Rescued! (air ambulance services) (includes related article on medical evacuation services)

• Author: Sullivan, Patty

In the Bush, receiving even the most basic care sometimes means being moved hundreds of miles just to reach the nearest x-ray machine. On the Kuskokwim and Yukon rivers, many of the 56 villages are sprinkled up and down the shores, connected only by boat in summer, ice road in winter, or by airplane in good weather. Time and distance can be deadly in this roadless subarctic region, which rivals the state of Washington in size. Enter Aeromed.

In the past six months, flight paramedic David Harbour has landed on an air strip lit by the headlamps of snow machines. He has tended to patients stretched out in the bed of a wooden sled. He has rushed to someone's aid aboard the village ambulance, a 1972 Suburban.

Harbour works for Aeromed International, a new medevac service dedicated primarily to the Yukon-Kuskokwim Delta and its 22,000 Native residents. Getting an ill or injured person from a remote spot to a hospital may be his job, but his efforts are shaped by the rigors of the land and the resources of the locals. As paramedic and acting operations manager for Aeromed, Harbour is far afoot from his paramedic days in urban Texas.

Recently, when he helped transport a girl with appendicitis from the Bush to Anchorage, the girl's grandmother gave him a big hug and invited him to hunt moose on their land. "The moose is food for their table," Harbour said. "That really touches you. Makes it worthwhile after a long day."

Aeromed has been operating as a critical care air ambulance provider since January, an extension of the Yukon-Kuskokwim Regional Hospital in Bethel. It is the first critical care air ambulance run by a not-for-profit Native health organization in the country, let alone the state, said Ed Hansen, corporate vice president for hospital services at Yukon-Kuskokwim Health Corporation.

As of April, more than 350 patients were flown out of a village either to the Bethel hospital or one of three hospitals in Anchorage, among them a man with a gunshot wound in Aniak, a snow machiner with a fractured leg in St. Marys, and a heart-attack victim in Kwigillingok.

On a busy day as many as five medevacs flights can be sent to rural Alaska. On a slow day, none. "It's feast or famine," said Harbour. "Whenever the weather is the worst is when everybody wants you."

The wheels of the medevac are set in motion by a village community health aid who reports the injury or illness to Bethel. The emergency room physician there decides whether the patient...