Repatriation of bedridden patients in UAE still a hurdle

Dubai - Not knowing the right procedure has led to delays, stress and costs.

To repatriate a bedridden patient is a significant concern for expatriate residents across the UAE. Though much has been spoken and written on the challenges on repatriating mortal remains of individuals who have died in the UAE, procedures to repatriate bedridden patients continue to be less-known and discussed. 
Failing to have the right information about the procedures has led many into more delay, stress and costs. Naseer Vatanapally, a social worker who specialises in repatriating bed-ridden patients to families and care centres in India, said the biggest challenge is re-homing the patients.
"I've worked on countless cases of repatriation. The main problem I faced was that many families don't want their kin back. Most of them belong to low-income families, and there is no one to take care of them. The patient becomes an additional burden," he explained.
"In some cases, there is no way to pay hospital bills and the patient remains stranded for several years."
Khaleej Times, to develop readers' awareness, spoke to a group of social workers who tirelessly work towards repatriation of bed-ridden individuals.
 Processes streamlined to avoid delays
Prasad Sreedharan, an Indian social worker in Ras Al Khaimah, has dealt with numerous such cases. "Repatriating a bedridden patient is a hectic job. If one is unaware of the procedure, it can cause a delay in the process."
Sreedharan, who is also a member of the Indian Consulate-General volunteer medical committee, said there are standard procedures with slight differences from one airline to another. "If you want to repatriate a bedridden patient back to India with the support from the consulate, you have to follow the steps."
Latest medical report from the treating doctor and a special form from the airline for repatriating a stretcher patient should be obtained first, he added.
"The doctor has to certify that the patient is fit to travel. He has also to specify that the patient needs a stretcher till the aircraft and whether he or she needs to be accompanied by a doctor, a nurse or a non-medical escort." 

It is also advisable to be clear about oxygen, suction or any other medical equipment required onboard, Sreedharan noted. "After filling the form that has to be submitted to the airline office along with a medical report and the patient's passport copy, they will send it to the airline medical officer for approval."
If it is Air India, they have to obtain permission from the airline medical team in India; he pointed out. "Once approval is obtained, the airline officials concerned will contact the engineering department to arrange a stretcher facility."
According to the availability of the stretcher, the engineering department will give a date for the passenger to fly. In case oxygen is required, it may take more time."
If suction is required, it has to be arranged from the hospital in the UAE, he explained. "Operation manual has to be given to the Air India office, and they will obtain permission from the engineering department," Sreedharan said.
High costs of transportation 
"If the patient can't afford the cost and the sponsor is not ready to bear the expenses, Indian diplomatic missions in Abu Dhabi or Dubai can be approached with all the documents for speeding up approval."
These documents include the medical report, airline stretcher request form filled and signed by the treating doctor, a passport copy with visa page of the patient, a passport copy of the escort person, if needed, he said.
"The other document requirements include a no-objection letter from the sponsor and an acceptance letter from the hospital where the patient will be treated on arrival. The sponsor has to state in the letter that he is not able to bear the repatriation expenses."
"Once it is approved by the consul-general, an authority letter will be sent to Air India for issuing the ticket. Air India is giving the tickets in a subsidised price - fromDh6,000 to Dh9,000 - to the Indian consulate," he said. "Some airlines are charging over Dh20,000 and all of them don't provide stretcher facilities."
Once the patient receives the ticket, its copy has to be given to hospital PRO for processing gate pass. "You have to inform the ward in charge about the exact date and time of departure. You also have to inform the airport clinic about the patient 48 hours before departure. They will charge Dh450 while receiving the patient, and if you are late in giving information, you have to pay Dh650."  
dhanusha@khaleejtimes.com
What about abandoned patients?
Ahmed Shabaan 
Often, blue-collared workers suffer accidents that leave them in a comatose or bed-ridden state. With no one to claim their responsibility and no money to pay the bills, these workers end up lying in hospital beds for several years.
For example, 29-year-old Indian worker Suresh Surendran, who was in a comatose state since 2016, was repatriated only in the summer of 2018. "Suresh had attempted to commit suicide, but he injured himself, which resulted in him slipping into a comatose state. With no one to claim responsibility for his care, Suresh was admitted to a ward in Rashid Hospital, Dubai, since 2016. There are several such cases in the hospital at all times - there is no one who can take up the responsibility of his care," said Naseer Vatanapally, a social worker.
He added: "The hospital bills keep mounting, and they are stuck in the hospital for several years. In most cases, Rashid Hospital pardons the patients and writes off their bills."
 Even if the hospitals waive off the bills, the airfare for repatriation is huge.
Ashraf Thamarassery, an Indian business owner in Ajman who has repatriated over 4,700 bodies to 38 countries across the world, said: "Procedural details can be handled by us, given we've been doing it for so many years. However, for families of blue-collared workers living back home, steps must be taken to provide the service for free."
Vatanapally said: "Air India is the go-to airline for most Indian expatriates. It is a brand and name that we trust. If people feel like they cannot afford the costs levied by the national carrier, there would be delay in the process." 
Angels of mercy
Surendran was repatriated to the Santhi Medical Centre in August 2018, thanks to the benevolence displayed by Uma Preman, founder of Santhi Medical Information Centre. Established in 1987, a majority of the donations to run the non-profit centre comes from benefactors in the Middle East. 
The centre provides patients with palliative care, physiotherapy, as well as psychotherapy. "We provide them with ayurveda as well as allopathy treatment. Doctors, including neurosurgeons, visit the centre, giving patients all kind of care," explained Uma.
 The centre does face its share of challenges as the patients are currently placed in a rented building. "There are eight nurses and one physiotherapist providing the patients with 24-hour care," she added. In June 2018, Uma and Naseer repatriated Baij Nath Prajapathi, a worker who suffered a stroke and paralytic attack in March 2018.
During the amnesty, Uma also claimed responsibility for 80-year-old Saira Saeed Ahmed Bazadani and her son Parvez Ahmed (50), who were living undocumented in Fujairah, with support from local social workers. Their neighbour Saeed Hussain said: "Saira's son is a determined one. No one was there to take care of him as he grew older, and Saira had too many health complications."
Vatanapally said: "Families of patients in India, especially ones who suffer from financial distress, cannot travel all the way to the UAE to visit or take care of their loved ones. It is better to be at Santhi Medical Information Centre since they can travel easily to Kerala."
"A total of five bedridden patients were sent to Santhi Medical Information Centre this year alone." Speaking to Khaleej Times, Suresh's brother Sudheesh said: "Since our mother was diagnosed with psychiatric illness several years ago, we are in no physical or financial condition to take care of Suresh in his present state. It is better that he is at Santhi Medical Information Centre."
ahmedshaaban@khaleejtimes.com
 

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