Tairāwhiti's rescue helicopter service is sounding the alarm that lives are at risk due to its inability to fly in low cloud.
As early as last week, it had to abandon a potential rescue of people in need of help.
Eastland Helicopter Rescue Trust said it needed up to $20 million for a new chopper, and it was becoming urgent with the region's roads continuing to crumble - leaving no other way in or out of some far-flung communities.
Ngāti Porou Oranga director of health Sonya Smith painted a picture of what East Coasters were dealing with.
"Locals ferried a whānau member across the river due to the broken bridge, and the helicopter couldn't fly in."
They were trucked out by an ambulance on dodgy roads.
"That was the delay in care, so that normally would have been a helicopter transfer for quite an acute, serious presentation."
People were anxious in an emergency already, said Smith - and that was made worse with the worry that an ambulance or helicopter might not even reach them.
The fact the Eastland Helicopter Rescue Trust's chopper cannot fly in low cloud was a big issue - and it made the region a dangerous place to live, said chair Patrick Willock.
"With the ongoing fragility of our roading network, and the increasing regularity of these weather events, it's becoming more and more critical."
The trust faced a three-pronged problem.
First, Tairāwhiti flight paths only allow for flying under what are called visual flight rules, that require a certain amount of visibility - and when there's not enough, they were forced to abandon mission.
So, they need new routes to be built - which is done digitally - that allow for what are called instrument flight rules, which are in place in other parts of the country.
"The helicopter can respond to that, and the pilots are trained to fly under instrument only, so they can get through when the cloud is low," said Willock.
To do that, they needed a new helicopter which is properly equipped.
But that came with a $20 million price tag - and service contracts with Te Whatu Ora and ACC were too short to get financiers on board, he said.
"We battle away, we get hugely supported, you know we have a community that supports us amazingly, but that's for the small stuff, it's when you get into the big stuff that we just don't have a chance."
Ministers were well aware of the need, said local MP Dana Kirkpatrick, who used to work for the trust.
"When I spoke with them they were definitely keen to make sure that this was looked at and my understand was that Te Whatu Ora, or Health New Zealand, understands the issues, accepts that the service is critical, and wants to support it - and that we will be working on that."
Further south, Hawke's Bay Rescue Helicopter Trust general manager Ian Wilmot said it would be putting pressure on the government to come to the party - because it too needed a new helicopter.
"To commit that amount of community money you'd probably want a 10 year contract, so you've got the certainty you've got the contract to provide the service," said Wilmot.
Te Whatu Ora told RNZ it acknowledged short-term contracts could be a constraint, and it was working on establishing contracts that last at least 10 years.
Some funding was available for new instrument flight rules routes to build resilience in cyclone-affected areas like Tairāwhiti, it said.
But it was focused on supporting Eastland Helicopter Rescue Trust's more immediate needs, like helipad and fuel infrastructure upgrades.