The Otago Rescue Helicopter Trust is 21 years old. Nobody thinks they will be the next to need its help, yet hundreds of people throughout the lower South Island owe it their survival. That is what it is all about, founding pilot Graeme Gale tells Bruce Munro.
Graeme Gale had already been flying helicopters for a decade when the first dedicated air ambulance service in Otago and Southland took to the air in the mid-1990s.
''We were the only area in New Zealand that did not have a rescue helicopter,'' Mr Gale recalls.
''I thought, why should our people in the region have a lower level of service than anywhere else in the country?
''We have something like 28% of New Zealand's land mass and only 6% of the population. So, you've got huge distances between people and medical facilities. It was vital that we had an [air] service.''
Tonight, 21 years later, Mr Gale will be among 300 people celebrating all the Otago Rescue Helicopter Trust has accomplished, the vital service it continues to provide, and all the people who make it happen.
The first helicopter was a Bell Jet Ranger known as the Speight's Rescue Helicopter.
Within eight minutes of its official launch in February 1994, it was off on the first of two missions that day.
By 1988, a trust had been set up to oversee the operation, the Jet Ranger had been replaced by a twin-engine MBB-Kawasaki BK117 helicopter, and a helipad had been built on the roof of Dunedin Hospital.
''The BK117 had a lot more room and capacity. And the first winch was introduced into Dunedin at the same time,'' Mr Gale says.
''The pad on the hospital roof ... was a major development from early on, which meant we could stop all that double-handling of patients, particularly when critical care was needed.
''That is a major, major asset to our whole community, to be able to come back and land directly on the hospital. The patient comes straight off the roof into the lift. They can be taken straight to theatre, or down to A&E, or ICU or wherever.''
As demand for its services grew, the trust began to operate 24 hours a day, 7 days a week.
The ability to fly at night was enhanced by the use of night vision goggles (NVG).
''We introduced NVG goggles to New Zealand and ran all the training courses here at Taieri. We brought all the instructors out of the US.''
Funding has always been a challenge.
Police, ACC and hospitals contribute to the cost, as does the Otago Regional Council, hence the current name, Otago Regional Rescue Helicopter.
But that still leaves an annual shortfall of up to $500,000, money which has had to be found to allow the rescue service to meet costs, update equipment and grow to meet demand.
Helicopters have been upgraded with the latest terrain awareness and safety systems.
One primary helicopter is on standby 24/7.
Another two identical helicopters can be called on when needed.
''It's pretty common to have two or even three helicopters out on rescue work.''
The latest innovation, begun in 2013 and now increasingly being used, is Instrument Flight Rules (IFR), that is, flying without seeing.
Flying in the lower South Island, with its spectacular but challenging terrain and weather, presents distinct difficulties.
''So, now we are taking it to another level again with the IFR ... We've put in a flight simulator for advanced pilot training, particularly IFR instrument flying.
''No-one else in the South Island is doing it. We are the first. We've already done a few missions IFR.''
These days the rescue helicopter is flying about 450 missions a year.
It takes a lot of dedicated people to make it all work, Mr Gale says.
There are six pilots capable of flying the rescue helicopter, of which four are also trained as winchmen.
The helicopters and pilots are supplied to the trust by Helicopters Otago, which is owned by Mr Gale.
One of two senior St John paramedics, Doug Flett or Ian Ridley, is on board for every mission.
A second paramedic on each flight comes from a rostered pool of 10 trained St John paramedics.
And then there are Dunedin Hospital's intensive care unit (ICU) doctors and nurses.
''We have an extremely close working relationship with the Dunedin intensive care unit. And we've had it since day one.
''We were the first in the country to have a relationship like that.''
ICU staff work closely with the helicopter crew. Responding to serious incidents, an ICU nurse and sometimes an ICU doctor will travel with them.
''The service they provide, and the timeframe they provide it in, is just unreal, it's fantastic.''
• Put it all together and you get a rescue helicopter service that can connect people in need with those who can help them, more quickly.
''If you've got a person that's serious, bleeding out, and you need to get them to hospital urgently, or someone who needs intensive care, we can take an intensive care nurse and doctor out into the region and start administering that level of care to the patient before they get to hospital.
''I've done hundreds and hundreds of missions, and I'm still amazed at the level of care and the difference it makes.''
Not so long ago, Mr Gale says, they got a call about an extremely unwell sailor on a ship 100 nautical miles (180km) off the Otago coast.
In the first such instance he knows of, an ICU consultant doctor flew with a rescue helicopter that far from the New Zealand coastline to assist.
The paramedic was winched down to the ship and stabilised the patient enough to bring him back up to the helicopter.
Then the ICU consultant worked on him all the way back to the hospital.
The helicopter made the journey back in one hour. The ship would have taken 10 hours to travel to port.
''Now that made a significant difference to the patient's outcome and survivability.''
It does not work so well if wrong or insufficient information is given to the personnel at the 111 emergency call centre, Mr Gale says.
''It does crop up. It's just a matter of education ... If you don't tell them, they [the call centre] won't know; and if they don't know, they may not respond [call] us.''
No-one expects to be the next to need the rescue helicopter's help, yet thousands of people owe it their more timely assistance and hundreds owe it their lives.
''I've seen many people for whom it's made a huge difference, whether they've been a hospital transfer or a major trauma accident ... We've gone out and retrieved them and brought them back to the hospital, and they've called in here some time later. That's pretty satisfying.''
Tragically, not everyone survives.
''But the comfort comes from knowing we gave it the best shot. We took the very best people there, in the shortest possible time.''
So, why do Mr Gale and all the others involved do what they do? What drives them to be available day and night, to fly into difficult and demanding situations, to tirelessly work to raise enough funds to keep the rescue helicopter service in the air?
''It's all about the patient,'' Mr Gale says.
''And people lose sight of that. It's not about anyone else. It's not about anyone's egos ... It's all about the patient.
''And that's what the focus has been all the way through. We've had a lot of critics, and politics over the years that creep into it. But people forget it is all about the patient. That is the sole purpose of what the air ambulance service is about.
''It's about going and delivering the very highest level of care, in the best possible timeframe, to the best of our ability, to get the best outcome.''
