In November 2020, while Romania was fighting the second wave of the COVID-19 pandemic, a fire destroyed the intensive care section of the county hospital in Piatra Neamt, in northeastern Romania. 10 COVID-19 patients lost their lives, seven other people were severely injured, including a doctor who jumped into the fire to try and save some of his patients. Since Romania does not have a severe burns centre, the doctor, who suffered severe burns on almost half of his body, was transferred to Belgium by the Romanian Air Force.
Obsolete aircraft endanger lives
More and more frequently, military aircraft have to be deployed because one or both of the two medical aeroplanes operated by the Romanian General Inspectorate for Emergency Situations is grounded due to technical problems. But even with the military’s help, there are often delays, which reduce the chances of recovery or even survival.
Romania has a population of 19 million but currently only two aeroplanes for long-distance urgent medical transfers. Neighbouring countries such as Hungary and Austria, which have barely half the population of Romania, have three and 10 medical aircraft respectively. Romania's two air ambulances, both over 30-years old and in constant need of maintenance work, are not up to the task of guaranteeing urgent medical transport. Due to their poor condition, both aircraft are only partially operational and in recent years have flown an average of just 269 hours down from 412 hours in 2015, This has been an even bigger problem in recent times due to the need to transfer critical COVID-19 patients to intensive care units across the country.
What does it take to save a life?
Recognising this problem, Romania’s General Inspectorate for Emergency Situations reached out to the European Investment Bank through the Project Advisory Support Service Agreement (PASSA) initiative for a plan to purchase two new aircraft. The Bank sent a team from the Project Advisory Support Unit (PASU) to provide technical assistance in preparing the cost-benefit analysis for a €30 million project that would be a step toward securing funds from the EU’s Large Infrastructure Operational Programme.
Experts from the EIB prepared an analysis showing that the purchase of planes for long-distance medical transfers was the most efficient option for the number of lives saved. Four scenarios were considered - transport with ambulance, aeroplane, heavy helicopter and light helicopter. The plane came out as the best-suited solution from a social and economic perspective.
The 2008 study "Air ambulance transportation with capabilities to provide advanced life support" found that for distances up to 150 km, the ambulance is the best option, the helicopter for distances from 150 to 250 km and the aeroplane for distances over 250 km. The most important medical centres across Romania like Timisoara, Cluj, Iasi are at least 250 km away from Romania's capital Bucharest.
During the procurement stage, particular attention will be devoted to the technical specifications regarding the CO2 emissions, which will have a high weighting in terms of the aircraft performance indicators.
With an estimated life duration of 27 years and 14 000 hours of use each, the two new aeroplanes would increase the response time to critical situations and provide prompt access to adequate medical care. The new machines could save at least 300 lives per year instead of the current 82.