Behind-the-Scenes: Evacuation from St Helena and Ascension 

When a serious infectious disease threat emerges anywhere in the world, the UK needs to be able to respond quickly. UKHSA plays a central role in that response, including through the government's medical evacuation arrangements, which allow us to safely repatriate those who may have been exposed to a high-consequence infectious disease.

Here, Renu Bindra, Deputy Director for All Hazards Public Health Response, describes how that played out during a recent deployment to the South Atlantic. 

Public health emergency response often moves quickly, with teams transitioning straight from one operation to the next. Shortly after leading the repatriation of 22 passengers from Tenerife following the arrival of the MV Hondius, I led a second deployment - this time to the UK Overseas Territories of St Helena and Ascension Island. That first operation moved fast. This one moved faster. 

St Helena and Ascension Island are among the most remote inhabited places in the world - tiny volcanic outcrops in the South Atlantic, several thousand miles from the UK. From a response perspective, I was very aware that this distance shapes what is possible and when - particularly where specialist clinical care may be needed - and decisions taken early can have a significant impact on how an outbreak evolves. 

The team  Group shot in front of the plane at Stansted: (From left to right) Emilio (UKHSA), Tom (UK-PHRST and LSHTM), Renu (UKHSA), Matthew (UK-Med), Kate (UK-Med).

This was a genuinely multidisciplinary and multi-agency effort: myself and UKHSA colleague Emilio Hornsey, Senior Infection Prevention and Control Nurse from the UK Public Health Rapid Support Team (UK-PHRST); Tom Fletcher, Professor of Emerging and High Consequence Infectious Diseases from the Liverpool School of Tropical Medicine; and Dr Matthew Newport and Nurse Kate Wight from UK-Med. 

What stood out was how quickly we aligned around a shared plan. The team brought together public health, infection prevention and control, infectious disease and emergency medicine expertise - but it was the coordination and shared planning that made the operation workable. 

The mission 

Our task was to support the precautionary evacuation of 9 higher-risk contacts of hantavirus to the UK, where the NHS would be on hand should they become unwell. None had symptoms at the time. 

This evacuation was about managing risk proportionately. Hantavirus cases can deteriorate rapidly, and given the limited specialist infectious disease capacity on the islands, transferring individuals to the UK ensured appropriate care would be immediately available if needed. 

The route 

The flight path alone tells you something about the scale of this operation. We flew from the UK to Accra in Ghana, then south to St Helena to collect our first passengers, and on to Ascension Island for the rest. Every leg required planning, coordination and careful thought about what might happen at each stage. 

Plane landing at St Helena

In St Helena we met the local incident management team and the Chief Medical Officer, as well as the Governor of St Helena, Ascension Island and Tristan da Cunha. We also dropped off additional lab supplies for our UK-PHRST colleagues, who had been deployed earlier in the week with laboratory equipment including PCR testing capacity. Seeing that infrastructure built up in a matter of days was genuinely remarkable. 

We made a short stop in Ascension Island to refuel, collect our remaining passengers, and meet the Administrator, the deputy Chief Medical Officer and local Royal Air Force staff. 

Passengers at Ascension Island Preparation and protocols 

By the time we touched down on St Helena, the groundwork had long been laid. Before boarding our first flight, UKHSA teams in the UK had been working through detailed plans with colleagues from the UK Overseas Territories, the Foreign, Commonwealth & Development Office (FCDO), the Ministry of Defence (MOD) and UK-Med - reviewing infection prevention and control protocols, running through clinical assessment procedures, and preparing for scenarios such as delays, diversions due to weather or a passenger developing symptoms. I've learned over the years that the work that happens before you land is just as important than the work you do when you get there. 

Renu in PPE waiting to receive passengers at Ascension Island

Local teams had put strong public health measures in place. Contacts were being monitored daily, and communication with those affected was clear and regular. By the time we met our passengers, they had received detailed information about hantavirus, the reasons for evacuation and the end-to-end process. 

Before anyone boarded, we ensured final symptom and temperature screening had taken place. Everyone was assessed individually, provided with masks and transported safely to the airport.  

Throughout the evacuation, I was conscious that this was a significant moment for those travelling. A priority for me was to make sure the process was explained clearly and carried out in a way that was organised, safe and supportive. 

The flight home 

Throughout the journey, passengers, crew and the clinical team maintained strict infection prevention and control including wearing PPE. We pre-allocated seating with the cabin crew, and the clinical team monitored passengers throughout. Our priority was to maintain the safety of everyone on board while supporting passenger health and wellbeing. 

Arriving in the UK 

Landing back in the UK was not the end - it marked the beginning of the next phase. Passengers were transferred to Arrowe Park hospital in Wirral where a team was ready to support them, undertake assessment and carry out ongoing monitoring. Throughout their quarantine, UKHSA health protection teams are in daily contact - monitoring symptoms, checking in and providing support. 

What stays with me 

St Helena and Ascension Island sit 4,000 miles from the UK, in the middle of a vast and empty ocean. Getting there requires a sequence of flights, careful logistics and the quiet, determined work of dozens of people across UKHSA, the FCDO, UK Overseas Territories, the NHS and partner organisations. 

None of it happens automatically. None of it is simple. But all of it is worth it. 

https://ukhsa.blog.gov.uk/2026/05/29/behind-the-scenes-evacuation-from-st-helena-and-ascension/

seen at 18:32, 29 May in UK Health Security Agency.