Symptoms and treatment - a day of Bike Guide on cruise ship

Working as Bike Guide on a cruise ship, one learns to deal with injuries and then giving first aid in minor cases regularly. But how to react  when the symptoms are unusually different?

Cycling along the Corniche in Alexandria

 I have the privilege to visit almost every port along the itinerary by bike.  However, there are few exceptions, usually due to safety reasons, where  the Bike Team  support  Shore  Excursions as tour escort. One of  them is Safaga in Egypt.

Lonely horse in Safaga

 On a bus transfer to Hurghada, which take about quarter an hour, the local tour guide  did his best to entertain the guests. Upon  arrival he stepped out of the bus and bit later talked to a couple.  It was still warm - about 28°C.

All of sudden, one  older lady fold herself down like in a spiral. Her husband and the tour guide tried to lift her from the ground. Witnessing this happening from the  bus,  it took only a while  to reach her.  I spotted a grimace on right side of her face. Even though she could communicate,  I got very strong feeling that it looked like a light version of stroke.

The bar tender  from  nearby café brought a chair and she was lifted into it. Even though it was late afternoon, the sun still hot, so she was  repositioned into shadow.

However, local guide thought that in this  case similarly as so frequently holidaymakers from Europe, she just got a shock from the  heat.  And elevated her  legs. 

Still  responsive, she moaned to leave her calm and to lower her legs.  To me, it was clear sign that the problem might be with the brain.

 As the pain did not  ceased, her friends and husband decided to return on their own cost  back to ship - as they  hoped to receive  better medical care from board  hospital.  The Egyptian guide supported their  decision as he had very  little trust to Egyptian medical care - or simply wanted to have them finally away...

Corniche in Safaga

The story goes on.  The initial consultation at board  MP resulted in recommendation to rest as they  thought it was just an exhaustion.  However, as the pain persisted, the very  next day she  was flown shoreside as by then the symptoms of stroke  and the related pain could be treated only in proper  hospital.

Honestly, the only medical training I passed was the First aid course in Austria,  but the symptoms for me were unambiguous. Sometimes I refresh my knowledge with the free android app from Austrian Red Cross.

How would you react in such a situation? 

What do you think would be a proper action in this case?