White Mars: Doctoring in the Coldest Place on Earth

Extreme medicine and expedition doctor Alexander Kumar provides an account of his time spent working in one of  the coldest places in Antarctica and one of the few true extreme environments on Planet Earth.  Known for his sense of humour, he has lived, worked and travelled through over 80 countries all over the world, including the Amazon and extensively across the Arctic and the Antarctic a few times also over the past 10 years

Alex Kumar Expedition & Wilderness Medicine

Dr Alex Kumar

Shackleton in Space

Antarctica is a large flat egg-white expanse with bits of egg shell in it (aka the TransAntarctic mountain range) that is greater in area than India and China put together.

Exactly 100 years on from Scott and Shackleton, I travelled to Antarctica and spent around one year living at Concordia, a joint French-Italian inland Antarctic research station as the Human Spaceflight Research MD to conduct research for the European Space Agency in an attempt to understand how far human physiology and psychology can be pushed towards a future manned mission to Mars.  It is one of the most remote outposts on the planet located in one of the world’s most extreme environments.

Expedition & Wilderness Medicine Alex Kumar

The most extreme place on the planet?
Environmental extremes experienced there include:

*  Enduring around 3 months of complete darkness, where the sun does not rise above the horizon
*  The world’s coldest temperatures dropping down below minus 80 degrees Celsius
*  Complete isolation with no means of escape for 9 months, simulating long duration space missions and life on the surface of another planet
*  Chronic hypobaric hypoxia being located at around 3800 metres equivalent altitude
*  Nothing lives outside the station for over 1,000 kilometres, in nearly all directions.
*  Our nearest neighbours are the astronauts orbiting the earth on board the International Space Station, and then some Russians snowed* in at Vostok station (* = it does not actually ‘snow’ inside Antarctica).

Answering the job advertisement for what may be the coldest and loneliest job in the world, I found packing my mind for a year away was much more difficult than my bags.

“The uttermost end of the world”

To travel to the moon from the base would only take three days – far less than the three weeks it took to fly from London to Hobart and then to sail by icebreaker across the Southern Ocean, battling high seas, whales and being stuck in the ice pack with leopard seals before reaching a 60,000-strong rookery and football stadium’s worth of Adélie penguins.  The stench nearly turned me back home.

Antarctica is an ill defined space in people’s minds.  It incorporates South Georgia and other sub Antarctic islands, which are in fact closer to South America than the continent of Antarctica itself.  People can and have sailed to South Georgia even during its winter.  Whereas the interior of Antarctica remains an inpenetrable block of ice.  Even a team led by Sir Ranulph Fiennes’ (Coldest Journey) could not penetrate the continent’s interior during winter.

The longest on-call 

Antarctica is full of surprises (and penguins).  Adding to that it was the first time since the station opened 10 years previously that there would be just one doctor overwintering – that was to be me, since another doctor left the base just before winter began.  It was a game of Tag and I was ‘it’.  I can’t complain now about a set of nights or hardship on-call after doing nearly a year on-call in Antarctica.

The journey wasn’t over, it had just begun.  After flying a further five-hour flight inland in a Twin Otter over the Great White Silence, a blank white canvas.  Perhaps God had forgotten to paint this continent, intentionally I thought, as he took rest on the 7th day.

Alex Kumar, Expedition & Wilderness Medicine

Coldest science on earth

Antarctica’s ice layer protects and hides its secrets like a thick skin, stretched over the bedrock many thousands of feet below. Recent efforts at Russia’s Antarctic Vostok station tapped the veins of the sub-glacial lakes, which flow deep beneath the surface, that may harbour evidence of life forms of our distant past.  But as yet, this continent’s secrets remain teasingly elusive.

Ice cores plumbed out of the 800,000-year-old ice have told a story of their own – the impact of mankind on Earth and climate change. Century-old equipment was used in the discovery of a hole in the ozone – earth’s own flesh wound, which may yet scar over.

We conducted earth science research including glaciology, meteorology, seismology and astronomy, alongside my own research (on the adaptation of human health and well-being to this extreme environment), and trying to help in arranging the jigsaw pieces involved in sending a manned mission to Mars and back.

Curtain of darkness

As winter sets in, you stop living and start surviving.  Temperatures plummet below minus 80C. In May the sun sets for the last time.  A curtain of darkness falls, leaving you to endure three months of 24-hour darkness.  Spinning uncontrollably through the world’s time zones, leaving you gasping as you wake from unforgiving, hypoxia-euphoric vivid dreams.  The cold and isolation begin to seep in and your mind begins to stretch uncomfortably, as your senses become blunted by the sensory deprivation.

There is light at the end of the tunnel as multicoloured lights flicker overhead in the darkness, the Aurora Australis.

One way journey to the great beyond

Once you enter the Antarctic winter, you begin a personal journey of discovery and you will learn a lot about yourself.  You cannot turn back or go home.  Once that last plane departs, there is only one way up, you have to summit and there is no quitting, only crying along the way.

Alex Kumar, Expedition & Wilderness Medicine

Living and over-wintering as the only British national among a team of 13 Europeans in the most extreme and remote environment on the planet was not ‘easy’ but not so challenging as it was predictable.  As in any stressful environment living in an Antarctic station can be likened to living in one of the Old West frontier towns – a continual sense of not knowing who is going to shoot at who next or why.  As a team, we ate, slept, exercised, conducted science and survived alone frozen into the landscape in close proximity.  We all survived.

Not wanting to spoil the winter and many stories that came from it, I can summarise wintering in Antarctica in one sentence… it is one of the world’s only psychological marathons and one of the Earth’s greatest, most magnificent and most peculiar journeys.

‘I’ve been to Antarctica’

Tourists are so often bedazzled by Antarctica.  And the public are often impressed by those who have been there. It certainly is special.  However, all in all, you can say you have ‘been’ to Antarctica if you have flown in to work there for a few weeks or been on a cruise down there, during the breezy summertime.  Take heed, when this is so often thrown about in conversations and talks.

We are all just tourists when it comes to Antarctica

Really, you can never say you actually know Antarctica until you have wintered there.  And not just anywhere.    A winter on a subantarctic island such as South Georgia, Antarctica’s coast or peninsula (-20C climbing and skiing activities which can be accessible during the winter) is nothing like a winter in the interior of the continent (-80C in hypoxic darkness that is inaccessible for months).  And even a well connected wifi ridden winter in the interior nowadays is nothing like a broken radio winter in Shackleton’s day.  If you want real isolation, you’ll have to bury your head and phone in the ice.

My own conclusion?  Simple – Watching people around you unfold and unzip at the seams during wintering as a doctor is an interesting and can be an unforgiving past time.  For sure, people aren’t made of the same grit and stuff these days.  If you want to really experience something try to do it properly.  Challenge yourself and mankind.  What have you got to lose? … Only a few fingers or toes.

Alex Kumar, Expedition & Wilderness Medicine

 

Alex has since worked in different space analogue environments and constructed the ‘White Mars’ research protocol for Sir Ranulph Fiennes. 

As an accomplished writer, photographer and public speaker, he has published articles in BBC News, New York Times and by invitation, recently held an exhibition at the Royal Photographic Society, featured in The Guardian.  

Alex now talks and works internationally for different organisations and humanitarian agencies, conducts global health research and continues to enjoy taking photos behind his camera and presenting in front of cameras for TV including BBC and Discovery, alongside his day to day NHS job and is a member of the EWM faculty.

Alex is continuing important work on a patent for a unique blend of cheerful and optimistic British sarcasm.

More information can be found at: www.AlexanderKumar.com  

Alex’s TED talk ‘Malaria to Mars’ can be found at: http://youtu.be/OukZ04e6kOM

 

 

FacebookTwitterLinkedInMySpaceBeboFriendFeedPingDiggDeliciousNetvibes ShareNewsVineStumbleUponRedditShare

Concordia Calling!

If taking part in research that paves the way for space exploration appeals, then the European Space Agency would like to hear from you.  You will spend 12 months living in one of the most secluded places on earth at the remote Concordia Antarctic station.  After training spacecraft pilot training, you will conduct simulations and various experiments which will assist space mission designers.  Applicants must be from an ESA Member State.  Application deadline 1 April.
ConcordiaHalley_VI_medium

ESA is looking for a medical doctor to spend a year at the remote Concordia Antarctic station. Like a martian outpost can be imagined, you will be away for over a year and cut off from the rest of the world, living and working with 15 colleagues to conduct science  in preparation for missions to the Red Planet.
Astronauts on long missions in space need to pilot their spacecraft and conduct complex operations months or even years after their training on Earth. On the International Space Station, astronauts periodically take refresher courses for critical tasks such as berthing cargo spacecraft.
ConcordiaAurora_Australis_over_Concordia_base_medium
For astronauts returning from Mars, mission designers need to know that they will be able to perform after months of isolation and stressful exploration. The Simskill experiment needs a spacecraft simulator to be shipped down to Antarctica to see how the Concordia crew will cope over the course of their stay.
Another planned experiment will look closely at how our immune system responds to the isolation at Concordia. Blood, urine and saliva samples will be collected and compared to stress test results to understand how stress influences our immune system. This research is also being done on the International Space Station to understand what factors are causing astronauts immune systems to behave as they do.
Further experiments include looking at how special lights could help keep a normal sleep pattern during the dark winter months. Others are checking bone health and monitoring how the crew interact and form groups during the isolation through  activity monitors and games that test teamwork.
Does taking part in research that is paving the way for space exploration, while living in one of the most secluded places on Earth for a year, appeal to you? Anyone from an ESA Member State with a medical degree can apply before the 1 April deadline    

Links

ESA Research Announcements

EWM polar medicine course

Vacancy List

 

 

FacebookTwitterLinkedInMySpaceBeboFriendFeedPingDiggDeliciousNetvibes ShareNewsVineStumbleUponRedditShare

Sir Ranulph Fiennes joins Extreme Medicine ’15 line-up

Extreme Medicine

We are delighted to welcome veteran explorer and writer Sir Ranulph Fiennes as guest speaker at the World Extreme Medicine Conference.

Fiennes was the first person to visit both the North and South Poles by surface means and the first to completely cross Antarctica on foot, and in 1984 was recognised as the “world’s greatest living explorer” by The Guinness Book of World Records.

The veteran explorer is still breaking records and undertaking expeditions, and in April this year is taking part in the ‘toughest footrace on Earth’; the Marathon des Sables in Morocco. If he completes it, he will be the oldest Briton ever to have done so. Fiennes, who has written numerous books about his army service and his expeditions as well as a book defending Robert Falcon Scott from modern revisionists, is bound to be an enthralling speaker…

Now in its fifth year, the World Extreme Medicine conference challenges thinking, builds bridges and introduces new ideas about medicine at its most remote and austere. We join together in one arena, four disparate but overlapping medical fields; Pre-hospital, Disaster & Humanitarian, Expedition, and Extreme medicine, to present new ideas and experiences from leading experts in their field.

New for 2015, are speakers on nanotechnology, remote diagnosis tools, extreme physiology and endurance sports medicine. We will also be considering the impact of climate change on global health, as well as the impact of conflict on civilians.

Always keen to inspire debate, our Innovation Platform will see ambitious medics pitching their ideas for small research grants before an expert panel.

The conference opens for registrations on March 29th 2015

Extreme Medicine

FacebookTwitterLinkedInMySpaceBeboFriendFeedPingDiggDeliciousNetvibes ShareNewsVineStumbleUponRedditShare

Extreme Undergraduate Medicine Conference: 7/8 March, 2015

ExtremeUndergradA collaboration between King’s College London Wilderness Society, Emergency Medicine Society and St George’s Pre-Hospital Care Society, this fantastically extreme event is for all students with an interest in Pre-hospital or Wilderness Medicine.

Extreme Medicine Conference 2015
Date: Saturday 7th and Sunday 8th March
Venue: King’s College London, Guy’s Campus, SE1 9RT
Timings: 09:00 – 18:00
Audience: Any student with an interest in Pre-hospital or Wilderness Medicine
Cost: £40 including all refreshments, certificates and entry to the conference social
Ticket Sales: http://www.kclsu.org/ents/event/2127/

KCL Wilderness Medicine Society, Emergency Medicine Society and St George’s Pre-hospital Care Society are delighted to announce that tickets are now available for the Second Annual Extreme Medicine Conference 2015. We are anticipating a multi-disciplinary audience with a range of skill sets and experiences. There is no such thing as too new or too experienced as our tailored program will ensure that every delegate gains from a wealth of knowledge and expertise​.

We have an amazing list of confirmed speakers including:

  • Dr Ben Singer – Pre-hospital ECMO
  • Lt Col Dr Guy Sanders – Trauma in Afghanistan and Haemorrhage Management
  • Dr Simon Jones – MSF and Expedition Medicine
  • Dr Jason Fitch – Dive Medicine
  • Sr Kay Mitchell​ – Extreme Physiology
  • Dr Andy Grieve – RAF – Assessing Patients in Extreme/Difficult Environments
  • Dr Russell Hearn – Wilderness Medicine in the US
  • Mr Michael Bradfield – King’s Sierra Leone Partnership

We are also awaiting confirmation from a couple of additional speakers.

We will also be hosting an interactive Careers Forum at the end of the conference delivered by some of the speakers.

There will be Clinical Skills Workshops on the Saturday afternoon and either Moulages or Masterclasses on the Sunday morning dependent on each delegate’s experience. We want to tailor make the Sunday morning to ensure that each delegate is able to maximise on the session. However any delegate can opt to attend the masterclasses if they would prefer. All teaching will be provided by ED/Anaesthetics Registrars and Senior Paramedics.

Masterclasses will include:

  • Primary Survey and Initial Management
  • Secondary Survey and Handovers
  • Scene Safety
  • Trauma Radiology – including a prize quiz

The Conference Social will be held at Guy’s Bar on Saturday evening and will be a great chance for everyone to get to know each other and network.

The link for the tickets is http://www.kclsu.org/ents/event/2127/ and non-KCL students will have to create a guest account which only takes a few minutes.

We look forward to welcoming as many of your students as can attend for what promises to be an excellent weekend of Pre-hospital and Wilderness Medicine.

 

Links
Expedition & Wilderness Medicine
KCLSU

FacebookTwitterLinkedInMySpaceBeboFriendFeedPingDiggDeliciousNetvibes ShareNewsVineStumbleUponRedditShare

Doctor(s) / Nurse Practitioner required at Lifeline Clinic, Namibia

The N/a’an ku sê Foundation is looking for two doctors or a doctor and a nurse practitioner to run the Lifeline

Clinic 2Clinic based in Pos 3 in the remote Omaheke region of Namibia, from May 2015. This is a unique opportunity to provide primary and pre-hospital care to the San Bushman.  This is a voluntary position with food, accommodation and a living allowance provided and the Foundation would like applicants to stay for at least one year. The N/a’an ku sê Foundation is looking for two doctors or a doctor and a nurse practitioner to run the Lifeline Clinic based in Pos 3 in the remote Omaheke region of Namibia, from May 2015. This is a unique opportunity to provide primary and pre-hospital care to the San Bushman.  This is a voluntary position with food, accommodation and a living allowance provided.  The Foundation would like applicants to stay for at least one year.

 

Ambulance-at-Lifeline-Clinic-960

The San are considered to be the oldest peoples in the world. For tens of thousands of years the San were hunter gatherers and did not farm or keep livestock. With the advent of agriculture, the San have been forced from their original lands and are unable live their traditional lifestyle.  As a consequence, most San people now live in extreme poverty. They are the poorest group in Namibia with a per capita income of just N$ 3,263 compared with a national average of N$ 10,358. They suffer from discrimination, political and social marginalisation, domination and exploitation. They are the unhealthiest group in Namibia and have a life expectancy of just 46 years.
The N/a’an ku sê Foundation is committed to improving the health and wellbeing of the San and is looking for two doctors or a doctor and a nurse practitioner to run the Lifeline Clinic based in Pos 3 in the Omaheke region of Namibia from May 2015 for one year or longer.
You will provide primary healthcare services and pre-hospital care to the local San population from a reasonably modern, clean and well-equipped clinic. You will also, through outreach clinics, provide care to those living further afield on farms and re-settlement villages. Working with you is a UK trained respiratory consultant who, as part of a research programme, is screening for TB among the San (we estimate 10% of the San people currently have TB) and will be looking at ways of improving their compliance with treatment.
The work is rewarding but the logistics of providing a quality service can be challenging at times – after all ‘this is Africa’. Experience in general medicine, primary care, or emergency medicine is desirable. Most importantly you need to be resilient, flexible, and tolerant.  Having a sense of humour definitely helps!
This role provides you with an opportunity to improve the lives of the San people and leave a legacy that remains long after you have returned home. If you would like to find out more about these posts, contact Sharon Smart by emailing “sharon at naankuse dot com” [email address spelled out to deter spamming]
Links
FacebookTwitterLinkedInMySpaceBeboFriendFeedPingDiggDeliciousNetvibes ShareNewsVineStumbleUponRedditShare

Antarctic Medical Conference 2015: Special Offer

Antarctic Wilderness Medicine ConferenceFree flights from Miami to Buenos Aires!

Secure complimentary flights from Miami to board expedition ship, National Geographic Explorer in Buenos Aires on 7th December for the iconic Antarctic Medical Conference, when you book with Lindblad Expeditions & mention Expedition & Wilderness Medicine’s medical conference.

Expect breathtaking scenery and huge photo opportunities on this voyage; whales, penguins & a multitude of seabirds:  7th – 20th December.

To read more about this life changing experience visit our Antarctic web-page HERE

 

 Links
Antarctic Medical Conference

EWM course portfolio

 

FacebookTwitterLinkedInMySpaceBeboFriendFeedPingDiggDeliciousNetvibes ShareNewsVineStumbleUponRedditShare

Extreme Dental Anaesthesia

Simple, practical guides to expedition dentistry.

Dental

Writing their third article for the Adventure Medic’s dental series, EWM faculty Burjor Langdana and

Matt Edwards have produced a step-by-step guide to local anaesthesia when working in the field.

Achieving Dental local Anaesthesia is a very useful skill to have while working as a medic in a remote area.  This freely accessible article could help you develop a skill to help control excruciating dental pain. A simple dental procedure in a dentally phobic patient would be possible, if only you knew how to get that tooth numb!

Using their experience while working for several expeditions and providing remote access dental cover, Burjor & Matt have produced a straight-forward guide aimed towards doctors, nurses, paramedics, medics & advanced first-aiders which is available freely HERE.

Links
Expedition & Wilderness Medicine logo

 

 

 

 

 

 


The Adventure Medic

 

FacebookTwitterLinkedInMySpaceBeboFriendFeedPingDiggDeliciousNetvibes ShareNewsVineStumbleUponRedditShare

Are you a British GP working in the UK?

Dragonfly Film and Television, makers of One Born 
Every Minute, are looking for Britain’s best GPs to take part in a brand new medical series.  

This new medical format we will take three of some of Britain’s most dynamic, talented and engaging GPs in a brand new medical series.

We’re searching for GPs from across the UK, both NHS and private. We will share the GPs’ reactions as they discover exactly what lies behind each new front door in their catchment area. We’ll show how living conditions can play a part in poor health uncover emerging health trends such as increasing levels of TB and morbid obesity.patients’ homes as they explore the connection between lifestyle and health.

If you’d like to know more or recommend a GP please contact: DragonFly Logo
Sarah, tel: 020 7033 3195
Email:  doctors@dragonfly.tv
(Please also include your contact details)

All correspondence will be dealt with in complete confidence and by contacting us, you are not making a commitment to take part in the final programme.

Links
Expedition & Wilderness Medicine logo

FacebookTwitterLinkedInMySpaceBeboFriendFeedPingDiggDeliciousNetvibes ShareNewsVineStumbleUponRedditShare

Glad to welcome the makers of ‘Helicopter Heroes Down Under’ to the Brisbane Extreme Medicine Conference

Thrilled that we are going to featuring the team behind ‘Helicopter Heroes Down Under’ at our Brisbane Extreme Medicine Conference – tickets now open for sale!!

Top International speakers at the Extreme Medicine Conference at the Royal Society of Medicine inspired a packed auditorium of international delegates in November, 2014.  This specialist conference was developed specifically with medical professionals in mind, providing an opportunity to share experience and learning from the various areas of remote medicine and, we’re bringing our conference programme to Australia!
Our delegate audience is roughly 70% doctors, the remainder, nurses, paramedics, students and industry professionals.
“This was the best attended conference I have been to in eons and small wonder, fantastic standard of speakers, good mix of fact, glorious slides and amazing case studies.”  
88% of respondents rated the 2014 event as Excellent or Very Good, telling us “…
I would rate it one of the best two conferences available at the moment for professionals working in emergency and critical care environments.”

At Brisbane, we will include some of the very best speakers from around the world on remote medicine topics; Day 1 will focus on Pre-Hospital and Day 2 Expedition Medicine.  Our programme of speakers and adventurous medics will remind you just why you entered medicine and the possibilities available to you.

“Great conference with very knowledgeable speakers with a vast amount of experience! “  

We promise a full programme with a chance to get to know delegates, speakers and exhibitors at social and networking breaks.
This conference has had a profoundly positive impact on me…

Brisbane Extreme Medicine Conference

FacebookTwitterLinkedInMySpaceBeboFriendFeedPingDiggDeliciousNetvibes ShareNewsVineStumbleUponRedditShare

EWM faculty and EverestER founder Dr Luanne Freer working with inspirational NGO Partners in Health reports from West Africa

Ebola emerged in West Africa in late 2013 and has spread across borders, killing thousands and leaving behind survivors and shattered families.

Partners In Health has helped respond to the epidemic, aiming to address not only Ebola but also the “staff, stuff, systems, and space” challenges that hamper containment efforts. PIH has recruited and trained American volunteers, many of whom are now working to curb Ebola alongside West African partners in Liberia and Sierra Leone. Several share their reflections below:

Article (c) Partners in Health   

Photo: Rebecca E. Rollins / Partners In Health

Partners In Health and Last Mile Health staff tour the Ebola Treatment Unit in Bong, Liberia, managed by the International Medical Corps.

Ebola emerged in West Africa in late 2013 and has spread across borders, killing thousands and leaving behind survivors and shattered families. Partners In Health has helped respond to the epidemic, aiming to address not only Ebola but also the “staff, stuff, systems, and space” challenges that hamper containment efforts. PIH has recruited and trained American volunteers, many of whom are now working to curb Ebola alongside West African partners in Liberia and Sierra Leone. Several share their reflections below:

Sorrow and Celebration

January 1, 2015–It is crazy busy here [in Port Loko district, Sierra Leone], and I’ve cried every day. Not despondent crying, but trying to be appropriate and grieve when I need to. One of our employees, a 52-year-old sprayer (they spray us down with chlorine as we are taking off the personal protective equipment) died yesterday. He was the sole caregiver for two young boys, who were two of our last admits of 2014 yesterday.

One 28-year-old father who survived Ebola was nursing his last child (his wife and other kids died two weeks ago), and we tried so hard to get his baby through. You know where this is going. His last family member, a 1-year-old tiny little girl, died yesterday. Our staff sobbed at the gate when he wailed and said she was all he had left in the world.

It guts me to see their grief. I can deal with the corpses and the horrible illness, but their grief is overwhelming when I think about what it must feel like. They have nothing, live in dirt-floor shacks with a few goats and have to haul their unclean water from the river, have no available health care, and then they lose their family? I’m crying just writing this. I, we, have so much to be grateful for.

But if I had to choose a way to spend New Year’s Eve (I was on the 4 p.m.-12:30 a.m. shift last night), it would be to be doing what I was doing. Giving sleeping pills and valium to people who can’t sleep because of their suffering, feeding a starving little baby with no parents, sedating elderly encephalopathic adults. They just look terrified and mumble unintelligibly, but I can understand enough to know they are having awful hallucinations. And you know what? Sometimes they pull through, and I celebrate those victories; they keep me coming back.

We discharged nine survivors one day last week. I treated a case of cerebral malaria this week and transferred the patient to a government hospital that has one nurse on duty for 50 patients. I hope he gets his artesunate [medication for malaria], but we didn’t want him to catch Ebola just because he had the bad luck to catch malaria in the middle of this epidemic.

So that was my New Year’s Eve. Today I have the only day off I will have for an entire month, and I woke up to go on a 10K run on a relatively cool, breezy morning. I ran through several villages where little kids ran to the road yelling “abado!” (white person!), and adults said “Happy New Year and thank you!” (I am crying again—it’s so beautiful to have people from the community say thanks for what you are doing.) A few little kids ran along with me for a while, and we raced from sign to sign. It will be very difficult to leave this place when it is my time to go.

Luanne Freer

Article (c) Partners in Health 

FacebookTwitterLinkedInMySpaceBeboFriendFeedPingDiggDeliciousNetvibes ShareNewsVineStumbleUponRedditShare