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A Traveling Sportsman’s Nightmare
(posted July)

As a traveling sportsman, you have probably heard of an arcane form of insurance known as Medical Evacuation Insurance. Likely as not, though, you do not have such a policy. And that is a mistake so large and important that I urge you to correct it, if not immediately, at least before you venture outside your home country on a trip of any sort, even a family trip to Europe, not to mention a safari to Africa or a mountain hunt in some remote part of Asia.

     Why this shrill warning? Let me start at the beginning….

      Here at The Hunting Report, we publish a lot of information about remote, difficult-to-access parts of the world, and we cover on a regular basis hunts that involve a certain amount of risk. Polar bear hunts in the High Arctic come to mind right away. So do hunts for forest elephant in Cameroon, Marco Polo hunts in the Pamirs, foot hunts in Tanzania for buffalo in thick reeds.

    But hold the phone. This focus on geographic remoteness and obvious risk is somewhat beside the point, because the financial and physical danger you face by not having evacuation insurance is every bit as great for the hunter who falls out of a jeep in Mexico or, in between hunts, falls and breaks his hip on a cruise ship in the Caribbean. I’ll have more to say on the latter in a moment….

    First, though, a snapshot of the personal nightmare I just experienced. It happened in the west African country of Cameroon, where I was on a hunting trip in the southern part of the country, on the border of Brazzaville, Congo, a $5,742 plane ride from the major city of Douala, where international air carriers provide service to Europe. Remember that number, $5,742: it is the first of several that will eventually take your breath.

     On the afternoon of May 4, 2005, I climbed into a machan located near a mini-savannah where Professional Hunter Dougie Stephenson had spotted large numbers of animal tracks. Our plan was to wait until dark in that machan for a forest buffalo or forest sitatunga to come into the clearing. If none did, we would stay in the machan until the next morning, leaving sometime after full light.

     Unfortunately, in the small hours of the morning of May 5, sometime around 3 am, a strong wind broke a limb from a neighboring tree, which crashed across our machan, destroying it and spilling us to the ground. I was asleep when it happened, and I woke up falling. My first clear recollection was the sound of a large limb striking the ground, followed by an impact so severe I temporarily lost consciousness.

     On regaining consciousness, I was blindsided by a searing pain in my lower back that rose and fell with what turned out to be uncontrollable muscle spasms originating somewhere near my waist. It was a pain so severe as to be dangerous to your sanity and will to live. And it was hurtling at me, in wave after wave, as I lay on the floor of a remote west African jungle in complete darkness. Making matters worse was a soaking rain that pattered down on every part of my body, soaking me to the bone, hammering my spirit, filling my eye sockets.

    Where was Dougie Stephenson? Where were our guns? My God, what were we going to do?

    From somewhere nearby, Dougie suddenly called out. Yes, he had fallen, too. But he was ok, he said. He would be right over. Yes, he could walk.

     Momentarily, he fell to the ground beside me. He was breathing heavily, obviously in pain himself, but fully alert. He had the satellite phone, he said. Everything would be ok. Help would come.

     With that, he moved away in the darkness to look for the guns and for the local tracker who had been in the tree with us. The tracker was hurt but able to walk, Dougie told me on returning. And both of the guns were fine.

    At that point, he leaned over me in the rain and began to fumble with a flashlight so he could see the numbers of the satellite phone. Soon, he had it on and began to dial. It was too early, though. No one at camp had their phone switched on. Yes, it was a satellite phone, and we could have called any number in the world. But to what end? There was no US Coast Guard within 9,000 miles. There was, quite literally, no one in the world we could call who would be able to do anything for us in less than a matter of days, if ever. Our only hope was to reach the camp, some 50 miles away.

     “We’ll just have to keep trying,” he said in a trembling voice.

    Ultimately, it was over three hours before we reached anyone in camp and more than five hours before help came. The low point in that pain-wracked, five-hour-long ordeal was the moment when Dougie whispered hoarsely, “I’m going into shock. I’m losing it.” He was still slumped over me in the rain. It was getting light enough for me to make out his face.

    Recalling such moments clearly is impossible, but I do remember shouting, “You can’t do that, Dougie! I don’t have the number of the camp.” With that, I remember shaking him, perhaps striking out with my right arm. Whether that had any effect on the situation is unclear, but momentarily, or maybe it was sometime later after a period of unconsciousness, I heard him call out the name of the camp owner. I knew he had connected with help.

     Indeed, around 8 am the camp owner arrived with enough help to build a primitive stretcher out of poles, which was used to transport me back to the road and from there back to camp. More important at the moment was the fact that the camp owner came with a powerful pain killer of some sort, in liquid form, which he poured down my throat. After that, everything was a blur for hours.

     Now comes the interesting part. Back at camp, it was clear (to me at least) that I could not safely walk, or even sit up. Attempting to even do so sent lightning bolts of pain down both sides of my groin. I had some numbness in my right leg that got ominously worse after a particularly energetic effort to get up and muster the resolve to catch my charter flight back to Douala, where I would have to catch a six-hour flight back to Paris and then a 10-hour flight back to Miami.

    It was clear (again to me at least) that I was simply in no condition to make such a journey. I would have to be flown back to the States, or to a first-world hospital somewhere, strapped into a horizontal position. Intuitively, I knew the alternative was potential loss of mobility, maybe even paralysis.

    Our first call was to the American Embassy in Yaoundé. I didn’t make the call. Dougie did, as he was able to walk outside where the satellite phone could pick up a signal. He reported back that the Embassy had listened intently to everything he said. At one point, he said he heard an individual in the background say, “Yes, I’ve got him on the screen now. He’s a Vietnam-era vet. We have to help him get out of there.”

     Our request for help was a modest one. We didn’t ask for a helicopter. We asked the embassy to help us work with Air France to fly me out of Douala on a stretcher placed across six Economy-Class seats and then with American Airlines to do the same thing out of Paris. Yes, we were prepared to pay for all those seats. Our problem was linking up with suitable medical facilities in Douala and Paris that would certify me as being medically able to fly. We also needed some help simply getting Air France on the phone and focused on the problem. Ditto American Airlines.

    The embassy’s help with all this was necessary, we already knew, because too many lawyers have sued airlines recently on behalf of medi-vaced passengers who worsened or died enroute. Some airlines simply don’t medi-vac passengers any more under any circumstances. Those that still do want a medical facility in the line of fire between them and lawyers. Handling all this via sat phone in a remote corner of Cameroon was all but impossible. Hence our call to the embassy.

    When the embassy called back, we were all stunned. The reply was, the embassy just could not help us in any way. No, they couldn’t call the French Embassy for us or Air France. Relations between the countries were so bad, we were told, the embassies were barely speaking with one another. “We’ve had Americans literally dying of malaria, and the French Embassy won’t lift a finger,” the US Embassy official said. With that, she volunteered the phone number of the US Ambassador. “Call him if you want. But I assure you that we cannot help you in any way.”

    Clearly, all we could do at that point was arrange for private evacuation service. I was already familiar with a US provider of that service, and I had toyed with the idea of buying coverage. However, I had not done so because I had heard several accounts of hunters arranging their own evacuation on commercial air carriers. Problems of the sort we ran into in Cameroon had just never appeared on my radar screen, so the risk/reward ratio involved in buying medical evacuation insurance had simply not computed. You would have to be a worry wart to buy that kind of insurance.

    Boy, was I wrong! The amount of money involved in a private evacuation, I quickly learned, was stunning. It was such a large figure, and it needed to be raised so quickly, the only practical solution was to ask a wealthy friend to pledge the necessary amount.

    He did so, and that put in motion a process that took several days. It began with a King Air Flight from camp to Douala, arranged for by the camp owner, where I was met by a Citation twin-engine jet with a doctor on board and a medical assistant. I was whisked from Douala… to Aswan, Egypt… to Entebbe Airport in Uganda… to Nairobi, Kenya, where preliminary x-rays revealed that I had four fractured vertebra, one of them broken and so unstable the head of neurosurgery recommended against commercial aviation evacuation even if it could be found. I needed immediate medical care (in his opinion that included surgery) or private evacuation.

    Since lumbar surgery in Nairobi, with no second opinion, seemed out of the question, it was back to the air. The first leg, again aboard a Citation twin-engine jet, took me to Corfu, Greece, and thence to Brussels, Belgium, where an air ambulance service out of Atlanta happened to be delivering a seriously injured soccer player. Their Lear Jet took me to Shannon, Ireland; Gander, Newfoundland; Baltimore, Maryland; and finally Miami, Florida.

The transportation bill alone?

Just under $125,000.

     As this is written, two weeks later, I still spend a good part of my days flat on my back, laptop balanced on my knees. I’ve lost 30 pounds, and I have a removable brace I have to wear whenever I sit or stand. Only stubbornness and an aversion to medicine keep me out of the painkiller bottle. I also still have occasional nightmares about falling. On the bright side, I can walk and climb stairs, and I am looking forward to getting back to the office, perhaps even out in the field somewhere by late this fall. My prospects for a near-full recovery in time are excellent, according to my doctors, who all agree, incidentally, that anything but a full-scale evacuation would have probably left me crippled.

    What have I learned? That life is fragile and terrible things happen. That you cannot wall yourself off from danger, but there are some important things you can – and should do – if you travel. One of them is buy evacuation insurance. You should do that, I’ve now learned, even if you don’t take adventurous trips. One of the clear memories I have of the whole ordeal is lying on a stretcher in that Lear Jet somewhere over the North Atlantic, talking with the paramedic on board, who was battling to stay awake after flying all the way from Atlanta to Brussels and back with stops every five hours.

     That paramedic wasn’t really surprised to hear that my flight had not been arranged by an evacuation insurance company, that the up-front payment was coming out of my own pocket. It happened all the time, he said. American tourists in Europe. Fishermen in Canada who slip on a piece of ice. Saddest of all, he said, are retirees who book a cruise out of Ft. Lauderdale only to slip and fall in the shower and break their hip. To get home from somewhere like Cancun they have to pony up, on the spot, something like $18,000 or more.

     “Someone needs to tell travelers that their regular insurance doesn’t help them get home in the event of a medical crisis,” he said.

     “I’ll do that,” I said. – Don Causey.

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