January in Northern Canada is extreme: 24 hours of darkness throughout most of the region, constant wind and several weeks of daily temperatures as low as minus 30 degrees Fahrenheit. It’s also not unusual for the wind chill to drop temperatures as cold as minus 65 degrees during this month, which is one of the busiest for air ambulance provider Keewatin Air LP.
It’s typically a busy start to the year for the Winnipeg-based company that will register 10,000 annual flight hours serving residents and travelers in the province of Manitoba and the Canadian Arctic territory of Nunavut – an area comprising 1,058,000 square miles, nearly four times the area of Texas.
Keewatin Air operates a fleet of 12 air ambulance aircraft, including nine Beechcraft King Air B200 models, at seven stations throughout the region. Supporting the operations is a group of well-trained professionals. The company has 45 pilots and 45 aircraft maintenance designers strategically positioned throughout their northern bases of operations. Unlike many other air ambulance operators, they employ their own medical professionals and currently have about 65 registered flight nurses, respiratory therapists, critical and advanced care paramedics and psychiatric nurses.
“You have to wonder if when Beechcraft engineers were designing the King Air back in the day, did they think someone was really going to fly their aircraft into minus 65 degrees Fahrenheit and be loading patients on it and getting out of these short, gravel shale strips?” said John Kliewer, director of Business Development & Strategic Planning for Keewatin Air.
That’s exactly what Keewatin Air does. Performance that impressed company executives when they got their first King Air, in 1995, is simply routine and expected operation today. Still, they give credit to the King Air platform for making it possible to grow the business into today’s high-quality air service that provides safe, reliable and extensive 24-hour emergency air ambulance services for remote communities.
“There are very few aircraft that you could put the kind of hours and cycles on it that we do and have such a reliable product,” said Wayne McLeod, a former chief pilot at Keewatin Air and now the firm’s president.
“And all the way to the end of life for the airframe, right to 30,000 hours,” added Jason Kendall, Keewatin’s Person Responsible for Maintenance.
Helping shape Canada’s medevac industry
Keewatin Air formed in 1971 to provide charter services using one single-engine Cessna 185 aircraft and quickly expanded by adding a de Havilland Canada DHC-2 Beaver.
In the early days of the operation, Keewatin Air would dispatch an airplane to a remote community to meet a nurse from the local nursing station, who would accompany the patient on the airplane until the patient arrived at the receiving hospital or facility. Oftentimes, the medical equipment and supplies coming from the nursing station were not suitable for air transport. Another issue was that the nursing station would remain short-staffed for several days while staff was ferried back. The cost of overtime and transportation for the nurses in these situations threatened the future of the nursing stations.
Sensing that this operational structure wasn’t sustainable and knowing that these remote northern communities needed the nursing stations, Keewatin Air championed the idea with local authorities that the airline versus the nursing stations could be responsible for providing medical personnel.
The first Keewatin Air Medevac/Emergency Air Ambulance division was born in 1986 when the company hired experienced registered nurses and purchased proper air ambulance medical equipment. In 2003 Keewatin Air signed its first formal service contract to provide air medical services for the Government of Nunavut. This included providing flight nurses and establishing numerous northern bases to improve reliability in the harsh Canadian Arctic.
“To improve the quality of our services, and establish a network of team collaboration, Keewatin Air developed an aeromedical cross-training program for nurses and pilots, and also provided this same training to medical personnel in the community,” McLeod said. “These collaboration efforts helped ensure proper and efficient preparation of the patient for transport and improved the overall transportation experience for all stakeholders.”
Over the next few years Keewatin rapidly evolved while continually improving its operations, including creating an internal training program; developing comprehensive medevac policies, procedures and medical care protocols; producing a Total Quality Management Program (TQMP) including an extensive statistical data management program; and establishing an effective human resources program.
Employing all staff required to provide air ambulance services is a different approach and is what sets Keewatin Air apart from other providers.
“We find this allows us to set the bar high and provides all of our staff – from maintenance to pilots to medical crews – the understanding of what goes into a medevac mission,” McLeod said. “Our pilots and medical crews are cross-trained to develop an understanding of what each other’s challenges and responsibilities are, allowing us to manage each flight for a better patient outcome.”
Another key to creating a successful team is employee satisfaction, and one way Keewatin Air builds the longevity of its workforce is to allow employees to live anywhere in Canada. They report to their base location and work for two weeks, then have two weeks off and can return home.
“By allowing our staff to live where they want to, they can maintain their family and social lifestyles as they rotate in and out of their home,” McLeod said.
In the late 1980s and early 1990s, Keewatin Air also changed its aircraft platform. They were flying Beechcraft Model 18 Twin Beechs with Tradewind and Westwind modifications, then Swearingen Merlin IIA aircraft. In 1996, they purchased their first King Air: a 1981 model B200. That airplane is expected to retire in 2019 when the airframe reaches 30,000 flight hours, and the King Air is now solidly entrenched as the backbone of Keewatin Air’s operations.
The current fleet
On average, Keewatin Air transports about 1,700 patients and flies more than 2.3 million miles of medevac missions each year. It has provided contracted air ambulance services for the Government of Nunavut since 2003. McLeod said the company is always looking for new opportunities to expand its operations providing the high-quality medical care to other areas of Canada.
Keewatin Air has four base locations in the Nunavut territory: Rankin Inlet, Iqaluit, Cambridge Bay and Igloolik; two in the province of Manitoba: Winnipeg and Churchill; and one in the Northwest Territories: Yellowknife.
The area of operations is very large and their crews can experience more than one weather system when conducting a day’s operation. Winds and low visibilities are something they experience every day. Summer sees 24 hours of daylight and the winter months bring 24 hours of night. Extreme cold is the norm, and blowing snow reduces visibilities. It is a good day when visibilities are above 5 miles. The eastern side of Nunavut is mountainous, and runways are at very near to sea level in the valleys, which makes approaches challenging.
In addition to the nine King Air B200 aircraft, Keewatin Air has one Pilatus PC-12, two Learjet 35A and two Cessna Citation 560 Ultra aircraft.
A memorable mission that shows the scope of Keewatin Air’s work happened from one of its busiest bases, Iqaluit. A single pilot flew a medical crew 2.5 hours to the community where a woman in premature labor with twins required medical evacuation. The crew assisted the local health center in delivering the babies at 28 weeks, when they were small enough to fit in the palm of your hand. The newborns and the mother were then transported 2.5 hours on the King Air B200 back to Iqaluit, the territory’s only city, where they were taken to the hospital, stabilized and then moved again on a three-hour flight in a Learjet 35A to a specialized facility in Ottawa.
The King Air fleet has doubled since 2010, with the latest acquisition being a 1985 model added in 2017. Keewatin Air typically looks for midlife airframes and plans to operate them until they hit 30,000 hours.
The average age of their King Air fleet is 26 years. All have PT6A-42 engines, including two that have 3-bladed propellers. The aircraft all feature high float gear, ram air recovery systems, Frakes Aviation exhaust stacks, dual aft strakes and dedicated air ambulance interiors.
In 2014, Keewatin Air partnered with Elliott Aviation to upgrade all of its King Air aircraft to Garmin 1000 avionics as soon as the system could operate in the high arctic of Canada, specifically north of 65 degrees latitude.
Their aircraft were the first King Air B200 featuring 3-bladed props to get the upgrade. Over the course of the project, Keewatin Air found its breadth and depth of operations were helpful to Garmin.
“We work collaboratively with Garmin on identifying issues whether it’s from operating in the high arctic or operating aircraft with 3-bladed propellers as opposed to 4-bladed King Air 200 aircraft,” McLeod said. “There are a few different areas that we’ve assisted with research for their systems.”
In 2018, Keewatin Air completed the NXi upgrade to the G1000 system.
“With the harsh environment and challenging terrain we operate in, as well as the experience levels in the flight crew members, we have found the upgrade to the G1000 avionics platform has ensured that our flight crews have the most advanced, state of the art environment to safely meet the needs of our customers,” McLeod said. “The G1000 NXi installation has also brought our maintenance department to a new level with the ability to review data related to any flight, which assists in more effective troubleshooting of any issues that are encountered. As approach criteria and complexity continue to change, the G1000 system is able to ensure that Keewatin Air remains up to date with any changes.”
Challenging maintenance conditions
Keewatin Air has an extensive background in maintaining King Air aircraft and its in-house team handles everything from engine changes and prop replacements to landing gear overhauls and all phase inspections.
They operate maintenance personnel out of all seven bases, including heavy maintenance at the Winnipeg headquarters. The largest contingency of 10 AMEs works 12-hour shifts to provide 24-hour coverage at the busiest station, Iqaluit, where there is a 20,000-square-foot hangar built in 2010.
In total, there are 45 maintenance staff, from parts procurement specialists and quality assurance staff to maintenance planners and line staff. The team is accustomed to dealing with high volume and life-critical deadlines, as well as the effects of the environment.
“Temperature and environment are totally against us at all times up there,” Kendall said.
Frequent landing on gravel shale airstrips require daily attention to the fleet’s props and landing gear. In the summer, there is constant wind as well as flies and mosquitoes to deal with. In the winter, little things that take 20 minutes can take two hours due to the cold.
“Changing a tire – which seems so easy down south – can be quite a chore,” he said. “You basically get one chance to jack up the aircraft because the cold temperatures affect the hydraulics of the jack. If you don’t get it on the first try, you’ll have to wait until you either warm up the jack you are using or get another jack, which could be another 4 to 6 hours, or even longer.
“And we’ve had guys get frostbite on all their fingers just by changing a set of wheels, and that is even with wearing fully insulated gloves.”
The King Air makes the ideal partner in Keewatin Air’s air ambulance operations because it can operate safely in this harsh environment while handling the distances between communities.
“The King Air has been the backbone of our company for over 20 years now and we look forward to providing our customers a continued reliable service,” Kendall said. “We continue to look at improvements and advancements in systems and equipment to ensure that the standard does not diminish.”