UAB Medicine

February 10, 2010

CCT Jet Is First US Aircraft Over Cuba in 50 Years

UAB Synopsis, Vol. 29, No. 06, February 10, 2010

On a January 13 flight to carry a survivor of the earthquake in Haiti to a Miami hospital, UAB Hospital’s Critical Care Transport (CCT) jet became the first US aircraft in several decades to make an official flight through Cuban airspace.

After the earthquake occurred on January 12, US officials made requests of Cuba to allow implementation of a special medical evacuation route over its airspace, although the two countries are still at odds over the US trade embargo and other actions put into place years ago to protest Cuba’s human rights and political record.

The base commander at Guantanamo Bay sought a waiver from a Cuban military officer with whom he has regular meetings across the minefield that separates the 45-square-mile base from Cuba proper. The flight route had been negotiated over many years by the US military to expedite medical aircraft flights out of Guantanamo Bay in disaster situations. US diplomats also contacted the Cuban foreign ministry to discuss "this important humanitarian cooperation.''

The three-member UAB medical crew cared for an American serviceman injured in the earthquake-sparked collapse of a Port-au-Prince hotel. The patient, who was on the hotel’s fifth floor, had suffered bone fractures and other injuries. CCT Medical Director Kevin S. Barlotta, MD, says the patient was stable and conscious during the flight from a hospital at US Naval Station Guantanamo Bay on the southeastern tip of Cuba, to which he had been evacuated after the disaster.

He says the trip was medically uneventful, with no emergency interventions required, but the prospect of flying through Cuban airspace “did pique our interest.”

Dr. Barlotta, assistant professor of emergency medicine, says that although Cuban and US authorities had agreed on a flight path across Cuba, no craft actually had taken that more direct course to Miami. “We saved 20 to 30 minutes of flight time, which could be important in critical medical transports,” he says.

Other CCT staff on the flight team were nurse John W. Doriety Jr, RN, and respiratory therapist Regena L. Bragwell, RRT.

CCT Director Laura Lee Demmons, RN, MBA, says the flight was originated by Lifeguard Transportation Services, the vendor that provides pilots for and manages UAB’s Cessna Citation Bravo jet aircraft. “Lifeguard’s own aircraft and staff were overburdened by the needs in Haiti, so they contracted with us for the transport from Guantanamo Bay to Jackson Memorial Hospital in Miami,” she says. “I was told this flight makes us not only the first medical aircraft, but the first US aircraft, period, with permission to fly through Cuban airspace in close to half a century.”

Chief pilot Lewis E. Hitt took the flight, with copilot Justin Koenig. In an e-mail message, Hitt said, “Normal arrival and departure to Guantanamo Bay requires aircraft to follow a route around the eastern end of Cuba and take care not to enter Cuban airspace. In addition, air traffic controllers at Guantanamo Bay provided landing instructions, which required a tighter-than-normal turn because the runway was so close to the Cuban boundary.”

While the UAB CCT team stabilized the patient in the naval base medical facility, Hitt wrote, “I was told by airfield personnel of a medivac [medical evacuation] route that would take us over Cuba and save us some time. I was not eager to try it since it had never been used. I was assured it had been in the works for a long time and everyone was eager to use it.”

Hitt continued, “I still wasn’t sold on the idea, but about an hour later I received a call and the base commander expressed to me how important it was to them, and to Cuba, for us to try it. The route had been negotiated and in place for years, but there had never been an emergency like the earthquake in Haiti to justify its use. We were told this route would save us 20 to 30 minutes, so I agreed to try it.

“After takeoff and a tight turn to miss the airport boundary again, were told to contact Havana, which responded to our first call. The controller was very fluent in English and very friendly. He cleared us to our next location fixes and offered us any altitude we wanted. We were going toward 17,500 feet as we entered Cuban airspace. This allowed us to easily clear the 7000-foot mountain ranges that we were approaching but couldn’t see. We made our reports to Havana as we crossed the fixes, just as they had requested, and all was going well,” he wrote in his e-mail.

As the aircraft neared US airspace Hitt contacted Miami air traffic center and received clearance to land at the airport there. “Everything was back to normal,” he wrote. “A few minutes later we heard another medivac aircraft inbound to Guantanamo say they were about to join the route over Cuba that we had just left — but they were the second ones to use the route — we were the first!”

Since then, the route has been used by multiple medical emergency flights from Guantanamo Bay and from Haiti.