The Life-Line Clinic, Namibia | Job Oppurtunity

Namib Naukluft National Park, NamibiaNamibia 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.

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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. 

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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.

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Desert Medicine Course – Damaraland, Namibia, August 2008

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

The dramatic landscapes of Namibia
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

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

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.

Kuiseb Canyon | Namibia | first decent

Kobus Albert surveys the Kuiseb CanyonThere 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. kuiseb-trek.jpg 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  

Rains in the desert | Namibia

Desert Medicine training course Namibia

Desert Medicine training course Namibia

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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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