For helicopter manufacturers, Southeast Asia is an ideal romping ground. It is a vast, increasingly wealthy region with challenging terrain and often shoddy infrastructure. A thriving resources sector has meant that, up until a few years ago, there was solid demand for high-value, large-capacity helicopters. Despite challenges in the resources sector, the region is still getting richer. Growing wealth and business activity has been good news for helicopters tasked with VIP transport, utility and sightseeing, but there is a clear outlier: helicopter emergency medical services (EMS).
The Association of Southeast Asian Nations (ASEAN) estimates that in 2016 the region had 629 million inhabitants. If this 10-nation region was one country, it would be world’s third most populous after China and India – but relatively poor. It comprised just 3.3% of global GDP in 2016, with a GDP per capita of $3,867, a fraction of personal wealth in rich nations. The World Health Organisation estimates that average per capita healthcare expenditure in ASEAN is just $544.
This relative poverty, in addition to other issues, has a direct bearing on the region’s helicopter EMS fleet. Flight Fleets Analyzer shows that there are just 24 in-service helicopters in Southeast Asia with a primary or secondary EMS role. This compares with 78 in France, 134 in Germany, 75 in Australia and 67 in Japan. Compared with other emerging markets, however, Southeast Asia looks somewhat better: in all of China there are just 24 EMS helicopters, in India five.
INDONESIA: KEY MARKET
Flight Fleets Analyzer shows that of the 24 EMS helicopters in the region, 15 are operated in Indonesia. Of the Indonesian helicopters, eight are Bell 412s operated by an unconfirmed operator – probably the country’s military. There are also five Airbus Helicopters Bo105s operated by the country’s national search and rescue agency, but the average age of these helicopters is 29.6 years, with a sixth aircraft already retired. The primary role of the Bo105s is also search and rescue, with EMS listed as a secondary mission.
Southeast Asia’s other nine EMS helicopters are divided among Malaysia, the Philippines and Thailand. Malaysia has six in-service EMS helicopters flying with private operators. Four of these are with Layang-Layang Aerospace, a charter operator with four Bo105s, with an average age of 33.7 years. Malaysia’s other two EMS helicopters are a 6.3-year-old AS355N with Sabah Air Aviation, and a 16.9-year-old BK117C with an unconfirmed operator.
The Philippines has just one helicopter tasked with EMS, a 45.7-year-old Bell UH-1 operated by the air force. The region’s last two EMS helicopters are with Thailand’s Bangkok Helicopter Services, which operates two H145s equipped with a full EMS suite and trained crew. Its helicopters can deal with a range of conditions including trauma, cardiac, neonatal, obstetrics and paediatrics. Bangkok Helicopter Services, however, is aimed primarily at the private market. It is not an emergency EMS service comparable with those available in more developed markets.
And Southeast Asia’s orderbook for EMS helicopters is not exactly bursting. Flight Fleets Analyzer shows just one firm order: a single H135 for Malaysian company Aerial Power Lines. This helicopter, which will bear registration 9M-DRA, was part of a deal for two EMS-equipped H135s signed at the Langkawi International Maritime and Aerospace Exhibition (LIMA) in March 2015. The first helicopter, 9M-DRD, has already been delivered, but Flight Fleets Analyzer lists its primary usage as surveying, mapping, and powerline inspection. It is not clear if the second helicopter, 9M-DRA, will also see a different main role other than EMS.
The one ASEAN member rich enough to afford helicopter EMS is Singapore. The city-state’s small size, well-trained civil defence force and ready availability of world-class hospitals, however, largely obviate the need for a helicopter EMS system.
MONEY TROUBLES
Helicopter manufacturers give several reasons for the Southeast Asia market’s lack of activity, the first being the relative wealth of the region, which dictates healthcare spending.
“Helicopter EMS is one of the most efficient ways to save time when it matters the most,” says Christophe Nurit, regional sales executive Asia for Sikorsky. “It saves lives, but it is expensive. Although the ASEAN region is going through impressive GDP growth, a majority of its nations still have low minimum wages, making HEMS services financially inaccessible to a large portion of the public. Also, air spaces are often controlled tightly by the local governments, making it harder for private companies to expand HEMS operations.”
In addition, developed nations have developed sophisticated solutions to pay for helicopter EMS, which is provided through a range of payment models such as direct government-provided services or complicated insurance models. In Southeast Asia, and in other major developing markets such China and India, helicopter transport for medical reasons is regarded as a luxury item available only to the very richest members of society, who effectively pay in cash.
Indeed, industry sources say that Southeast Asia’s modest fleet of EMS helicopters is not tasked with rescuing citizens injured in emergency events such as road accidents, fires and the like, but with transporting well-heeled patients to and from medical facilities. Given that Southeast Asia’s cities are often choked with traffic, this type of transport offers considerable benefit – but only for society’s elite.
“We need this market to develop,” says Fabrice Rochereau, vice-president and head of sales, Southeast Asia & Pacific at Airbus Helicopters.
“There is a real need, because you can use helicopter EMS for road accidents. In this part of the world road conditions are not too good – lots of accidents. You really need to take care of roads, and to do this you need the appropriate medical evacuation system.”
He adds, however, that if a nation’s citizens are aware of helicopter EMS at all, they could well have a negative view of it.
RICH MAN’S PERK
“There is still a perception that the EMS helicopter is for rich people. In Europe, being evacuated by helicopters is not for rich people, it’s a public service.”
Should the money become available, which is likely with further economic development, helicopter technology will not be an issue. Rochereau says his company’s H145 can go from engine start to take-off in just five minutes, making it an ideal platform for helicopter EMS. The helicopter can operate in both IFR and VFR conditions, and is compatible with night vision goggles. The cabin, which can be accessed via clamshell doors, can take one or two wheeled stretchers, and can accommodate up to three medical personnel.
Sikorsky’s Nurit says the S-76 is an excellent option. “EMS operators’ choice has been the S-76 helicopter to manage these difficult transport situations,” he says. “It gives them the ability to transport two adult patients and four medical crew members in the cabin area to care for them. The S-76 platform is fast at 145-150kts and it is also exceptionally smooth for patient comfort and safety. The aircraft can be operated by a single or dual pilots in a wide range of weather conditions.”
Platforms from Bell Helicopter and AgustaWestland are also widely deployed for the EMS mission.
Yet, however impressive the EMS rotorcraft offered by the world’s elite helicopter makers may be, they are only as capable as the regulatory regime in which they operate, and the crews operating them. The state of Southeast Asian infrastructure in developed areas is also an issue.
“Hospitals in Southeast Asia often lack the space or means to accommodate or build helipads,” says Nurit. “Pre-hospital care is rather limited. With a few exceptions, most urban roads are too encumbered with traffic, electrical wires, street businesses and light structures to allow the landing of a helicopter.”
Regulation is another problem. However impressive the start-up performance Rochereau claims for the H145, he acknowledges that to varying degrees, governments in the region restrict helicopter operations. Most are dubious about allowing helicopter movements without a flight plan filed well in advance. He says one role of his sales team is working with regional regulators to improve the overall environment for helicopter operations.
Still, there is room for optimism. The region is getting richer, and this will drive a requirement for better healthcare. New funding models are also being explored. One regional toll road operator is proposing to use a small fraction of every toll it collects to fund a helicopter EMS service.
Mark Burgess, vice-president, defence & space, Asia Pacific at Honeywell Aerospace, sounds an optimistic note: “While Indonesia is likely to be the most EMS-friendly country in the Southeast Asia region due to its landscape and surge of local entrepreneurs, we are also seeing a growing interest in EMS-dedicated helicopters from Thailand and Malaysia, and can expect both countries to be even more EMS-friendly in the coming years.”
Source: FlightGlobal.com
