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135, so Ayiti Air Anbilans not only has to meet Haiti Offi ce of National Aviation Civil (OFNAC) regulations, but also FAA regulations. The result is that fl ying is conducted as if it were in U.S. airspace. “Aviation is right down the line of what you’d expect in the U.S.,” says McDaniel. “It’s when you’re on the ground—the infrastructure and communication, or educating enough people on the ground to establish and secure a landing zone— that it’s a little bit diff erent.” OFNAC doesn’t have many rules and regulations for helicopter air ambulance operations, because they’ve never had one before. So they lean on Ayiti Air Anbilans to operate within the guidelines of the FAA. “If the FAA is a book of regulations, OFNAC is a page,” says McDaniel.

One regulation on that OFNAC “page” is a prohibition against night fl ight. Even if OFNAC eventually eases this restriction, Haiti’s infrastructure—or lack of it—makes fl ying in the dark too risky. McDaniel explains, “Someone might run a thin

wire across a soccer fi eld designated as a landing zone to tap into the power line, and even with NVGs you’d never see it.”

Not fl ying at night can be frustrating. In Haiti it is not uncommon to have events leaving 20 or more dead, and another 20 or more injured. When incidents like this happen, the helicopter transports patients, one at a time … until they run out of time. McDaniel laments that there have been situations when “We probably could have picked up 10 more, but then we ran out of daylight.” Likewise, if an incident occurs at night, assistance can be delayed for hours until dawn.

There are other fl ight deterrents in Haiti that one doesn’t usually fi nd in more developed nations. For example, there are only two aviation fueling locations in the entire country: Port Au Prince and Cap-Haitien. So, while Ayiti Air Anbilans can cover almost the entire island, the far southwest corner is out of range. Similarly, they can fl y out of range of the island’s

fl ight radio communication system. It’s then that cell phones are used.


Few hospitals in Haiti are equipped to off er critical care, and those that can stay full. McDaniel says, “I can’t begin to tell you how many times we’ll have a patient in dire need, but there’s no hospital to accept them because the two ventilators at this hospital are already being used, or the fi ve at another hospital are being used, or the 45 beds at another hospital are already full.”

These sad scenarios make the care that Ayiti Air Anbilans off ers even more crucial. “It’s almost as if the best quality health care you’re going to get in Haiti is in that helicopter,” says McDaniel.


medical director of a local hospital agrees. After seeing the aircraft’s equipment, he remarked, “I’d get better care here in this helicopter than I would in my own hospital.”


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