A patient is transferred from the air ambulance to a road ambulance at Whanganui Airport.
"Whanganui's best-kept secret" is how Dean Martin describes the company he works for - and it's also one of New Zealand's best keepers of secrets.
Dean is the chief executive at Air Wanganui Commuter Ltd (Air Wanganui), a company founded 31 years ago that largely flies under the radar despite the crucial service it provides and the high-profile passengers it carries.
Air Wanganui is a privately-owned business that started out as a personal charter service with one Baron aircraft. It later bought a Mojave aircraft and began providing charter flights for local businesspeople. However, its main focus for the past 21 years has been providing air ambulance services, primarily for the Whanganui District Health Board.
"It was one of the first air ambulances in New Zealand, apart from Life Flight which was based in Auckland at that stage," Martin says.
"Twelve years ago the company bought the C90 turboprop which is a lot faster, slicker and is pressurised. Then a year-and-a-half ago it purchased a Super King Air 200 turboprop which can carry nine passengers. It is also set up to do air ambulance work and can carry two stretchers whereas the C90 takes a single stretcher."
Air Wanganui operates 24/7 - staff have to be ready to go at any time for air ambulance, organ transfer and charter work.
The company has seven staff, a few of them part-time, and has just employed another pilot because of the business' growth. From time to time, they need to use casual pilots and for charter work have to have two pilots on board.
The King Air C90 is predominantly used as an air ambulance but can be configured for charter flights. It takes about 90 minutes to reconfigure an aircraft between the air ambulance and charter flight set-ups.
The air ambulance is the "backbone" of Air Wanganui's services, Martin says.
"We fly about 600 patients a year in and out of Whanganui, transferring them anywhere from Dunedin to Auckland hospitals but predominantly to Wellington.
"We have a close association with Life Flight in Wellington. We are their back-up aircraft and we also work closely with Taranaki District Health Board. Because hospitals these days are quite specialised with the services they provide, we go all over New Zealand. I think since I've been here we've been to every DHB location.
"Often the first people know about Air Wanganui is when they are lying on one of our stretchers looking up at us. We're Whanganui's best-kept secret. When you tell people you work for Air Wanganui, usually they say 'who?'"
So far this year the air ambulance has transferred more than 220 patients.
A lot of the work is taking patients to Wellington Hospital for angiography services and often there is more than one patient on board. The King Air 200 can transport two patients on stretchers and three more seated.
"They look really sick when we take them down there and then we'll pick them up the next day and say 'are you the same person?' because they look so much better."
Whanganui DHB has nine flight nurses who work a 24/7 roster to care for air ambulance patients but Martin says many DHBs don't have that local support and have to rely on services outside their region.
The organ donor work involves flying surgical teams around the country.
"We fly to Auckland, get the surgical team and take them anywhere in New Zealand to harvest the organs. We do one, or sometimes two, of those a month.
"Two planes are needed to transport the surgical teams. One takes the major organs and the other takes the minor organs. There can be planes from Australia as we have a reciprocal arrangement to share organs in New Zealand and Australia.
"A lot of it happens at night so we'll get a call and have to be ready to go in half an hour.
"Generally, it's a six to eight-hour round trip. Our last two jobs have been to Dunedin. We're generally on the ground for six hours and then we take the surgical team back to Auckland."
The Wanganui Air Ambulance Trust, which is separate to Air Wanganui Commuter Ltd, does all the fundraising for the specialist equipment like the stretchers that are in both aircraft.
Rex McKinnon is the chair of the trust and has worked closely with Air Wanganui Commuter Ltd to ensure they have the best equipment available, Dean said.
Air ambulance services are currently under review by NASO (National Ambulance Sector Office), which is proposing to cut several helicopter services, but Martin says there is no indication yet whether Air Wanganui's air ambulance will be affected.
"Our focus is to continue to supply the service we have given to the Whanganui and outlying regions for the last 21 years. NASO have announced the helicopter service review but not what's happening with the fixed wing service. It would be devastating for Whanganui if the service didn't continue here."
With an eye to the future and diversification within the business, Air Wanganui has increased its focus on the charter market in the past 18 months.
"When we got the King Air 200 we moved into the premium market for charter business," Martin said.
"Prior to the purchase of the new King Air our business was about 95 per cent air ambulance and 4 per cent charter.
"New business has grown substantially in the last 18 months. Now the split of the business is more like 75 per cent air ambulance and 20 per cent charter, with some other little bits making up the rest.
"We have flown some very high profile people who want to remain nameless."
When Martin says 'high profile', he's talking international celebrities and that's where the secret-keeping comes in.
So how does a small company in Whanganui attract some of the world's biggest stars to use its services?
"We've built a close association with Pacific Jets [a private jet charter airline that services the top end of the tourism market]. They have large jets based in Auckland but they can't fly into the smaller places like Kerikeri.
"Our aircraft can land at most airports around New Zealand. The 'golden triangle' for New Zealand charters is Queenstown, Kerikeri, Taupo. The runway in Kerikeri, for example, is too short for a larger aircraft to land.
"Pacific Jets may have flown people in from Australia and we pick up the smaller destinations. Most of the charter work comes through agents in Auckland – through Pacific Jets and Inflite Charters."
Wealthy international visitors book charter flights with Air Wanganui.
"The main period for charter work is from November to about April. The predominant users of the charter service are Russian, French and American.
"We recently flew a Russian family from their launch - we would call it a ship - in Auckland to Queenstown for 24 hours.
"At 10pm one night, we got a call to pick up some Americans from Auckland and took them to Napier.
"At Chinese New Year we get a lot of Chinese people in that period. They are generally going to Queenstown. We had one occasion where six ladies were flying around the country in a jet and our plane was flying behind them carrying all their bags. That is the sort of wealth we are dealing with.
"Air Wanganui has seen some strong growth in the last 18 months, driven by the charter market and the foresight of our board to purchase an aircraft that meets that market."
Another, very small, part of the company's business is flight training for pilots doing their Airline Transport Pilot Licence (ATPL). Air Wanganui has instructors rated for that level of training and is one of only a few airlines in New Zealand to provide it.
Martin is quick to praise the directors of Air Wanganui, who are keen to stay out of the limelight, for their commitment to the community.
"My background is in logistics and operations, not flying, but every young boy wants to play with planes and it's a great company to work for. The owners have been very generous and supportive of the community over the years and without their support Whanganui wouldn't have this fantastic air ambulance service.
"I think the success for Air Wanganui is that when we're needed they can ring the chief pilot or myself and we're ready to depart within half an hour, especially for hospital work under our contract with the DHB.
"It's exciting times for Air Wanganui. We're in a growth period so hopefully that will continue."