Desert Medicine Course – Damaraland, Namibia, August 2008

Namibia was the location for Expedition Medicine’s first Desert Medicine Course 

The dramatic landscapes of Namibia

2009 dates for Desert Medicine Course; 19th – 25th of April.

Author: Dr Claire Roche

A country famous for its Skeleton coast, an eerie graveyard of numerous shipwrecks which have fallen victim to its rough waters, home to towering sand dunes and of course Africa’s “big five”. Tucked away in South West Africa, Namibia is a country of mystery with a unique landscape and proved to be one of the worlds’ best possible locations in which to learn expedition medicine, desert style.

After undertaking a four day 4×4 self drive safari prior to the course I soon became aware that a lack of understanding of such terrain could have deadly consequences. Described by explorers as “hell on earth” and described in the bible as “the dust of death”, the desert environment can kill in a matter of hours.

A destination popular with European holiday makers and best enjoyed by taking self drive safaris, Namibia’s International airport is a hub of car hire companies. Tourists are pouring onto Namibia’s roads with no journey preparation or experience in handling 4×4 vehicles on off road terrain. This was demonstrated when I crossed paths with a group of four female German exchange students who ventured out to the popular beauty spot of Sossulvei dunes and petrified forest. They had hired the most economical car which was completely unsuitable to gravel roads (which make up the majority of Namibian roads outside of the major cities) and a momentary lapse of concentration resulted in the car sliding out of control, ending up on its’ roof in a field bordering the road. Fortunately no passenger was injured and help passed within the hour but this daily occurrence on Namibian roads has claimed the lives of many tourists and locals. We exchanged stories at a desert lodge as only the previous day I too managed to end up stranded after our 4×4 became lodged in sand whilst visiting the same area. Our only saving grace was that this occurred in a popular area where passers-by stopped to help within half an hour, however if this was to have happened two days previously whilst we had been traversing similar terrain in a desolate area of the skeleton coast I dread to think of the possible implications, especially as the day was drawing in and we had not seen another car in several hours.

Namibia is home to multiple tales of travellers making the mistake of leaving their vehicle to find help and falling victim to temperatures of 50 degrees and limited water availability. Prior to starting the course my experiences made me desperate to feel self sufficient in this unforgiving environment should I ever have the misfortune to be stranded.

Male Namib Rock Agama, Damaraland - Namibia

Base camp for the course was a 5 hour drive from the capital city of Windhoek to the Brandberg Range, in a region named Damaraland in the north west of Namibia. The first thing I noted was that the term “desert” was an umbrella term for multiple types of terrain. Besides the obvious rolling sand dunes, deserts can be dry, barren and rocky areas or vast, open, dusty plains extending for miles. In this location there was no readily available running water, electricity or mobile phone signal. Just 20 single man tents surrounded by a jaw dropping backdrop of the surrounding desert. From my previous Expedition Medicine experience of Polar and Jungle courses, once again, they had excelled themselves in choice of location for their course. As the sun went down and poured its’ pink heart into the desert floor we sat around natures’ television, warmed our feet and listened to what was planned for the first desert medicine course over the coming week.

We were led by our fantastic guides: Volker, Faan and Korbus, on our first of many desert treks. A ten hour “stroll” in 45 degrees of heat, across plains and gorges. We learnt how to navigate our way using GPS (global positioning system), maps and compasses but the first skill we had to obtain was that of finding water in this apparently bone dry environment. We headed for gorges and began to learn the art of animal tracking. The desert is a maze of animal tracks, the most intriguing to me was that of the desert elephant. An animal that required 12l+ of water per day so if you could find the animals the chances were you could find the water. We were taught water purification techniques and fire lighting. I noticed how morale was boosted in camp when fire was lit as it became dark and the temperature began to drop and also how important fire was to cooking, signalling and keeping warm. The only downside was the unwelcome visitors it attracted such as scorpions, insects and hyenas. The nights spent away from base camp with no tent to protect us I became quite aware that the desert was buzzing with life. As the lights went out the odd call of the barking gecko and the laugh of the hyenas made me feel most vulnerable and somewhat uneasy.

Our first day brought heat related illness to reality as several of the group complained of nausea and headache. Yet to be fully acclimatised, the harsh environment was already having an effect. One member needing to be cooled in the field after developing lightheadedness and tachycardia we were given first-hand experience of minor heat related illness and learnt in the form of lectures about more severe heat related illness. Interestingly we found that measuring temperature is of insignificant value when comparing to the signs and symptoms and is often inaccurate.

Over the week we learned more and more about the flora and fauna of the area and how to treat snake, spider and scorpion bites. To enforce what we learnt we were introduced to a snake handler who brought a variety of snakes and scorpions for us to see and to help demonstrate envenomation. Most snake bites are dry bites and the waiting for symptoms to develop can be distressing. We undertook a practical where venom was taken from a puff adder and added to 5mls of freshly venesected blood. After 20 minutes of being left to stand the blood had still failed to coagulate demonstrating the effects of envenomation.

In desert regions the most common mode of transport is by vehicle and after my experiences prior to the course I had lost all confidence in handling a 4×4 over rough terrain and vowed never to do so again! But the desert medicine course gave me the opportunity to practice extraction of a 4×4 lodged in dense sand or mud using multiple handy tips from our amazing guides who when in their company I felt so safe. We were taught the use of the car if stranded – water in the radiator for drinking, sparks from the battery to generate fire, mirrors for signalling to aircraft and shade from the burning sun. What we learnt was enforced by tales of those who had left their car and fallen to dehydration, heat stroke or the sampling of flora which proved to be toxic.

On our final day all we had been taught was put into practice in a scenario situation.

Divided into groups of ten whilst trekking we came across a familiar patient lying in the scrub having been bitten by a snake. I must say it is a credit to the expedition medicine team of instructors as both groups located their patient, washed the wound, applied a compression bandage and splint, improvised a stretcher, transported the patient 2kms to an arranged rendezvous using GPS and radios, erected shelter and made a small fire in under 20 minutes. The final day was made extra special when we successfully tracked a herd of desert elephant to a water source. To see these amazing majestic animals who had hidden themselves so well all week except for their tracks was in a word, awesome. This was an experience that no game safari could have given me especially when we were “false charged” in an effort to protect their calves. This was the point at which it was time to go back to civilisation, go back to our electricity, showers, iPods and double beds with some profound memories.

Desert Elephant near Brandberg Mountain, Namibia

Expedition medicine courses join my two loves of travel and medicine. They do not just teach everyday medics medicine relevant to an environment but also how to survive and care for others in these environments. With this knowledge travel to previously hostile, remote destinations becomes safe, possible and enjoyable. There is a great world of travel opportunity and as Winston Churchill aptly said a century to the year ago ” for the formation of opinion, for the stirring and enlivenment of thought and for the discernment of colour and proportion, the gifts of travel, especially travel on foot, are priceless”.

Dr Claire Roche | Junior Registrar in Emergency Medicine | Gold Coast Hospital

The next Expedition medicine course will be in Diving and Marine Medicine, Oman, United Arab Emirates, October 2008.

The next Desert Medicine Course is scheduled for the 19th – 25th of April 2009.  Please register your interest with Expedition and Wilderness Medical Training at  admin@expeditionmedicine.co.uk

Worldwide Wilderness Medicine medical training CME accredited training courses.

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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.

Desert Medicine training course Namibia

Desert Medicine training course Namibia

This has got to be one of the most superbly located medical training courses in the world. With a base camp in the shadow of the countries highest mountain – Burnt Mountain or Brandberg in a river valley frequented by desert elephants the training syllabus with explore this region as well as the plains in the foreground.

As well as the obvious training benefits we also hope to see the elusive desert adapted rhino and elephants, giraffes, oryx (gemsbok) as well as more common plains animals such as Thompson’s Gazelles, Ostriches and Hartman’s Mountain Zebras

The course is filling fast so to make sure you get a place email Catherine Harding or download a Desert Medicine course application form here.

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