Newsletter
July 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; Wilderness Magazine features Polar Course; Diploma in Mountain Medicine; Jungle Medicine and much more.
We still have places left on our Jungle, Diving, and Polar courses, PLUS last two places left on our Desert course - 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.
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 17th - 23rd August 2008
LAST TWO PLACES LEFT
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.
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.
Last TWO places left | Desert Medicine Course
 We have just TWO places left on our desert medicine course in Namibia this August. We are lucky enough to have Dr Sundeep Dhillon of the Caudwell Xtreme Everest medical research expedition as our guest speaker. If you book by the 4th August we'll throw in an EML goodie bag!
The Desert course is set in Namibia - a truly amazing place. The course will feature animal tracking, setting up camp, building shelters as well as learning all about tropical diseases and managing animal bites - plus much more. Set in a real remote area, ideal for this course.
Click here for further details or email Luci to book your place.
Diploma in Mountain Medicine | By John Ellerton
Diploma in Mountain Medicine - specialty rescue module
 The Medical Commissions of Union Internationale Des Associations D'alpinisme (UIAA) and International Commission for Alpine Rescue (ICAR), and the International Society for Mountain Medicine (ISMM) set up the syllabus for a Diploma in Mountain Medicine aiming to teach the core medical subjects relevant to mountaineering and provide an internationally accepted qualification. Eight ‘basic’ courses are approved, including the UK course run by the University of Leicester in conjunction with Medex.
Now in its 8th year and with 59 successful diplomats, this course teaches the fundamentals of mountain, altitude and rescue medicine, and in doing so equips the student with the knowledge needed to act as an expedition or trekking Doctor. Until this year, the more specialist module on mountain rescue has not been taught in the English language.
This is changing with the introduction of a specialty course run by Dr Oliver Reisten of Air Zermatt in Switzerland. Here you are taught by one of the leading mountain rescue teams in advanced techniques. Over two weeks, you will experience first hand the equipment used, the helicopter procedures, and the practicalities of rescue from rock faces, crevasses, canyons, and avalanches. It promises to be a stimulating course and one suited to those Doctors wanting to work in mountain rescue.
Photo courtesy of Dr Oliver Reisten (Air Zermatt)
For more information contact Dr John Ellerton.
Jungle Medicine
 It's hard to imagine a better journey to a lecture theatre. 4 hours down a Grade 3 rapid, especially when the lecture theatre looks like this. The venue for the 2008 Jungle Medicine Course is the beautiful jungle of Costa Rica on the banks of the river Pacuare. What better environment to learn about dealing with scorpion stings and snake bites, where scorpions can be found in the kitchen and pythons on the grass lawn. The jungle around the camp is a fabulous mixture of rainforest and the occasional village clearing. The staff are wonderfully knowledgeable and the food delicious.
The main purpose of the course is to develop the practical skills to function as a valuable medical officer for a jungle expedition. The evenings are spent learning about advances in tropical and jungle medicine, whilst the days are spent in the jungle or on the river. The course culminates in a 3 day trek, finishing by rafting out to the second camp for a gala dinner.
For further information click here.
Diving Medicine Course
.jpg) As you know we are running our first Diving and Marine Medicine Course, set in Oman, this year. The course is ideal for those who are considering working on a diving, kayaking or rafting expedition. Through a combination of practical and evening lectures we will cover such topics as: kayaking, night dives, marine animals, search and rescue techniques plus numerous dives.
For further information click here.
Expedition Medicine heads south
 Our highly rated Expedition and Wilderness Medical Training Course is heading south to the moors of Dartmoor.
We are really excited about our new course - following the same schedule as our Lakeland course and with many of the same inspirational faculty we have linked up with Dartmoor’s premier training faculty, the Heatree Centre located near Newton Abbot to provide an additional course in May.
We are hoping that will make the travelling time shorter for some of you and reduce to carbon footprint of the courses, we will of course be working with the Woodland Trust as well to identify one of their projects close by which the proceeds of the course will help support.
For further information visit our website.
Wilderness Medicine Features Polar Course Article
 The setting for this year’s polar medicine training course was Alta, a small settlement, 72 degrees north and well within the arctic circle. A place with a deserted high street where you would be lucky to see one other passer by every 15 minutes, easily explained by a temperature at least ten degrees below freezing and a good foot of snow on the ground.
Base camp was a 40 km drive along icy roads to a picturesque mountain lodge by the name of Ongajoksetra. At the higher altitude the temperature was that much lower and if a wind was blowing, temperatures as low as minus fifty could be achieved. We were introduced to the Scandinavian team who would teach us methods of navigation across such tough terrain in harsh conditions and also to the Expedition Medicine team who would teach us polar medicine in a series of lectures and practical sessions both in the classroom and in the field. One more group I must not forget to mention is the team of fifty sled dogs who would provide another mode of transport across the snow.
My first day involved skidooing up a mountain demonstrating the importance of protective clothing, navigation aids and preparation for travel in severe blizzards with visibility of approximately two metres, sudden drops in temperature and rapid weather changes. I realised that without our trustworthy guide, Espen Ottem, we could become hopelessly lost in such conditions where you would be unable to survive more than a couple of hours at most. Our dog sledding guide, Pre-Thore was the perfect example of this as he told us of the time where inadequate preparation resulted in frostbite, blackening of his fingertips but fortunately no amputation. This story made me somewhat paranoid about the daily pain and numbness in my hands and feet when outside in the cold for prolonged periods. A “buddy system” was paramount to preventing frostnip. Simply by having that small exposed area of skin, pointed out to you to cover up.
 Dr Leslie Thomson, a consultant anesthetist who had first - hand experience of polar medicine after spending several years in Antarctica taking part in the British Antarctic Survey gave an excellent lecture on hypothermia, bringing home how hypothermia is not just a condition seen near the poles but also in the Saturday night party goer who collapses under the stars, the homeless and the elderly. We were taught how to treat by various re-warming methods and when to commence C.P.R in the hypothermic patient sending home the message of not pronouncing death until warm and dead in certain individuals. This information was demonstrated by the story of Dr Anna Bagenholm , a 29 year old doctor who fell into icy water whilst skiing in Northern Sweden, immersed for approximately an hour, her body temperature was 13.7 degrees centigrade. C.P.R continued for three and a half hours alongside re-warming techniques such as bypass, bladder / stomach / peritoneal lavage and warm intravenous fluids. She survived to become the person with the lowest body temperature ever to survive.
Expedition Medicine obviously feel that first- hand experience is the best way of teaching and as a result each member of the group had to undergo cold water immersion. Prior to undertaking this challenge we were kindly taught about the cardiac arrhythmias that can be induced by the shock of entering the water, the short term cold water gasp reflex increasing the chance of aspiration and swimmers failure! One by one we stepped up to an ice hole in our thermal underwear and in the more daring members of the group a little less! to swim across icy water. I can confidently say that was the coldest I had ever been. As if several knives had been plunged into my body, breath taking and inducing chest pain, I swam across water of ridiculously low temperature to attempt getting out of the hole using my ski poles.
 Of our nights spent in the field we were taught how to construct snow holes. Five hours later our own little home with two double beds, stove, cupboards and shelves for our candles was constructed. It was as comfortable as it could be on a mountain side with winds blowing outside dropping the temperature to twenty below. I was amazed that the snow hole was so warm at five degrees compared to the outside however a slight air of nervousness was in the back of my mind as my avalanche detector slowly flashed in the corner and a rope attached to a spade inside connected our holes to other holes in case of us having to be dug out. The course perfectly demonstrated how to survive in such conditions.
In summary the course prepared 25 everyday doctors to be able to traverse the polar landscape, recognise and competently treat local cold injury and hypothermia as well as to be safe expedition medics capable of caring for their groups and evacuating when required. To spend a week in such a location gave me the upmost respect for those who live in these regions and cross the landscape as part of everyday life, as well as a great respect for the land. In a day and age of global warming and melting of the polar ice caps it becomes paramount to look after our environment, to take only photographs and to leave only footprints.
Dr Claire Roche
Clinical Fellow in Emergency Medicine
Countess of Chester Hospital.
see the BMJ article
The next expedition medicine course will be in Desert Medicine Training Course which will be held in Namibia, August 17th – 23rd 2008.
For further details visit the website.
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
More Media
One of our medics has just come back from filming with Ginger Production's and ITV2 for Jack Osbourne's Celebrity Adrenalin Junkie.
Jack Osbourne said: "Fear, pain, blood, sweat, tears, celebrities and me...Adrenaline Junkie is back. Terror is more addictive than ever."
So once you've been on our courses you could be heading off with a celeb for a media job somewhere exciting.
To be part of our media crew please email Luci.
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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