The healthcare company that is on constant alert

Arnaud Vaissie sleeps well. This is despite overseeing International SOS, the medical and security services company he co-founded, which treats sick employees of multinationals and non-governmental organisations in 92 countries around the world. The company is on constant alert for the need to evacuate in times of disasters, man-made and natural.

"The nature of the job is to be involved in crises," he says. "To lead a company you need to be relaxed. If not, you can die of stress . . . The bad news comes often and the good news doesn't because nobody informs [you] the [bad news] has been dealt with."

The 60-year-old Parisian ("I am a Parisian all through") shuttles between his home in Paris and the London office (the company has dual headquarters there and in Singapore) where we meet, in a modern business park in Chiswick, west London. Away from the chief executive's office - a big, sparsely furnished space - is the hub of operations. It is a vast room dotted with TV monitors and maps. Doctors, nurses and security specialists are on the phones offering diagnoses and security advice to members. The stalking terror is for a critical call to go unanswered.

Mr Vaissie used to carry several phones with him to monitor news and information sources but kept leaving them behind in taxis so now has just one. If a team disagrees on the right course of action, the Corporate Assistance Department adjudicates, "Always by phone so that it's not lost in messages," he says.

Video consultations are arranged for gas and oil workers on oil rigs, exploring teams in the Arctic and remote miners. Companies pay a membership fee. Big operations, such as evacuations, cost extra.

A team was deployed to the Pacific island nation Vanuatu last month, after Cyclone Pam ripped through the Pacific archipelago. The medical staff searched hospitals and disaster centres, looking for International SOS's 400 members in the area, working for 27 NGOs. The company helped out when two helicopters crashed in Argentina, killing 10, including three French sports stars, involved in a French reality TV programme. International SOS, which had been appointed by the production company, flew in post-traumatic stress disorder counsellors and a Spanish-speaking specialist to repatriate the victims' bodies.

The most recent large-scale evacuation was in 2011 during the Arab Spring when 3,000 expatriates were flown back home. The most stressful was the Indonesian unrest in 1998, when President Suharto was forced to step down. All the commercial airports were closed but the company managed to secure space in a military airport, flying more than 4,000 people to Singapore. The incident taught Mr Vaissie of the need to provide security services (the operation had been patched together by medical staff) and that they had to plan and identify such incidents earlier.

More typical cases are those such as a recent one in which a child in Nigeria swallowed a penny. The local doctor suggested airlifting her overseas but the mother took a picture of the X-ray and sent it to the International SOS doctors who suggested they let nature take its course. The penny eventually dropped.

Mr Vaissie's childhood ambition to follow his father into medicine was replaced by a vague interest in business. After graduating from Sciences Po in Paris, Mr Vaissie worked for Germany's Clou, a vehicle leasing company, in France. He later moved to San Francisco to run Clou's US subsidiary, Compass, just as the dollar plummeted against the franc.

"It was a good thing to be an expatriate in San Francisco at the time", he laughs. Mr Vaissie also enjoyed the US because of its attitude to innovation. In France, he says, innovation is seen negatively, as risk.

In 1985, his childhood friend Pascal Rey-Herme, a doctor who had completed a stint as medical attache to the French embassy in Jakarta, came up with the idea of setting up an emergency medical system in Singapore and Jakarta to help expats in the region. Mr Vaissie put together the business plan and $100,000 of investment, principally his own savings.

The two however made a serious mistake which "nearly killed us", reflects Mr Vaissie. They decided to establish a house-call system. It was, he says, "fantastically effective technically" but nobody wanted a doctor to visit their home. "Asians, British or Americans, when they get sick they go to the emergency room. Whereas in continental Europe it's common. It was available, it was working, but it was not used." So they created a medical centre instead.

Timing was important. The 1980s and 1990s heralded a surge of foreign direct investment in southeast Asia. "All those people wanted a system to help their employees across the region," he says. In 1998, the pair bought their main competitor, SOS Assistance. Based in the US, it gave them a global client database.

Over the years their services have become less about western expats and more for local populations. "We manage more healthcare for local [employees] than internationals," he notes. Last year, he says, the company saw turnover of $1.5bn.

The company becomes vulnerable when multinationals make cuts to their workforce and employee benefits. The 1997 Asian financial crisis saw a drastic reduction in business in the region. More recently, the company has been hurt by slowdowns in the mining and oil sectors. So International SOS has spread itself geographically and across industries to protect itself from peaks and troughs in any one sector or locality. Its single largest client is the US military.

With so many employees (11,000 across the world, of whom 5,600 are medical professionals) there is also a risk to their safety. Two employees were killed in the bombings in Bali in 2002.

The company remains private, in large part because Mr Vaissie enjoys the freedom for long-term planning. "It takes a huge amount of time to recruit and train people, so the last thing we want is to let people go [in a downturn]. If you are a publicly listed company, you are under very strong [pressure] to react extremely quickly."

Nobody goes into medicine to sit on the end of a telephone, admits Mr Vaissie. The appeal, he says, is "we are offering [staff] a way of practising medicine where the world is their playing-field".

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