A UAE-based company said it had recorded around 1,000 flight hours over three to four months, supporting security operations and medical evacuations.
Medical evacuations from conflict-affected areas can involve far more than simply dispatching an aircraft. When airspace is closed or an airport is inaccessible, patients may first need to be transported by armoured vehicle, escorted across an international border and transferred to an air ambulance at a location where it is safe to fly.
That was the sequence in an operation described by Steven Wines, chief executive of Prometheus Medical International, during an interview with Khaleej Times on the sidelines of Adipec 2026 in Abu Dhabi. The UAE-based firm provides medical evacuation, emergency medical support and specialist trauma training.
Wines described an operation involving a patient who needed to be evacuated from an area that aircraft could not reach. The team arranged ground transport in an armoured vehicle, accompanied by a security team, and coordinated the journey to a border where an aircraft could safely access the patient.
The team also helped arrange the necessary visas. Once the patient had crossed into a neighbouring country, an aircraft equipped with a mobile intensive care unit arrived, carrying a doctor, specialist paramedic and nurse. The patient was then flown to the UAE, where arrangements had been made for onward transfer to hospital.
The operation was coordinated throughout the journey, with medical and logistical arrangements adapted as circumstances changed.
Wines said the group’s operations had involved approximately 1,000 flight hours over the preceding three to four months — three times the number recorded during the same period last year. These covered both security operations and medical evacuations.
He said the ability to coordinate every stage of an evacuation was critical, particularly when missions involved multiple countries and changing security conditions.
“Everything that we do, from case management to medics, to land transportation, security, air evacuation, medics on the flight, receiving the patient in the home country, transfer to the hospital – all of that is one organisation,” he explained.
Wines said established local networks were essential when operating in conflict-affected areas. Teams need contacts on the ground who understand local conditions and can help navigate access and border arrangements.
“If you’ve tried to mobilise after the event, it’s impossible,” he said, emphasising that these relationships and operational arrangements must be in place before a crisis occurs.
Preparing before an emergency
This approach also informs the group’s work with energy companies, where emergency planning begins well before an incident takes place.
Wines said Prometheus works with major oil and gas companies and renewable energy producers, conducting regular simulations and drills to test how teams would respond to different emergencies. These exercises help identify weaknesses and inform revised training and operational plans.
One scenario involves a bus carrying 50 workers to a remote site crashing. Responders must determine how to reach the location, deploy emergency teams, triage casualties and arrange medical evacuations.
Offshore operations present a different set of challenges. Helicopters may be unable to fly in bad weather or when sea conditions are too rough. Wines said experience with sea ambulances in Norway could help inform alternative evacuation arrangements in the region.
The focus is not only on deploying professional medical teams to an incident, but also on ensuring that people already at the site can provide immediate assistance.
Wines highlighted the importance of the first few minutes after a serious injury, when a trained colleague may be able to prevent a casualty’s condition from deteriorating before emergency responders arrive.
In cases of severe bleeding, for example, correctly applying a tourniquet can help stabilise an injured person. He said the company was also exploring community training initiatives in the UAE to give more people the confidence to respond to medical emergencies.
He cited the example of an organisation that had installed automated external defibrillators (AEDs) in its offices, but whose employees did not know how to use them. Having emergency equipment available, he argued, is not enough unless people are trained to operate it.
When medical help cannot arrive immediately
The need to stabilise patients for extended periods is particularly important in remote or insecure locations.
Wines described an emergency at an industrial plant in Africa, close to an area affected by conflict. The location and security conditions made it difficult to fly directly to the patient, requiring a helicopter to be mobilised to reach the area.
In the meantime, people on the ground had to provide care until the medical team arrived. Wines said training in prolonged field care, which draws on techniques used in military medicine, can help workers manage casualties when professional medical support is delayed.
The same principle applies to civilian operations, he said. People working at remote sites need to know how to assess and stabilise an injured colleague while waiting for specialist assistance.
Prometheus conducts training at client sites and at its own facilities, recreating scenarios based on the specific locations and risks involved.
For Wines, the objective is to ensure that workers, company procedures and external emergency services can work together when an incident occurs, rather than having to establish roles and responsibilities in the middle of a crisis.
