Medical evacuation: what exists on small islands

We cannot confirm a medical evacuation service for any island, and many small islands have little or no hospital care. So the best preparation is to ask your resort in writing how an urgent case is handled, and to travel with the right insurance and contacts. This page gives you the questions and a plan.

It is written for families with older parents or someone with a medical condition. For the full route, see the journey to a Malaysian island in four legs, and save the numbers in emergency contacts to save before an island trip.

What can we say, and what can we not?

We can say that small islands often have limited medical facilities, that a boat transfer may be needed to reach a hospital, and that sea conditions can change what is possible. Nothing in our research confirms an evacuation service, an ambulance boat or a clinic at any island.

For example, serious jellyfish stings have occurred off Peninsular Malaysia and Sabah, and the study we checked noted that urgent medical care is needed ^[1]. That is a reason to ask about help on the island, not a statement about any specific resort.

What should you ask the resort?

Send these in writing, and keep the reply with your booking.

• Is there a clinic or trained first-aider on the island, and where?
• How does a guest reach the mainland in an urgent case, by day and at night?
• Who arranges it, and who pays?
• What happens in rough seas, when boats do not sail?
• Which number do I call, and who answers at night?
• Are there limits, such as for stretchers or wheelchairs?

If the resort cannot answer, you have learned something important. Our page on rough sea warnings explains why sailing can stop.

What should you do in the first minutes of an emergency?

Keep to a simple order.

1. Call the national emergency number and give your exact location.
2. Tell the resort and the boat operator.
3. Follow the instructions of trained people.
4. Keep medicines, documents and insurance details together.
5. Note times, names and what was done.

Do not assume that any contact will answer, which is why the questions above matter before you go.

How should older travellers and people with conditions prepare?

Prepare on paper and in the phone.

• A written list of conditions, allergies and regular medicines, with doses.
• A supply of medicines for the whole trip, plus extra for a delay, in your hand luggage.
• A doctor’s contact and a note you can show.
• The insurance policy number and the emergency line.
• A conversation with your doctor about whether the island suits you.

Ask about boat boarding too. Our page on boat boarding for older passengers lists the questions.

What should you check in your insurance?

Check the wording on emergency transport, sea transfers and pre-existing conditions. Ask the insurer in writing, and keep the reply. Read travel insurance and missed boat connections for how to read a policy.

A better fit if…

An island with confirmed medical access on the mainland within a short transfer may be a better fit if someone in your group has a condition. A remote island may be a better fit only if the resort can explain its plan clearly. Send us your needs and we will help you ask the right questions.