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Air Rescue from Kullu (Hill Station in India)

2 foreigners (very young girls) broke their leg, nose, spine in a bus accident in hilly village of India; in the afternoon. Local authorities had taken them to the Government hospital in the hill town. Some primary diagnosis and medication. The further treatment was kept pending to the next day. By the night, youngsters were Distressed due to language, anxiety, food, lack of medical facilities and emotions.
Past midnight, ISAPL was tasked by their home company to handle immediately shift them to a better medical facility and provide for Medical care, food and language. The anxiety levels of employer, Embassy and family very high. Our Medic-logistic team swung inti action. The town’s 2 ambulances were Overburdened in shifting another 15+ injured to a town hospital 3 hours drive 1-way. Real ambulance and professional care is a far cry. We arranged makeshift ‘ambulance’ to Road Transfer the young girls to a speciality secondary care private hospital to a bigger town.  Some  mattresses and restrain belts in the transfer vans. Shifted from Govt to private hospital for secondary care. Our medic teams’ preference was to conduct surgery in a city hospital.
3 days of stabilising and pain management. Reviews by home-country doctors. Emotional care.

Meantime ISAPL worked on their Air transfer from Hilly town to Suprspeciality Delhi. Special pilot, special machines are needed for this hilly Airport. Lots of algorithm and consideration for Medical risks. We chose over the fixed wing AA to a chopper. Fixtures and fittings, Cushions and mattresses and restrains-belts.

Integrating best of Medical and logistic support. We could shift them to Delhi and then to their home country. Our toil of 6 days-nights was far less than what they had been going thru. It was actually tough on them.

We simply bring some smile to those in severe distress !

Is Surrogacy Legal

To me, any Legal framework is derived from the ‘ethics’ of a society / religion / culture and genre.
So any ‘legal’ aspect has a ‘relevance factor’ to a specific situation. Any blanket law is a fiasco. Otherwise how do we justify Spying (theft) ? or War (killing) ?

Surrogacy is now a drawing-room debate. Those IP accept it and others go hush-hush.
With the changing times and info-age…there are far many endorsers to surrogacy than the detractors. Wile many governments still flip-flop, the society at large is coming to the terms of Surrogacy. Once, it becomes ethically acceptable, laws will abide by it 🙂

I shall soon talk about the ’emotional’ aspects of it……

Air Ambulance

Air Evacuation and other options

A person in distress is an emotional event. The Medical Emergency is of exigency. There are many facets to the support required. The relatives expect emotional support. The person needs timely medical attention. While the concerns of the family and friends are important, the professional prefer to focus on the patient. Air Ambulance is an option.

The Medical Evacuation needs to be arranged with the lightening speed. At times, the access to patient is difficult due to terrain, weather or geopolitical constraints. And thus speed and swiftness has increased significance. The patient condition warrants split-second Medical movements. Over the years, the Road ambulance and road accessibility has improved significantly. Nowadays, evacuation thru Road is far more convenient and safe. Although, it takes longer, but the time is utilized by the medical escort team perform small tests and also provide temporary medication to the distressed. So now the Road Ambulance is a turning into a steady, economical and dependable method.

Advent of Air Ambulance in Eastern world

Like their western counterparts the Air Evacuation is picking fast in Asian countries.

The key benefits of Air evacuation is speedy access to tricky terrains. The medical institutions and para-med have also evolved in their evacuation attentiveness. The Medical Emergency kit is more practical and concise. The Air Ambulance carries the usual medical equipment like ECG and monitors, ventilators, medication and stretchers. So now, patients can receive preliminary treatment while they are being sent away to the appropriate medical facility.
Many governments have their standards for Medical Evacuation for both Road and Air Ambulance that applies to various stakeholders, processes, equipment and devices.

Air Ambulance Selection

The concern is that Air ambulance operations require special experience in safety and the capability of the pilot in flying emergency flights. Few countries have exceptional Medical Evacuation system, operated by the Federal. But, most have a set of private service providers. Over the last decade, a lot of professional Air-Ambulance services have appeared on the arena. Many a times, the business air charters are ‘rented’ for Medical Evacuation. For Air Ambulance, although the commercial Charter Aircraft are available, but equipping those with Life support facilities and crew credibility is a job in itself. The air ambulance selection should be based upon the terrain and timing. In exigencies and protected areas it is regulatory requirement for to Air Ambulance to be licensed. The Choppers Air Ambulance are real swift and have deeper reach, with the limitations on the air pressure, ambient noise, space, and physical stability. The selection of crew on Air Ambulance needs to be based upon the experience, insurance, authorization, dependability and language expertise. Only experienced medical team can handle traumatized patient during medical evacuation. During medical evacuation, the medical staff selection on Air Ambulance is specific to the patient condition, prognosis, medical policy, Doctor’s advice, Patient history and family preferences.

A good Medical Evacuation service provider must have experts who have handled geographically and medically versatile cases. A seamless arrangement with the state and medical facilities is critical.

The terminal point of medical evacuation is decided by the medical team to ensure relevant specialty of the medical facilities…


It is conclusive that the preferred mode of Medical evacuation is Air Ambulance, but only experienced hands can decide the most favorable mode and timing of an evacuation.

Our Director Poonam Jain has even helped the crash victims of the Air Ambulance crash in 2011.

Latest news in Surrogacy

Surrogacy Bill To Be Taken Up By Union Cabinet On Wednesday

NEW DELHI:  The union cabinet will take up a draft bill on Wednesday which aims to safeguard the rights of surrogate mothers. The bill will then be introduced in parliament in the winter session, said sources.

According to the Health Ministry proposal, the draft Surrogacy Bill, 2016 aims at regulating commissioning surrogacy in the country in a proper manner.

Some of the basic features of the bill, apart from legalising surrogacy and setting up a board to regulate and inspect clinics, is banning commercial surrogacy. No foreigners will be permitted to take part in this process after the Ministry of External Affairs raised a number of issues ranging from citizenship, abandoning the child, visa and passport issues.

Surrogacy will be permitted only for proven infertility, for altruistic purposes where medical expenses will be paid only and not for carrying the child. Under no circumstances will this be permitted for selling children.

No new surrogacy clinic will be allowed and the new board which will be set up will regulate and ensure proper implantation of the act and its rules once passed in parliament.

The draft has already been cleared by a Group of Ministers (GoM) after consideration. Apart from Health Minister JP Nadda, Commerce Minister Nirmala Sitharaman and Food Processing Industries Minister Harsimrat Kaur Badal, were among those part of the GoM.

The government had recently said in parliament that provisions are being made in the draft Bill to make parentage of children born out of surrogacy “legal and transparent”.

LH flight ISAPL nurse escort to Toronto Canada

This medical escort by a flight nurse is another example of the type of complicated transfer ISAPL safely arranges on regular basis.

Dear Officer,

I would like to express my gratitude for providing assistance (via information and support to ISAPL) in bringing Mrs. Kamaladevi (Canadian Senior Citizen required medical evacuation from Chennai to Toronto.)

I am absolutely happy with the exceptional services provided by the ISAPL Group. Group’s impeccable communications, record keeping and invoicing methods are exemplary. It was pleasure meeting your nurse, she is very kind, caring and courteous.

In addition, Ms. Poonam Jain has meticulously and patiently managed the entire medical nurse based evacuation processes. She is THE go to person regarding services in this type of nature. My very best wishes to her.

Once again, THANK YOU.


Pending Frozen Embryos (Release Efforts)

In my opinion, the embryos should be either returned or allowed to be used by Intended parents.

Here is an article appearing in today’s daily. I have shared my opinion.

Human embryos of couples from across the world, frozen in liquid nitrogen at countless infertility clinics across India, now float in a sea of uncertainty with surrogacy laws in India set to become tougher, but no explanation on offer as to why these embryos can’t be returned to their genetic owners.

Couples from the world over who came to India for surrogacy service are now demanding that their embryos be shipped back to them, but it is an almost impossible proposition as export of human embryos is barred. India banned commercial surrogacy in November, 2015, but panic among couples has set in only now after the Cabinet cleared the Surrogacy (Regulation) Bill 2016 last month.

The bill, which has made the government’s intent to ban commercial surrogacy clear, is silent on the fate of embryos already banked in India.

“I have 186 embryos of couples in my clinic and I have received about 20 requests from the U.S., Canada and the U.K. to ship the embryos back to them. For now, we are holding the embryos for them,” says surrogacy specialist Dr Nayana Patel. who runs Akansha Infertility Clinic at Anand, Gujarat. She says she has met state officials at Gandhinagar to discuss the issue. Similarly about six embryos are kept at the International Fertility Centre, New Delhi and around 100 at Mumbai’s Rotunda Fertility Clinic.

“The Indian government has given no real thought, no concession to people who have their embryos locked in India,” says Sam Everingham, Global Director, Families Through Surrogacy.

Speaking to The Hindu from Australia, Mr Everingham says he has clients who would like to go for surrogacy in countries where commercial surrogacy is still allowed, or try it in their home country itself.

Australia, for instance, allows altruistic surrogacy, Mr. Everingham says, adding that the solution lies in allowing people with embryos in India to go for surrogacy here. “The government should give a grace period,” he says.

It’s an option that Dr. Patel is trying to discuss with Gujarat State offcials as well.

Of pain and fear

The Indian government has put a cap of five years on keeping embryos, following which they should either be discarded or given out for research. And this has given Melbourne-based Dr Uzma Aslam sleepless nights. Born in Pakistan, raised in Australia and married to a Ukranian, Dr Aslam had a successful surrogacy experience in Mumbai in 2009. Pleased, she decided to return for a second child after two years. Only this time the surrogacy attempt failed and her wait for a second baby became longer, during which time the laws in India changed.

In a video interview with this newspaper, Dr Aslam smarts tears as she narrates the painful and cost-intensive surgical procedure she underwent for her eggs to be harvested. Her eggs and her husband’s sperm was used for the embryo, which was then shipped to Mumbai. “There were 20 excellent quality embryos and this was my last chance. I am 45 now, and won’t have those eggs any more,”she says.

New Delhi-based migration agent Poonam Jain, who is currently helping about half a dozen couples make representations to the Indian government, puts the concern in perspective: “The embryos are a property of these couples and not of the government. And these are live embryos that can be sold or misused.”

Besides, it’s a rights issue. Dr Aslam says she is being denied the right to what is genetically hers. Hari G Ramasubramanian, surrogacy law expert and founder of Indian Surrogacy Law Centre and Gift Life Egg bank, Chennai, agrees. “These embryos are their last chance of having a child that is genetically related to them,” says Mr Ramasubramanian, who has sent a legal representation to the Maharashtra State Health Department seeking approval for a surrogate for a U.S. couple that has their embryo in a Mumbai clinic. He points out that India allowed surrogacy at one point and even issued surrogacy visas, thus promoting it. The issue of embryos has to be seen in that perspective, he says.

Approval chase

Representations seeking embryo export approval are pouring into various government offices, nobody really sure who the approving authority is. Top pick for many is the Indian Council of Medical Research (ICMR) that has in the past issued approvals for import and export of embryos. But Dr Soumya Swaminathan, Director General, ICMR says the body is no longer responsible for giving approvals.

Calls are also being made to Department of Health Research. “We were not involved in the import of embryos, so how do we figure in their export permission,” says Manoj Pant, Joint Secretary, DHR.

Representations have been made to the Ministry of Home Affairs, but an official there tells The Hindu: “We can’t be issuing visas to embryos, so we don’t figure in this.”

As couples and their aides in India frantically seek help, they are unaware that an approval for export is, in fact, unlikely. “Export of human embryos is prohibited,” says an official of the Directorate General of Foreign Trade (DGFT).

Dr Swaminathan, however, offers hope. She says the matter will be taken up with the Ministry of Trade and Commerce.

Latest Surrogacy News, Cambodia

With tougher laws in India, doctors and couples are increasingly moving to the east Asian nation.

Bhoomi Shah says she lives the good life in Ahmedabad. She has a well-paying job, has a car that she likes to drive around and lives in a bungalow with her parents, who have always supported her decisions and life choices. So last week, she packed her bags and made a quick three-day trip to Cambodia — not drawn to the east Aisa nation by the iconic Angkor Wat, but to rent a womb.

“I am 32 and I do not wish to get married. And getting a surrogate in India for a single person is now impossible,” she tells The Hindu over the phone. “I wanted a baby, who I am genetically linked to. So it made imminent sense to try surrogacy. But it is impossible in India so I searched on the Internet and found Cambodia offers it,” she says.

During her three-day trip, she visited the clinic where she will be making the egg donation and met four women who were willing to carry her child. “The women I met were Cambodian. My only criterion was that a healthy woman should carry my child,” says Ms Shah, who is scheduled to travel to Phnom Penh in October to start the surrogacy process – which will cost her around Rs 15 lakh.

With India toughening its stand on surrogacy, evident in the Surrogacy (Regulation) Bill 2016 which the Cabinet cleared last month, surrogacy service seekers, and even doctors have started moving to destinations that still allow this service.

While Cambodia has become popular among people — both Indians and from other parts of the world — countries such as Ukraine and Kenya are attracting doctors from India.

The big rush

Bhoomi Shah’s search for a surrogate was facilitated by Benhur Samson, CEO of Surrogacy Abroad, who has taken 23 sets of people to the country this year alone, of which six were from India.

“India is no longer on the surrogacy map and after Bangkok and Thailand stopped surrogacy, Cambodia opened up,” Mr Samson says, adding that this was the “first batch” that he has taken to Cambodia.

As in the early days of surrogacy in India, the lack of proper laws or guidelines in Cambodia has proved a big attraction. Medical tourism consultants such as Mr Samson say doctors from Thailand have set up infertility clinics here.

But the focus on Cambodia has its set of concerns.

“There is growth in surrogacy in Cambodia since last year. There is a huge pressure building and Cambodia is ill-prepared to handle it. Besides, there are no laws in place (in Cambodia),” says Sam Everingham, Australia Partner of ISAPL. Sam says that couples from Australia too are looking at other destinations including Cambodia, but there are concerns about its medical infrastructure vis-à-vis other destinations such as India.

Sam says doctors from Thailand have set up shop in Cambodia and that the surrogates are from Thailand, Cambodia and also India.

Collaborations elsewhere

Doctors who offered surrogacy service in India are aware of the new hubs. Dr Rita Bakshi, chairperson of International Fertility Centre in Delhi, says: “Cambodia may have emerged as a hub, but it has only one or two players currently. It doesn’t have well-defined laws so a better place is Ukraine that has laws in place.”

Ukraine’s presence is not lost on Indian doctors who once had a good surrogacy business going.

After the ban on commercial surrogacy in November last year, Hyderabad-based Kiran Infertility Centre collaborated with an infertility clinic in Ukraine. “We have done this work for the last 10 years and we have patients still approaching us for it. We tell them it will cost more, but we can offer the service,” says Dr Samit Sekhar, who visits Ukraine once in two months.

Latest news article regarding Embryos Release (court responds)

latest news article requesting embryos release (Mumbai Court Responds) ISAPL team has been closely following with government departments requesting release of embryos. Once release officially granted then team can assist with the courier.

Bombay high court has asked the central government to clear its stand on whether an American couple can take back their embryo – unborn child/baby – kept in a laboratory to their home country after the Union government banned commercial surrogacy in India last month.

The division bench of Justice Shantanu Kemkar and Justice M.S. Karnik was hearing a writ petition filed by the American couple which wants to take back its embryos to America. On Friday, while hearing the matter, the HC asked petitioner how could a foreign national file a writ petition because the Constitution had given this right only to citizens of India.

Petitioner’s counsel Ashutosh Kumbhakoni argued that Article 21 of Constitution gives right to life to everyone, even if the person is a foreign national. Kumbhakoni further argued that right to life says everyone has the right to take every efforts to have a baby and therefore, the petitioner has the right to file a writ petition.

According to the petition, doctors had advised the couple to go in for surrogacy. The American doctors then with the help of the couple’s sperms and eggs created the embryos and advised them to adopt a surrogate mother for the same.

The couple made eight embryos and dispatched it to India by a special courier. The couple had also taken a surrogacy visa and visited India and followed every procedure.

The petition further stated that when the surrogacy process was about to begin, the Union government had declared a ban on surrogacy.

The couple then made correspondence with the Indian authorities and requested them to allow them to take back their embryos to US. However, the Indian government had refused, saying that while banning surrogacy it had banned import and export of foetus too.

Finally the Legal Surrogacy is the way

The recent developments at India, Thailand, Nepal and Cambodia has clearly set the path for the Legal Surrogacy. No more mess around Surrogate mother and harassment. Even the Citizens and their Embassies will be more sorted on the process.

I am headed Ukraine in the coming month. Many cases to help 🙂

Cambodia bans booming Surrogacy industry, government may consider drafting law

Ministry of Health Bans Surrogate Pregnancy