Foreign Parts: Flying Doctors laid low after fatal plane crash

The kerosene flares have been lit, the kangaroos have been chased off the dirt runway and a knot of people anxiously scans the night sky.

An hour later comes a welcome sight: a plane swooping out of the darkness to disgorge a medical team on another Outback mission.

Seventy-four years after it was founded to provide a "mantle of safety" for residents of the vast Australian interior, the Royal Flying Doctor Service remains a lifeline to far-flung cattle stations and remote Aboriginal communities. But the service, an Australian icon that inspired the television soap opera The Flying Doctors, is suffering low morale because of the death of a pilot in a recent accident.

Brian Smith, 54, was killed when his Beechcraft King Air B200C crashed into pine trees at Dismal Swamp, South Australia. The plane was heading for nearby Mount Gambier airport to transfer a little boy to Sydney for a kidney transplant, but came down three miles (5km) short of the runway. A flight nurse, Alice Brennan, was unharmed.

Mr Smith was an experienced pilot with 15,000 flying hours; the aircraft was only 11 years old and well maintained. Poor weather is suspected to have caused the accident, which has served as a reminder of the perilous conditions under which the Flying Doctor operates.

Tropical storms, dust clouds and severe turbulence are frequently encountered by the 44 planes that fly from 20 bases around Australia. Animals are another danger; a Flying Doctor aircraft made an emergency landing after hitting a kangaroo soon after the Mount Gambier crash. Another plane was damaged in a collision with an emu.

Staff at Mr Smith's base in Port Augusta, South Australia, are in mourning. "People are badly shaken," said Tony Wade, the base director. Astonishingly, it was only the second fatal accident since the service was founded in 1928 by the Reverend John Flynn. A pilot died in a crash near Kalgoorlie, Western Australia, in 1981.

Mr Flynn, a roving Presbyterian cleric, was horrified by the number of deaths among Outback dwellers who travelled for days and weeks to reach medical help.

In the early days, the Flying Doctor operated with one fabric-covered biplane. It grew into the world's first comprehensive aerial medical network and last year made 43,500 flights. It holds primary healthcare clinics as well as doing emergency evacuations and deals with a range of illnesses and injuries including premature babies, broken bones, spider bites and gunshot wounds.

The working conditions, which include extreme heat, are a challenge. Judy Whitehead, a senior flight nurse, said: "The plane fills up with flies and the turbulence can be absolutely horrendous. You give the patient an injection and try to avoid stabbing yourself as the plane bucks and rolls around the sky."

Rod Mitchell, a senior medical officer, landed on the Stuart Highway in central Australia to attend a motorbike accident last year. "The plane came in to land with only inches of space on each side of the wheels," he said.

Most cattle stations have built an airstrip. Sally Lightburn, whose daughter, Jessie, gave herself an electric shock when she was 18 months old, said: "Her heart stopped. She wouldn't be alive today if it wasn't for the Flying Doctor."