Russia has always been a huge country with vast territories and numerous remote areas. In many cases adequate healthcare services were unavailable in distant regions and small settlements, where the closest facility is located hundreds kilometers away. It was the main reason that emergency medical transportation system in the former Soviet Union was highly developed and gained significant experience in escorting patients and organizing complicated evacuations.
During the last years the situation has changed. The territories has not become less, but the system of medical transportation (excluding local ambulance service) has practically ruined. The last HEMS (helicopter emergency medical service) evacuation performed by Aeromedical Department of St.-Petersburg Regional Hospital took place five years ago. The main problem of state aeromedical service is insufficient financial support from the state government and absence of flight equipment and disposables.