Newsletter
August 2008
Hello to all our readers and welcome to the latest edition of the Expedition Medicine eNews.
We have lots in store in this newsletter including; how our first desert medicine course went ; read reviews of our very own EML Manual; Jungle Medicine course write up; new office hours plus much more.
We still have places left on our Jungle, UK, Diving and Polar courses - so get your skates on before you miss the boat on these, as they are selling out fast!
We hope you enjoy this edition of eNews and happy reading.
What's in this issue:
Course news -what’s going on and where
We have our usual favourite courses lined up, as well as our NEW Desert and Diving medicine courses. Our courses are getting very popular with the Polar and EML UK courses always being oversubscribed. We think our new courses will be just as popular.
Diving Medicine- Oman 2008 18th - 24th October.
LIMITED TO 30 PLACES
We are very excited at being able to offer an inspirational Diving & Marine Medicine Course for all those medical professionals responsible for clients or expedition team members in a diving or marine environment. The course aims to introduce participants to the skills required to manage the common medical problems, which may emerge in a diving or marine environment. For application forms or further details visit our website.
Jungle Course - Costa Rica 9th - 15th November 2008.
LIMITED TO 30 PLACES
Our jungle course is going strength to strength we are now running our third course in Costa Rica. Ideal for those interested in tropical and jungle medicine. For further details click here.
Polar Course - Norway 15th - 21st February 2009.
LIMITED TO 30 PLACES
A winter extreme climate expedition medicine course for or anyone wanting to work in a polar, high altitude or arctic environment. For further details click here.
EML UK Course - Keswick, Cumbria 23RD - 26TH mARCH 2009 & wIDECOMBE-IN-THE-MOOR, daRTMOOR, 11TH - 23RD mAY 2009
LIMITED TO 60 PLACES
The UK expedition medicine course is intensive and thorough, drawing on the wealth of skills within the Expedition Medicine faculty, to provide you with the skills and practical knowledge to become valuable members of an expedition team. Read about the recent course in the BMJ for further details about the course click here.
Desert Course - Namibia April 2009 - Dates tbc
Expedition Medicine is delighted at being able to offer a comprehensive course for all those medical professionals responsible for clients, patients or team members in a desert environment. The course aims to introduce participants to the skills required to be a valuable member of a desert expeditionary team, and to care for and treat injuries and illnesses likely to occur in this harsh environment. Set in the stunning Damaraland area in Namibia, for further details click here.
Desert Medicine Course | How it went
 EML Director Mark Hannaford is just back from Namibia and the very first Desert Medicine course.
‘its always a bit nerve racking running a new course, best laid plans of men and mice and all that, but I have to say I think the first course went superbly. The teaching staff was headed up by Drs Sean Hudson and Sundeep Dhillon both of whom bring an immense amount of experience to the course. This was complimented by the local knowledge of local guides Kobus Alberts a former game ranger and director of Wild at Heart Safaris - www.wildatheartsafaris.com , Volker Rhoeder and Faan Oosthuizen, director of Karimibi Expeditions, whose collective knowledge of desert environments is unparalleled and Stuart Hibbard director of the Swakopmund Snake Park’.
We have a fantastic group of delegates as well drawn from all over the world whose own huge experience really added to the course and collective experience.
We are hoping to run next year’s course in April to reduce the cost of flights and also to enable those people who want an additional challenge to take part in the Namibia Ultra Marathon which starts in the same area – see www.adventure-racing.org for more details, there were also numerous re quests for an additional Ranger style course concentrating more on non-medical skills so watch this space for more information on this.
All in all a great week in the shadow of Namibia most impressive mountain all topped off by superb viewings of the areas elusive desert adapted elephants on the journey out.
Click here for further details or email Luci to reserve your place on next years course in April.
Read reviews of our EML Manual
We have recently had two people independently review the new EML Manual.
Andy Cave, www.andycave.net, IFMGA Mountain Guide has written up his views which you can read here.
Erik McLaughlin, www.adventuredoc.org, MD, MPH has also had a good old read, to hear all about his views click here.
The EML Manual is available free to those who are on a course but you can also download it for £15.00 or to have the paperback book posted it's £18.00 (includes P&P). The authors Drs Sean Hudson and Caroline Knox have condensed the essentials of expedition and wilderness medicine into this marvellously detailed field guide. They have drawn together some of the most experienced medical expeditioners in the world to ensure the second edition is packed with practical advice on managing medical problems in the wilderness.
‘An invaluable resource for anyone planning a trip in the outdoors, either as part of an expedition or a wilderness adventure’
To purchase the book please visit the website.
Jungle Medicine | Course write up
 Welcome to the jungle
Tilman Stasch braves an expedition leadership course in the Costa Rican rainforest
Jaguar paw prints were visible in the mud outside our overnight camp in the Costa Rican jungle. Many of our group of 17 doctors and 1 nurse had a restless night, struggling to be comfortable in lightweight hammocks. We used army issue ponchos to make roofs against the rain. We also had mosquito nets to protect us from bugs, spiders, and scorpions. This five day course organised by Expedition Medicine offered teamwork, leadership, and survival skills.
Three doctors experienced in expedition medicine taught us core skills. The programme had interactive lectures on tropical topics and outdoor activities, which pushed us both mentally and physically.
Three hours of a bumpy bus ride and two hours of white water rafting later, we arrived in a beautiful camp along the Pacuare river in dense tropical rainforest. From here we did field excursions and learnt about treatment of various tropical diseases and common injuries. We spent some time away from the main base to set up camp beneath the canopy of rainforest.
Pre-course instructions meant we were well equipped with quick-dry shirts, trousers, bandanas, mosquito head nets, and various potions and lotions to protect us against malaria, dengue fever, botfly infestations, and other biting creepy crawlies.
But how could jungle strength DEET lotion (50-70%) protect us from the fer-de-lance (terciopelo), the most dangerous snake of Central and South America? This viper has a bite so deadly it frightens even the most hardened locals. On the first day of the course we visited the national serpentarium near San Jose and learnt about local reptiles. The fer-de-lance has been extending its territory from coast to mountains and has recently begun to breed twice a season, which is most unusual. These changes have been attributed to global warming. It is responsible for over 2000 snake bites a year in Costa Rica, five times more than a decade ago. If you survive its bite, there is still a 1% chance of death despite widely available antivenom. Amputations of limbs macerated from haemotoxic venom are common.
After nearly four days in the jungle without encountering anything bigger than spiders and leaf cutting ants, we encountered a fully grown two metre specimen, curled up on the side of our narrow path winding down the steep mountain.
Head cocked. Ready to strike. We had learnt how to help a victim using makeshift stretchers, following a casevac plan, and contacting rescue teams via satellite phone. Luckily none of this had to be tested.
Teamwork is essential in extreme environments. Being constantly vigilant for each other's safety inspired camaraderie. Getting to know our strengths and weaknesses enabled us to complete allocated survival tasks.
Navigating through dense terrain demanded trust in the person leading us; crossing the river that we used to raft into our camp required intelligence, careful planning, and meticulous execution to avoid anyone being washed downstream. We learnt about ropes, carabiners, figure of eight devices, and harnesses. Our skills were tested in tree tops, where our so called canopy work consisted of climbing over 10 cm thin planks of wood, wobbly hanging bridges, and pulley rides along steel cables spanned across gorges.
When charged with securing my colleagues into harnesses on the pulley and steel rope to send them off on a 200 metre long ride high up in the air, I was reminded of the responsibility akin to doing my first unsupervised operation.
Late at night, with all members of the team safely back in camp, we enjoyed yet another delicious meal of traditional Costa Rican gallo pinto (beans with rice), fresh fruit, and ubiquitous cups of freshly brewed coffee. But we never did encounter the jaguar that must have been watching us bushwhacking through his beautiful forest.
Tilman Stasch, SHO in plastic surgery
Norfolk and Norwich University Hospital
Next Jungle course in Costa Rica, is on the 9th - 15th November 2008. To book email Luci.
Dr Amy Hughes
Coming soon.
New Spainish Ultra
 Our friends at Adventure-racing.org have just returned back from Spain from the recce of our new ultra race. A 250km race over 5 days in the stunning Andalucia region. A beautiful mountian trail running through villages, taking in a wide range of landscapes including the white peaks of the Sierra Nevada. The race takes place on the 13th July - 17th July 2009
Also coming up is the Costa Rica 24hour Adventure Race in December this year, the Namibia 24hour Ultra Marathon in April next year, plus dates coming soon for the Taj Mahal Marathon, Iceland Ultra Marathon and Grand Canyon Ultra Marathon.
For Further information on this race and many more visit the website.
New Office Hours
Our office opening hours have changed.
We are now open from 10.00am - 2.00pm Monday to Friday.
The best way to contact Luci Ridout, our Expedition Medicine Course Manager is by email - admin@expeditionmedicine.co.uk
or call 01460 298092.
Iceland Ultra Marathon | team return
The team have just returned back from the Iceland Ultra Marathon. Steve Clark writes up his race report below:
 We arrived in Iceland with 7 runners from a variety of different backgrounds and running experience. Some were experienced ultra runners, but for some the task ahead was very daunting with two runners never having run further than 16 miles.
We gave a detailed race brief, including hydration, nutrition advice and medical briefing, which left everyone fully aware of the challenge ahead and exactly what they had let themselves up for! Although short for an ultra (53km) the course is punishing and much harder than the distance suggests. The first 17km involves 600m of climbing along difficult mountain trails, over ice, mud and sand, although the amazing scenery certainly distracts from the burn in the legs. What goes up must come down, and there follows a steep and difficult descent on uneven ground for 2km before the first major river crossing through glacial fed waters. The later stages of the course are slightly easier underfoot and undulating, but still involve some steep descents with one assisted by ropes, before the final ice cold river crossing and the 4km run through the woods to the finish.
The weather this year was terrible, with everyone shivering at the starting line before the off. 250 runners started – more than doubling last year’s numbers – yet the race still retained its friendly local feel, with people chatting and swapping race stories. Up in the mountains the clouds closed in taking visibility to just 30m at times. Ice cold rain lashed in from the left but it only seemed to spur people on in the face of adversity. Snow cover was heavy making running difficult and slippy at times. Over the latter stages the rain continued to pour and runners didn’t hang around at the checkpoints, going throug h as quick as possible to avoid the cold and keep their body temperature up. There is a cut-off time of 6hours at the 37km point and many runners had to push hard to get there on time. Once through they still had a 16km slog to the finish, and this is often the hardest stretch mentally, with runners pushing themselves onwards whilst their bodies are telling them to stop with every footfall.
Our small group did incredibly well, and all were shocked at how hard this race is, much harder than they ever imagined. Sam was the first of the group to arrive home around the 6hour 20 mark having never run a marathon before – in fact he said that he hates running! Dan, a veteran of the Gobi desert stage race was next in at 6hours 50, followed by Terry and Christopher in 7hours 30. Richard finished just under 8hours having and raised an incredible $95000 for charity to take part in the race, followed by Will and Maria past the 8hour mark. It was a huge achievement and they all should be very proud of their efforts as this race is definitely not for the faint hearted.
We are all now taking it all in, whilst we wait for our legs to stop aching and the day that walking downstairs or steep inclines becomes pain free.
Roll on 2009!
Steve Clark
Race Director
www.adventure-racing.org
Situations Vacant
 We have some exciting new job opportunities for 2008 on our website, these include: An urgent request from the Luangwa Safari Association Medical Fund in Zambia, who need a volunteer doctor to start in immediately until January 2009. Based in the stunning South Luangwa Valley, one of Africa's prime safari destinations. Most of the doctor's time is donated to the Kakumbi Rural Health Centre in Mfuwe near the main entrance to the national park. At the clinic the doctor works as a consultant to the staff nurses seeing patients with a wide variety of health problems ranging from malaria to AIDS to trauma to obstetric issues. The ideal doctor for this position is a GP/family physician or emergency medicine physician with broad clinical training and experience in caring for patients of all ages. Knowledge of tropical medicine is essential, and prior medical work in the tropics or a course in tropical medicine is encouraged but not required. To enjoy the work here, the doctor should be comfortable practicing alone in a remote setting with a limited array of medications and equipment.Click here for further information, please mention Expedition Medicine in your correspondence.
PLUS doctors and nurses needed who can spend some time in a remote village in the foothills of the Everest area! Nepal's healthcare facilities outside the Kathmandu valley are very poor, with healthposts where they exist, rarely staffed by qualified nurses. Most of the hospitals outside the Valley do not even have qualified doctors working in them.
Deusa is an example of such a village. Whilst there is a healthpost, there is no one employed there. Fortunately there is a lady who knows a bit about giving injections and basic first aid, but otherwise the closest alternative medical care is a day's walk away at the hospital at Phaphlu - where there are no doctors or the next alternative is to fly from Phaphlu to Kathmandu or walk 3 - 4 days to Jiri, where there is the nearest road and transport to Kathmandu.
So anyone that might be interested in providing some training, some healthcare and perhaps education at the local school, for whatever period of time - whether for a few days or longer - maybe on the way to or from a trek in the Everest area, please contact me for further information about this or any other related matter: Marianne Heredge, GPO 24529, Kathmandu, Nepal. Please mention Expedition Medicine in your correspondence.
Please visit our situations vacant page – for an opportunity of a lifetime click here.
Join Across the Divide on a fundraising challenge
 Open charity challenges are designed so you can raise money for a charity of your choice - it could be your local hospice or a major cancer charity. Across the Divide have been delighted at the response to their new open events for 2008 and 2009 . For 2008 we have a few places left on our China and Kilimanjaro. PLUS we have just listed a few new more trip in 2009 an India bike ride, Trekking in Jordan and a project in Namibia- so book now to avoid disappointment later. Find out more about Across the Divide here.
For further information on our open events email Susan McDonagh.
Visit our NEW blog
We have set up a new blog here at EML, feel free to have a look and add a comment or two. We have on there videos, course write ups, photo's and much more.
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