Amman-based Arab Wings is flying around seven medical evacuation flights a month into neighbouring Iraq as demand for dangerous mercy missions continues to rise. The pilots have adopted safety first procedures and tactics to minimise risk when they evacuate the seriously injured but their flying abilities and nerve are often tested to the limit.

Experienced air ambulance pilot Capt. Ibrahim Nahar confirms: "Flying over Iraqi territories is risky but Baghdad is downright dangerous. Approaching the airport you have to stay at a very high altitude - approximately 21,000 feet. Then, once over the runway, you start with a very steep bank and a high rate of descent. You must remain within 3.5 miles from the centre of airport to avoid any ground fire whether it's conventional or rocketry."

He recalls: "On one mission we landed and waited for a badly injured man. While waiting we saw an explosion roughly 500 feet away from the Beech King Air 200. The wings were shaking and everybody got out of the aircraft, then the second mortar shell came in and exploded even closer than the first one."

Capt. Nahar adds: "We took to the ground and covered our heads with our hands. Once the dust cleared I asked everybody if they were OK. I kept waiting for my patient although we had a chance to leave back to Amman; instead we stayed next to our aircraft until the patient was brought to us.

"The patient was badly injured and he needed medical attention as soon as possible. In fact, his condition was critical. He was loaded on to a stretcher and put aboard the aircraft. I then requested immediate and quick departure to Amman. When we arrived the ambulance was waiting and they took him to the hospital. Later on we did follow up on his situation and they said he was OK thanks to the way that our flight and departure was conducted. As always, taking the fastest way and shortest distance can make the difference between life and death." The injured man was cared for by two specialist doctors that had been on board since early in the morning.

Arab Wings, established in 1975 and privatised in 2005, was originally part of Royal Jordanian Airlines and ran the first service in Jordan that focused on private and executive business travel. It began medical evacuation services in the mid-1980s with aircraft converted to transport medical teams and patients. "Medical evacuation was launched to increase the variety of services offered by Arab Wings," explains Noor Abu Matar, marketing. The service has expanded to take in Europe and Africa as well as the main Arab Gulf and Middle East regions. Two Hawker 800XPs and a Beech King Air 200 are used for medical and flying ambulance work but can also be converted for charter.

Medical crews are provided by specialised hospitals in Jordan. "We have an agreement with two to three teams from specialised hospitals to support medical evacuation. These include the Jordan hospital, the Isteshari hospital and the Arab medical centre," she says.

An average of seven flights a month to various locations in Iraq are made to evacuate the sick as well as the seriously injured under agreements with the aviation authorities in both countries. An Amman-Baghdad-Amman flight might cost in the region of US$18,000 inclusive of the medical team and insurance.