The Critical Role of Medical Air Transport in Disaster Response: A Comprehensive Analysis of the November 2025 Hat Yai Mega Flood

Abstract

Major disasters, particularly large-scale flooding, frequently paralyze urban infrastructure and isolate critical healthcare facilities, necessitating rapid, complex decision-making for hospital evacuation. This review examines the role of aeromedical evacuation as a logistical lifeline during internal hospital disasters, utilizing the November 2025 Hat Yai mega-flood in Southern Thailand as a case study. This study employs a retrospective case study approach combined with a narrative review. Data were derived from the academic literature, official operational reports, and relevant information from press releases between January 2016 and May 2026, as appropriate. Analysis followed a thematic framework aligned with the Hospital Incident Command System, focusing on strategic planning, operational decision schemes, and system elements. The November 2025 Hat Yai flood—the most intense precipitation event in 300 years—resulted in the inundation of critical medical facilities and compromised vital infrastructure. The study highlights the successful, phased evacuation of critically ill patients from Hatyai Hospital using governmental aviation assets, demonstrating the efficacy of the Thai Sky Doctor Service. However, the response also revealed significant systemic gaps, including delayed evacuation orders due to municipal communication failures and an over-reliance on premium aviation assets. Aeromedical transport serves as a critical force multiplier in disaster medicine, providing an essential vertical lifeline when ground infrastructure fails.