Interaction disorder: why sanitation has problems
An inspection of the air ambulance service will be carried out in the Kamchatka Territory after two patients from Ust-Khairyuzovo with a heart attack and stroke could not be taken to the regional hospital for four days, although the weather was suitable for the work of air ambulance. Right now, the patients are fine, they are receiving medical help, but the work of the sanitation department has to be sorted out. However, experts emphasize that there are no global problems right now — it works well in Russia, but there is still room for improvement. For more information, see the Izvestia article.
Why couldn't residents of Kamchatka be hospitalized?
The head of the Kamchatka Territory, Vladimir Solodov, told about the incident in his Telegram. According to him, for more than four days, patients from Ust-Khairyuzovo were in the general practitioner's department, although they suffered a heart attack and stroke, and the medical facility had "neither intensive care facilities nor an appropriate medical care profile." At the same time, the weather conditions allowed for the departure of an air ambulance, Solodov said, "regular planes and helicopters were flying.
Only after the intervention in the situation, they were taken to the Kamchatka regional hospital, and now nothing threatens the lives and health of people.
"This situation is unacceptable — by their actions, employees of the National Air Ambulance Service have put the health and lives of our citizens at risk. An internal audit will be conducted, the perpetrators will be punished, and the very order of interaction between remote healthcare institutions, the Ministry of Health and the sanitation service needs to be reviewed," the head of the region said.
He stressed that if the sanaviation flight is "delayed for more than a day," the entire health system of the region should be informed. Vladimir Solodov pointed out that he understands situations when departures are objectively impossible, but this should not happen "because of organizational laziness."
Izvestia sent a request to the governor of the Kamchatka Territory.
How does the work of air ambulance work?
In Kamchatka, air ambulance is of great importance — there are a lot of places in the region that can only be reached by helicopter. The mentioned Ust-Khairyuzovo is one of such settlements. There is no road connection to this village. The local airport accepts light aircraft and helicopters. As of 2021, about 800 people lived there.
And the attention to sanitation in this subject of the Russian Federation is great: in 2023, for example, funding for it was increased 4.7 times. In particular, the region receives serious injections for the organization of this type of medical care from the federal budget.
Pavel Popov, an anesthesiologist and intensive care specialist at Medaero-Service LLC, emphasizes that there are no global problems with air ambulance in the country right now, as well as with the order of interaction between medical institutions and sanitation. The system only needs minor improvements, he says.
"There are isolated cases when someone could not be taken out," he told Izvestia. — But most of the time, in my experience, these situations are inflated by people who do not fully understand the organization of this work: patients may not be transportable; helicopters could be used on other flights — especially these days there were earthquakes in Kamchatka. We need to understand the specific situation and wait for the results of the check.
According to Pavel Popov, Russia has one of the best air ambulance and relief systems in the world, given its distance, size and population.
Aviation expert Maxim Fedosov notes that there is a shortage of specialized aircraft with medical equipment in Russia. But there are helicopters in almost every region. He added that each region should have its own air ambulance program, as well as accumulated statistics and targets for such flights. In addition, well-established communication with local medical institutions is necessary.
— But I'll repeat it again: There are probably no obvious problems with helicopters, but with airplanes, it is necessary to develop the technical base, because it is one thing to transport a patient from a remote area to a regional center, and another to send a difficult patient to Moscow or a large federal medical center," Maxim Fedosov told Izvestia.
The press service of the Ministry of Health of the Russian Federation emphasized in a comment to Izvestia that the organization of sanitation is within the authority of the regional authorities. At the federal level, the national project "Healthcare" was responsible for the development of sanitary aviation in 2019-2024, and the national project "Long and Active Life" from 2025.
— From 2019 to 2024, almost 72 thousand flights of sanitary evacuation were carried out, including more than 1.5 thousand flights on the territory of the Kamchatka Territory. Almost 95,000 patients have been evacuated, including more than 2,000 patients in the Kamchatka Territory, the Ministry of Health said.
In the first seven months of 2025, more than 9,000 air ambulance flights have already been completed, and more than 200 in the Kamchatka Territory.
How does the National Air Ambulance Service work?
The National Air Ambulance Service (NSAA), whose employees were asked to check by Vladimir Solodov, was established in 2017. Currently, more than 50 regions of the country, including Kamchatka, have contracts with it. In 23 regions, the company has received the status of a single supplier of sanitation. A number of subjects of the federation are still trying to fulfill the tasks of organizing work by various airlines. Maxim Fedosov recalled the incident in the Kamchatka Territory last year, when the Vityaz-Aero company's license was revoked. It was replaced by the NSSA.
At the end of January, Russian Minister of Health Mikhail Murashko appealed to Vladimir Putin with a request to transfer all helicopter shipments for medical care to the National Air Ambulance Service, as it already was from 2019 to 2022.
According to open data, the NSSA fleet has 76 helicopters: Mi-8 and Ansat, which employ more than 320 pilots. According to one of the contracts of the National Air Ambulance Service concluded in the Kamchatka Territory, a flight hour on a helicopter with a medical module costs just over 380 thousand rubles.
Izvestia sent a request to the National Air Ambulance Service.
At the Sanaviation forum in May 2025, Alexander Vorobyov, acting Chief Physician of the Territorial Center for Disaster Medicine, Emergency and Emergency Medical Care in the Tula region, described how cooperation is being built with the NSSA, with which the region has signed an agreement.
"On the one hand, it's convenient because we don't have any problems with maintenance of equipment, refueling, and so on — all this, like pilot training, supplies, and so on, is handled by NASA," he said. "However, the helicopters don't belong to us, and that's a disadvantage."
The medical team that responded to the call and diagnosed a stroke or acute coronary syndrome, taking into account the range of distances, calls a helicopter. After receiving the call, the operational duty officer makes a request to the NSSA control room. They look at the weather, give the go-ahead for departure, and the work of the operations department begins: organizing the call and the actual departure. The helicopter should arrive at a landing site adapted for landing. An ambulance team with a patient is also going there.
"The main disadvantage of the fact that the helicopter does not belong to us lies precisely in this time gap, which runs from the start of the call to the departure itself: according to the regulations, it is 30 minutes in summer and even more in winter. This time gap often negates the advantages that sanitation gives us, unfortunately," said Alexander Vorobyov.
Who finances the sanitation
At the same time, the regions are mostly engaged in financing sanitary aviation. In the Tula region, in particular, the participation of the regional budget in the organization of sanitation has increased dramatically in recent years: if in 2019 more than 80% of funding came from the federal center, now about 75% is the share of the regional budget.
Financing problems are especially common when it comes to inter-regional medical evacuation, Sergey Suvorov, a senior researcher at the Veltischev Institute of Pirogov University, spoke about this at the Sanaviation forum in May.
"For example, a few years ago, a Muscovite went to Kamchatka, to a geyser, where his child was scalded. Which region pays for the evacuation? — said Sergey Suvorov. — The issue could not be resolved until the mother came to the reception of the governor of Kamchatka.
He noted that the financing of inter—regional sanitation is not a fully settled issue, especially given the establishment of a system of federal medical centers that must take difficult patients from different regions.
Pavel Popov, in an interview with Izvestia, also noted that very often problems arise due to tourists who have health problems when they find themselves in hard-to-reach places. They complicate the process of their evacuation to a medical facility by not coordinating their route with anyone and not caring about life and health insurance.
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