Defence Medics parachute into Tristan da Cunha to treat hantavirus patient

Fastest route to care: how Defence Medical personnel helped stabilise a critically ill patient on a remote island.

When a British resident on Tristan da Cunha, one of the world’s most remote inhabited islands, became critically ill with hantavirus linked to an outbreak aboard the cruise ship MV Hondius, the challenge was immediate: how do you deliver advanced medical care when the nearest specialist unit is thousands of miles away and evacuation could take weeks?

For Wing Commander Toby Elkington, a Defence Medical anaesthetic and intensive care consultant with 16 Medical Regiment, who was on NHS placement at Peterborough City Hospital and about to anaesthetise a patient for surgery, his mission changed quickly.  Within hours, alternative cover at the hospital had been found and he was en-route to the South Atlantic as part of a two-person medical team.

The deployment would become notable for another reason too: it involved the first known parachute insertion onto Tristan da Cunha (Toby’s first parachute jump) , and possibly the fastest ever journey from the UK to the island (approximately 27 hours instead of the usual two week trip by sea).

The two military clinicians flew with six paratroopers carrying specialist equipment, essential medicines and oxygen support on an RAF A400M, before dropping through 4,000 feet of cloud in 20-knot winds to reach the island.

Toby and his team had to plan for all eventualities before they started their journey. “We were trying to think what we might need if we had to stay there for a long time,” Elkington said. They did not know exactly what equipment was already available and whether power supplies would be reliable. In practical terms, that meant building a package capable of supporting prolonged critical care in a distant environment.