartering a plane for a personal trip might sound lavish to most travelers, the reality is that it cost nearly half as much as an air ambulance.
The cost to reserve a smaller plane with the amenities needed to keep Ebiye comfortable during her trip at $45,000 was significantly less than the price of a transcontinental air ambulance ride, which could easily cost at least $75,000. A private charter flight with a flight nurse in attendance was an excellent and much more affordable option.
After consulting with several private charter companies to find the best price on a plane with the capacity for a bed on board, Chloe contacted Madia to present her findings to Ebiye’s family. Her timing was fortunate, too – Madia’s group was also looking for a travel solution for Ebiye’s friend, Raniya. Both couples happily agreed to travel together and split the price.
Now, it was only a matter of Sky Nurses introducing both families to the private charter company. As Sky Nurses is not an air ambulance company, we’re precluded from procuring the charter flight directly. What we did do, and do regularly for our very special needs passengers, is communicate the detailed needs and wishes of both families to the private charter company to make all of the necessary arrangements ahead of time.
For Ebiye, it was requested that a bed be installed so she could lie in comfort even during takeoff and landing. For Raniya, flatbed seating had been requested, with the understanding that she could sit upright during ascent and descent at a slight incline, then lie down during the remainder of the flight. By the time the reservation was ready to be finalized, all the families had to do was provide payment. Sky Nurses had handled the rest – arranging for a plane that could accommodate two beds and three seated passengers.
For this mission, Chloe assigned seasoned commercial flight nurse Alice F., who had over 5 years’ experience conducting medical escorts and over 15 years’ experience working in the emergency room and intensive care unit at her local hospital in Atlanta, Georgia.
Alice was chosen both for her experience working with high acuity patients over the course of longer trips and for her close proximity to Ebiye and Raniya’s destination in Atlanta. (Not only is choosing a local nurse more cost-effective – a local nurse would be better equipped to provide support if necessary during their stay.)
Alice arrived in San Francisco on March 14th, the day before departure. Her first stop was the home of Nadir and Ebiye in Concord, where she conducted a pre-flight assessment to make sure Ebiye would handle the following day’s flight without distress. In addition to taking vital signs and making note of Ebiye’s condition, Alice also spoke with Ebiye’s husband Nadir to make note of all the important factors that would make this trip comfortable for his wife.
There are some details that don’t show up in medical notes, so it’s important for family members to be able to meet with the flight nurse prior to departure whenever possible. Because Ebiye could no longer speak, this meeting was all the more important.
Alice’s next stop was Raniya’s nursing home in Valllejo. When she arrived, Alice found Raniya and her husband Siraj visiting in Raniya’s room. At that time, Alice took the time to speak with Siraj and Raniya while she conducted her pre-flight assessment. Due to her dementia, Raniya preferred to speak in her native tongue, with Siraj acting as an interpreter. In just 30 minutes, Raniya was confirmed to be fit to fly. After answering questions from Siraj about the logistics of the trip, Alice left the couple to prepare for departure.
At 5:41 am the following morning, Alice arrived at Nadir and Ebiye’s home 30 minutes before the ambulance was scheduled to arrive to help Ebiye’s caretaker prepare her for departure. Once the ambulance came, Alice assisted Ebiye’s caretaker with settling her into the vehicle safely. While Nadir, Ebiye, and Ebiye’s caretaker set off for San Francisco International Airport, Alice caught a taxi to Raniya’s nursing home to assist her husband Siraj with Raniya’s travel preparations in the same way. By 10:32, both parties arrived at the airport where their private plane was being fueled.
With both Ebiye and Raniya resting comfortably in their beds, and Nadir, Siraj, and Ebiye’s caretaker seated, the plane took off at 11:56 am from San Francisco International Airport with all six passengers secured safely, landing in Atlanta, GA by 6:06 pm local time on the same day. The flight was fairly uneventful. Ebiye mostly slept while Alice cared for Raniya, taking vital signs and administering medication as needed.
When the party arrived in Hartsfield International Airport in Atlanta, Sky Nurses had two ambulances waiting for them on the tarmac. Both Ebiye and Raniya were disembarked to their respective vehicles, with Ebiye riding with her husband and her caretaker and Raniya riding with her husband and the flight nurse to a local rehabilitation center where medical coordinators Madia and Daniya had arranged for them to stay during the conference. (This would allow Ebiye and Raniya to receive the right level of care during the time they weren’t at the conference.) Both parties arrived at the rehabilitation center at 6:47 pm. Alice gave report to the nursing staff there to confirm all Ebiye and Raniya’s needs would be met before returning to her own home in Atlanta.
During the next three days, both couples were able to achieve their dreams of seeing Mawlana Hazar Imam while also enjoying the events of the Diamond Jubilee convention. Fortunately, the organizers of the conference had anticipated that there would be guests who would require additional care in order to attend the convention. To accommodate them, local ambulance companies offered rides to and from the convention center and hospital beds had been set up on site, so attendees could participate in comfort.
By the time the conference came to a close, both couples were ready to return home. It had been a fulfilling weekend, but a long one for someone in Ebiye and Raniya’s condition.
At 8:20 am on the morning of March 18th, Alice arrived at the rehabilitation center to perform another pre-flight assessment to confirm it was still safe for both Ebiye and Raniya to fly to California. Sky Nurses arranged for ambulances to bring both patients to the airport for arrival at 10:00. Once both Ebiye and Raniya were secure in their beds and all other passengers were seated, they took to the skies.
For Ebiye and Raniya, the flight was smooth enough with Raniya sleeping most of the way and Ebiye resting peacefully. With a brief stop in Pueblo, Co for refueling, they landed safely and comfortably in San Francisco at 4:15.
Our flight nurse, Alice, assisted boarding both Ebiye and Raniya onto the ambulances we arranged for them that were waiting on the tarmac upon landing. Following that, Alice gave report to the medics on board Ebiye’s ambulance before saying her goodbyes to Ebiye, Nadir, and Ebiye’s caretaker. Alice traveled with Raniya and her husband to the nursing home, where she provided a full report to, and discharged Alice into their care.
Both patients had traveled to the event of a lifetime across the country and returned to their homes safe and sound.
The above story was compiled from the intake files and stream of constant communications the case managers at Sky Nurses receive from the clinicians and air medical escorts throughout the repatriation trip with our patient. When you travel with a flight nurse from Sky Nurses, you’re travelling with an entire team of medical professionals and travel agents.
We take privacy very seriously. All names have been changed to protect patient and clinician privacy.