If you have staff based across Africa, it’s worth giving serious consideration to providing emergency evacuation cover, enabling them to get to safety in case of illness, injury or major threats. Africa is a huge and diverse continent and the level of medical provision available across – and even within – its 54 countries is equally varied.
While there are established centres of medical excellence in major cities in South Africa and Kenya, medical facilities in remote rural areas are few and far between, and are often poorly equipped and under-staffed. In other African countries the situation is much worse. For example in Mozambique, there are just 63 doctors covering the Tete province, which has two million inhabitants, and medical facilities in the Democratic Republic of Congo (DRC) are extremely limited.
The levels of danger to health and personal wellbeing also vary widely. Sadly, the areas fraught with most danger are generally the least well equipped, making evacuation cover essential.
International private insurance plans
Many companies provide international private medical insurance (IPMI) plans for senior staff and expatriates as standard. IPMI policies often include cover for medical evacuation and repatriation, but check the small print, as they vary in their details and levels of coverage.
Many companies provide international private medical insurance (IPMI) plans for senior staff and expatriates as standard.
Here are some key questions to ask:
- What is the maximum amount covered for medical evacuation expenses? (Note that the actual evacuation alone can cost between GBP 5,000 and GBP 180,000 according to data from the International Medical Group insurance provider.)
- Does the policy cover companionate travel – a loved one travelling with the person affected?
- Does it cover emergency medical reunion – transport for their next of kin to join them?
- Does it include medical repatriation – taking the person to their home country to recover once they have been stabilised?
- Does it cover ongoing care once the person has arrived in their home country?
- And does it include repatriation of remains – the return of a person’s body to their homeland if the worst should happen?
Add-ons and extras
Some IPMI policies don’t include medical evacuation and repatriation cover as standard, but in those cases it will usually be available as an add-on option.
Another aspect that may be important to consider, depending on where your staff are based, is whether a policy includes evacuation due to security issues. Travel insurance policies usually include security evacuation as standard. The same doesn’t apply to permanent international health insurance policies, though it is starting to become more common in response to demand from employers.
If your existing policies don’t include security evacuation, ask whether it’s available as an add-on, or consider investing in dedicated emergency evacuation insurance for staff who work in high risk areas.
There are also various evacuation membership schemes available. If possible, look for one that includes a ‘hospital of choice’ benefit. This will allow employees to decide which hospital they would like to be evacuated to, rather than just being taken to the nearest facility that the attending physician and provider decide would be suitable.
If you have staff on local medical insurance policies, odds are that evacuation won’t be included. Again, you might want to consider signing them up for standalone emergency evacuation cover, which can be purchased as low as $30 per person per year.
The risks your staff in Africa may face
When you’re thinking about the appropriate evacuation cover for your employees, it’s important to consider the risks to which they may be exposed. Here are some of the potential issues:
1. Diseases: There are a number of health concerns across the continent. Malaria and dengue fever are just two concerns which are present in several countries. While there are ways of combatting these threats, figures from the World Health Organization (WHO) show that these continue to be very serious conditions and are particularly prevalent in sub-Saharan Africa.
2. Working conditions: Some roles inevitably put staff in more danger than others. Frontline workers in industries such as mining, oil, gas, iron, steel and construction can face challenges in their day-to-day work that may increase the likelihood of accidents and injuries. Poor health and safety practices can exacerbate this risk.
Frontline workers in industries such as mining, oil, gas, iron, steel and construction can face challenges in their day-to-day work that may increase the likelihood of accidents and injuries.
3. Lack of stability: Many of the dangers your staff may face in Africa will be sparked by political instability. The Global Peace Index uses a variety of criteria to rank countries according to their level of peace – according to the 2017 index, out of 163 countries in the world, seven of the 15 least peaceful are in Africa. Obviously the chaos that ensues in the wake of political unrest or terrorism can have a knock-on effect in terms of day-to-day life – for example poor sanitation increases the risk of waterborne diseases and health facilities struggle to cope with demand.
4. Crime: According to statistics from online database Numbeo, six of the top ten most dangerous African cities in terms of criminal violence are in South Africa. The remaining four are in Libya (Benghazi), Nigeria (Lagos), Angola (Luanda) and Kenya (Nairobi). Worryingly, several studies suggest that violent crime rates may be equally high or possibly even higher in rural areas, where it’s harder for victims to access help.
So should you provide evacuation cover for your staff?
The short answer is yes. At the very least, staff who are based in the more remote areas of Africa or working in high-risk environments should be provided with emergency evacuation cover as standard. If they don’t already have decent evacuation cover as part of an IPMI policy, ideally including security evacuation, sign them up for a dedicated evacuation insurance plan or evacuation membership scheme. In the future, consider switching to an IPMI provider that offers security evacuation as part of the package.
For those based in major cities with reasonable and even excellent medical facilities, such as Nairobi in Kenya or Cape Town in South Africa, evacuation cover may not be essential. However, you might want to offer evacuation and repatriation as part of the package for expats and senior staff. As well as providing reassurance, this can be a valuable tool to help you attract and retain the best people.
For those staff who don’t have any evacuation cover, it’s a good idea to remind them that they should invest in suitable travel insurance when they take a holiday.
For those staff who don’t have any evacuation cover, it’s a good idea to remind them that they should invest in suitable travel insurance when they take a holiday. This is especially important if they are planning to go somewhere dangerous or to get involved in potentially risky activities. They should check the small print to make sure that the policy they are buying covers them for what they have planned. For example, some policies become invalid if the beneficiary travels to certain destinations or gets injured while doing adventure sports. If you have a company intranet or newsletter, these would be good ways to communicate this type of information, helping employees at all levels to feel valued.
If you want to discuss the best evacuation cover choices for your staff, an insurance adviser with experience of the African market will be well placed to help.