Expedition & Wilderness Medicine is pleased to announce the launch of the much- requested Dive & Marine CME accredited wilderness medical training course on the Great Barrier Reef
Topics covered will include pre-expedition medicals, diving-related illness, marine envenomation, emergency treatments and casevac plans. Practical sessions include boat handling, search and rescue and underwater communications. We will aim for at least 2 dives a day, including a night dive. At the end of the week, participants should feel confident to act as medical officer on a diving expedition, or in any diving medical practice
Diving & Marine Medicine participants will arrive in the Gladstone area and transfer to the Eastern Voyager on a Sunday morning. It is advisable to fly into the region on the Saturday if possible to get over jet lag before starting the course. You’ll then meet the rest of your group, with whom you’ll be living and diving over the following week. One of the challenges of expedition life is living in close quarters in a group, with people who you would not naturally choose as companions…so please bring a positive attitude and a sense of humour!
As our CME accredited Diving and Marine Medicine course in the Maldives hoves into view in October Dr Rob Conway, founder of award winning marine conservation charity Blue Ventures, looks at Malaria and its risks to diving.
An increasing number of us are heading to more remote areas to discover that dream dive, which means that you may be exposed to an increasing number of diseases.
Malaria is common and caused by the parasite Plasmodium. There are several different types that effect humans, most commonly Plasmodium falciparum. The others are less common and cause a milder form of the disease that is rarely fatal.
Malaria is transmitted by female mosquitos (Anopheles sp) that bite from dusk. Males feed on plant nectar and so do not transmit malaria. They transmit the parasite whilst feeding on your blood. These migrate to the liver and over 7 to 30 days multiply before bursting and infecting red blood cells in waves. Therefore an infected individual may feel waves of fever that are characteristic of the disease. Other symptoms include severe headache, shivering, arthralgia (joint pain) and vomiting all of which may be confused with a diving related illness. Signs include enlarging of the spleen and anaemia. In severe cases there is blood in the urine, renal failure, seizures, coma and death.
If you are heading to an endemic area be smart. Avoid getting bitten by using a suitable repellant, wear long sleeves and trousers from dusk and sleep under a net. Take an anti-malarial medication for the correct amount of time. The most common drugs include mefloquine (Lariam), doxycycline (an antibiotic) and a combination of atovaquone and proguanil (Malarone). There is no evidence that any of these are contraindicated in SCUBA, but efloquine is not universally accepted by all doctors and there is little data on Malarone at depth. Each has its own benefits and pitfalls. Some require you to take them for a period of time before and after a trip, remember, the parasites life cycle can be over a month. Consult a physician before departing.
If you suspect malaria, seek medical treatment immediately. Look for flu like symptoms from 7 days after entering a malarial area. Work along the lines of it is malaria until proven otherwise. I evacuated someone from Madagascar on a diving expedition with convulsions, I had no idea at the time of the cause, it turned out to be malaria. If you are going remote then there is a rapid test available (ICT kit) and take a stand by emergency treatment with you such as artemether-lumefantrine (Coartem) or quinine plus doxycycline.
Previously Expedition Medicine had run it’s Diving and Marine Medicine course in the Bander Khayran area of the Oman coast but decided to change location to guarantee great diving to the Maldives. So, in October of this year an eclectic band of medics from literally all over the world joined Diving Medic Dr Lesley Thomson – who has treated divers at the Plymouth and Aberdeen Hyperbaric Units, Dr Robert Conway founder of award winning marine conservation charity Blue Ventures, Dr Mark Read a marine biologist and Head of the endangered species unit of the Great Barrier Reef National Park and Mark Hannaford veteran of over 25 years of adventure travel and expeditions to all of the worlds continents aboard the dive boat Ari Queen for a week amongst the coral atolls of the Maldives.
The diving standard was set by our first ‘proper’ dive after our initial check dive when we dived at a Manta Ray feeding station. I don’t think any of us were really prepared for the spectacle surrounding us. Diving down to about 25 metres we positioned ourselves below the reef edge and it wasn’t long before a mass of manta rays, both fully grown adults and juveniles, were looming out of the slightly murky water and gracefully glided over our heads. This really set the standard for the diving on the course, which reached a pinnacle on the last dive where a mass a over 10 Grey Sharks were spotted amongst huge flight of Eagle Rays, White tipped Reef Sharks, a giant Napoleon Wrasse and the most relaxed Hawksbill Turtle that any of us had ever dived with, calmly grazing next to us as we admired the gallery of marine life whilst a territorial Titan Trigger Fish took a fancy to our dive guide!
The teaching side of the course maintained equally high standards, with a range of specific diving medicine related topics covered, including decompression sickness and diving physiology. The team also drew upon Lesley’s experiences as a medical officer and diving medic for the British Antarctic Survey, Rob’s years of marine conservation work in Madagascar, Mark Read’s encyclopaedic knowledge of the underwater world and Mark Hannaford’s quarter century of experience of running expeditions and adventure travel.
If you are getting the impression that it was a pretty action-packed course you would be right - some days lecturing did not finish until 10pm! - but it was also hugely enjoyable! The enormous wealth of experience amongst the delegates meant that their input and knowledge added a great deal to the overall leaning. In terms of meeting like-minded people it was a great opportunity to establish some great networks and share contacts.
The Diving and Marine Medicine course in the Maldives is accredited by the Wildness Medical Society for CME points and also counts towards gaining a Fellowship of the Wilderness Medicine (FAWN). A full list of the topics covered can be found on the Diving Medicine course page of the Expedition Medicine website.
Dates for next year’s course are to be confirmed exactly but will be mid-October 2011 – send us an email here admin@expeditionmedicine.co.uk to preregister your interest.
Dr Leslie Thomson Course Director of the Diving and Marine Medicine course talks about her hyperbaric experience and diving in Antarctica
Dive Medicine expert and founder of award winning Blue Ventures marine conservation charity Dr Rob Conway explains why he likes the course so much.
Dr Mark Read of the Great Barrier National Park talks about what he gets out of the Diving Medicine course.
Dr Klassje Doorenbosch, a GP from Perth, Australia, a delegate on the Dive Medicine course gives her feedback.
Expedition Medicines recent Diving and Marine Medicine course in the Maldives was judged by all to be a outstanding success – even this grazing Hawksbill Turtle seemed to get something out of it!
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