From sinking boats to babies being born in the air, the Herald takes you behind the scenes of a team who saved hundreds of lives this year. Emma Russell reports.
A baby born healthy 1200ft above the ocean in the back of a helicopter.
Four fishermen life-jacketless saved from a sinking boat, two couldn't swim.
An erupting volcano, where 22 lives were lost.
A shooting that left a man, covered in blood, fighting for his life on a driveway in Blockhouse Bay.
These are just some of the triggering memories the crew at Auckland Rescue Helicopter Trust (ARHT) take home with them each day.
Some bring joy, others leave scars.
"Every rescue affects everyone differently, a rescue of a small child will likely affect those with young children more than someone without," ARHT chief intensive care paramedic Karl Taylor says.
As New Zealand enters peak rescue season, the Herald takes readers behind the scenes of a team who save hundreds of lives, often from tough terrain, each year.
Increased bird activity and hazardous cranes
It's 8am sharp and base manager and pilot Jason Haggitt has just clocked on for the day.
At Ardmore base, near Clevedon in South Auckland, he is seated in a computer room with a doctor, paramedic and two aircraft officers. It's a cloudy day with moderate wind, "not bad flying conditions".
Out the window is a glimpse of one of the two AW169 aircrafts dressed in bright red and yellow glossy paint. Each aircraft costs about $15 million, Haggitt reveals after four lower digit guesses.
Behind the shine, sits "the older one" which is "40 years different in design". It's named the BK117.
During the morning briefing, Haggitt - or Haggs as his comrades call him - discusses with his team possible weather warnings, increased bird activity at Auckland airport and hazardous cranes near Auckland City Hospital.
A matter of minutes
At any moment in the day, Haggs could get an alert on his phone from a 111 operator and have minutes to make a plan, prep an aircraft and take off to the mission. This happens on average, four times a day.
"If the hotline goes, anyone that's on the crew congregates and then we generally get them on speaker and find out what's going on so they can give us information about where it is, what it is, details about the patient's condition," air crew officer Callan Carn-Bennett says.
Last year, 1187 missions were completed by ARHT. Of those, 183 were outside the Auckland region, the majority being in Whangarei, followed by Hamilton, then Tauranga.
About $5000 of community funding is needed per mission. That money goes towards staff, equipment, petrol and helicopter maintenance.
"The room comes alive when the weather is really stormy, because sure there is a patient that's sick but we have to work out if Haggs can safely fly up and get from point A to point B," Carn-Bennett says.
Haggs has to make a decision about the most appropriate crew to send - whether that's a doctor and an intensive care paramedic or two intensive care paramedics.
Cameron Rosie is one of 19 Auckland doctors who takes time away from the busy hospital emergency room to help fill 60 rescue mission shifts a month.
"It's a nice balance to be able to jump between the emergency room and rescue helicopter missions, it gives you an insight into pre-hospital care which a lot of my colleagues who only work at the hospital don't get, for example, you had to get the patient down three flights of stairs, how does that actually work?"
Having a doctor on board meant the crew could provide more treatment on the ground before transporting the patient to hospital.
"I remember being told, by a very junior ambulance service person, that a doctor is often the worst person to have at a rescue job because they have no context of scene. Unless they are trained to fit in as part of a team," Rosie says.
Without Stefan Gabor - an intensive care paramedic (ICP) - Rosie's job would be extremely difficult.
As the pair wind each other up, clearly spending a lot of time working together, Haggs explains the relationship between the ICP and doctor being like an architect and a trades person, they both have equally important roles.
"The ICPs are really good at working with what they've got.
"It's really cool to watch the ICP and doctor work together. I'm challenged to put a bandaid on, but they really bounce ideas of each other, 'what do you think of this', 'this is what I'm thinking', to provide the best care for the patient," Haggs says.
Gabor says: "To get someone who is having potentially the worst day of their life, to get them out of there requires all of us to work collaboratively."
Life or death
Two years on, the Whakaari / White Island eruption still sticks out in the crew's minds.
"It was a massive day, the scale of the task was huge ... it was a big national event, mass casualty," Haggs says.
"It was particularly hairy because we were talking to pilots on the ground who fly there regularly and they were giving suggestions on where to land but they weren't familiar with the size and scale of the helicopter and so trying to assess the risk and whether it was safe was really tough.
"I remember someone saying 'well it's just erupted so that would have released the pressure' and thinking 'well do you know that for sure, could it erupt more?' ..."
In the end, they rested their back wheels on the shore line and were on the island for only 50 seconds while they unloaded a doctor and paramedic, Haggs says.
"At the time we had landed, we were under the impression there were still survivors left on the island.
"We searched the coastline ... we were getting to the point we needed more fuel and departed back to mainland. No more patients were brought to hospital," Haggs says.
Whakatane Hospital became quickly overwhelmed so it became a matter of transferring patients, he says.
"We took an American tourist back to Middlemore and she perished before Christmas, five weeks later, so that brought it home."
But that horror didn't stop the team from continuing to carry out life-saving missions.
Cardiac arrests were the most common medical callouts and the most frequent accident missions were car crashes, followed by farm-related accidents such as tractor rolls, people harmed by machinery and falling off horses or quad bikes.
Summer was the busiest season with all accidents increasing and more people out on boats getting into trouble.
The Firth of Thames rescue, back in February, was a good reminder to wear a life jacket at sea, Haggs says.
Four people were out on the water east of Auckland when their boat sank. No one was wearing a life jacket and two couldn't swim properly.
At about 6pm that day ARHT was called.
"We put a policeman in the water to help them stay afloat," Haggs says.
"It was a successful outcome but it so nearly wasn't. It reminded us how important it was to get away quickly."
Another harrowing day cemented in their minds was a shooting in Blockhouse Bay where a male patient was left on a driveway in a critical condition.
"That was horrific," Gabor says.
Taylor says: "After every significant mission we carry out a debrief. The whole team looks out for each other and we always reach out if we think a member of the team is struggling. I personally find a lot of benefit discussing missions with my colleagues."
And every now and then, the crew get to welcome a baby into the world - sometimes 1200ft above the ocean.
"Ideally you don't want a woman in labour to give birth in the back of a helicopter, particularly if there's complications, so if there is a road transport option that would be first choice but sometimes that option isn't there."
It takes just six minutes to get to Waiheke Island, where a mum in labour was picked up and gave birth while in the air on Sunday, October 18 soon after 6pm.
The mum was planning to catch the ferry to give birth at Auckland City Hospital but she went into labour 10 days early.
"That was a pretty special day," Gabor says.