Rebecca Ode expected to return from her Bali holiday the way most Australians do: on a commercial flight.
Instead, the 36-year-old from Newcastle was medically evacuated after she sustained horrific head and facial injuries on Nusa Lembongan island.
Ms Ode needed brain, eye and reconstructive surgery after being found on a roadside and rushed to hospital in Denpasar.
Her family, who crowdfunded to help fly her home, said the cost of her treatment in Indonesia and the evacuation flight was about $250,000.
It’s a staggering amount most travellers don’t think they will ever need.
But emergencies like Ms Ode’s do occur, so what happens if you need to be medically evacuated home to Australia?
A medical evacuation needs to be organised by you or your loved ones.
In a statement, the Department of Foreign Affairs and Trade (DFAT) said it was able to provide limited assistance.
“The Australian government can’t organise or pay for a medical evacuation back to Australia,” a DFAT spokesperson said.
The statement referred to the government’s SmartTraveller website, which advises travellers on what to do if they experience medical trouble overseas.
DFAT cannot recommend hospitals or doctors, organise local medical care or book appointments, according to the website.
It can, however, provide a list of local hospitals with doctors and lawyers who speak English and can assist with contacting friends and family back home.
Critical care service CareFlight provides medical evacuation flights and transfers in Australia. It is planning to expand its services to some overseas areas.
CareFlight chief operating officer Peter Broschofsky told ABC Radio Newcastle the decision about whether a medical evacuation flight was appropriate was usually made by the local treating doctor and the flight operator’s medical retrieval consultants.
“The kind of personnel that are typically on board are what we call critical care doctors and flight nurses; they’re extremely well credentialed with lots of critical care experience, normally in hospital emergency departments,” he said.
“But [they have] the additional training required to operate in what’s a very difficult medical environment.
“In this case, it’s within the hull of an aircraft that potentially cruises at 40,000 feet.”
Mr Broschofsky said the aircraft typically used for evacuations was similar to smaller planes available for commercial travel, but was purpose-fit.
He said cabin pressure, low humidity and other typical parts of air travel could make a medical flight difficult.
“Those types of environments can create particular issues where, for example, if the patient has any gas-related injury, such as pneumothorax [the presence of air or gas in the lung] or a collapsed lung, or if they’re septic,” Mr Broschofsky said.
“Blood can pool in the legs on take-off, affecting blood pressure, those types of things, there’s many more of those.
“There are parts of the body that they potentially couldn’t attend to if there was an emergency. But our clinicians are very well adept at dealing with those issues.”
Mr Broschofsky said evacuees still needed to go through customs, but providers could assist them and others on board.
The evacuee and/or their family are almost always liable for flight costs.
“Australians should ensure they have travel insurance that will cover these costs,” the DFAT spokesperson said.
“They should also read and understand the fine print on policy exclusions, including any for pre-existing conditions, adventure activities or drugs and alcohol.”
The Insurance Council of Australia said in a statement that most travel insurance policies included coverage for medical evacuation and repatriation “if agreed it is medically necessary, up to the relevant benefit limit”.
“The costs for a medical evacuation will either be covered by the insurer or paid following the emergency evacuation or repatriation, depending on what is outlined in the customer’s product disclosure statement,” a spokesperson said.
“Travel insurance is as important as your passport, but it does not provide unlimited cover, and all policies have limits and exclusions, so it’s important to be informed and choose the right level of cover.”
More than $217,000 has been crowdfunded to help cover Ms Ode’s evacuation and ongoing treatment costs.
“Currently, we have invoices of approximately $250,000,” her brother-in-law, Jesse Wilton, said in a GoFundMe post.
“$135,000 approximately to fly her home … $100,000 approximately in current baseline hospital bills and medication.
“The costs of what treatment she will require in Australia are currently unknown.”
Indonesian police believe Ms Ode’s injuries were sustained in a motorcycle crash.
Mr Wilton said their family was seeking Australian medical advice about what may have caused her injuries.
“We are so grateful that Bec is home in Australia; we know now she will get the best possible medical treatment.”
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