US embassy cable - 05HANOI664

UNCLAS HANOI 000664 
 
SIPDIS 
 
FOR CA/OCS/ACS/EAP; EAP/EX; EAP/BCLTV 
BANGKOK FOR RMO, CDC 
STATE PASS HHS 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP FOR LEW STERN 
 
E.O. 12958: N/A 
TAGS: AMED, AMGT, CASC, EAGR, TBIO, VM, AFLU 
SUBJECT: VIETNAM  - AVIAN FLU: MEDEVAC OPTIONS THRU 
INTERNATIONAL SOS 
 
REF: Hanoi 626 and previous 
 
1.  Summary:  The SOS International Clinic in Hanoi reports 
that they have the capability to transport AI patients, but 
cautions that it is uncertain whether the GVN will release 
patients, or countries will be found to accept patients. 
End Summary. 
 
2. On March 9th, Consular Chief and MED specialist met with 
the Medical Director of the SOS International Clinic in 
Hanoi, Dr. Bruce Miller.  (SOS is an international, for- 
profit, emergency health care provider.)  Dr. Miller said 
that SOS has equipment and resources available to medevac 
patients with respiratory symptoms.  They have a "large 
number" of isolation units that have been approved to 
transport patients with highly contagious respiratory 
illness.  The units are spread around the world, but could 
be brought to the Southeast Asian region if demand 
increased. 
 
3.  With the use of these isolation units, the planes would 
not have to be retrofitted to meet CDC guidelines.  Pilots 
and crew would wear N-95 respirators. SOS has redesigned and 
gotten approval for a new respirator design which pilots can 
legally wear while flying.  SOS also has access to a wide 
range of planes from lear jets to a C-130.  While not every 
pilot and plane owner is willing to transport highly 
contagious patients, SOS has a cadre of pilots and plane 
owners (of the full range of planes) who are fully informed 
about the isolation units and willing to fly such patients. 
SOS is capable of long-haul medevacs via short hops with re- 
fueling, or, if necessary, a plane that can do mid-air re- 
fueling. 
 
4.  An important outstanding issue is whether other 
countries will accept patients.  SOS has an agreement in 
principle from G-7 countries to take back their own 
citizens, but each case would be reviewed on a case-by-case 
basis.  SOS cannot guarantee that even his or her own, G-7 
country will accept a patient.  (A recent example that 
illuminates Dr. Miller's hesitancy is one in which Canada 
recently nearly refused landing rights to a commercial jet 
full of passengers because one passenger was a patient (with 
an eye injury and no respiratory symptoms) being escorted 
from Vietnam.  In the end the plane was allowed to land.) 
 
5.  Another unknown is whether or not the GVN will release 
patients from isolation in Vietnamese hospitals.  SOS has a 
general agreement with the GVN to release patients being 
transported in isolation units, but the ambulance would be 
given a GVN military escort to the airport and permission in 
each instance will be decided on a case-by-case basis. 
Because of the need for individual consideration of the 
cases and arrangement for military escort, Dr. Miller warned 
that if the number of cases became large, it would be 
unlikely that the GVN would have the capacity to release 
patients under these conditions. 
BOARDMAN