Managing foreseeable
risks
•
Which factors should be considered when
determining the needs of business travellers and
short term assignees?
•
What is risk tolerance and how do you provide
the right care for business travellers, students
and expats?
Paul Hedman, Risk Advisor February 20th 2014
Falck – a global assistance company
Falck core services
Emergency Assistance Healthcare Safety Services Fire
Services Ambulance Services
Ambulance Services Fire
Services
Assistance Assistance Assistance • Risk Management
• 24/7 Emergency Response Center • Evacuation • Repatriation
• Travel risks & security • Ambulance • Medical Clinics • Elderly care • Employee Assistance Programs (EAP) ‒ Psychological crisis
aid and counseling • Staffing • Sea Survival • Fire Fighting • Other ‒ Safety enclosures ‒ Crisis management Travel Risk Mgt Training Crisis Management Onsite Medical Services Assistance & Evacuation
Falck Global Assistance
Fire Services • Provision of onsite Fire Services medical staff, clinics,
and emergency care services
• 24/7 Emergency assistance and evacuation from site to relevant care unit
• Provision of risk advisory, risk rapports, security training and travel tracking • Provision of on-site training – general as well as specialized training services • Provision of crisis plans, crisis mgt. teams, equipment and rescue operations Fire Services
• Public fire fighting • Industrial fire
fighting
• Consultancy and training
A global travel, medical, and security assistance structure
with regional alarm centres
There are many issues to consider when an organization is
responsible for guaranteeing the safety of its international
employees
Medical Evacuation in a Hostile Environment:
Bangui, Central African Republic – December, 2013
• Chaos and violence as deadly clashes
erupted between rivals Seleka and Anti-balaka armed groups
• At least 400 casualties – civilians indiscriminately targeted
• Complete shut down of government and
hospitals
• 2 000 people sought refuge at Bangui
M´Poko International Airport, controlled by French troops
• Most westerners gathered at the same
hotel for protection.
Situation in Bangui - Dec 6
Location
: Bangui
,
Central African Republic
Service:
Medical Evacuation in Hostile
Environment
Patient :
Employee collapsed at hotel due
to undetermined diagnosis. No medical
treatment available locally.
Case Outcome:
Successful air ambulance
medevac to Nairobi with help of heavy
security support on ground in Bangui
.
French troops at the airport gates
“Risk doesn't always make sense and despite the fact that many people have a hard time managing the uncertainty that comes with risk-taking;”1
• Risks make life more interesting
• More engaging
• More exciting
Risk mapping Risk Appetite and Risk Tolerance
What we are up against
6
Determining what measurements to take to fulfil your duty
of care obligations starts with a risk assessment
7
DESTINATION CHARACTERISTICS
Medical:
•
Health risks
•
Infrastructural health risk
•
Health care system
•
Medical evacuation
Security:
•
Political stability
•
Civil unrest
•
Crime
•
Terrorism
TRAVELLER CHARACTERISTICS
•
Gender
•
Age
•
Pre-existing conditions
•
Physics
•
Assignment (short term/long tern)
•
Psychosocial characteristics
•
Experience
Destination specific risks: Duty of Care strategy and medical risks
Solid decision on an informed ground
Health risks
Infrastructural health risks
Health care system
Medical evacuation
Risk matrix
• Hygiene
• Environment
• Natural disasters
• Crime, urban related
• Culture and religion
• Language skills
• Resources
• Infrastructure/transportation
• Psychological
• Centres of excellence
• Specialties, diagnostics, equipment
• Regional variation
• Blood, medications and consumables
• Mobilization time
• Local air ambulance and HEMS
• Ground ambulance
Destination specific risks:
Duty of Care strategy and
security
risks
Solid decision on an informed ground
• Political conflicts
• Strikes, riots, demonstrations
• Religious protests/riots • Violent Unrest • Traffic
Political stability
• Strikes • Demonstrations • Public tension• Violence and lack of control from the government
• Civil war
Civil unrest
• Petty crime/violent crime
• Organized crime/gangs • Curfews • Kidnapping • Corruption
Crime
• Domestic groups• Daily risk of terror
• Political terrorism
• Religious terrorism
• International terrorism
Terrorism
Risk matrix
Traveller specific risks related to type of traveller
Based on case data and statistics
Students Business travellers
• Age: 13 – 25
• Length of stay: 4 months to 1 year • First time traveller
• Age: 25 – 65
• Short travel periods
• Used to travelling – not familiar with destination
Expats
• Age: 25-65
• Length of stay: Minimum half a year – some are repositioned
• Travels with spouse and family
10
Chara
c-terist
ics
• Injuries caused by behaviour (limited illness) – Age 16-19: Often alcohol related
• Sports and car accidents • Psychosocial/mental
– Homesickness (root cause) • Low risk, high cost countries
Typic
al
co
mplicat
io
n
s
• <40 years travellers: Sports and STD • >40 years travellers: Cardiac related
• Stress related diseases ex. stomach ache and headache (symptoms of stomach ulcer) • Cardiac arrest and stressed heart • Cold, sore throat and flu
• Gastroenteritis
• Psychosocial challenges due to adaption • Lifestyle diseases related to way of life • Pre-existing conditions not examined before
travel
• Long term treatments
• Dependents often ill or worried
• Repeat expats experience more problems • No obvious diseases (such as Malaria) • High risk countries with no access to general
Traveller specific risks for students
Based on case data and statistics
Students Business travellers
•
Age: 13 – 25
•
Lenght of stay: 4 months
to 1 year
•
First time traveller
Expats
11
Characteristics
•
Injuries caused by behaviour (limited illness)
– Age 16-19: often alcohol related accidents
•
Sports and car accidents
•
Psychosocial/mental
– Homesickness (root cause)
•
Low risk, high cost countries
Traveller specific risks for business travellers
Based on case data and statistics
Students Business travellers
•
Age: 25 – 65
•
Short travel periods
•
Used to travelling – not
familier with destination
Expats
12
Characteristics
•
<40 years travellers: Sports and STDs
•
>40 years travellers: Cardiac related
•
Stress related diseases ex. stomach ache and
headache (symptoms of stomach ulcer)
•
Cardiac arrest and stressed heart
•
Cold, sore throat, and flu
•
Gastroenteritis
Traveller specific risks for expats
Based on case data and statistics
Students Business travellers
•
Age: 25-65
•
Length of stay: Minimum
half a year – some are
repositioned
•
Travels with spouse and
family
Expats
13
Characteristics
•
Psychosocial challenges due to adaption
•
Lifestyle diseases related to way of life
•
Pre-existing conditions not examined before travel
•
Long term treatments
•
Dependents often ill or worried
•
Repeat expats experience more problems
•
No obvious diseases (such as Malaria)
•
High risk countries with no access to general physician
Traveller specific advice to mitigate typical traveller related
risks
Students Business travellers
• Training for University exchange
students
• Define university risk appetite and choose exchange program
accordingly
• Arrange homesickness hotline for
students
• Robust driving policy
• Make sure clinics can handle sport
related injuries
• Set-up for ”high” & ”extreme” countries
• Alcohol is and will be a problem
• Demand pre-ex
• Keep medical records of
employees
• Develop travel training for age
groups
• Regular medical check ups for
40+
• Promote exercise
• Corporate risk appetite should be
in the travellers DNA
• Have an open reporting system
where travel experiences can be shared.
Expats
• Develop specific expat travel
policy
• Training for dependents
• Follow up on dependents health
regularly
• Rote domestic / abroad to avoid
expats for life.
• Promote exercise
• Have clear alcohol policy
• Offer psychology hotline
• Do not dispatch expats on short
notice. Give time to prepare.
Practical advice
15
Action Reason
