Free Medical Training for Media Production Companies working in Remote Locations

Medical Training for Media Production Companies

December 3rd 2009
09.00 – 13.00

Royal Geographical Society, London

This is a free training seminar, limited to 25 places, for people involved in filming or media projects abroad in locations where medical cover is not close at hand. It will highlight the biggest risks and you will learn how to administer immediate care and the importance of including the medical provision in your planning.

Anyone who is part of a media crew or production company working on location abroad in remote environments or who is filming and photographing adventurous activities.

Interested?   Then contact Piers Carter on  Piers@expeditionmedicine.co.uk  or  07801 104604

Expedition and Wilderness Medical Training

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Cervical collar or SAM splint in a pre-hospital wilderness environment – Dr Sean Hudson reviews

For some time there has been a debate about the value of cervical collars in the pre-hospital wilderness environment. A recent article has lent weight to the ‘don’t take collars on expedition’ protagonists.

The recent journal of Wilderness and Environmental Medicine: Vol. 20, No. 2, pp. 166–168 compares a molded SAM splint as a collar with the traditional philadelphia collar.

The SAM splint was simply wrapped and molded around the C spine. and degrees of movement of the C spine were tested in all planes.

They found no significant difference in the ability of the 2 collars at limiting movement of the cervical spine. Podolsky and colleagues, in a prior study, found that the Philadelphia collar is as effective as numerous other collars available for cervical spine immobilization.

None of these devices has the broad range of uses that can be performed by a SAM splint (in addition to limiting movement of the cervical spine) The ability to carry one universal device for so many different medical conditions is one of the advantages of the SAM splint. This study helps to validate the practice of using a SAM splint as a universal splint for environments with limited medical supplies.

For more information on Expedition and Wilderness Medicine visit www.expeditionmedicine.co.uk.

Wilderness Medicine resources and training courses.

Volunteering in Zambia

 

Life In Luangwa , Zambia

“Doctor Emergency”! I had seen the blood spattered wheelbarrow parked on the veranda that served as the waiting room and now the sign of the shuffling flip flops told me I was about to meet its occupant. He entered the room uncertainly, supported between his two inebriated friends. The blood soaked tea towel adorning his head giving a big clue as to his presenting complaint. Removal revealed a 7inch gash across his forehead down to the skull. His helpful friends informed me it had been inflicted by an axe, two nights ago, in a fight and they excitedly asked me to examine his leg which had been stabbed by a spear.

The Life-Line Clinic, Namibia | Job Oppurtunity

Namibia Medical volunteer
This challenging programme offers you a unique opportunity to work at a small, rural Bushman clinic in Africa and make a difference to the lives of those in most need.
N/a’an ku sê is a unique and special place in the heart of Namibia which is committed to conserving wildlife and improving the lives of the Bushman community. Live your African dream and help make a difference by volunteering at our Lifeline Clinic.

About N/a’an ku sê’s Lifeline Clinic
• Bushman are treated as third class citizens and live in extreme poverty
• Adult onset diabetes, cardiovascular disease and cancer are sharply increasing in Bushmen and alcoholism has become prevalent
• Many Bushman children suffer from malnutrition, disease, discrimination and abuse

The N/a’an ku sê Lifeline Clinic was set up in 2003 to address the needs of the rural indigenous communities in Epukiro, a remote part of Namibia. The demand for a basic but comprehensive health service became apparent to medical professionals working in the area when they witnessed the tragic and unnecessary death of a young child due to the failure of ambulance service and hospital staff, largely due to the fact that the child was a Bushman.   This vital service relies upon the time and dedication of volunteers and donations from supporters to continue to run and serve the communities in need.

Heat related injuries in extreme desert conditions

Operating in extremely hot conditions creates a unique set of medical risks. In the link is the medical outline – for non medics, regarding those risks from the Namibia Ultra Marathon training guide.

DEHYDRATION
Dehydration is the most common heat related illness – in fact, it is thought that dehydration could be the single greatest threat to the health of an athlete. When training regularly and for long distances, fluid intake should be made a priority. You must drink fluids all day – not just during training. 

Don’t depend on feeling thirsty to tell you when to drink. Thirst is a late response of the body to fluid depletion. Once you feel thirsty, you are already low on fluids. The best indicator of proper fluid levels is urine output and colour. Ample urine that is light coloured to clear shows that the body has plenty of fluid. 

Dark urine means that the body is low on water, and is trying to conserve its supply by hoarding fluid which means that urine becomes more concentrated (thereby darker). 

Dehydration can be the cause of feelings of fatigue or exhaustion – at all times watch out for signs of dehydration and take on water regularly through out the day. 

Runners prepare themselves

Start line near Brandberg

Namibia Ultra Marathon

News just in…Namibia Ultra Marathon completed

We’ve just heard from the Namibia Ultra Marathon race director Steve Clark, that everyone is now back in Swakopmund. Steve said the race was very tough with temperatures getting up to 42 ºc. Winner Darren Roberts was very surprised and shocked to hear he won the race but once it sunk in he was delighted. Tom Adams very nearly caught Darren up at the finish line which made it a nail-biting finish.

Namibia 24-hr Ultra Marathon Results are as follows:

1st Place – Darren Roberts 20hr 28

2nd Place – Tom Adams 20hr 29

3rd Place – Tom Maguire 21 hr 05

4th Place – Emma Rogan 21 hr 27 – First female to complete the Namibia 24-hr Ultra Marathon

5th Place – Jerry Haywood 22 hr 30

6th Place – Nick Tidbull 23 hr 17

7th Place – Nicholas Wright 23 hr 45

8th Place – Helen Skelton 23 hr 50 – BBC Blue Peter Presenter

9th Place – Adrian Crossley, Stuart Moore, Kellie Power & Michael Skakesheff 25 hr 07. These guys all crossed the line together holding hands, they were all just outside the 24 hour deadline but all were allowed to finish.

Dr Amy Hughes will when she’s back write up about the medical situations she was faced with on the race and how people coped with the extreme heat.

Expedition and Wilderness Medicine partners with the Wilderness Medical Society of America

Wilderness Medical Society Approved Courses

All of Expedition and Wilderness Medicine Courses are approved for credit by the Wilderness Medical Society (WMS) for the Academy of Wilderness Medicine Fellowship Program (FAWM). For more information visit: http://www.wms.org The Wilderness Medical Society has entered a partnership with Expedition and Wilderness Medicine to offer you an opportunity to earn credits towards the WMS Academy of Wilderness Medicine Fellowship program (FAWM).

This is an exciting postgraduate qualification in Expedition and Wilderness Medicine which is likely to become the gold standard in this field.

What is the FAWM?

The Fellowship in the Academy of Wilderness Medicine is designed for individuals who want to be acknowledged for their professional achievement in Wilderness Medicine, and wish to validate their training for their patients, and clients. This initiative between Expedition and Wilderness Medicine and WMS offers a means to identify those who have achieved a demanding set of requirements. Society members enrol in the Academy and, by completing Expedition and Wilderness Medicine courses, receive credit for specific, identifiable experience, accumulating credit toward becoming a Fellow.

Any current member of the Wilderness Medical Society who successfully completes the requirements will have the distinction of being a registered member of the Academy of Wilderness Medicine and entitled to use the designation Fellow of the Academy of Wilderness Medicine (FAWM) and may reference it on resumes, business cards, and advertisements. The Academy maintains a demanding set of requirements that validates each member’s qualifications in wilderness medicine. C

andidates for the Academy participate in Expedition and Wilderness Medicine Courses and receive credit for the topics covered. When candidates fulfil the requirements of the Core Curriculum and demonstrate other required experience in Wilderness Medicine, they qualify to be reviewed to become members of the Academy with the designation “Fellow of the Academy of Wilderness Medicine.”

To find out more visit the Expedition and Wilderness Medicine website.

Local MP visits EML/ ATD HQ

The Rt Hon Oliver Letwin MP for West Dorset came to visit the Across the Divide headquarters and below is a copy of his impression written up for the Western Gazette.

 

I have seen the future – right here in West Dorset; and it is with us now.

If you want to see it too, you have to make a pilgrimage to Thorncombe (which happens to be the village in which I live)..

You have to go up the main street and turn off it down a tiny lane.  There you will find a barn.

Some time back, this barn was rather the worse for wear – and had clearly ceased to have the original agricultural purpose for which it had been constructed.

Today, it is as smart a building as any in West Dorset, or anywhere else in the country, for that matter.  Its stone positively glistens. It has splendidly restored beams, a magnificent set of skylights which are appropriately invisible from outside, cunningly inserted places for birds and owls to eat and roost, and wonderfully polished restored wooden fittings.

But it is not just a West Dorset stone barn brought back to life. It is also packed with  high-tech, eco-conscious design features. It has absolutely the latest air heat recovery system, a solar water heating system, and fixed line broadband as well as – for safety’s sake – a line-of-sight wireless broadband system,

Enter the barn, and you find yourself in a brilliantly equipped and ultra-modern office, with ranks of calmly efficient young people working on the latest computers and surrounded by remarkable works of modern art, chic glass and metal tables, and all the other apparatus of the fanciest and grandest of London city firms.

The only thing that differs from a London city office is that this barn, instead of being cramped into some tiny keyhole-space amidst the grime and noise of city life, is surrounded by some of the loveliest of West Dorset’s hills and by the charm of Thorncombe’s little streets.

The business that is going on in this remarkable environment is, in itself, remarkable.  Known as “Across the Divide”, it is an organisation devoted to arranging outdoor activities across the world for charities, voluntary bodies and corporations that are raising money for charities.  From all over the country, experienced travellers and skillful medics are brought together to lead expeditions that venture not only along the heritage coastline of Britain but also to the North Pole and the Amazon .

The range is vast: an expedition to refurbish a decaying school in South Africa; a tour of a great city by night; the ascent of some dangerous peak; wherever, whatever and whenever – and all quietly and efficiently arranged from this barn in Thorncombe.

Ten years ago, it would have been quite another matter.  Twenty years ago, it would have been quite impossible.  But today, with broadband communications (mercifully available in Thorncombe, unlike some other parts of West  Dorset), it can all be done exactly as efficiently as in a big city office, and with a vastly higher quality of life for those involved.

Those who say that rural areas are inevitably  going to be left behind in the fast-moving global economy should pay a visit, and repent !

Off road vechicle safety by our offroad guru in Namibia Faan Oesthuizen

Expedition and Wilderness Medicine recently ran it first highly succesful Desert Medicine course in Namibia and it was highlighted on the course that one of biggest dangers facing you in remote locations is actually the travel there and back in local transport.

Below Faan Oesthuizen of Kaurimbi Expeditions gives his top tips for defensive four wheel driving.

High lift jack demonstration

• Only place light bulky cargo on roof racks or high on vehicles in order to keep the centre of gravity as low as possible.
• Place heavy cargo low in vehicle load beds and as far as possible forward in order to distribute more weight onto the front wheels and avoid uncontrolably light steering response.
• Ensure that luggage is stowed where no damage to property may ensue.
• Ensure that all cargo is thoroughly secured in load bins or tied down to prevent loss of equipment and luggage while vehicle is moving or stationery.
• Driving on Gravel and Dirt Roads:  It is of critical importance that a speed of 80 km per hour is never exceeded whilst driving on gravel or dirt roads.  Speed will be further reduced when approaching curves or blind rises in the road, or when approaching oncoming traffic.
• Overtaking should be kept to a minimum whilst driving on gravel or dirt roads. Following distances will be kept sufficiently long as to ensure that driving in the front vehicle’s dust is avoided at all costs.
• Great care will be taken by all drivers to sufficiently reduce speed prior to entering bends or curves in the road, and that extreme control is maintained to prevent the vehicle from losing its traction whilst negotiating the bend.
• You should at all times ensure that you have as the absolute minimum 2 x 25 litre containers of water, a jack, spare tire, tow rope and jump leads

Remote wilderness medical cover in arid environments.

Kuiseb Canyon | Namibia | first decent

There are not many places left in the world that have not been fully explored but the Kuiseb Canyon located deep within Namibia Namib-Naukluft is one such place.  Its remoteness, inhospitality and lack of water have stopped easy travel though its hidden folds and preserved a landscape little influenced by outside influences.

However, recently an expedition to traverse its most inaccessible sections was mounted by former Namib Park Ranger Kobus Alberts from Namibia and veteran explorer and director of Expedition Medicine training company Expedition and Wilderness Medicine, Mark Hannaford. Starting at the Kuiseb Bridge and finishing at the Topnar settlement at Homeb its aim was to be the longest ever journey through the canyon and to record via video and photography the interior this remote area.

The main challenges to the expedition were expected to be very high temperatures within the canyon itself, expected to be in the region of 50 C, hyenas, a lack of water, the nigh time presence of marauding hyenas and the physical challenge of trekking 110 kilometres over difficult terrain. Preparation for the journey started the year before with special permission being kindly granted by the Namibia National Park Authority and the incumbent park manager Manie Le Roux and the preparation of the comprehensive route and safety plan. Given the lack of any sort of road in the area of the canyon – the impossibly of landing a helicopter within the narrow confines of the canyon itself the safety plan ended up being pretty simple – don’t get injured and if you do break a leg be prepared to wait four days before getting out.

The reality of the journey turned out to be somewhat different than expected, the 2008 wet season resulted in the much higher rainfall levels than normal with the plains surrounding the canyon erupting in a multi coloured carpet of otherwise dormant wild flowers and rather than a dry and water-scarce route the valley was flooded in some places wall-to-wall by a Kuiseb River in full flow. The flood water solved one problem of finding drinking water for the expedition but created a number of others. Quicksand and deep mud made movement in some areas virtually impossible without a massive effort or in some cases a long excursion up the side of the towering cliffs of canyon walls following meandering zebra trails. The manner in which these trails skirted obstacles and wended their way past seemingly impossible obstacles filled us with renewed admiration for the agility of the Mountain Zebras.

It was within ten paces of the start of the trek that we entered the river and seemingly we didn’t seem to exit it until four days later, we had expected the whole journey to take us about three and half days walking an average of about 30 kilometres a day – distances Kobus and I frequently walk together but this was based on a dry relatively flat canyon bottom with early morning starts resting during the hottest part of the day and then continuing on until the early evening before camping. The first evening saw us camping under a protective rock overhand a couple kilometres ahead of our schedule an in high spirits with our initial target reached and exceeded. The valley was still quite open and whilst the river was certainly flowing the banks on either side afforded us a good walking surface and the chance to spot the spoor of Gemsbok (Oryx), Hyena, Mountain Zebra and Springbok. Our main concern this evening was the presence of hyenas. The canyon has a well deserved reputation locally for large quite aggressive hyenas- campers recently at the tourist campsite near the dunes of Sesreim had been attacked during the night when camping without tents, so we were glad to have the rock wall at our backs and the rifle which Kobus had the pleasure of carrying for most of the expedition. Aside from the incessant drone of mosquitoes and a night time rain shower the night passed uneventfully.

The pattern of the next day set the template for the others – wake up just before first light at 05.30 and get the kit packed away whilst the stove boiled water for a single cup of coffee the kick start the day and to help wash down the three rusks – a type of hard baked biscuit which constituted breakfast, and then heading out as the sun rose and cast its welcome light in the gloomy corners of the canyon. This year wet season really was a bumper one and consequently the very high temperatures that we had been anticipating didn’t materialise and our days in the canyon followed a pattern of cloudy skies in the morning, burning off in the afternoon to give high temperatures for a couple of hours before giving way to an afternoon cloud build up and the first roll of thunder of surrounding storms in the late afternoon.

Camps where selected the criteria with the having our backs protected but also affording some sort of shelter from night-time storms. As we entered the canyon more deeply the walls close in on us and grew steadily higher and higher this had the effected of narrowing the river and we steadily lost the helpful banks being forced more and more often into the river itself – at one stage we did a two kilometre wade but we where soon presented with our biggest challenge of the expedition – quicksand. where the waters of the river where forced through narrower and narrower gaps the quicksand got deeper and deeper rising steadily up our legs, over our thighs until eventually we were stuck over our waists in a mixture of cloying sand and mud. It made movement extremely slow and tiring our hourly rate dropped to about 1.4 km an hour- at one stage seemingly completely stuck the only way to escape was to lie as flat as possible and crawl on hands and knees to the river back no mean task in a river with a heavy rucksack on our backs I can tell you!!

On the second day we only managed to cover 6 kilometres completely shattering any hopes of keeping up a 30 kilometre a day rate. Our original plan had been to scale the walls of the canyon to camp on its rim but the height of the walls – well over a kilometre tall in places just presented to much of a challenge at the end of hard days slogging through quicksand- the thought of filtering and then carrying five litres of water each on top of our already weighty packs up the steep cliffs also didn’t fill us with joy! That evening in camp Kobus and I discussed our options. The Google map (isn’t it great to able to get satellite imagery on the web) of the canyon showed the valley opening up further down its course- but we could not be sure how much would be flooded but hoped that there was a adequate river bank left to walk on- otherwise at midday on the next day we would be forced to climb out of the canyon – a challenge in itself, walk across the plains for 20 kilometres to road access at a park camping site at Zebra Pan. Whatever we decided our food would not last unless we started to ration it.The next day started with the usual narrow valley, steep cliffs and the now inevitable quicksand and Kobus and I had decided that 11 o’clock would our breakout point if we were not able to pick up hour speed but after an hour or so we got the break we needed as the valley opened up – the banks became visible and we were able to stretch our legs. The deadline passed with bearing a comment from the either of us as where now trundling our way rapidly down the valley – the canyon did narrow again and the quicksand did suck us back into its gritty folds but the joy of getting some distance under our belts has reassured us significantly and as the day went on the widening became more and more frequent. The day end total was 28 kilometres.

We left our overnight camp – if you can call two sleeping bags under a overhanging rock a camp, and continued down the canyon now painted by the red sands of the dune sea on its south bank and they grey of the rock desert on its north side – disturbing a large troop of baboons with some massive males feeding in the valley. As the valley broadened the wildlife, especially the birdlife increased significantly with large boisterous colonies of Cape Swifts’ enlivening the canyon with their raucous calls. Two snakes where spotted- both juveniles and both lying just of our track – a Western Banded Spitting Cobra which lifted itself and opened its hood in an irritable manner and more relaxed Horned Adder. The valley was now open and well vegetated along its banks with one of the issues now being able to find our way through the mass of fallen bands, flood debris and wild mustard stands but it allowed us to reach our end point at Homeb at 6 o’clock with tired backs, sore feet but with a massive sense of achievement.  

Sometimes a plan works, sometimes it adapts, occasionally its perfection… We took out packs off and within 15 minutes Kobus’ co worker turned up with our transport, and a cooler full of cold beer… bliss! 

 To find out more about Expedition Medicines Desert Medicine training course in Namibia visit the Desert Medicine page here