Medical repatriation from Africa to Europe: steps and timescales
When someone falls ill or is injured in Africa and needs treatment in Europe, the journey home follows a clear sequence. This guide explains each step and what decides how quickly a transfer can happen.
Medical review: [name and qualification of the referring doctor]
Who this guide is for
It is written for families in Europe with a relative in hospital in Africa, for travellers and expatriates, and for insurers. We handle requests from North Africa (Morocco, Algeria, Tunisia), West Africa (Senegal, Côte d’Ivoire, Mali) and Central Africa (Cameroon, Gabon, DR Congo) towards Europe. Each of these routes has its own page: see our medical repatriation routes.
No two repatriations are alike, and the timescale is only known once the medical file has been reviewed. Insurers will find more on our page for insurers and assistance companies.
The steps, from the first call to the handover
- First contact. We note where the patient is (hospital, city, country), the destination, their condition in a few words, any insurance contract and one family contact.
- Medical assessment. A doctor reviews a recent medical report and speaks with the treating doctor on site to assess whether, when and how the patient can travel.
- Choice of transport. Depending on the patient’s condition and medical advice, the options are an air ambulance, a stretcher on a scheduled flight, or a seat on a scheduled flight with a medical escort. Our guide air ambulance or stretcher on a scheduled flight explains the differences.
- Quote and payment. We send a quote. The mission is confirmed when the insurer issues a guarantee of payment or when payment is made. See what a medical repatriation costs.
- A bed in Europe. A receiving hospital confirms that it can admit the patient to the right department at the expected time of arrival.
- Authorisations and flight planning. Permits, flight plans, crew and medical equipment for an air ambulance; the airline’s medical approval and bookings for a scheduled flight.
- Ground ambulance to the airport. The patient is taken from the ward to the aircraft with the medical team and the documents.
- The flight. The medical team monitors the patient throughout, following the care plan agreed with the treating doctor.
- Handover to the receiving team. An ambulance takes the patient to the receiving hospital, where the escorting team hands over the patient and a report on the journey.
For an overview of how we deal with every request, see how it works.
What determines the timescale
There is no standard lead time. Once the medical plan, the payment and the bed are agreed, our usual time to take-off is [usual time from agreement to take-off]. The factors below can change that, and a complete file from the first call saves time.
Landing and overflight permits
An air ambulance operates as a non-scheduled flight. Under the Chicago Convention on International Civil Aviation, such flights may in principle cross a country, or stop there to refuel, without prior permission, but each state may set conditions when passengers are carried for payment and taken on or set down on its territory.
In practice, many countries require a landing permit, some also an overflight permit, and each publishes its rules in its aeronautical information publication. Requirements and lead times vary by country and can change, so they are checked for every route.
Airport hours and night operations
Not every airport operates around the clock. Each country publishes the opening hours of its airports and of services such as customs, immigration and health control; outside those hours, opening may only be possible on request, with advance notice. A night departure or arrival depends on what both airports, and any stopover, can offer.
Distance and technical stops
On long routes, the aircraft may need to refuel on the way, depending on its range, its load and the weather. Each stop must be planned and, where required, authorised. Crew working hours are also limited by aviation rules.
Airline approval on scheduled flights
On a scheduled flight, the airline’s medical service must approve the patient’s travel in advance, based on a form completed by the treating doctor, usually called a MEDIF. A stretcher, oxygen or a medical escort must also be requested beforehand, and availability depends on the airline, the route and the aircraft.
Documents and entry rights
The patient and any relative travelling need valid travel documents and, if they are not nationals of the destination country, the right to enter it. Check visa needs on the very first day.
For the Schengen area, a short-stay visa application is normally lodged at least 15 days before travel and decided within 15 calendar days, which can be extended. In justified urgent cases, consulates may accept a later application and decide without delay. For medical treatment, they may ask for a document from the receiving hospital and proof that the care can be paid for. See the European Commission’s page on applying for a Schengen visa.
Acceptance by the receiving hospital
A repatriation goes ahead once a hospital in Europe has agreed to admit the patient. Finding a bed can take longer when a specific unit is needed, so tell us early which city or hospital the family prefers.
Health formalities: yellow fever and other requirements
Under the International Health Regulations, a country may require travellers to show proof of vaccination against yellow fever, recorded on the international certificate of vaccination or prophylaxis. Some countries ask all arriving travellers; others only those arriving from, or transiting through, a country with a risk of transmission.
According to the World Health Organization, a single dose gives lifelong protection, but immunity takes several days to develop. Exemptions for medical reasons must be certified.
This mainly concerns a relative flying out to join the patient. Ask a doctor about vaccines, and check each country’s current requirements with its embassy and in your foreign ministry’s travel advice.
Practical advice for families
See also our page for patients and families.
Choose one point of contact
Agree on one family member who speaks with us, the hospital and the insurer, so that information stays consistent.
Gather the documents
A recent medical report, a copy of the passport and the insurance details come first. See the documents needed.
Call the assistance company first
If there is a travel insurance or assistance contract, call its emergency number first. The insurer normally arranges or approves the repatriation, and costs it has not agreed may not be covered. See our insurance guide.
Share the hospital’s details
Send the hospital and department, the treating doctor’s name and a direct phone number, so that medical information comes first-hand.
Important information
This guide provides general information only and does not replace the advice of the treating doctor. Whether and how a patient can travel is decided by the treating doctor and the medical team organising the transfer and, on a scheduled flight, by the airline’s medical service. In an emergency, call the local emergency number (112 in the European Union).
Frequently asked questions
How quickly can a patient be repatriated from Africa?
It depends on the patient’s condition, the type of transport, the permits, the airports’ opening hours and the availability of a bed. Once everything is agreed, our usual time to take-off is [usual time from agreement to take-off]. We give a realistic estimate after the medical assessment.
Can a family member travel with the patient?
It depends on the type of transport and the space on board. [whether and how many relatives can travel on board, by type of transport]. The relative needs their own travel documents and, where required, a visa.
Who decides whether the patient is fit to fly?
The treating doctor and the medical team organising the transfer; on a scheduled flight, the airline’s medical service too. This guide cannot answer that question for an individual patient.
Does travel insurance pay for a medical repatriation?
It depends on the contract and its limits, so call the insurer’s emergency number first. The UK government, for example, states in its guidance on hospitalisation abroad that its embassies and consulates cannot arrange or pay for a medical repatriation. See also our insurance guide.
Related guides
Air ambulance or stretcher on a scheduled flight
How to choose the transport. Read the guide
Documents for a medical repatriation
The medical report, the MEDIF and more. Read the guide
Travel insurance and repatriation
What to check in a contract. Read the guide
Choosing a repatriation provider
The questions to ask first. Read the guide
A relative needs to come home from Africa?
Send us the hospital’s details and the treating doctor’s contact. Our medical team obtains the medical report from them, reviews the file and comes back to you with the options and a quote.