Newsletter
March 2008
Hello to all our readers and welcome to the latest edition of the Expedition Medicine eNews.
We have lots of exciting articles in this edition; Dr Amy Hughes tells us all about the European Masters in Disaster Medicine (EMDM); Dr Claire Roche writes about her time in Norway on the Polar Medicine Course, plus all our course news! We still have places left on our Jungle, Diving and Desert courses and our UK course in September, so get your skates on before you miss the boat on these.
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 9th - 12th september 2008.
LIMITED TO 60 PLACES
Held in the stunning Barrow House, Keswick this course is for anyone aspiring to become and expedition medic. Read about the recent course in the BMJ for further details about the course click here.
NEW FOR 2008 Desert Course - Namibia 17th - 23rd August 2008
LIMITED TO 30 PLACES
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.
NEW FOR 2008 Diving Medicine- Oman 2008 18th - 24th Ocotber.
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 Medicine | Course write up by Dr Claire Roche
 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 anaesthetist 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.
Dr Roche paid for the
course in full and did not receive any payment for writing up the article.
Dr Amy Hughes writes about the EMDM
 .........PART 1 by Dr Amy Hughes
European Masters in Disaster Medicine – at first glance the NHS may spring to mind, especially for those who have been unfortunate enough to be entwined in the MMC debacle over the last year. However, not so, this is in-fact a superb, year long European Masters covering all aspects of disasters - epidemiology, preparation, management and prevention – whether they be human generated (terrorist attacks, chemical, biological, transport), natural (earthquakes, floods, tsunamis), mass casualty incidents or complex humanitarian emergencies; the aim being to enhance disaster education, train individuals in medical preparedness and management of disasters, improve research globally and ultimately merge together individuals internationally who share a common passion for the speciality.
Organised by the Universita' del Piemonte Orientale, Italy and the Free University Brussels, Belgium, and supported internationally by the World Health Organization (WHO), International Committee of the Red Cross (ICRC), the European Academy of Disaster Medicine (EURADIM) and the European Society for Emergency Medicine (EuSEM), the EMDM is led by very distinguished and experienced professionals, many professors in Emergency Medicine, Anaesthetics or Intensive Care, all of whom have dedicated their time, both academically and practically, to increasing the awareness of and education in disaster medicine.
Having access to the internet is a must for successful completion of the Masters as it is structured as an online self-directed learning tool – modules are uploaded every two to three weeks depending on module length and the number of assessments requiring completion (MCQs and short answer). Topics include epidemiology of disasters, research methods, logistics, ethics, mass casualty management, public health, injury types and complex humanitarian operations. During completion of the modules there is constant liaison via email and a forum page to the professors, to your mentor (allocated in week one) and, most importantly, between the thirty other international students completing the Masters generating debates and discussions.
Towards the end of May, and following completion of eight modules, a residential course in Italy is organised where international students and tutors meet for an intensive, didactic interactive two week course encompassing mass casualty simulation exercises, discussion forums, scenarios, lectures and – for successful completion of the EMDM - planning and initiation of a thesis.
Five weeks in and three completed modules later – the latter finished in between Vin Chauds and snow plough turns in the French Alps and a week of ICU nights – I find it hard to fault the EMDM. The modules, although long and intensive, are varied, thought engaging, relevant and constructive. There is no lack of support and plenty of discussion and debate amongst all participants – whom combined have a wealth of experience. As a chance to be educated in a field of increasing prevalence and relevance by enthusiastic, inspiring and driven professionals, it would seem a shame not to embark on such an opportunity. As for any chance of a social life outside of work……that’s the one sacrifice…………
To be continued….
For further information: www.dismedmaster.com or email amyhughes@doctors.org.uk
Mountain Medicine Course
, appearing out of early morning cloud, Annapurna -Mardi Himal Region, Nepal2.jpg) Most of the UK Expedition Medicine Faculty has a background in Mountain Medicine, and like many British expedition medics most of us started climbing in the Alps before moving to the bigger mountains in Nepal. Following the same theme as our other extreme environment courses, the main thrust of the mountain medicine course is to introduce medics to the practical elements of working and providing medical cover in the mountains. The instructors aim to familiarise the team with the fundamental skills which are essential to treat and evacuate casualties in the mountains as well as covering the common conditions encountered at altitude. Where else could we run this course but in Nepal. In order to experience winter conditions in the mountains the course will be run in the beautiful amphitheatre and ridges of Annapurna with the sacred mountain of Machapuchere as a backdrop. At this time of year the snow cover is low and the team will be able to train and experience the environment without undue exposure to high altitude.
Expedition Medicine is now a unique provider of medical courses in extreme environments and continues to attract fantastic staff and lecturers from around the world. The faculty in Nepal will be very exciting and experienced. Can't divulge any names yet but no one will be disappointed. It's advisable to put your name down now for this course as we envisage it to be a popular one! Email Luci at admin@expeditionmedicine.co.uk
EML Director on Kuiseb walk, Namibia
Mark Hannaford has just come back after successfully walking the Kuiseb Canyon in Namibia. This was the first expedition to walk its entire length and Mark was accompanied by ex-park ranger Kobus Alberts, who many of you will know from our Namibia challenges. The canyon marks the boundary of the great sand sea to the south and the rocky mountainous desert to the north. With special permission from the National Park Authority the venture was set.
The team had many highs and lows, quick sand, flood waters, hyenas, extreme heat, food rations and creepy crawlies for a start! But asked if he would do it again and you can guess the answer! To view the full article click here.
The expedition is going to be featured on the ATD blog. Once all the equipment has dried out, we will start getting commentary, photos and videos loaded up next week.
Charity Partnerships | Expedition Medicine
Further to our announcement in our last newsletter about the Polar Medicine Partnership, we have now set up partnerships for all our courses. Each of our medical training courses has a relevant charity partner to which a proportion of the course fees are paid. Full details can be found here.
Desert Medicine | Guest speaker
We are delighted to announce that Dr Sundeep Dhillon is joining us on the desert medicine course this year. Sundeep has been an explorer or medical expert in virtually every wilderness terrain in more than 40 countries. To view Sundeep's bio click here.
Just Walk 2008
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Calling all medics in the South - come and join us on Just Walk. A fantastic fundraising event in the stunning South Downs. A great way to train for events and get those fitness levels up and raise funds for the charity of your choice.
For further details on this great event, visit the website www.just-walk.co.uk
NEW | Expedition Medicine Media Support
Due to the increasing number of enquiries, we have now set up a dedicated web page for any production/TV companies who need medical support whilst filming. The page gives you an idea what we can offer, support, and an idea of the costings for hiring equipment and a medic whilst on location.
Situations Vacant
We have some exciting new job opportunities for 2008 on our website, these include: BSES seeking a medic for their leadership programme in Norway, the BBC Natural History Unit in partnership with Discovery, who are looking for a female medic and volunteer doctors needed for the Luangwa Safari Association Medical Fund in Zambia. 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 . The dog sledding and Kilimanjaro challenges are selling out fast but they still have places left on the Peru, Ladakh, CHina and Everest challenge events - 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.
Iceland Laugavegur Ultra Marathon July
 The "Laugavegur" course is one of the most beautiful in Iceland, stretching from Landmannalaugar in the highlands to Thorsmork, a natural reservation area. The area is famous for the yellow, orange and purple hues of the surrounding mountains.
The race blazes a trail through moss fields, meadows of wool grass, steam springs, and bizarre lava formations, where various blossoms defy the raw climate.
The race ends at Thorsmork, described as Iceland’s brightest pearl, surrounded by rugged mountains and beautiful glaciers. To view further details about this race click here.
Sales Manager and Ultra marathon runner Steve Clark has recently returned from completing the marathon. Read about how he got on here.
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