The parliamentary International Relations Committee on Wednesday directed the government to make arrangements for the local administration to issue helicopter rescue permits in restricted areas.

The House panel issued the directive following complaints about an increase in the number of deaths due to delayed medical evacuation flights resulting from complex paperwork. The restricted areas adjoin the northern border with China. In these places, lengthy official procedures need to be completed to fly ill persons to hospital.

Last October, a 17-year-old girl who sustained serious head injuries in a rock fall at Sirdibas in northern Gorkha died as she could not be flown out for medical treatment in time. According to locals, it took nearly five hours to charter a helicopter to fly critically injured Salina Gurung to Kathmandu. The helicopter, which was chartered at a cost of Rs150,000, arrived in the village only at 4pm. The victim bled to death en route to the Capital.

Locals have no alternative but to charter a helicopter to take patients to hospital as the village is not connected by roads and medical treatment is not available locally. Upper Mustang, Upper Dolpo, Manaslu, Lower Dolpo, Upper Gorkha, Rasuwa, Manang, Humla, Mugu, Makalu, Kanchenjunga and Gunsha in Taplejung and few areas in Dolakha are some of the restricted areas in Nepal which helicopters cannot enter without a special permit.

“The process of obtaining a permit is so long that patients requiring immediate care are at risk of dying,” said Anil Manandhar, corporate manager at Shree Airlines, the country’s largest helicopter operator.

“We need to make the rounds of the Home Ministry, Tourism Ministry and Civil Aviation Authority of Nepal to get a permit. It’s not easy. There are many examples of sick or injured people dying by the time the permit is granted,” he said, adding that if the process had been simplified, it would be a big relief for the operators and the residents in remote areas.

According to helicopter operators, normally six procedures are involved to get a medical evacuation flight permit. One, the family who is chartering the flight has to submit a request to the chief district officer of the concerned district in writing. The family has to provide one copy of the application to the helicopter company. Two, the helicopter company has to write separately to the chief district officer. Three, after the application is verified, the chief district officer writes to the Home Ministry recommending that a permit be issued. Four, the Home Ministry issues a permit based on the identity of the sick or injured person. Five, the Home Ministry writes to the Tourism Ministry stating that security issues have been cleared and the helicopter may be granted a permit. Six, the Tourism Ministry writes to the Civil Aviation Authority of Nepal to grant a permit.

People in remote areas have long been raising concerns over the long bureaucratic process that needs to be completed to charter a flight. Emergency incidents occur in remote areas frequently. “In the remote hilly and mountainous regions, delays in issuing a permit also means waiting for bad weather,” said one company. “If the permit is issued in a timely manner, the helicopter can plan effectively—look for a good weather window—and mount the rescue flight. But a delayed permit puts the helicopter too at risk.”

In January 2017, an investigation report into the crash of a Fishtail Air helicopter in August 2016 in Nuwakot said that it was due to pilot stress. The chopper was evacuating a post-maternity sick woman and her infant from Gorkha to hospital in Kathmandu. Seven persons, including the pilot, newborn child and other passengers, were killed in the mishap.