Issue: Volume XXV

Security
Black Diamond Screening Lanes - Schengen Visa Expansion
Health Health Emergencies at 35,000 Feet - Case File: The Pits in St. Kitts
Travel Airport Performance - Wheelchair Assistance Challenges
Regional Information Africa - East Asia - Europe - Near East - South Asia - Western Hemisphere

Security

BLACK DIAMOND SCREENING LANES  [Top Of Page]

The Transportation Security Administration (TSA) will expand the "Self-Select Lanes" security screening program to six additional airports by the end of April. 

Originally fielded at airports in Salt Lake City and in Denver, the program’s designations are modeled after the ski slope icons symbolizing level of difficulty: green, blue and black diamond. Green lanes are primarily for families, blue lanes for casual travelers, and black diamond for expert travelers who are fully prepared for the checkpoint (think business travelers who arrive at the security gate with laptops out and shoes off).  Although all travelers receive the same level of security screening based on their needs, security processing for those in the black diamond lines is expedited. 

The TSA’s intent is to improve the passenger screening experience, providing customized and appropriate service, while increasing security. At the same time, grouping travelers according to their level of familiarity with the security process reduces pressure on the lines and improves customer service. So far the program is running on the honor system. 

TSA is in the process of selecting additional airports. Airport selection will be based on a number of factors, including checkpoint configuration, stakeholder support and passenger population. The two inaugural airports using the system have seen an increase in screening efficiency and increased customer satisfaction.

SCHENGEN AGREEMENT EXPANSION  [Top Of Page]

As of April 1, 2008, citizens of states participating in the Schengen Agreement can now bypass the passport controls in the airports of 9 new member countries: Malta, Poland, the Czech Republic, Estonia, Latvia, Lithuani, Hungary, Slovakia and Slovenia. 

The Schengen Agreement, which abolished systematic border controls between participating countries, was finalized in 1990. Its scope includes provisions on common policy for temporary entry into participating countries (Schengen Visa), standardization of external border controls, and cross-border police and judicial co-operation. 

Schengen zone countries must demonstrate adequate airport policies, including special departure gates for Schengen passengers, and appropriate ticket and security checks, in order to participate. 

Initial members included Austria, Germany, Belgium, Denmark, Finland, France, Greece, Iceland, Italy, Luxemburg, Norway, Portugal, Spain, Sweden, and The Netherlands. Today, in all, 31 states, including 27 states and four non-EU members (Iceland, Norway, Liechtenstein and Switzerland, are subject to all or some of the Schengen rules. The agreement affects more than 400 million people and a total area of 1,648,128 square miles. Switzerland, Cyprus and Liechtenstein are expected to join the Schengen Agreement later this year, while Bulgaria and Romania hope to do so by 2011.  

A common Schengen visa allows visitors unfettered access to all Schengen full member countries. Holders of residence permits to a Schengen state enjoy the freedom of travel to other Schengen states for a period of up to three months. Road, rail and air passengers no longer have their identity checked by border guards when crossing borders. (Security checks by commercial airlines are still required.) 

U.S. citizens may visit any Schengen state for 90 days without a visa (certain other nationals also have this privilege, including Japan, New Zealand, Australia, much of South America and several other countries). Non-EU citizens of most other parts of the world, will first need to obtain a common Schengen Visa from the Embassy or Consulate of the Schengen country of their main destination, or, if such main destination cannot be identified, the state they intend to visit first; they may then visit any of the participating Schengen countries. 

The visa is granted in the form of a sticker affixed by a Member State onto a passport, travel document or another valid document which entitles the holder to cross the border. It is available in several categories from the embassies and consulates of participating countries. Schengen visas will only be granted to individuals who can prove they have travel assistance coverage for emergency medical treatment and repatriation.

Health

HEALTH EMERGENCIES AT 35,000 FEET  [Top Of Page]

As airline passenger traffic has increased (as well as passenger age and flight length), so has the number of in-flight medical emergencies. Recent stories in the news have highlighted emergency medical landings, illnesses in the air, even on-plane deaths.

Airlines are not required to report on in-flight illness or death; estimates of on-plane mortality in the last 5 years range from 95 deaths to 219 deaths. Medical emergencies aboard commercial flights doubled from 2000 to 2006, from 19 to 35 per 1 million passengers. 

The pressurization and dryness of the airline cabin, combined with the possibility of pre-trip jostling, toting of heavy bags, anxiety, jet lag, changes to eating/drinking habits, cramped seating and other factors cause certain strains on the body. Healthy people can take these stresses without difficulty, but those same stresses can send other passengers over the edge.  

Though data is sketchy due to lack of required reporting, some facts have been gleaned from providers like MedAire, a company that specializes in handling in-flight medical emergencies. They have found that the most common medical crisis in flight is neurological, which can range from a fainting spell to a seizure to a stroke, and that last year there were 5,837 calls about neurological emergencies, causing 266 emergency diversions. Other leading causes for in-flight deaths and medically-related flight diversions are diabetes, seizure disorders, heart and respiratory ailments, and food poisoning.  

According to USA TODAY:  

  • There are more deaths from in-flight medical emergencies than from airline accidents.  
  • Of passengers with medical emergencies in-flight, those aged 51 and older accounted for 83% of 63 in-flight deaths and 59% of 550 medical-related flight diversions in 2006.  
  • Analyzing 911 dispatch data from 10 agencies that operate major airports (such as LAX and Dallas-Fort Worth International), eight of those agencies reported that crews were sent to help a very sick passenger at least once a week.  
  • 559 reports were filed to a NASA database from 1998 to 2006 regarding in-flight illnesses. In 25% of the cases, crews said onboard medical emergencies caused potentially dangerous flying situations, such as diverted jets landing overweight due to excess fuel (sometimes blowing tires) and flying faster than allowed by aviation regulations.  
  • Security measures taken after the 9/11 terrorist attacks, including removal of cabin phones and securing of cockpit doors, make communication with doctors on the ground difficult. Flight crew generally relay emergency medical information from the planes cabin via intercom to the pilots, who communicate with doctors on the ground. This chain of communication makes assessment of symptoms and treatment a challenge for physicians. 

At minimum, airplanes are generally equipped with oxygen, defibrillators, bandages, gloves, aspirin, allergy treatments and cardiac medications; many airlines have more robust medical supplies onboard. Flight crews, who are alerted to onboard medical emergencies via four rings of the aircraft’s chimes, are trained in basic lifesaving techniques; any medical personnel traveling on a plane may be asked to help with a health emergency.  

Pilots make the ultimate decision of whether or not to divert a flight, but even if they do, the process of making an emergency landing usually takes well over an hour even in the best of conditions. 

Passengers can also do their part in preventing in-flight medical situations.  

  • Carry adequate supplies of prescribed medicine in your carry-on bag
  • Carry a copy of your medical history
  • Carry phone numbers for your doctor(s) and family members (and Assist America)
  • During the flight, drink plenty of fluids but avoid alcohol
  • If you have a chronic medical condition, consult your doctor for pre-trip testing and “fit to fly” clearance—this is especially important for flyers with heart or lung disease, asthma, emphysema, history of blood clots, seizures, stroke or diabetes
  • Leave copies of your passport and drivers license with someone back home so that if they are lost or stolen, a copy can easily be faxed    

Do not attempt to fly: 

  • If you are feeling very ill (especially with relapsing illness, chest pains, dizziness or trouble  
    breathing), or against doctor’s orders
  • If you have inner ear problems or infection
  • If you have recently had a penetrating injury to the eye
  • If you have a small or large bowel obstruction
  • I f you have had a heart attack, stroke or coronary artery stent placement within the last two to 
    three weeks
  • If you have unstable angina or poorly controlled congestive heart failure or arrhythmias
  • If you are 34 or more weeks pregnant (new babies are generally fit to fly 48 hours after normal 
    delivery)
  • You have epilepsy not controlled by medication
  • You have suffered recent trauma to your lower limbs or abdomen
  • If you have recently (within the last 6 weeks) had a craniotomy, air encephalogram, abdominal 
    surgery or any major surgery
  • You have severe lung disease
  • If you have pneumothorax without a thoracic drain
  • If you have acute sinusitis or facial injuries with sinus hemorrhage
  • You have had recent oral surgery, especially for abscesses
  • You have a wired jaw
  • If you have gone SCUBA diving within the last 12 hours, or deep-sea diving below 50 feet within
    the previous 48 hours
     

Remember to call Assist America if you have a medical emergency while traveling. We will help to determine whether you are fit to fly, and if not, will arrange to bring you home, safely, when the time is right.

FROM THE ASSIST AMERICA CASE FILES: THE PITS IN ST. KITTS [Top Of Page]

Flu-like symptoms of fever, chills and headache brought Carl*, a 22-year old studying on the island of St. Kitts, to the school infirmary for evaluation, and the nurse there was concerned enough to send him to the hospital. By the time he reached the medical facility, he had developed a rash and abdominal pain, and was looking jaundiced. The doctors ran a panel of tests, all of which were inconclusive.  

Carl’s treating physician knew—regardless of the ambiguity of the test results—that his symptoms could point to any of three potentially life-threatening diseases, and a major component of all of them was renal failure. Assist America knew—although Carl was stable at present—that if he went into renal failure the situation would become dire: the island’s medical facility was very basic and not equipped with a dialysis machine. Together we agreed that Carl needed to be moved to a hospital capable of providing a higher standard of care. 

Within 24 hours, Assist America arranged for a bed for Carl at a hospital in Puerto Rico and moved him via medically-staffed air ambulance and ground transportation at both ends of the journey. He was admitted immediately into the waiting hospital bed and diagnosed with leptospirosis and viral hepatitis—conditions that, left untreated, would most certainly have caused renal failure. After a week of treatment in the hospital he was discharged and was well enough to continue his studies. We provided his commercial carrier air transportation and he returned to St. Kitts without any problems.

*name has been changed for privacy

Travel

AIRPORT PERFORMANCE REPORT [Top Of Page]

Airlines are not the only ones suffering from poor performance and complaints these days. Forbes Magazine, in conjunction with an organization called FlightStats, recently tallied the most delayed airports (arrivals and departures) in the world. The study looked only at international airports that served at least 10 million passengers in 2006, and defined a “delay” as at least 15 minutes behind schedule. Here’s what they found: 

Bring a Book to Brazil  

Brasilia International Airport scored worst for on-time departures. In 2007, fewer than 27% of flights took off within 15 minutes of their scheduled departure. 

In Sao Paolo, Guarulhos International Airport had a 41% on-time departure rate and 59% on time arrival rate, with Congonhas International Airport only slightly better at 43% on-time departure and 54% on-time arrival. Rio de Janeiro'’s airport record is similar. 

Asia , Africa & Europe  

Beijing Capital International Airport ranks second worst for on-time departures, with only 33% leaving as planned.  

Flights at Cairo International (Egypt) left as scheduled only 47% of the time; at Charles de Gaulle Airport in Paris (France), the least on-schedule airport in Europe—on-time departure rates are estimated at 50%. 

More often than not at the Mumbai and Delhi (India) airports, planes did not land on time, putting them at the top of the list for least timely arrivals. 

Plan to Nap in New York  

LaGuardia and Newark International Airports virtually tied for most delayed arrivals, with just 58% of flights arriving on time. At JFK International, which sees 44 million passengers annually, things are not much better: more than 40% of flights arrive late.  

Smoother Sailing  

So which airports are at the top of their game? Look to Korea and JapanSeoul’s Gimpo International is the most efficient airport for arrivals, with 95% of commercial flights landing on time; Jeju International scored 94%. 

Japan' ’s Osaka Itami International boasts a 92% on-time arrival record and 97% on-time departures. Tokyo’s Haneda airport, which sees 66 million passengers annually, has a 93% on-time departure rate. In total, Japan has six airports in the top 10 for punctuality. 

For more information, visit:  http://www.forbes.com/ or http://www.flightstats.com/

WHEELCHAIR ASSISTANCE...NEEDS ASSISTANCE? [Top Of Page] 

If you find yourself with a sprained ankle, broken leg or other injury or illness while traveling and require wheelchair assistance, plan ahead. Though airlines are obligated to comply with the Air Carrier Access Act and provide free, prompt car-to-plane seat wheelchair assistance to compromised passengers, obtaining such assistance is becoming a challenge as more disabled and elderly people travel by plane. 

A study by the U.S. government shows that in the last three years, 34,000 passengers-in-need filed complaints (1.07 complaints per 100,000 passengers) with airlines, and 54% of those complaints have been about inadequate wheelchair assistance. 

Contract providers hired by the airlines are usually responsible for handling wheelchair assistance needs. Those companies often furnish untrained staff working at low wages, which result in the substandard service. In addition to numerous complaints of wheelchair unavailability, missed flights and delays in de-boarding, there have been isolated reports of disabled flyers having to instruct their attendants in how to operate the wheelchair, of having to borrow a vehicle from other private passengers, even—in one case—of being stranded by attendants for 24 hours at Chicago O’Hare. 

The demand for wheelchair assistance and occasional lapse in providing it is attributable to many factors, including: 

  • Increase in airline departure/arrival delays and cancellations make accurate wheelchair assistance scheduling more challenging. 
  • The U.S. population is growing older. It is estimated that by 2030, nearly 24% of the U.S. population will be disabled. 
  • Developments in medicine allow longer, more active lives for the injured and disabled, including air travel. 
  • Lack of formal regulations for requesting/using an airport wheelchair allows any passenger to access it ahead of another. 

Some tips for injured or disabled travelers:

  • Book a ticket that gives you plenty of time (1.5 to 2 hours) between flights—special needs passengers are always the first to board, but often the last off the plane. Allow plenty of time for your plane to be late and for delays in gate attendants providing terminal transport.  
  • Inform your air carrier of any special needs ahead of time, not only online but on the phone.  Tell them if you require assistance getting to your gate, if you need an aisle chair to get on and off the plane, if you have a service animal with you, and if you have any specific seating requests, etc.
  • Print your boarding passes before getting to the airport—it will save time even if you have to wait in line to check your bags.
  • Make use of laws that allow injured or disabled travelers to bypass airport security lines. Approach a security official and they will direct you through a separate entrance. Others in your party may be required to go through the regular detectors. 
  • Proceed immediately to your gate and remind the agent of your special needs. 
  • Use the restroom before boarding—flight attendants are not required to assist you onboard.
  • Just before preparation for landing starts, remind the flight attendant that you will need help departing the plane. 

If you become ill or injured due to an emergency while traveling away from home, and require any kind of assistance, call Assist America—we can arrange specifically for your transport through the terminals  in addition to many other custom services.

Regional Information

For the latest, up-to-date information regarding key regions, click on the links below:

AFRICA

EAST ASIA & PACIFIC

EUROPE & EURASIA

NEAR EAST

SOUTH & CENTRAL ASIA

WESTERN HEMISPHERE

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Sources for this document include, but are not limited to: CNN, ABC News, AP, Forbes, Flightstats.com, USA Today, The CDC, The U.S. State Department.

For pre-trip information: Assist America members can access travel information directly via the Assist America website, http://www.assistamerica.com/. Log in using your Assist America ID/Reference number.

Interested in learning more about Assist America? Please visit us at http://www.assistamerica.com/. Tell a fellow traveler about the newsletter and show them how to subscribe online! Interested in having your organization become a member of Assist America? Please e-mail us at sales@assistamerica.com.