Emergencies are their specialties

By Shira Springer
Globe Staff / August 8, 2010

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When Gabrielle Bartusiak and her staff learned of a US citizen desperate for help in Quito, they gathered information and developed a rescue plan with military efficiency. Within hours, Bartusiak boarded a flight for Ecuador’s capital. Prepared for complications on the ground, she brought a bag of medical supplies.

Bartusiak is president and CEO of Rescue Nurse International. She traveled to Quito to rescue an elderly woman who had broken her hip on vacation.

Rescue Nurse International handles about 30 emergency transports per month — the college student who fell from a second-floor window in Barcelona, the man who suffered heart problems in rural Vietnam, the woman who struggled with respiratory issues in Utah. Nurses fly anywhere at a mo ment’s notice and accompany stable patients home, making sure they receive whatever care is needed during the trip.

“We do what’s called bedside-to-bedside care,’’ said Bartusiak. “When people have assistance plans, they don’t need to stress over the details. That’s what we’re here for.’’

Traveling should be fun-filled and worry-free. But vacationers leave behind the predictability and convenience of home. Travel can be complicated by unforeseen crises — medical emergencies, canceled flights, lost luggage, natural disasters, political turmoil. In tough economic times, amid less sympathetic airlines, a dream getaway can devolve into a logistical challenge or worse.

Knowing how to handle travel emergencies can salvage a trip or, in the most dire situations, save a life. Preparedness can make a huge difference.

“We find that people spend more time looking for dinner reservations than finding out where they should go in the event of a problem,’’ said Mike Kelly, CEO of On Call International, a provider of travel assistance. “People should spend a little more time on their departure plan. Figure out what’s going to happen if mom gets sick at home, what’s going to happen if you lose your passport.’’

Specialists familiar with all kinds of travel emergencies can provide advice worth packing away for your next trip.

Medical emergencies
At On Call International, a typical day might include handling a medical evacuation off Antarctica, a motorcycle accident in Hawaii, and a tour bus crash in Russia. But there was also the teenager who developed heart valve problems in France. And the pregnant woman who delivered months early in Singapore.

Medical emergencies frighten travelers because of the unpredictability, cost, and varying quality of foreign health care systems. Without the benefit of assistance plans or trip protection, medevacs can range from $35,000 for a commercial flight with a nurse escort from Europe to $125,000 for a specially-equipped private jet departing from the same place.

Travelers are advised to think through their plans and use common sense. If you have a cardiac history or other health concerns, get a checkup and inform your doctor of your travel plans. If you are a parent sending a child abroad, make sure your own passport is current. No one wants to encounter passport issues with an injured child overseas.

Get the recommended vaccinations for foreign travel. (Websites for the Centers for Disease Control and Prevention and the World Health Organization post the latest international health warnings.) Make sure you have easy access to money. Locate hospitals near your hotel. Pack an extra week of medications in your carry-on. Bring practical shoes to guard against broken bones.

Politics and nature
When the US Department of State exhausts all evacuation options during a foreign crisis, it turns to the Department of Defense. Noncombatant Evacuation Operations, or NEOs, extricated US citizens from Lebanon four years ago, when political violence led to air and sea blockades, and from Haiti after the January earthquake.

Violent political demonstrations, terrorist attacks, earthquakes, and other disasters can create chaotic, life-threatening situations. Getting accurate, timely information is essential.

The State Department’s Office of American Citizen Services and Crisis Management recommends that information gathering begin before departure. Enroll trips with the department at to get security updates overseas. The website also posts country-specific information, embassy and consulate contacts, and travel warnings and alerts.

In addition to the State Department’s offerings, other countries have their own websites with security information for travelers. The Internet makes English newspapers at your destination readily available. And don’t discount social media as a potentially valuable, real-time information source.

“I always tell people to become a media junkie, because you don’t want to be caught off guard,’’ said Michelle Bernier-Toth, director of American Citizens Services, a unit of the State Department. “Also, stay in touch with the embassy or consulate; get the information from them on what’s happening.

“We will assess the security situation and give our best recommendation. It might be, ‘Hunker down, avoid crowds, make sure you have food, water or medicine’ or it might be, ‘This is a good time to consider leaving the country.’ We will make sure people understand there are commercial options available or, if not, what contingency plans we’re making for American citizens in that country.’’

Additionally, insurance plan administrators can distribute crucial information. During the 2008 terrorist attacks in Mumbai, On Call International had 27 clients trapped in the Taj Mahal Hotel. As gunmen knocked on doors telling hotel guests it was safe to come out, On Call staff told clients with text messages to stay put.

Trip interruptions
When volcanic ash from Iceland disrupted air travel this spring, the insurance industry boomed. For good reason. Travel insurance offers the best protection against trip interruptions, especially for vacationers subject to the capriciousness of airlines and mother nature.

“If you were buying your airline ticket for a particular trip and you or a family member became ill and couldn’t travel, the airline probably would’ve looked kindly upon you 15 or 20 years ago,’’ said Judy Sutton, director of product management at Travel Insured International, Inc. “They would have taken your doctor’s note as a free pass to rebook for another flight another time. Airlines don’t have the privilege of offering you that kind of courtesy anymore. It’s economics.’’

When faced with paying for a missed vacation, the economics of trip protection are favorable. Prices depend on the length of the trip, destination, and coverage included. With Travel Insured International, the most popular plan ranges from 4 percent to 9 percent of a traveler’s total trip cost. On Call International provides single trip coverage starting at $55, yearlong coverage ($225), and academic trip coverage ($45).

As with all insurance policies, it is important to read the fine print. Be clear about what constitutes a “covered expense.’’ In general, travelers should be as informed as possible. Websites like relay on-time statistics and rate general flight quality.

And know your rights as a traveler. For passengers stranded in European airports by volcanic ash, European Union regulations entitled them to meals, overnight accommodations, and reimbursement for alternative travel arrangements.

“We can solve people’s problem, rebook, do everything then and there on the computer,’’ said Nancy Greenfield, director of Leisure Sales at Garber Travel in Chestnut Hill. “They don’t have to stand there with 100 other people, wait to get to the front of the line, then find out they can’t fly out for the next four days because nothing’s left.’’

Lost or stolen
Lost your passport abroad? It’s no big deal, according to the State Department.

“Losing your passport should be the least of your worries,’’ said Bernier-Toth. “It is an inconvenience, but we can certainly help. It is something that we do every day.’’

When you realize your passport has been lost or stolen, the State Department advises filing a police report. Then, contact the nearest embassy or consulate to get either an emergency passport or a full-validity passport book. Issued within days, an emergency passport allows a traveler to reenter the United States. A full-validity book takes a week or two to turn around.

Pack color copies of your passport and travel visas in your carry-on luggage separate from the originals. The copies can expedite the replacement process.

Unfortunately, the Department of State doesn’t retrieve lost suitcases, but there are ways to ensure baggage issues don’t ruin your journey.

Buy suitcases that look distinct. Take a picture of your luggage for easy description. Pack a carry-on with all essentials.

“You have this precious carry-on and you really need to think out exactly what’s going to be in that carry-on,’’ said Jessica Good, owner of Passport a travel boutique in Cambridge. “You need to think, If I was going to lose my luggage, what are the things I really, really need? Or, What are the things I can’t buy there?’’

Good is looking into tracking devices for checked luggage. In the event a suitcase with the device is lost, it can be located electronically.

A traveler in trouble can use any help available.

Shira Springer can be reached at