The call that changed boating safety in the Bahamas: Anthony Marinello on Tropic Air Rescue

When help is more than 200 miles away, the sea does not wait, and in the Bahamas, waiting can be the difference between a life saved and a life lost. Anthony Marinello, President of Tropic Air Rescue, has spent a lifetime in the air, but it was a call from the water that changed what he believed aviation should do in the islands. Tropic Air Rescue was built for the moments when the clock is brutal, the runway does not exist, and every mile between a patient and a trauma centre feels like another door closing.

PBR: When you say a medical emergency in the Bahamas, what does that actually look like for somebody on a boat with no plan?

It looks like heat on the deck, the generator humming, somebody suddenly going quiet where they shouldn’t be quiet, and then the skipper staring at a phone that doesn’t really help because there’s no road to the patient and no hospital over the horizon. The Bahamas has more than 700 islands, and advanced medical care is concentrated on just a handful of islands, so if you’re anchored in the Exumas, cruising through the Abacos or exploring Eleuthera, you’re often looking at a nurse, a first-aid kit and prayer while the person you care about is getting worse in front of you.

I’ve seen that look on the faces of people who thought they were just going fishing or spending a week aboard a boat, and then all at once they’re not tourists anymore, they’re trying to buy time with towels, ice, and panic. Out there, you may be 120, 180 or even more than 250 miles from advanced medical care, and if the answer you need depends on a fixed-wing aircraft getting permission, finding a runway and then arranging ground transportation, the minutes keep draining away while everybody keeps pretending the clock isn’t real.

PBR: What was the first call that made you realize there was a hole in the system big enough to build a company around?

One of my own pilots called me from the Bahamas and said a passenger was having a stroke. I got on the phone myself and started calling every air ambulance company I could find, ten, maybe twelve calls in a row, and every single one of them was fixed-wing. None of them could reach a remote shoreline. None of them could get to an outer island quickly enough to bring the patient off the boat and into advanced medical care. I kept hearing the same calm voice, the same polite response, the same dead end, and all the while my pilot was waiting, the patient was waiting, and that family was waiting for somebody to figure out what to do with a human being whose brain was running out of time.

The fastest answer any of those companies gave me was three days. Three days for a stroke. Three days while the damage keeps spreading. That was the moment I understood the gap had never really been filled in the Bahamas, not once, and if we didn’t build something that could get in close, lift off fast, and take a patient straight to the care they needed, then the next call like that would end the same way.

PBR: You talk about geography as if it’s part of the diagnosis. Why does that matter so much in the islands?

Because geography decides whether a person has a fighting chance before the doctors ever see them. In the islands, the nearest decent care might be a ferry ride, an unreliable flight, or nothing at all if the weather turns. A fixed-wing air ambulance can take eight hours, sometimes thirty-six, by the time it’s arranged, fueled, and cleared to go where you need it, and by then the patient may already be out of the window where medicine can do what medicine is supposed to do.

We built Tropic Air Rescue for the opposite of that. Once a patient is brought safely to shore, our helicopter can be airborne quickly and on its way to a U.S. trauma center within a couple of hours, and that changes everything when you’re dealing with a stroke, a head injury, a cardiac event, or something that’s gone bad on a dive trip or a boat where nobody saw it coming. The sea around the Bahamas is beautiful until it’s not, and then it’s a moat, and if you don’t have the right aircraft, the right crew, and the right plan already in place, that moat doesn’t open.

PBR: Tell me about a rescue that still lives with you, one where the stakes were so high you could feel them in the cabin.

An eight-year-old boy in Bimini had been shot in the head. There’s no trauma center in Bimini, barely a clinic, and when we got the call there was no room for hesitation, no room for anyone to act surprised by the distance, because the distance was already there and the child was already fighting for his life. We got to him, got him into the aircraft, and worked to stabilize him in flight while the ocean fell away beneath us and the cabin turned into a moving emergency room with the sound of rotors beating above us and everyone inside holding to the task in front of them.

By the time we landed him at Broward Health Trauma Center in Fort Lauderdale, every mile had mattered. He’s expected to survive, and when you say that about a child who was shot in the head, you understand how thin the line was and how much work it took to hold him on it. That kind of flight doesn’t leave you. Neither does the Boston doctor we found lying on a cot in a local island clinic, paralyzed and waiting for hours because there was no aircraft to move him, no plan to get him out, and by the time we reached him his outcome had already been compromised by the wait. That’s what happens when nobody is coming.

PBR: What do boaters misunderstand about insurance and medevac coverage before they head south?

One of the biggest misconceptions we see is that people believe they have a complete emergency response plan in place when, in reality, they may simply have access to a service that coordinates transportation after an emergency occurs. In many situations, multiple calls are still being made behind the scenes to locate available aircraft, medical providers and transportation options. During a serious medical emergency, those delays can matter.

PBR: When that membership call comes in, what is actually waiting on the other end?

What’s waiting is a crew that never really goes off duty. We keep a 48-person team on twenty-four-seven standby, and the aircraft are Sikorsky S-76B helicopters with twin engines, GPS, 4-axis autopilot, a high-power searchlight, an onboard defibrillator, cardiac monitor, oxygen, and whole blood, because a patient doesn’t get to choose the kind of night they’re having. They can be on a boat outside Nassau, on an outer island dock, or in the middle of a storm line, and the aircraft still has to be ready to launch into whatever the night has become.

When we flew into Haiti in March 2024, it was like that in a different shape. A U.S. congressman called because ten Americans were trapped in a Port-au-Prince orphanage during the civil unrest. I flew from Fort Lauderdale to the Dominican Republic, then into Port-au-Prince, and we landed at 3 a.m. We successfully rescued those 10 Americans and brought them safely out of Haiti.

Later, during a separate mission, I coordinated a multi-helicopter task force for the Florida Division of Emergency Management to assist with the evacuation of nearly 700 additional Americans. My crews personally evacuated 143 of them. Those efforts were later recognized with the 2024 Sikorsky Rescue Award, but the part I remember is the hour and the darkness and knowing there were people counting on aircraft to reach them before the city closed in any tighter.

PBR: You’ve spent 39 years in aviation, more than 14,000 flight hours, over two decades as a New Jersey State Police helicopter pilot. What do you want every skipper to know before they cross the Gulf Stream?

I want them to know that the Gulf Stream doesn’t care what their itinerary says, and the islands don’t forgive people who assume the closest help is close enough. If you’re crossing with your family, your crew, or your clients, you ought to know what happens if somebody goes down on deck, if a prop strike turns ugly, if a stroke hits a guest at midnight, if a child is hurt in a place with no trauma surgeon and no rapid way to reach advanced medical care. Don’t wait until that moment to learn who’s coming, how long it takes, or whether the aircraft can get where you are.

I’ve seen people die because no one came, and that stays with you. I’ve also heard the relief in a parent’s voice after a rescue when they said, “We never felt so helpless in our lives. Thank God you were there.” That’s why this exists, because there are places where the sea is generous until the moment it isn’t, and then the only thing that matters is whether somebody built the thing that could come get you.

PBR: If exploring this region by boat, why is it important to become a Tropic Air Rescue member before an emergency happens?

The key is having a plan in place before you ever need it. Tropic Air Rescue is not travel insurance. We are a concierge emergency response membership program that gives members direct access to our emergency response system, including our helicopters, advanced life support resources and highly trained medical teams.

Many people assume they are covered because they have travel insurance or a medical evacuation benefit. In many cases, those programs are designed to arrange transportation after a patient has already been evaluated and stabilized at a local hospital. Depending on where you are in the Bahamas, there may not be a hospital nearby that can provide the level of care you need, which can create additional delays.

With Tropic Air Rescue, members make one call directly to us. That call activates our emergency response system. Our team coordinates the response, deploys our helicopters and advanced life support resources when appropriate, and works to get members to the care they need as quickly as possible. Our focus is on emergency response when minutes matter most, not simply arranging transportation after the fact.