Doctor-Heli Network

SPIN DOCTORS

Japan has been gradually extending the coverage of the Doctor-Heli emergency medical services (EMS) network since its inauguration at a hospital in Okayama Prefecture in April 2001. In conjunction with the introduction of a varied fleet of helicopters equipped with state-of-the-art equipment, a great deal of investment has been made in infrastructure to support and facilitate the organisation’s highly specialized operations.

A commemorative stone and marker plaque have been placed at the site of the first operational
Doctor-Heli flight, which was made from Kawasaki Medical School Hospital in Kurashiki,
Okayama Prefecture. A translation of the text is provided below.
The stone was unveiled at a ceremony held on August 1, 2013, to mark 5,000
successfully completed missions. (Photo [Nov. 2019]: ピースvia Twitter @PieceMillion)

Birthplace of Doctor-Heli

It was from this spot that the first Doctor-Heli flight in our country took off, on April 1, 2001. Prior to the launch of Doctor-Heli operations, we had conducted practical research for several years using a doctor-carrying emergency medical helicopter at our hospital’s Advanced Emergency Medical Care Center. The Doctor-Heli network has become what it is today and been deployed nationwide by this hospital having demonstrated that medical care that utilizes helicopters is effective in saving lives and improving the prognoses of the injured or ill.

Commemorating 5,000 safe flights, May 7, 2013
Kawasaki Medical School Hospital

According to figures from the Japanese Society for Aeromedical Services (JSAS), 392 missions were flown during test operations conducted in 1999, and the figure had risen to 2,092 by the end of March 2001, when the business of promoting their introduction got under way. Having passed through the 100,000- and 200,000-mission mark in fiscals 2014 and 2018, respectively, as at March 31, 2021, the cumulative total stood at 280,153 missions.

As at the end of August 2018, the network had comprised a total of more than 50 helicopters that were operational for 57 hospitals in 39 of Japan’s 46 prefectures outside Tokyo. However, a spate of new operation starts led to Kagawa becoming the 45th prefecture and 58th base to join the now nationwide network in April 2022; the capital had only commenced its own operation in March 2022. (See Bulletin Board story for April 2022.) The only prefecture without its own operation is Kyoto, which is covered by others in the Kansai area.

One of the pair of Bell 429 GlobalRangers that commenced operations with Nakanihon Air in the
summer of 2017. (Photo [Komatsu airport, August 2021]: Senda Jet via Twitter @santa463

Unlike disaster response helicopters, Doctor-Heli aircraft can be made ready for takeoff in five minutes. In addition, doctors and nurses will be on board and the equipment necessary for advanced life support on hand so that treatment can be performed immediately upon arrival at the scene.

According to research conducted by Japan’s Ministry of Health, Labor and Welfare, a Doctor-Heli takes an average of 14 minutes from the request for dispatch to the start of treatment by a doctor, which is about 27 minutes shorter than that of an ambulance and has the effect of reducing cases of death by about 39% and severe cases and after-effects by 13%.

 The NishiNippon Airlines BK117C-2 with which operations revolving around Oita University
Hospital’s Emergency & Critical Care Center were inaugurated in October 2012.
(Photo: Takao Kadokami)

The Hirata Gakuen-operated EC135P2+ assigned to the Hyogo Prefectural Medical Center,
Kakogawa, in mid-December 2015. (Kishuji Rapid via Wikimedia Commons)

This section will provide information about Doctor-Heli aircraft and unit case studies.

As will be seen, several operations utilize aircraft from the major Japanese fleet operators, which means that helicopters can be rotated to different locations as required. To compensate for this, the first tables included below attempt to list all the aircraft that have ever been operated in official Doctor-Heli guise by the nine main operators. With the current number of their operations in brackets, these are: Aero Asahi Corporation (10); Central Helicopter Service Ltd. (5): Hirata Gakuen, Aviation Operation Division (13); Kagoshima International Aviation Co., Ltd. (3); NAKANIHON AIR Co., Ltd. (16); NishiNippon Airlines Co., Ltd. (4); Shikoku Air Service Co., Ltd. (3); Shizuoka Air Commuter Corporation (2) and Toho Air Service, Co., Ltd. (2).  

These are followed by tables showing the participating hospitals by prefecture. The listings for two prefectures, Tochigi and Yamanashi, include details of their operators (Honda Airways and JANET Corporation, respectively) and assigned aircraft.

All these tables will eventually be moved to a separate Data File page.

Kawasaki Helicopter System’s MBB/Kawasaki BK117A-4 Doctor-Heli demonstrator JA9699 visited
JGSDF Kasumigaura, Ibaraki Prefecture, in April 2002.

Based at the Dokkyo Medical University Hospital in Mibu, Tochigi Prefecture, this Eurocopter
EC135P2 is a typical example of the equipment currently operated by the Doctor-Heli network.

Plastic fans are a popular PR device in the hot summers in Japan, and Doctor-Heli Tochigi adopted
this design in 2013. The reverse side includes a request for public cooperation and details about the
organization; subjects that will be covered in greater detail on this page of J-HangarSpace.

Doctor-Heli Markings

Like that of the prefectural police, the colour scheme of Doctor-Heli network aircraft is akin to a uniform, as befits their official, serious role. As many are operated in a pool system, these flying ambulances tend to be finished in just standard doctor coat-white with red stripes with blue Doctor-Heli fuselage titling and the operating company’s name/logo. Some wear a blue staff of Asclepius, the internationally recognized rod-and-snake insignia of the medical profession, on their fuselage sides or nose.

The staff of Asclepius marking carried on the nose of Hirata Gakuen’s
Okinawa-based EC135P2+ JA837H. (Photo [Takae, Okinawa, Oct. 2019]:
アキノ隊員の緊急車両等撮影記 via Twitter @rangerakino)

. . . and in a lighter blue on the tail of a Hachinohe, Aomori Prefecture-based
Nakanihon EC135 in 2017. (Photo: 特車会議 via Twitter @tokusha_kaigi)

Some aircraft carry the name and/or logo of the hospital to which they are assigned, either on the cockpit doors or along the fuselage beneath the cabin. There are some instances of them sporting the symbol from the prefectural flag or the logo of a sponsor.

There are examples of off-beat artwork additions. While these have yet to be as light-hearted as, say, the addition of a stethoscope draped over an aircraft’s nose, some operations have added images from Japanese popular culture for PR purposes.

(All photographs on this website are copyright J-HangarSpace
unless otherwise stated.) 

Doctor-Heli Network: Fleet Operator Tables

One of the latest aircraft to join the Doctor-Heli ranks is this BK117C-2, which was operated by
manufacturer KHI from early 2018 until delivered to Aero Asahi on March 9, 2022. Going as far
back as the 1980s, the Japanese looked closely at European operations as a model for their own,
so it is not surprising that the locally produced BK117 and its Airbus Helicopter (formerly
Eurocopter) counterparts are so well represented in the Doctor-Heli fleets. (Photo: KHI)

Doctor-Heli Census (March 2022)
EC135 (33), BK117 (32), A(W)109 (8), MD902 (7), Bell 429 (4)

Aero Asahi Corporation operations (10): Akita, Chiba (North and South), Gunma, Hokkaido (Asahikawa), Ibaraki, Kanagawa, Kumamoto, Saitama, Yamaguchi

Aero Asahi-operated MD 902 Explorer JA6909 overflies Nagoya airport in August 2013.
(Photo: Alec Wilson via Wikimedia

MBB/Kawasaki BK117C-2 JA117R was the Aero Asahi aircraft assigned to the Maebashi Red Cross
Hospital in Gunma Prefecture in 2013. These photographs show the aircraft in flight at Nagoya
airport in August 2013 and about to depart Gunma Heliport the following month.
(Photos: [above] Alec Wilson via Wikimedia Commons; [below] J-HangarSpace)

(Photo [January 2022]: うまぴょいあーちゃん via Twitter @magus490)

(Above and below) A departure from the norm. Initially operated by Kawasaki Heavy Industries in corporate markings, 2002-model BK117C-2 JA01BK joined Aero Asahi’s ranks and had been given standard Doctor-Heli markings scheme by early 2011. Operated in Yamagata and Niigata (link) prefectures till 2013, the aircraft was based in Hakodate, Hokkaido Prefecture, but bearing the Kawasaki name and logo on its cockpit doors later that same year (link). In March 2018, the aircraft debuted in its blue colour scheme with corporate titling along its fuselage sides, and at that time had the Japanese for Gifu-Kakamigahara Air and Space Museum on its doors (link). In August 2020, temporary-looking Doctor-Heli markings were placed on the fuselage sides, and the Japanese for Aero Asahi added forward of the engine intakes. Most often seen at Nagoya or Tokyo Heliport, the aircraft was still sporting this colour scheme in early 2022.

(Photo [Tokyo Heliport, Oct. 2020] Mizuki via Twitter @214STmizuki)

Two CHS BK117s photographed at Kawasaki Medical School Hospital in
Kurashiki, Okayama Prefecture, the first Doctor-Heli base facility.
(Above) BK117C-1 JA9979 in September 2006, and (below)
BK117C-2 JA117K cooling off in September 2007.
(Photos: [above] Nissy-KITAK and [below] tatushin, both via Wikimedia Commons)

Seen here at Nagoya airport in August 2013, JA9979 was already 18 years old when
acquired by CHS in 2007. (Photo: Alec Wilson via Wikimedia Commons) 

A CHS pilot manoeuvres one of the company’s fleet of BK117s (once again, ‘C-1 JA9979) at dusk at
Nagoya in December 2011. (Photo: Kentaro Iemoto via Wikimedia Commons)

A CHS-operated aircraft and crew participate in a major earthquake response training drill by
delivering an “injured” person onto the deck of the JMSDF tank landing ship Shimokita on
August 31, 2013. The event was also reported on the CHS website news page (link).
(Photo: Japan Ministry of Defense)

CHS-operated JA6932 in action with the Shimane Prefecture operation in June 2019. Prior to its
full entry into service, as Japanese tradition dictates, a serene Shinto purification ceremony was
held on October 25, 2013 (link). Another ritual is the annual company ceremony to pray for
safety over the coming year, as was held in the CHS hangar on January 4, 2022 (link).
(Photo : さばちゃん via Twitter @shimanepolice3)

When attending a training exercise in Gotemba, Shizuoka Prefecture, in 2016, CHS BK117C-2
JA6923 had company logos beneath its registration and on its cockpit doors. The latter and
the JAXA (Japan Aerospace Exploration Agency) logo were removed in March 2017.
(Photo: via Twitter @spci61_260)
The logo above JA6923’s cabin door at that time was of the Global Emergency Medical Supporting
Intelligence System (GEMITS), which was developed to assist the decision-making process prior to
delivering patients to the most suitable hospital in the shortest possible of time.
(Photo: via Twitter @spci61_260)
(Image from Ministry of Health, Labour and Welfare website)

The recipient of the first BK117D-3 in Japan, seen above during flight testing in August 2021,
CHS held a Shinto purification ceremony for JA145C on October 20 that year.
Two scenes from that day can be found on the company’s website (link).
(Photo: きりしま via Twitter @katori93cp)

HIRATA GAKUEN operations (13): Hyogo (Himeji, Kakogawa and Toyooka), Kyoto, Nagasaki, Nara, Okinawa, Osaka, Shiga, Tokushima, Tokyo, Tottori, Wakayama

Established in 1993 initially as an aviation school, Hiratagakuen serves the Kansai region; its Aviation Division was formed in 1997. After having been a regular Eurocopter customer, the company received its first post-name change Airbus Helicopter type, an H135, for its Helicopter Emergency Medical Services (HEMS) operations in 2010.

Hirata Gakuen was operating the EC135 shown above in its own distinctive colour scheme circa
2000. In the summer of 2006, this aircraft was serving the Wakayama Medical University Hospital
in a unique colour scheme (link) before the standard scheme was applied (link). The Doctor-Heli
scheme had largely been removed by the end of 2015 (link) ahead of the aircraft’s change
of ownership. (Photo [undated]: むいむい via Twitter @R1ffP1w1aX1b7BA)

It was also in 2010, nine years after the first Doctor-Heli deployment, that the Kansai government implemented a region-wide EMS support network, and Hiratagakuen became its main operator for these missions.

The EC135P2+ JA806H operated by Hirata Gakuen for the local Urasoe General Hospital
prepares to land at the U.S. Marine Corps’ Camp Kinser, Okinawa, in late October 2014.
The helicopter was being used to ferry in “casualties” during Exercise Constant
Vigilance 2014, in which SDF and U.S. military units as well as civilian agencies
tested their cooperative procedures in response to a simulated tsunami.
(Photo: U.S. Marine Corps/Sgt. Matthew Manning)

Like every company, Hiratagakuen has faced its fair share of challenges over the years, such as securing yearly financial support from the Japanese government, especially at times when operating costs have been on rising. Other operational issues have included a lack of developed hangars in which to house the helicopters and conducting landings on challenging surfaces such as sandy areas without a supply of water, although the situation has since improved.

Hiratagakuen has undertaken numerous missions in the region. Between April 2019 and March 2020 alone, it launched 6,336 missions across its 10 bases, accumulating a total of nearly 3,000 flight hours.

The company cites the 2016 Kumamoto earthquakes as one of its most significant missions, Hiratagakuen operations having involved the dispatching of several helicopters concurrently to the affected areas for rescue operations.

Hirata Gakuen’s first H145 entered service in mid-2018 for aeromedical operations from
the Nagasaki Medical Centre. (Photo: Airbus Helicopters)

As at December 2020, the company was operating an all-Airbus fleet of 17 aircraft, comprising 13 H135s and two H145s, which were dispatched to 10 hospitals across nine prefectures and supported by 75 pilots and other crew members.

Originally built in 2000, JA02KG had been on the UK register before arriving in Japan in 2011.
Sold to a Japanese corporate operator in 2018, the aircraft retains part of its Doctor-Heli scheme.
(Photo [Kagoshima Airport, Jan. 2022]: Official髭曇dism Ver5.07 via Twitter @foggy_JA6389)

Although based in Kagoshima, KIA is responsible for Hakodate, one of the four Doctor-Heli
operations in faraway Hokkaido. (Photo [Aug. 2017]: 特車会議 via Twitter @tokusha_kaigi)

NAKANIHON AIR Operations (16): Aichi, Aomori (Aomori City and Hachinohe), Ehime, Fukushima (Fukushima City and Futaba), Hiroshima, Hokkaido (Kushiro and Sapporo), Ishikawa, Iwate, Mie, Nagano (Matsumoto and Saku), Shizuoka (West)

Serving the Kushiro City General Hospital and the Kushiro Kojinkai Memorial Hospital, this
Nakanihon-operated EC135 was photographed at the Masyuu Kosei Hospital in the town
of Teshikaga, Hokkaido, on July 1, 2011. (Photo: Chatama via Wikimedia Commons

Seen at Fukushima Airport in November 2021, this Nakanihon Bell 429 was wearing fuselage
titling for the Futaba Medical Center in the prefecture. (Photo: 祥 via Twitter @rescue60k)

NishiNippon BK117C-2 JA016W was a present at a rainswept Fukuoka airport on August 30, 2013.
(Photo: Alec Wilson via Wikimedia Commons) 

The NishiNippon BK117C-2 assigned to Miyazaki departs the Nyutabaru air show in
December 2012, the year in which Doctor-Heli operations were commenced
in the prefecture. (Photo: Takao Kadokami)

Although they have been removed from JA6844, Shikoku Air Service’s BK117C-2 was still adorned
with Anpanman (Bean Bun Man) children’s cartoon characters on its nose and rear doors in
January 2022; other side shown here (link) in June 2021.
(Photo: KUWA via Twitter @kuwa767)

As seen in the above photo, Shikoku Air Service BK117s have been seen with a shield-shaped emblem beneath their registrations. Applied to JA6844 in December 2016 and to the other two aircraft in 2017, the emblem (below) was designed to mark the 60th anniversary of the company, which was founded in November 1956. All three aircraft were still noted with the emblem in 2021, in JA6844’s case in May 2022.

(Photo: Detail from Kochi Health Sciences Center’s former Facebook page)

(Photo [JA10YM, Crossland-Oyabe, August 2019]: なぎさ via Twitter @KatanoNagisa)

(Photo: vaze via Twitter @vaze32_TAKEOFF)

Newly arrived JA70RC at the Tokyo Aerospace Show, October 2016

(Photo [May 2018]: sawakazuair via Twitter @sawakazuair_139)

In April 2022, veteran TAS BK117B-2 was flying with the Doctor fuselage titling covered
but still readable. (Photo: 飛行機・鉄道大好きな人via Twitter @kimi_boku_anata)

Doctor-Heli Network by Prefecture

The numbers that follow the dates of the Start of Operations show that base’s chronological position in the 58 bases that were formed from 2002 to 2022. A list of Doctor-Heli operation start-ups by year appears at the end of this page.

 Nakanihon Air Service (since July 2020 Nakaninihon Air) EC135P1 JA113D is brought in for a
 landing at Tsurumai Park in Nagoya, Aichi Prefecture, in January 2008. The imposing building
in the background is the Nagoya University Graduate School of Medicine, which is affiliated
with the aircraft’s assigned base, Aichi Medical University Hospital.
(Photo: KAMUI via Wikimedia Commons)

The Aichi Prefecture Doctor-Heli takes part in a rescue training exercise conducted
jointly with Aichi Air Rescue on the Kiso River in September 2020.
(Photo: 愛知県消防航空隊 via Twitter @AichiAirRescue)

In early November 2011, an aircraft had been drafted in to Aichi Medical University Hospital (link) to cover the usual aircraft’s absence for maintenance. At that time, JA114D was carrying the INABA JUMP PROJECT logo on its cockpit doors, the details of which can be found in the Hokkaido Prefecture (Sapporo) entry below. Applied in October 2009, in this aircraft’s case the marking had been removed by February 2013.

A short video (link) shot in March 2011 records a departure from the Aichi Medical University Hospital helipad. Another video (link) from August 2019 offers a wider view of the facility, including the hangar.

A doctor walks out to the Aero Asahi-operated BK117C-2 assigned to the
Akita Japanese Red Cross Hospital.
(Photo: 医科歯科[Tokyo Medical and Dental University]ER via Twitter @tmdu_er)

A Nakanihon-operated EC135P1 photographed during a joint exercise with Aomori Prefecture
disaster relief units at Hirosaki University of Health & Welfare in August 2018.
(Photo: Hirosaki University of Health & Welfare Student PR Group via Twitter @hirosakijggkg1)

The Hachinohe-based Doctor-Heli aircraft lands on the sea wall during a combined public event
and disaster preparedness training exercise held at the Misawa Aviation & Science Museum
in 2010. (Photo: MH-38R via Twitter @38rMh)

A 2019 TV documentary covered the Aero Asahi operations from Chiba Hokusoh Hospital,
which was the first in Japan to launch full-scale operations.
(Photo: Fuji TV movie via Twitter @fujitv_movie)

A typical helipad scene at the Kameda Medical Center in southern Chiba
(Photo: Kameda Medical Center via Twitter @kmc_pr)

(Photo [June 2021]: Jet Keene via Twitter @JetKeene)

Its registration providing a clue to its former Nakanihon career with a TV company—Shizuoka Telecasting from 2002/03 (nearest camera [link])—JA17TV has continued to fulfill an advertising role since being converted for Doctor-Heli operations in 2015. Since late 2017, in some cases earlier and in different positions on the aircraft, this flying billboard has been promoting: the Taiyo Oil company’s SOLATO credit card and Japan Post (on and below cockpit door, respectively); ASTIS, an Ehime-based pharmaceutical product wholesaler (blue banner on rotor mast); the Ehime Medical Association (blue Japanese above cabin windows, above the black for NAKANIHON AIR); Ehime-based company Ai Pharmacy (orange banners above rear cabin doors) above the Ehime Dental Association logo and titling; the Honshu-Shikoku Bridge Expressway (JB) Company (tail boom); and Ehime Bank (above fenestron). These companies and organisations are supporters of the Ehime operation. 

The last EC135P2 Nakanihon acquired before purchasing its Bell 429s, JA17TV is seen on a visit
to Ishikawa Prefectural Central Hospital. Another chance to see the innovative advertising
that shows the companies and organisations lending their support to the Ehime operation.
(Photo [Oct. 2020]: ゴーにーいち via Twitter @series521_

Giving some indication of the lead time required prior to the start of operations, Central Helicopter
Service had been officially entrusted with Fukui base flight operations by a contract signed
on December 3, 2019. (Photo [Fukui Airport, Dec. 2021]: ‘… ‘ via Twitter @FgZUHO)

Fukuoka Prefecture is one of five prefectures served by NishiNippon Airlines. Three are advertised on the normally Fukuoka-assigned aircraft, its end-user there being the Department of Emergency and Critical Care Medicine at Kurume Medical University, the other two are Kumamoto and Miyazaki.

(Above and below) Right and left side-views of the veteran 2001-model BK117C-1, first registered
to NishiNippon Airlines in May 2006 and normally assigned to Kurume University Hospital.
Note that in the early photo above the aircraft has FUKUOKA SAGA titling along the
lower fuselage, to which OITA had been added by spring 2007. The two kanji on
the tail are an abbreviation for NishiNippon Airlines.
(Photos: NishiNippon Airlines website gallery [link])

The cockpit doors of JA005W, the helicopter usually assigned to Kurume University Hospital, have
always carried the “old school” university badge, even though this seems have been superseded by
a more modern design. The image above forms the centre of the white-bordered badge on the
aircraft, which is a brighter green and has the words KURUME UNIVERSITY HOSPITAL
around the top and UNIVERSITY around the bottom.
(Image: Kurume University Hospital website)

After 14 years of standard operations centred on Fukushima. as at March 31, 2022, the prefecture had, in cooperation with the relevant municipalities and fire departments, put in place 465 landing sites for Doctor-Heli operations.

(Photo [June 2017]: 福島県立医科大学 救急科 [Fukushima Medical University Hospital,
Department of Emergency and Critical Care Medicine (ECCM]] via Facebook)

In the summer months, operations are conducted when the temperature can reach the high 30s C
but close down at 19:00. (Photo [July 2019]: 福島県立医科大学 救急科
[Fukushima Medical University Hospital, Dept. of ECCM] via Facebook)

On occasion, the aircraft assigned to the main Fukushima operation will carry the kanji for Fukushima Prefecture 福島県 in black on their cockpit doors.

Around 10 years into the Fukushima operations, an unprecedented initiative for public hospitals in Japan had been launched. The plan involved the utilization of a specially equipped, multipurpose helicopter to airlift patients from medical institutions in the Hamadori area of southern Tohoku to those that can provide highly specialized treatment. Besides the Department of ECCM at Fukushima Medical University Hospital, which provides personnel and equipment while serving as the operational control centre, these include facilities in the cities of Iwaki and Koriyama.

Nakanihon undertook test flights in early September 2018 and one of its EC135s was present, wearing the logo of and Japanese for Futaba Medical Center on both sides of its fuselage, for the ceremony declaring the start of multipurpose operations on a wet September 21, 2018. On October 26, the EC135 was used for a training involving disaster medical assistance teams (DMATs) from several hospitals in an exercise that simulated multiple acceptances of injured cases.

A ceremony to mark the start of full-scale multipurpose medical helicopter operations was held on October 29, 2018, this time with Nakanihon Bell 429 JA128D present. Wasting no time, the following day an exercise simulating the response to a major earthquake like that of March 2011 was held with 12 DMATs.

Then Prime Minister Shinzō Abe (in raincoat, to the right of the aircraft logo) visits the
 Futaba operation, November 24, 2018.
(Photo: ふたば医療センター附属病院 [Futaba Medical Center] via Twitter @futaba_fuzoku)

The handout with which Fukushima Prefecture announced the start of multipurpose medical
helicopter operations from its second base Futaba on October 29, 2018. Also seen at the
top left corner of the poster, the Futaba-assigned aircraft have carried a two-tone logo
above the three kanji for Fukushima prefecture. The logo forms the central element
of a design that promotes the reconstruction and revival of the town following
the Great East Japan Earthquake of March 2011.
(Photo: Fukushima Prefecture via Twitter @fukushima_pref)

The Japanese for the medical center name reads from right to left on the left
side of Futaba aircraft,but as shown from right to left on the left side.
(Photo [Nov. 2018]: 物ぷーリスト via Twitter @NisePri)

In May 2022, EC135P2 JA116D was being operated from the Futaba facility.
(Photo: Katano Nagisa via Twitter @KatanoNagisa)

Built by Kawasaki Heavy Industries (KHI) in Gifu, a BK117C-2 operated by Central Helicopter
Service overflies Gifu University Hospital, the network facility in Gifu Prefecture. (Photo: KHI)

The Gifu operation has rated two mentions on the news page of the Central Helicopter Service website. The first was coverage of the tape-cutting ceremony that took place at Gifu University Hospital the day before the official start of operations (link). That was followed by the announcement that the Gifu operation had reached the 1,000th mission milestone after three years of operations at 11:02 on February 26, 2014 (link).

(Above) Assigned to the Maebashi Red Cross Hospital in June 2021 was this Aero Asahi BK117C-2.
(Below) The scene at the Doctor-Heli hangar at Gunma Heliport, one evening in January 2019.
(Photos: stone via Twitter @stone15DJ)

More recently, Aero Asahi have been assigning an MD 902 to the Gunma operation,
as evidenced by JA6911’s presence at Gunma Heliport in December 2021.
(Photo: stone via Twitter @stone15J)

A photo taken the time of the Hiroshima operation’s inauguration in 2013.
(Photo: Hiroshima Prefecture via Twitter @hiroshima_pref)

By late June 2013, what was to be long-term Hiroshima resident JA124D had received badges on its
cockpit doors. In the centre of the badge is a leaf from a maple, the prefecture’s official tree, on
which is a white white staff of Asclepius, the internationally recognized rod-and-snake insignia
of the medical profession. Around the outer ring is DOCTOR HELICOPTER HIROSHIMA,
with SINCE 2013 at the bottom. (Photo: Hiroshima Prefectural Hospital)

It is essential that the four Doctor-Heli operations covering Hokkaido Prefecture attach skis to their
aircraft in winter, as shown on this aircraft assigned to Japanese Red Cross Asahikawa Hospital.
(Photo: Aero Asahi via Twitter @aeroasahi)

(Photo [Aug. 2017]: 特車会議 via Twitter @tokusha_kaigi)

One of Nakanihon’s eight EC135P2+ helicopters awaits the next call on the
helipad at Kushiro Kojinkai Memorial Hospital.
(Photo [July 2018]: 函館マウンテン via Twitter @miyakenhakodate)

After two years and nine months of trial operations, Doctor-Heli services in Hokkaido started officially on April 1, 2005, when the Sapporo base became the ninth of its kind in the country. The size of this single-prefecture island, which covers an area roughly equivalent to that of Austria, necessitated the gradual addition of the three other bases included above.

A novel trolley/conveyor system was installed at Teine Keijikai Hospital to facilitate
miving the aircraft back and forth between the rooftop hangar and helipad.
(Photo: Teine Keijikai Hospital via Twitter @phanet_yakugai)

Its cockpit covered but with the doors open for ventilation, the resident EC135P2+ on-call sits
on the elevated “crow’s nest”-like helipad at Teine Keijikai Hospital in September 2019.
(Photo: あーす via Twitter @STKonttheearth)

The Sapporo-based helicopter shown in the above photo pays a visit to Tokyo Heliport in June 2021.
This aircraft still has the two markings described below on its cockpit doors.
(Photo: Mizuki via Twitter @214STmizuki)

(Image from Hokkaido NipponHam Fighters news release dated Oct. 28, 2009)

It was in June 2009 that Atsunori Inaba of the Hokkaido NipponHam Fighters baseball team launched a project by which money would be raised in accordance with the number of runs he made in a year. Those funds would be used to purchase medical equipment to treat children. As the focus was the at-the-scene treatment given by first responders, the participating facilities and recipients were the Asahikawa, Kushiro and Sapporo hospitals in the Doctor-Heli network. To promote the initiative INABA JUMP PROJECT stickers were first applied to the aircraft then assigned to the Sapporo and Kushiro operations on October 28, 2009.

(Image taken from promotional video posted on YouTube [link])

In October 2014, Teine Keijinkai Hospital adopted Teine, the mascot of Sapporo City’s Teine Ward, for stickers designed to raise the profile of its Doctor-Heli operations among children of all ages. 

The pilot brings Hirata Gakuen BK117D-2 JA905H in for a helipad landing at Steel Memorial
Hirohata Hospital, which is described as a semi-base hospital. An aircraft is normally
 based there on Wednesdays. (Photo: Daisuke Nonaka via Twitter @April10_2018)

After just over four months of operational existence, in April 2014 the Kakogawa service was moved to the Union of Kansai Governments, which now counts seven under its umbrella (the others being Hyogo-Toyooka [Three Prefectures], Osaka, Shiga [Keiji], Tokushima, Tottori and Wakayama.) In principle, this operation covers the Harima region of southwestern Hyogo Prefecture and the southern part of the Tanba region of central Hyogo.

A photo of the South Hyogo-assigned EC135P2+ JA831H released by the city of Akashi two weeks
before the official start of Kakogawa operations in November 2013. The purpose was to alert the
public to the 13 locations within Akashi that were earmarked for use by the emergency helicopter
based 30 km away in Kakogawa. (Photo: 明石市広報課 via Twitter @akashi_kouhou)

The SOUTH HYOGO titling, small prefectural flag emblem on the engine cover and prefectural
Habatan mascot markings (see below) were removed from JA831H soon after the start of
operations, only for the emblems and mascots to be reapplied with just HYOGO the
following year. They remained until the aircraft was transferred out in 2020.
(Photo [Apr. 2019]: ヒョウゴAA420/JP3UJR via Twitter @HYOGO_AA420)

The then still Hyogo-based Doctor-Heli JA831 sits on the helipad at Osaka University Hospital,
which overlooks the Tower of the Sun landmark in the city’s Expo’70 commemorative park. By
early 2017, an injured Habatan mascot and a first-aid box had been added to the right-side
rear cabin door of JA831H. This marking was still being carried by JA824H in May 2022.
(Photo [Dec. 2017]: 兵庫県立加古川医療センター
[Hyogo Prefectural Medical Center Kakokawa] via Facebook page)

The version of Hyogo Prefecture’s mascot Habatan that appears on the helicopter’s nose, aptly as
 the name is derived from the Japanese word for flapping wings. Adopted in 2003, its design is
said to be of a phoenix, a reference to Hyogo having risen from the ashes of the devastating
Hanshin-Awaji earthquake of 1995. (Image: Hyogo Prefecture Regional Medical Bureau)

Since April 2011 one of the seven operations under the Union of Kansai Governments, that at Toyooka is known as the Three Prefectures Doctor-Heli service. This is because, in principle, its area covers the northern parts of Hyogo and Kyoto prefectures as well as all of (originally just eastern) Tottori Prefecture; the tape-cutting ceremony on April 17, 2010, had included reference to the accord (link). The Toyooka City Fire Department (TCFD) zone extends to a radius of 50 km from its base hospital.

Having surpassed the cumulative total of 6,000 missions in January 2015, the 10,000th mission was flown on March 20, 2017. According to statistics released by the TCFD, in the year ended March 31, 2022, a total of 1,812 missions were added, in other words an average of five a day.

Of those 1,812 missions, 221 were within the city of Toyooka, and 892 elsewhere within Hyogo Prefecture. Responses to requests from medical institutions in Kyoto and Tottori prefectures numbered 264 and 339 missions, respectively. Interfacility airlift flights accounted for an additional 96 missions.

(Photo [undated]: Toyooka Public Hospitals’ Association website PR photo)

From April 2014, JA818H (above) sported a bird logo above the cockpit door slogan Fly to the wild, which had first appeared on sister aircraft JA822H in July the previous year. KANSAI and the Japanese for a white stork (Konōtori) had been added to its tail. The logo and name promoted a long-standing international initiative to reintroduce the white stork into the area around Toyooka. Having departed for maintenance in mid-February 2015, these markings were still present when the aircraft was reassigned to Toyooka from November 2015 through to the following summer. The rear fuselage also carried the green logo alongside the initials JA and the Japanese abbreviation for the national agricultural cooperatives’ organization. The aircraft was devoid of all but the standard Doctor-Heli titling at the time of its brief third stay from February to March 2017.

Hirata Gakuen EC135P2+ on the helipad at its TECCMC home base
(Photo [Feb. 2022]: keisuke828 via Twitter @keisuke_828)

There having being no Toyooka prefecture to succeed the former Toyooka feudal clan following the abolition of their domains, the current facilities trace their history back to the medical office that was established in the Odaicho part of the town of Toyooka on July 1, 1871. In 2021, staff were thus asked to submit logos for that year’s 150th anniversary. Incorporating the blue, bird wing-like logo of the Toyooka Public Hospitals’ Association and a white stork, the design created by male nurse Yūgo Nakamura (below) won the most votes, was officially selected on April 6 that year and appeared in sticker form on the aircraft’s cockpit doors.

(Image: 豊岡病院 via Twitter @toyooka_hp)

JA6926 June 2019 (Photo: ぺ via Twitter @6813_bk117)

Nakanihon Bell 429 JA128D is flown over the rooftops close to the Ishikawa Prefectural
Central Hospital helipad. (Photo [Oct. 2020]: ふとめさんvia Twitter @futomesan)

The aircraft with which Nakanihon commenced operations on Iwate Prefecture’s behalf at
Tokyo Heliport in December 2021. (Photo: ちぃすけ via Twitter @mononoke2020)

The Iwate aircraft is put through its paces on May 8, 2012, the day on which the
ceremony to mark the start of full operations was held.
(Photo from Iwate Medical University press release dated May 9, 2012)

Now serving as the Kagawa Prefecture Doctor-Heli (above), plain Shikoku Air Service BK117C-1
JA6844 was present to provide first-aid airlift cover at the Super GT motor racing event at
Okayama International Circuit in April 2021.
(Photos: [Top] tanisuke_photo via Twitter @ tanisuke_photo;
[above] 渋野 via Twitter @KtShibuchin)

This operation covers all of mainland Kagoshima, plus the Koshiki islands, the Kumage district (the islands of Tanegashima and Yakushima as well as the Osumi islands), Mishima village and, in part, the village of Toshima.

(Photo: Kagoshima Central Hospital website gallery)

April 28, 2015. A Kagoshima-based aircraft becomes the first to land in an official capacity on the
newly completed helipad at Miyakonojo Hospital in Miyazaki Prefecture. Having been sent to the
foot of Mt. Kirishima in Kagoshima Prefecture to airlift a trauma case, the crew had
requested that they divert to the Miyakonojo facility due to approaching bad weather.
(Photo: 都城市郡医師会病院救急科
[Miyakonojo Medical Association Hospital Emergency Department] via Facebook)

The cabin of an AW109SP GrandNew can be configured to accommodate one stretcher along the
left side with seating for either three or four doctors/nurses or to have seats for a doctor and a
nurse flanked by two stretcher cases. (Photo: Kagoshima Central Hospital website gallery)

The introduction of an aircraft into this area to serve the Amami island group and Toshima village completed the coverage within Kagoshima Prefecture.

The then only recently delivered Kagoshima International A109SP GrandNew JA07KG sits on the
helipad at Kagoshima Prefectural Hospital Amami-Oshima on November 16, 2016. The flight
training conducted that day was the first involving the simulated receipt of patients.
(Photo: 鹿児島県立大島病院 奄美救命救急センター [Kagoshima Prefectural Hospital
Amami-Oshima, Amami Critical Care Center] via Facebook)

(Above) Kagoshima Prefectural Hospital Amami-Oshima in January 2012 and (below) in
February 2022, long after the addition of the new building and helipad structure,
best seen here in an aerial view (link).
(Photos: [Top] アラツクvia Wikimedia Commons; [above] さーや@奄美 via Twitter @sayaka_86)

 Basking in the sun on the Tokai Universiry Hospital helipad on July 25, 2008, was
Aero Asahi-operated BK117C-2 JA6917. This aircraft was involved in an accident
when landing at Hadano, Kanagawa Prefecture, on August 8, 2016.
(Photo: Cassiopeia_sweet via Wikimedia Commons)

Although Doctor-Heli aircraft operate in potentially hazardous urban environments, they have maintained a commendable level of flight safety. Only one major incident has occurred.

In the afternoon of August 8, 2016, the aircraft assigned to Tokai University Hospital had its tail boom severed as the result of a heavy landing at a factory in Hadano, Kanagawa Prefecture. Though none of the five persons on board were harmed, the victim of a road traffic accident they were due to airlift to hospital succumbed to his injuries.

The English version of the accident report (link) dated November 30, 2017, cited the pilot’s non-standard steep approach angle over a high steel tower and high sink rate as contributory factors.

A bird’s eye view of the space-saving helipad specially built above a car park at the Kochi Health
Sciences Center. (Photo [Jan. 2019]: Hiroyuki Takeuchi via Twitter @ikutuniatemoam)

It’s all hands on deck to push the aircraft back into the hangar.
(Photo [June 2020]: Kochi Health Sciences Center’s former Facebook page)
(Below) The elements that appear on the cockpit doors of the Kochi aircraft, as seen above. 
(Image: Kochi Health Sciences Center website)

(Image taken from YouTube video shot in January 2012 [link])

The above image is from a video of JA6844 taken at Kochi-Ryoma Airport in January 2012. The video shows the Anpanman (Bean Bun Man) children’s cartoon characters that adorned the nose and rear cabin doors of the aircraft. In a photo from May 2012, that on the nose can be seen in close up here (link).

A short YouTube video of Shikoku Air Service’s JA6855 departing the helipad at Yuinooka Heliport in the Kochi Prefecture town of Yasuda in November 2019 can be found here (link). Maintaining the tradition from the abovementioned video, the Anpanman decorations were still in place in the summer of 2021.

On a wet day at Kumamoto Airport. (Photo [July 2019]: みぐ(sub) via Twitter @subnigu)

(Photo [Oct. 2019]: Japanese Red Cross Kumamoto Hospital via Facebook)

Since the spring of 2022 the sole prefecture not possessing a Doctor-Heli aircraft in its own right, Kyoto is a joint operation between Uji City, on the southern outskirts of the city of Kyoto, and Shiga Prefecture. The prefecture’s second city, the former covers each municipality south of the central Kyoto Prefecture town of Kyotamba, which when formed in 2005 took its name from Kyoto and the old province of Tanba.

Operations are conducted under visual flight rules daily from 08:30 to 30 minutes before sunset.

A YouTube video (link) from May 2015 places you in the front seat of Hirata Gakuen EC135P2+ JA833H (below) for a six-minute flight from the helipad atop the Uji-Tokushukai Medical Center. The footage was taken by politician and Kyoto assembly member Shōji Nishida, who was attending an opening ceremony for a new hospital building.

Hirata Gakuen EC135P2+ JA833H
(Photo [Yao Airport, Osaka, May 2021]: ヘリ三味 via Twitter @MH53E_Seadragon)

Light reflecting off the helipad gives JA122D a subtle fleeting change of colour scheme. The same
aircraft is seen coming in for a landing on the Mie University Hospital rooftop helipad in
this photo (link) from July 2016.
(Photo [May 2018]: やんたば via Twitter @tabachiu)

First registered to Tohoku Air Service in June 1997, BK117B-2 JA6620 (above) was still on the
company’s books early in 2022, although the inauguration ceremony for replacement
’C-2 JA117T had taken place on October 28, 2016.
(Photos: sawakazuair via Twitter @sawakazuair_139)

(Photo: betiQ via Twitter @betiQ)

The above close-up photo of then newly delivered JA117T from September 2016 shows the Miyagi Prefecture tourism promotion mascot Musubimaru—usually portrayed as a samurai with a rice ball-shaped head, in this case as a doctor with a stethoscope—which is carried on both rear cabin doors (link). The aircraft also carries the prefectural flag symbol of a stylized bush clover in the shape of み (mi) for Miyagi above the Japanese for Miyagi Prefecture.

The NishiNippon BK117C-2 assigned to the network hospital in Miyazaki Prefecture, which
commenced Doctor-Heli operations on April 1, 2012, made a publicity visit to the
Nyutabaru air show held in December of that year. (Photo: Takao Kadokami)

The Nakanihon EC135P2+ assigned to Shinshu University Hospital in Matsumoto,
Nagano Prefecture, on a visit to Tokyo Heliport in March 2022.
(Photo: Mizuki via Twitter @214STmizuki)

The Matsumoto-based aircraft carries the Shinshu University logo on its cockpit doors.
The four-kanji abbreviation for Shinshu University Hospital 信大病院 appears
beneath the doors. (Image: Shinshu University website)

Children who attend the nursery school on the premises of the Saku Central Hospital get some
 fresh air on the helipad while seemingly receiving a lecture on the finer points of the resident
Nakanihon EC135P2+. (Photo [Nov. 2021]: Saku Central Hospital via Twitter @sakubyoin)

The Saku Central Hospital aircraft at Karuizawa Fire Station in Nagano Prefecture,
New Year’s Day 2022. (Photo: あんすvia Twitter @Pvt_Noritama)

According to prefectural office statistics, in the 15-year period from December 2006 to December 2021 this operation was called upon a total of 10,806 times. Of those missions, 6,132 (57%) involved attendance at the scene of an accident or incident, 3,172 (29%) were inter-facility airlift missions, and 1,502 (14%) were called off before departure.

(Photo [April 2017]: 国立病院機構長崎医療センター 救命救急センター [Nagasaki Medical Center] via Facebook)

In January 2019, Nagasaki Prefecture-assigned BK117D-2 JA905H was used to airlift a
patient to hospital in Sasebo, where use was made of one of the city’s parks.
(Photo: 佐世保消防 via Twitter @ssb_firephoto)

Nagasaki Medical Center is located in the city of Ohmura, the base for JMSDF 22nd Fleet Air Wing
helicopters. (Photo taken from September 2021 Nagasaki Medical Center YouTube video [link])

(Above) The stylized blue N from the Nagasaki prefectural flag appears on the tail and is repeated
above the words NAGASAKI PREFECTURE on the nose (below). The Japanese subtitle states
thta Doctor-Heli operations were introduced in 2006.
(Image via Wikimedia Commons; another photo taken from September 2021
Nagasaki Medical Center YouTube video [link])

The hospital logo is carried on the cockpit doors. (Image: Nagasaki Medical Center)

The Nara operation’s EC135P2+ on display at a disaster preparedness event held at a
park in the city of Gojo in December 2021. (Photo: ESPER via Twitter @esper_hk)

The first of the two operations in Niigata was launched with Aero Asahi Corporation
supported, as evidenced here, by Toho Air Service.
(Photo [posted Apr. 2018]: Niigata Prefecture East Doctor-Heli Facebook page)

As the ideal Doctor-Heli mission is a 20-minute flight to enable the patient or casualty to receive specialist treatment in 30 minutes, Niigata Prefecture’s size demanded a two-helicopter operation. As its name suggests, the Niigata East operation is responsible for the area east of central Niigata but also covers Sado Island. The latter and the coastal city of Murakami, by area the prefecture’s largest, alone place requests for more than 200 flights a year. Few of the Doctor-Heli operations have the same level of demand. On one extreme day, the aircraft had to be flown 400 km, roughly the equivalent distance between Tokyo and Osaka stations, in response to eight requests for assistance.

Prior to its assignment to the Niigata East operation, AW109SP GrandNew JA15AC had carried
just a blue staff of Asclepius on either side of its fuselage. Around early March 2019, these had
been moved to the tail, and their places taken by the emblem from the prefectural flag above
the three kanji for Niigata Prefecture. The right-side cabin doors carried the words
NiiGATA UNiVERSiTY, with some of the letters highlighted in blue (link), while
the left side had the same in ornate black Japanese script (see below). Placed
at the front of the cabin doors was the Niigata University logo (also below).
(Photos [June 2019]: KJ via Twitter @JA10GR_JA01GP)

Niigata University logo and titling
(Images: Niigata University website)

(Photo [posted April 2022]: Niigata East Doctor-Heli via Facebook)

A JGSDF casualty from snow-clearing operations is transferred from SACC-operated
AW109SP Grand New JA17AC at the army garrison in Shibata, Niigata Prefecture.
(Photo [Feb. 2022]: JGSDF Shibata Army Camp via Twitter@JGSDF_30i_pr)

A scene from the ceremony that inaugurated operations from the second Niigata
base, the Nagaoka Red Cross Hospital, March 29, 2017.
(Photo: Nagaoka City Disaster Relief HQ Facebook page)

Initially flown with just the SACC corporate logo above its cabin doors, JA70RC received distinctive
markings in time for the Nagaoka operation’s inauguration ceremony. Taken when the aircraft was
being test flown from Shizuoka Heliport in September 2020, this photo shows the prefectural
logo and Nagaoka Red Cross Hospital titling that are still worn today.
(Photo: ヱ via Twitter @spci61_260)

A detail from of the NishiNippon Airlines BK117C-2 JA017W photo that appears at the
top of this page. (Photo: Takao Kadokami)

Where it all began, on April 1, 2001. (See the introduction at the top this page for a photo of the
memorial plaque and a translation of its inscription). This base recorded its 5,000th mission on
August 1, 2013. (Photo [Nov. 2019]: ピースvia Twitter @PieceMillion)

(Above and below) Two of the Central Helicopter aircraft that have been operated over the years
from the aptly named Kawasaki Medical School Hospital. Having on April 1, 2001, become
the first to commence operations, the Okayama service marked its 20th anniversary on
April 1, 2021, and logged its 8,000th mission on the 22nd of that month (link).
(Photos: Jet Keene via Twitter @JetKeene)

A more recent event was a tape-cutting ceremony (link) held on March 26, 2022, to mark the opening of a new hangar. The new facility was covered on the Central Helicopter Service website news page (link).

Compared with most helicopters in Doctor-Heli service, the Hirata Gakuen aircraft based in
Okinawa have on occasion been festooned with markings. (Photo [Miyagi, Higashi Village,
Okinawa, Dec. 2019]: アキノ隊員の緊急車両等撮影記 via Twitter @rangerakino)

The Okinawa Doctor-Heli initiative actually came to the assistance of a local EMS helicopter operation, the Urasoe Patient Immediate Transport System (U-PITS), which had partnered with the same hospital. Having commenced operations in July 2005 and upgraded to a twin-engine EC135 from Hirata Gakuen (photo from Dec. 2007 [link]) two years later, the costs had taken their toll on that operation’s financial health, and thus the injection of state and prefectural government funds for a Doctor-Heli operation was timely.

Taken from an Okinawan saying said to have become popular from a 1930s play,
the Japanese above a traditional mask on the tail means “life itself is a treasure”.
The colour of the mask is green on the left side but blue on the right.
(Photo [Takae, Okinawa, Oct. 2019]:
アキノ隊員の緊急車両等撮影記 via Twitter @rangerakino)

The Okinawa Doctor-Heli seen during a joint exercise held at U.S. Marine Corps Camp Schwab in
October 2021. It was this aircraft that completed the Okinawa operation’s 5,000th mission,
on November 3, 2019. (Photo: Ike Hirayasu/U.S. Marine Corps)

As is usually the case, the Osaka operation has a history of cooperation with neigbouring network elements and governments. After a year spent getting its own operation up to speed, from April 2009 mutual support was extended to Wakayama Prefecture (itself operational since 2003) and flights were operated to the northern part of Nara Prefecture, which at that time lacked its own aircraft. Providing Shiga Prefecture with full cover was initiated in April 2011, and responses to on-the-spot requests for assistance from southern Kyoto Prefecture commenced in July 2012. In April 2013, its operations became one of the seven that now come under the Union of Kansai Governments joint operational umbrella.

(Photo [Posted Aug. 2017]: 緊急車両写真館 via Twitter @emergency_world)

Following the inauguration of the Keiji (Kyoto-Shiga) and Nara operations, Osaka has been responding to on-site dispatch requests from fire departments not only from the Osaka government but also from Kyoto Prefecture’s Second Medical Care Zone around in the city of Nantan since April 2019. As the other areas have their own operations, Osaka now serves a back-up role.

(Photo [Posted Aug. 2018]: 緊急車両写真館 via Twitter @emergency_world)

For an aircraft based in such a densely populated area, the mission count seems comparatively low. Over the 10-fiscal year period from 2007 to 2018, the cumulative total of requests was 1,637, of which 157 were cancelled prior to launch, making a total of just 1,480 completed missions.

A Hirata Gakuen aircraft assigned to the Osaka operation carries the prefectural government’s blue
 logo on its cockpit doors. Created for the government’s centenary in 1968 and incorporating Os for
Osaka, the design is derived from the ensign bearing a cluster of gourds, as used by the samurai
warlord and major historical figure Hideyoshi Toyotomi (1537–1598).
(Photo [May 2019]: にらまんじゅうvia Twitter @niraJAPAN)

The TACCC logo, as usually worn on the nose of Osaka aircraft.
(Image: via TACCC Facebook page)

As control of the Osaka operation passed to the Union of Kansai Governments in April 2013, the aircraft carries KANSAI on its tail above the Japanese もず (mozu) for shrike, the prefectural bird (link).

(Photo: via TACCC Facebook page)

Initially undertaken in partnership with Kurume University Hospital in Fukuoka Prefecture, aircraft-lacking Saga’s piggy-backing on emergency medical helicopter services commenced on September 30, 2003. The tri-prefecture operation initiated on April 25, 2006, when Oita Prefecture had joined forces, grew to a northern Kyushu block of four with the addition of aircraft-operating Nagasaki Medical Center on October 26, 2009.

(Map: T. Kambayashi via Wikimedia Commons)

A newspaper article carried in the NishiNippon Shimbun dated January 18, 2014, noted the extent to which the usefulness of medical assistance helicopters had caught on and the sharp increase in the number of missions requested by Saga Prefecture: 42 in fiscal 2009, 87 in fiscal 2010 and 170 in fiscal 2012. Up until the previous day, those requests had been lodged with its next-door neighbours, Fukuoka or Nagasaki prefectures, as Saga was by then the odd-man out; the only one of the seven Kyushu prefectures without its own Doctor-Heli operation.

It was on the second day that an inauguration ceremony was held at the helicopter’s Saga University Hospital base in Nabeshima. Part of the prefecture’s disaster response preparations, the national government was footing 90% of the annual operating expenses of about 200 million yen; the rest was borne by the prefecture.

Scissors at the ready, visiting dignitaries on the point of fulfilling their duty at the tape-cutting
ceremony held at Saga University on January 18, 2014. (Photo taken from YouTube video [link])

Any part of the prefecture, from the mountainous areas to remote islands was within a flying time of 15 minutes, and systems would be put in place to maintain smooth coordination with operations involving its two neighbours. The operating hours were from sunrise to 30 minutes before sunset. From April 2014, the helicopter was to be on call at Saga University Hospital from Sunday to Thursday and at the Prefectural Medical Center Koseikan (Kasemachi, Saga City) on Fridays and Saturdays with 115 landing points at the crew’s disposal.

Two views of Bell 429 JA429D, the sole example operated by NishiNippon, exclusively for the Saga
operation. Although the type has not made deep inroads into the Japanese market—only three other
GlobalRangers are in service, with Nakanihon—at the time of the purchase of two by the latter
in 2017, Bell publicity videos cited three particular selling points for EMS operations: the
spacious cabin; ease of operation for pilots and ground crew; and low vibration levels.
(Photos [Top May 2020, [above] May 2021]: 佐賀大学医学部附属病院
高度救命救急センター [Saga University Hospital Trauma and
Resuscitation (SUHTAR] Center [link] via Facebook)

(Photo [JA6909, Jan. 2022]: KJ via Twitter @JA10GR_JA01GP)

As at March 31, 2021 (the end of fiscal 2020), the Saitama Doctor-Heli operation had accumulated a track record total of 4,964 missions and had averaged nearly 500 missions a year over that and the previous four fiscal years.

MD 902 Explorer JA6914 takes a well-earned rest at Saitama Medical University Hospital in the
town of Moroyama, December 2019. (Photo: なぎさ via Twitter @KatanoNagisa)

A Hirata Gakuen EC135P2+ when assigned to the Shiga operation, one of seven under the
Union of Kansai Governments. The Japanese on the tail is Yurikamome (Black-headed Gull),
the aircraft’s name. (Photo [July 2016]: 大砲鳥 via Twitter @taihoudori)

For four years from April 27, 2011, Shiga Prefecture had shared in the operation of the Osaka Prefecture Doctor-Heli. The now Keiji (Kyoto-Shiga) Doctor-Heli covers all of Shiga and the southern part of Kyoto Prefecture as one of the seven Union of Kansai Government operations.

Taken from the lyrics of a song written by the facility’s founder, the dew on nadeshiko (dianthus or
pink flower) emblem was adopted by what is today Saiseikai Shiga Hospital in 1912 and nowadays
also graces the cockpit doors of the based helicopter. (Image: Saiseikai Hospital website page)

The Central Helicopter Service website provides details of the period of simulated rehearsal training designed to ensure a smooth start that to operations. In the case of the Shimane operation, this took place between April 25 and May 30, 2011, so ending two weeks beforehand. For part of the first day’s exercise, having received a request for assistance from the fire department, the helicopter departed the network hospital. Via a brief stop at the fire department HQ, the crew proceeded to the landing area in a local elementary school that was being used as a temporary base, arriving within 30 minutes.

The badge on the tail of BK117C-1 JA6659 serves to date this photo. It was the summer of 2018
when the Lions Clubs International marking temporarily appeared above the names of the
three Lions Clubs in the city of Izumo. They were marking their 10 years of support
for the introduction and operation of an EMS helicopter in the prefecture.
(Photo : さばちゃん via Twitter @shimanepolice3)

At the time of its seventh anniversary on June 13, 2018, its mission tally had stood at 4,543, having reached the 4,000 mark on June 5, 2017; the 5,000th mission was completed on May 8, 2019.

From its base at Izumo-Enmusubi Airport, the Shimane Doctor-Heli operation can reach
the furthest points in the south of the prefecture 40 minutes after receiving the request for
assistance. When the need arises, cover is provided for and by its network counterparts in
Mie and Tottori prefectures. (Photo [2018] : さばちゃん via Twitter @shimanepolice3)

(Photo [Izumo-Enmusubi Airport, May 2021]: 満緒里殿 via Twitter @maorin175)

On June 13, 2021, a photo call was held as part of the events marking 10 years of Shimane operations (link). The base had recorded its 6,000th mission three months before, on March 10.

A pilot’s eye view of Juntendo University Shizuoka Hospital
(Photo [Sept. 2019]: 順天堂大学静岡病院ドクターヘリ運用対策室 via Facebook
@JuntendoShizuokaDrHeliTeam)

When sent on a mission, the Juntendo flight crew of a pilot and “heli-doctor” mechanic never varies.
Meanwhile, back at base, a flight control manager called a CS (communications specialist) and a
flight control office manager will be on duty in the hospital’s flight control room.
(Photo [July 2019]: 順天堂大学静岡病院ドクターヘリ運用対策室
via Facebook @JuntendoShizuokaDrHeliTeam)

In fiscal year 2020 (from April 2020 to March 2021 inclusive), the Juntendo Hospital-based helicopter was sent on 943 missions. The highest annual figure recorded so far is the 1,262 in fiscal 2018. A Central Helicopter Service news release dated July 29, 2018, announced that the cumulative total had reached 10,000 missions.

An on-site hangar naturally offers many operational advantages, not the least of which is negating
the need to fly to an airport to seek shelter at the first sign of a gathering storm. The fruits of
collaboration between the hospital, Central Helicopter Services, municipal and prefectural
authorities not to mention the construction company, the Juntendo hangar (link)
was formally opened at a dedication ceremony held on April 6, 2017 (link).
(Photo [June 2020]: 順天堂大学静岡病院ドクターヘリ運用対策室
via Facebook @JuntendoShizuokaDrHeliTeam)

The duty Nakanihon Bell 429 assigned to Seirei Mikatahara Hospital will normally carry two
identifying markings on either side of its engine cover: the stylized map of the prefecture that
doubles as Mt. Fuji (variations of which have been worn by Air Rescue Team helicopters)
and the hospital logo (below). (Photo: 東三指令の画像館 via Twitter @toyohashi51)

(Image: Seirei Mikatahara Hospital website)

Honda Airways’ EC135P2+ JA03HA parked in front of its hangar at Dokkyo University Hospital in
November 2016. (Photo: ジョウ via Twitter @nyjoems06s)

According to official operational statistics issued by the prefecture, in the year from April 2020 to
the end of March 2021, the Tokushima helicopter was sent on a total of 469 missions.
(Photos: [Top, Oct. 2019] だいすけ via Twitter @April10_2018;
[above, Nov. 2015] トリビュ－ンしこく [Tribune Shikoku] via Facebook)

Having commenced operations in October 2012, the Tokushima service moved to the joint operational control of the Union of Kansai Governments in April 2013. In principle, the service covers all of Tokushima Prefecture and the island of Awajishima in Hyogo Prefecture as well as parts of Wakayama Prefecture within a 100 km radius of its base hospital. Its aircraft is known as the Aiba-do (Indigo Bird).

Hirata Gakuen commenced operations on the Tokyo Metropolitan Government’s behalf in the Tama area of the city on March 31, 2022. The participating hospital is the Kyorin University Hospital in Mitaka in collaboration with Tokyo Medical University’s Hachijo Medical Center and the Tokyo Metropolitan Tama Medical Center.

Around a week before the start of full-scale operations, a Tokyo-based Doctor-Heli crew conducts
a demonstration in Ome, which lies in a rural setting in the far west of the capital.
(Photo: 東京都青梅市 via Twitter @ome_city_tokyo)

Based at Tachikawa when on call, the movements of the company’s BK117D-2 are coordinated from the Tokyo Fire Department Aviation Unit’s Tama Aviation Center. Operational cover is provided from 08:45 to sunset. A total of three locations in the city of Fussa, a sports facility and two baseball fields, serve as designated rendezvous points for transferring patients from an ambulance to the helicopter.

The Hirata Gakuen BK117D-2 (H145) initially assigned to cover the newly launched Tokyo
operation, JA903H carries the titling and green logos of the Tokyo Metropolitan
Government and Kyorin University Hospital on its cockpit doors.
(Photo [April 2022]: BOKA via Twitter @verandarw36)

Hirata Gakuen EC135P3 (H135) is taxy-hovered in the sun at Yonago Airport on the morning of
October 31, 2019. The aircraft carries the Japanese for Tottori University Hospital low along
the side of its fuselage and the name KANSAI Oshidori (Mandarin Duck) on its tail.
(Photo: RAM via Twitter @RAM_420C)

 The image that accompanied the March 4, 2015, AgustaWestland press release announcing the
selection of the Grand New for the Toyama operation, which commenced in
August 2015. (Photo: AgustaWestland)

Toyama operations were commenced by Shizuoka Air Commuter Corp. (SACC) and Kagoshima International Aviation Co., Ltd. They are now conducted by one of Toho Air Service Co., Ltd.’s Doctor-Heli aircraft, BK117C-2 JA173A.

The BK117C-2 that serves Toyama Prefecture sporting skis in February 2022. Originally registered
to manufacturer Kawasaki in March 2013, the aircraft’s ownership changed to Toho Air Service
that July and first sported the prefectural flag emblem and kanji for Toyama Prefecture on
its cockpit doors in March 2021. (Photo: nc39 306 J50 np via Twitter @306Z33)

(Photo [Tokyo Heliport, Dec.2021]: ヘリ三味 via Twitter @MH53E_Seadragon)

On January 1, 2003, Wakayama became the seventh prefecture to commence Doctor-Heli
operations. Its 6,000th accident-free mission was notched up on February 5, 2019.
(Photo: ECCM Center, Wakayama Medical University via Facebook)

Two photos of past and present Yamagata aircraft; that above of Toho Air Service EC135T2 JA32KC
taken in December 2012, that of current outsourced operator Tohoku Air Service BK117C-2
JA117B (below) in April 2022. Note the different positioning of the mountain peak design
from the prefectural flag and the logo promoting locally grown Tsuyahime organic rice,
as carried on the prefecture’s distinctive AW139 rescue helicopter.
(Photos: Yamagata Prefecture via Twitter @pref_yamagata)

In the fiscal year from April 2021 to March 2022, the Yamagata operation was called upon a total of 259 times. Of those, 205 involved attendance at the scene, 17 were interfacility airlift flights and the remaining 37 operations were cancelled and the crew stood down after the request had been received.

Unlike Yamagata’s AW139 rescue helicopter, the Doctor-Heli aircraft now wears the logo
promoting a different rice brand (Yukiwakamaru) on the right side of the aircraft.
(Photo [Mar. 2022]: 飛行機・鉄道大好きな人via Twitter @kimi_boku_anata)

(Photo [Yamaguchi-Ube Airport, June 2018]: れんしvia Twitter @Kirara21YA)

(Image: Yamaguchi University website)

Not too clearly seen in the above photo, the green marking on the cockpit door of JA6925 is the Yamaguchi University logo (above). The university website states that the design represents the bud of learning that “fosters education and research that values individuality, and will open wide to the world.” The aircraft also carries a predominantly pink, Hello Kitty-type nurse figure on the doors (link).

Nose weather radar-equipped JA6916 sits on the helipad at Yamaguchi University Hospital in
September 2016. This aircraft was provided by Aero Asahi as a temporary replacement
while JA6925 was away on overhaul. (Photo: いおりvia Twitter @jasiori)

Assigned to Yamanashi Prefectural Central Hospital in September 2021, presumably drafted in
while the JANET aircraft was undergoing an overhaul, was this Hirata Gakuen EC135T2.
(Photo: TA_KU via Twitter @ta_ku_nkn073)

On occasions from 2016 to 2018, the Yamanashi operation also utilized the EC135T2+ then owned
by SGC Saga Aviation as a stand-in.
(Photos: エス・ジー・シー佐賀航空株式会社[SGC Saga Aviation] via Facebook)

Doctor-Heli Operation Start-ups by Year

2001 (3)
Okayama (Apr. 1), Chiba (1/2 [North] Oct. 1), Shizuoka (1/2 [West] Oct. 1)

2002 (3)
Aichi (Jan. 1), Fukuoka (Feb. 1), Kanagawa (July 1)

2003 (1)
Wakayama* (Jan. 1 )

2004 (1)
Shizuoka (2/2 [East] (Mar. 15)

2005 (2)
Hokkaido (1/4 [Sapporo] Apr. 1), Nagano (1/2 [Saku] July 1)

2006 (1)
Nagasaki (Dec. 1)

2007 (1)
Saitama (Oct. 26)

2008 (3)
Osaka* (Jan. 17 ), Fukushima (1/2 [Fukushima City] Jan. 28), Okinawa (Dec. 1)

2009 (5)
Chiba (2/2 [South] Jan. 19), Gunma (Feb. 18),
Aomori (1/2 [Hachinohe] Mar. 25),
Hokkaido (2&3/4: [Kushiro] Oct. 5; [Asahikawa] Oct. 12)

2010 (3)
Tochigi (Jan. 20), Hyogo (1/3 [Toyooka* ] Apr. 17), Ibaraki (July 1)

2011 (6)
Yamaguchi (Jan. 21), Gifu (Feb. 9), Kochi (Mar. 16), Shimane (June 13),
Nagano (2/2 [Matsumoto] Oct. 1), Kagoshima (1/2 [Kagoshima City] Dec. 26)

2012 (11)
Kumamoto (Jan. 16), Akita (Jan. 23), Mie (Feb. 1), Miyazaki (Apr. 1),
Yamanashi (Apr. 1), Iwate (May 8), Aomori (2/2 [Aomori] Oct. 1),
Oita (Oct. 1), Tokushima* (Oct. 9), Niigata (1/2 [East] Oct. 30),
Yamagata (Nov. 15)

(Uji City, Kyoto Oct. 1)

2013 (2)
Hiroshima (May 1), Hyogo (2/3 [Kakogawa* ] Nov. 30)

2014 (2)
Saga (Jan. 17), Hyogo (3/3 [Himeji] Mar. 22)

2015 (3)
Hokkaido (4/4 [Hakodate] Feb. 16), Shiga* (Apr. 28), Toyama (Aug. 24)

2016 (2)
Miyagi (Oct. 28), Kagoshima (2/2 [Amami-Oshima] Dec. 29)

2017 (3)
Ehime (Feb. 1), Nara (Mar. 21), Niigata (2/2 [West] Mar. 29)

2018 (3)
Tottori* (Mar. 26), Ishikawa (Sept. 24), Fukushima (2/2 [Futaba] Oct. 29)

2021 (1)
Fukui (May 24)

2022 (2)
Tokyo (Mar. 31), Kagawa (Apr. 18)

* Denotes one of the seven jointly operated by the Union of Kansai Governments.