Will have a crew that has a heart condition with us this year, and while the odds of anything happening are low, it does raise a question i've never thought of before: what's the process if someone has a heart attack or a broken bone or some other low-probability, urgent case? Straight to Tortola? What if it's at night? Call 911?

Anybody had to work through something urgent/life-threatening before, especially from an outer island?

If you are out on the boat and it serious call VISAR. That will be your quickest response. They will coordinate where to take the person. Depending on where you are and weather conditions ect.. you might start your boat back to Tortola to reduce response time. Your charter company should provide contact info and off course you can make a emergency call on channel 16.
G

Yep. VISAR bases out of Tortola and Virgin Gorda, so they have close access to most places. 767 on a cellphone or a “mayday” on ch16.
https://visar.org/contact

On land I believe (make sure you check) 911 and 311 is the emergency phone number. (Police/fire/ambulance)

I know how you feel, I’m taking my 70-75 yr old parents and in-laws this year, it’s definitely something I’ve considered more this time than any other previous “friends trip”.

I had to make an emergency run from Anegada to Peeples hospital (Tortola) 6 years ago (early AM run). I coordinated with VISAR in case we thought we needed to get the crew person there quicker (I was on a 514 power cat). They are excellent to work with and would encourage anyone feeling charitably inclined to consider donating to them. Peebles was also excellent. I did modify my captains briefing after that to ask if "anyone has any medical issues I should be aware of"....

Can you bring a portable AED?

Health care in the BVI isn't particularly good, and there's only a minimum of a nurse on Jost, an ambulance w/paramedic on Virgin Gorda and I believe nothing permanent on Anegada. The private healthcare organizations in Road Town offer better services than the Peebles Hospital. VISAR is great for on-water and inter-island medical emergency transport, but their resources are limited as well.

I had a medical emergency 2 years ago (I hurt myself single-handing from the USA on day 3 of the 8 day passage) and friends organized an exception to the clearing-in process from the ministers directly so that I could go to the ER. Despite all this I was threatened with getting my boat impounded and got a bad diagnosis at the hospital.

We have a clinic and nurse stationed here on call 24/7.

All good information. Make sure you get medical evacuation insurance as well. We have a neighbor who had to pay out of pocket for evacuation to San Francisco this year. Look for a policy that takes you where you want to go, not to somewhere they determine you can be treated.

@duckfat - thanks for the update. I remember that there was a clinic office and a bi-weekly nurse visit via ferry; but that seems to be outdated information.

I assume things have changed, but in 2015 (IIRC) I got some kind of small (gnat size) water-borne animal in my eye swimming from the Baths to the boat on the mooring. Throughout the trip to the marina at Spanish Town, my eye started to redden and bother me. I tried rinsing it out and it felt better. So the next morning we headed to Leverick. By the time we got there, the eye was getting in pretty bad shape (mind you, I am the only one who can sail the boat. I had explained to the rest of the "crew", if I had to stop they would need to drop the sails and motor). I asked for guidance at the hotel check in and they arranged a car rental and gave me directions to a clinic back in ST. I was able to drive there and a doctor looked at me, said something about "this isn't good. Glad you came in now before the infection spread to the other eye." He gave me a prescription eye drop and everything was good. We spent an extra day at Leverick and all ended up well.

Now, that wasn't life or death, but it was urgent care. I don't know if that clinic in ST is still there after Irma, but they did a good job back then.

I would guess that VG would still have some kind of clinic that could handle urgent issues.

Pyrat Pistol--as someone else said, make sure your person gets medical evac insurance, IF they can. This probably will fall under the category of pre-existing condition, which they may not be able to ensure against. They need to be extremely careful to make sure that they can a) get coverage that covers them outside the US at all and b) especially medical evac, as anywhere in the Caribbean is NOT a good place to deal with cardiac issues. If they can't get coverage for this condition, they need to think long and hard about whether they want to go, in my opinion.

If the person is on Medicare, they have ZERO coverage outside the US. (Assuming the person is from the US). If they have an advantage or a medicare supplement plan, have them check to see what their coverage is outside the US. Our personal supplement only covers 80% outside the US. The rest is deductible. For a heart condition, could be big bucks. And I honestly don't know whether my supplement covers medical evac or not, as we always buy trip insurance to cover that. They can check on TTOL sponsor Insure My Trip for trip insurance, but as I said, it may be difficult to get insurance that will cover a pre-existing condition. A lot of times, it only covers pre-existing if the insurance is purchased within a very short time after the trip is booked, like 7 days.

VG does indeed have a clinic in Spanish Town, and I would say it is nicer than you might expect. I see Dr. Obi there myself.

I certainly would prefer to not deal with critical issues there, but for things like your situation I suspect it to be more than sufficient

I was somewhat hesitant to write details, but if someone has a life-threatening medical emergency in the BVI then they should not expect the same level of care as "back home".

Just to give an update on my experience - I'd hurt my back in a fall aboard and couldn't walk upright and was in serious pain. The diagnosis in the BVI was "severe sprain with bruising on lower back" and a prescription for Voltaren. I opted to fly to Europe and get a second opinion; it turned out that I had 3 broken vertebrae and the doctors wanted to put me in traction. I managed to convince them that since I'd survived 5 days of sailing single-handed and a coach-class seat on the long return flight, I wasn't going to subject myself to a month in hospital!

Very wise advice...in our case I looked into the cost of a flight to Miami if I had to fly our crew member out.

We carry Medjet insurance. Private medical evac to your preferred hospital. Two plan options one with a cash advance. We travel frequently so have an annual policy.

We, too, have a MedJet annual membership. Under their rules, one can only be out of the US for 90 consecutive days. I called, and the USVI counts as being in the US!

Medical evacuation is not the same as a plane ticket, at least in some cases. It is a special plane with medical staff.

This is great stuff. Thanks everyone.

If the person is not too ill, is the medical care on St Thomas better than the BVI? Could a water taxi there be an option?

On our trip a couple weeks ago, we had a priority, but not urgent case with a crew member that needed medical care. We were in Anegada, but opted to get back to Tortola first. We sailed to Cane Garden Bay, called ahead to the Eureka Medical Center, and coordinated with Quito's to have a taxi ready for us. It took them 15 minutes to get there, and they had a positive experience.

Bailau - did you run all the way in to Road Harbour?

Yes to Road Harbour as we had power cat and timing made it quicker than Cane and taxi and I wanted to go to hospital personally to have eyes on him...in the end I got lucky as the doctor indicated one more day and he wouldn't have made it. The lesson I learned as captain if you think something is wrong act immediately and ask your crew for any medical information in your briefing. Second lesson is make sure you know who you bring on your boat. I take college kids out all the time and they are no issue as they listen. A guys trip however is not like that....all it takes is one person to ruin a trip. My mistake among many was not having a qualified #2 to help me...very humbling experience.

I had a heart attack at Soggy Dollar on Jost in 2013. It was my second cardiac event as I had received a stent in 2011. I had done so well after the stent that I had been taken off blood thinners except for an 81 mg aspirin daily at that time. Anyway, I was treated by the nurse on JVD, a guy named Derek Sweeney. I was transported to Soper’s Hole via lobster boat by Rudy from Rudy’s Market and taken to Peeples Hospital via ambulance. The care I received was always excellent but the facilities were not. Eventually I had to charter a plane to St Thomas where I also received excellent care and a catheterization was done. Dr Roy Flood was the cardiac specialist that treated me in St Thomas. By the time the catheterization was done whatever blockage that caused the problem had disappeared, probably due to the injectable blood thinners (Lovenox) I was given in the BVI. Anyway I’m alive and well and will always be grateful to Derek, Rudy, and the medical professionals I encountered during this unfortunate incident.

@grillheel Very scary story, glad you came out of it well. I once took a guest to the JVD clinic for a mild finger crush injury. Let's just say I was glad it wasn't anything serious :-/

@grillheel...very glad that all worked out for you

Thanks! I am very aware that I was very lucky and that the BVI was not the best place to have a medical emergency. However, I felt the care I received was what I required at the time. Btw, I made three or 4 trips back to the BVIs after that with no problems. We sold our boat in 2016/2017 and I haven’t been back but I miss it all the time and hope to go back.