Newsletter
September 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; a write up from our first ever Desert medicine course; hear all about Caudwell Xtreme Everest; learn more about Blue Ventures our charity partner for our Diving medicine course, plus much more.
Our courses are filling up fast so to avoid disappointment book now! Coming up Diving and Jungle medicine courses.
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.
Participant writes up on the first Desert Medicine Course
Desert Heat
Desert Medicine Course – Damaraland, Namibia, August 2008.
Across the Divide / Expedition Medicine
Namibia was the location for “across the divides’” first desert medicine course. A country famous for its Skeleton coast, an eerie graveyard of numerous shipwrecks which have fallen victim to its rough waters, home to towering sand dunes and of course Africas’ “big five”. Tucked away in South West Africa, Namibia is a country of mystery with a unique landscape and proved to be one of the worlds’ best possible locations in which to learn expedition medicine, desert style.
After undertaking a four day 4*4 self drive safari prior to the course I soon became aware that a lack of understanding of such terrain could have deadly consequences. Described by explorers as “hell on earth” and described in the bible as “the dust of death”, the desert environment can kill in a matter of hours.
 A destination popular with European holiday makers and best enjoyed by taking self drive safaris, Namibias’ International airport is a hub of car hire companies. Tourists are pouring onto Namibias’ roads with no journey preparation or experience in handling 4*4 vehicles on off road terrain. This was demonstrated when I crossed paths with a group of four female German exchange students who ventured out to the popular beauty spot of Sossulvei dunes and petrified forest. They had hired the most economical car which was completely unsuitable to gravel roads (which make up the majority of Namibian roads outside of the major cities) and a momentary lapse of concentration resulted in the car sliding out of control, ending up on its’ roof in a field bordering the road. Fortunately no passenger was injured and help passed within the hour but this daily occurrence on Namibian roads has claimed the lives of many tourists and locals. We exchanged stories at a desert lodge as only the previous day I too managed to end up stranded after our 4*4 became lodged in sand whilst visiting the same area. Our only saving grace was that this occurred in a popular area where passers-by stopped to help within half an hour, however if this was to have happened two days previously whilst we had been traversing similar terrain in a desolate area of the skeleton coast I dread to think of the possible implications, especially as the day was drawing in and we had not seen another car in several hours.
Namibia is home to multiple tales of travellers making the mistake of leaving their vehicle to find help and falling victim to temperatures of 50 degrees and limited water availability. Prior to starting the course my experiences made me desperate to feel self sufficient in this unforgiving environment should I ever have the misfortune to be stranded.
 Base camp for the course was a 5 hour drive from the capital city of Windhoek to the Brandberg Range, In a region named, Damaraland in the north west of Namibia. The first thing I noted was that the term “desert” was an umbrella term for multiple types of terrain. Besides the obvious rolling sand dunes, deserts can be dry, barren and rocky areas or vast, open, dusty plains extending for miles. In this location there was no readily available running water, electricity or mobile phone signal. Just 20 single man tents surrounded by a jaw dropping backdrop of the surrounding desert. From my previous Across the Divide Expedition Medicine experience of Polar and Jungle courses, once again, they had excelled themselves in choice of location for their course. As the sun went down and poured its’ pink heart into the desert floor we sat around natures’ television, warmed our feet and listened to what was planned for the first desert medicine course over the coming week.
We were led by our fantastic guides: Volker, Faan and Korbus on our first of many desert treks. A ten hour “stroll” in 45 degrees of heat, across plains and gorges. We learnt how to navigate our way using GPS (global positioning system), maps and compasses but the first skill we had to obtain was that of finding water in this apparently bone dry environment. We headed for gorges and began to learn the art of animal tracking. The desert is a maze of animal tracks, the most intriguing to me was that of the desert elephant. An animal that required 12l+ of water per day so if you could find the animals the chances were you could find the water. We were taught water purification techniques and fire lighting. I notice how moral was boosted in camp when fire was lit when it became dark and the temperature began to drop and also how important fire was to cooking, signalling and keeping warm. The only downside was the unwelcome visitors it attracted such as scorpions, insects and hyenas. The nights spent away from base camp with no tent to protect us I became quite aware that the desert was buzzing with life. As the lights went out the odd call of the barking gecko and the laugh of the hyenas made me feel most vulnerable and somewhat uneasy.
Our first day brought heat related illness to reality as several of the group complained of nausea and headache. Yet to be fully acclimatised the harsh environment was already having an effect. One member needing to be cooled in the field after developing lightheadedness and tachycardia we were given first-hand experience of minor heat related illness and learnt in the form of lectures about more severe heat related illness. Interestingly we found that measuring temperature is of insignificant value when comparing to the signs and symptoms and is often inaccurate.
Over the week we learned more and more about the flora and fauna of the area and how to treat snake, spider and scorpion bites. To enforce what we learnt we were introduced to a snake handler who brought a variety of snakes and scorpions for us to see and to help demonstrate envenomation. Most snake bites are dry bites and the waiting for symptoms to develop can be distressing. We undertook a practical where venom was taken from a puff adder and added to 5mls of freshly venesected blood. After 20 mins of being left to stand the blood had still failed to coagulate demonstrating the effects of envenomation.
 In desert regions the most common mode of transport is by vehicle and after my experiences prior to the course I had lost all confidence in handling a 4*4 over rough terrain and vowed never to do so again! But the desert medicine course gave me the opportunity to practice extraction of a 4*4 lodged in dense sand or mud using multiple handy tips from our amazing guides who when in their company I felt so safe. We were taught the use of the car if stranded – water in the radiator for drinking, sparks from the battery to generate fire, mirrors for signalling to aircraft and shade from the burning sun. What we learnt was enforced by tales of those who had left their car and fallen to dehydration, heat stroke or the sampling of flora which proved to be toxic.
On our final day all we had been taught was put into practice in a scenario situation. Divided into groups of ten whilst trekking we came across a familiar patient lying in the scrub having been bitten by a snake. I must say it is a credit to the expedition medicine team of instructors as both groups located their patient, washed the wound, applied a compression bandage and splint, improvised a stretcher, transported the patient 2kms to an arranged rendez-vous using GPS and radios, erected shelter and made a small fire in under 20 minutes. The final day was made extra special when we successfully tracked a herd of desert elephant to a water source. To see these amazing majestic animals whom had hidden themselves so well all week except for their tracks was in a word, awesome. This was an experience that no game safari could have given me especially when we were “false charged” in an effort to protect their calves. This was the point at which it was time to go back to civilisation, go back to our electricity, showers, IPODS and double beds with some profound memories.
Expedition medicine courses join my two loves of travel and medicine. They do not just teach everyday medics medicine relevant to an environment but also how to survive and care for others in these environments. With this knowledge travel to previously hostile, remote destinations becomes safe, possible and enjoyable. There is a great world of travel opportunity and as Winston Churchill aptly said a century to the year ago “ for the formation of opinion, for the stirring and enlivenment of thought and for the discernment of colour and proportion, the gifts of travel, especially travel on foot, are priceless”.
Dr Claire Roche
Junior Registrar in Emergency Medicine
Gold Coast Hospital
The next Expedition medicine course will be in diving medicine, Oman, United Arab Emirates, October 2008.
Click here for further details or email Luci to reserve your place on next years course in April.
Caudwell Xtreme Everest
 Mike Grocott from Caudwell Xtreme Everest recently spoke at our UK EML Course. Caudwell Xtreme Everest is a research project coordinated by the UCL Centre for Altitude, Space and Extreme environment medicine (CASE) - doctors and scientists studying human systems stretched to breaking point in extreme environments to increase our understanding of critically ill patients.
The group placed a research team on the summit of Mount Everest in May 2007 and made the first ever measurement of the level of oxygen in human blood at 8400m, on the balcony of Everest. This was the centrepiece of an extensive and continuing programme of research into hypoxia (low oxygen levels) and human performance at extreme altitude aimed at improving the care of the critically ill and other patients where hypoxia is a fundamental problem.
Dr Mike Grocott - Director and Expedition Leader
Holds degrees in Immunology and Medicine from the University of London. Currently Consultant in Intensive Care Medicine, Southampton General Hospital and Senior Lecturer in Intensive Care Medicine at the Portex Unit, Institute of Child Health, UCL. Honorary Senior Lecturer in high-altitude physiology at UCL. Co-Founder and Director of CASE. Acting Director of Research and Development at the Whittington Hospital NHS Trust. Between 2005 and 2008 Mike was the Deputy-Director of the UCL Institute of Human Health and Performance. Mike's research interests include human responses to hypoxia, measuring and improving outcome following high-risk surgery and fluid therapy. He has co-authored more than 60 peer-reviewed scientific publications.
He has been climbing and mountaineering for more than 25 years, has been on 11 high altitude expeditions to the Himalaya and South American Andes (6 as leader) and has extensive remote environment medical experience as medical officer and co-ordinating high altitude medical research projects. Mike led the 2006 Caudwell Xtreme Everest Cho Oyu expedition and the 2007 Caudwell Xtreme Everest Expedition. He has ascended over 5000m on more than 40 occasions with multiple ascents to, and ski descents from, over 6000m and two ascent of 8000m peaks (Cho Oyu, 8201m, 2006; Everest 8850m, 2007). He is a qualified UK Mountain Leader and is on the faculty of the UK UIAA diploma in Mountain Medicine.
In the autumn of 2004 Mike was one of two resident physicians at the Himalayan Rescue Association Aid Post at Pheriche, Everest Base Camp Trek, Nepal.
Mike has been married since Febuary 2006 to Denny Levett who was the Caudwell Xtreme Everest Expedition Medical Officer and one of two Deputy Research Leaders.
Dr Denny Levett
Deputy Research Leader and Medical Officer
Dr Denny Levett is the Association of Anaesthetists Of Great Britain and Ireland's (AAGBI) Research Fellow.
As one of the Deputy Research Leaders, Denny helps to timetable the research projects and to make sure that the right equipment is in the right place at the right time! She is co-ordinating the oxygen utilisation research group. Her own PhD thesis at UCL is based on the efficiency of oxygen use and mitochondrial function in hypoxia (low oxygen levels).
As medical officer Denny is responsible for the health of the team on the expedition – preventing illness by pre-expedition screening, risk assessment and advice; sourcing medical equipment for use in the field; treating team members in the field and co-ordinating the medical evacuation plan for emergencies.
She has had extensive experience in Expedition Medicine, working as a Medical Officer for ‘Across the Divide Expeditions’ since 1999. She has accompanied groups on hiking, white water rafting and mountain biking expeditions in remote locations including Guatemala, Nepal, Patagonia, Lapland and Peru. She has also been the Medical Officer on three independent marine biology diving expeditions in Fiji, The Hallaniyat Islands and Tanzania. She is a lecturer on the Expedition Medicine for Medical Professionals course and is currently studying for the Diploma of Mountain Medicine.
Denny is a keen rock climber and mountaineer. She has climbed peaks in Canada, New Zealand, The Alps and the Himalayas. To date Denny has summited three mountains over 6,000 metres.
Denny holds degrees in Natural Sciences and Medicine from Cambridge and Oxford. She rowed intensively throughout her university career, gaining a Blue for women's rowing at Oxford in 1996. She captained the Medical Students Boat Club, and competed in the National Championships at Henley.
Denny was recently married in February 2006 to Dr Mike Grocott who is the Director of Xtreme-Everest and the Expedition Leader for the 2007 Xtreme-Everest Expedition.
To find out more click here website.
Blue Ventures | Our Charity partner for Diving Medicine Course
 Blue Ventures is an award-winning marine conservation organisation dedicated to conservation, education and sustainable development in tropical coastal communities.
Through our marine expeditions, volunteers from around the world join us on career breaks, student gap years and internships, working closely with our field research teams, in partnership with local communities.
We have a commitment to responsible travel on all of our expeditions.
Blue Ventures bases all its conservation work on in-depth scientific research. Working with local and international partners, our field scientists study the growing threats to coastal regions, changes in habitat health, impacts of conservation initiatives and how local communities interact with, and rely upon, natural resources. Our research tells us where to work and what conservation strategies to use
They firmly believe that their award-winning, socially and environmentally responsible, volunteer programmes offer some of the most rewarding and productive marine conservation and educational experiences available today.
To learn more visit their website.
Diving Medicine | Sign up now
Our next course is our Diving and Marine medicine course. We are very excited about this course as it's the first time we've run it.
The course concentrates on practical water experience and the core medical skills needed to support water based expeditions or provide medical support. A basic SCUBA diving qualification is a requirement for this course.
Remember a proportion of your course fee goes to support the work of Blue Ventures featured in this newsletter.
Book now as course limted to 20 people and we only have a few places left.
Local MP visits EML/ATD HQ
The Rt Hon Oliver Letwin MP for West Dorset came to visit the Across the Divide/EML headquarters and below is a copy of his impression written up for the Western Gazette.
I have seen the future - right here in West Dorset; and it is with us now.
If you want to see it too, you have to make a pilgrimage to Thorncombe (which happens to be the village in which I live)..
You have to go up the main street and turn off it down a tiny lane. There you will find a barn.
Some time back, this barn was rather the worse for wear - and had clearly ceased to have the original agricultural purpose for which it had been constructed.
Today, it is as smart a building as any in West Dorset, or anywhere else in the country, for that matter. Its stone positively glistens. It has splendidly restored beams, a magnificent set of skylights which are appropriately invisible from outside, cunningly inserted places for birds and owls to eat and roost, and wonderfully polished restored wooden fittings.
But it is not just a West Dorset stone barn brought back to life. It is also packed with high-tech, eco-conscious design features. It has absolutely the latest air heat recovery system, a solar water heating system, and fixed line broadband as well as - for safety’s sake - a line-of-sight wireless broadband system,
Enter the barn, and you find yourself in a brilliantly equipped and ultra-modern office, with ranks of calmly efficient young people working on the latest computers and surrounded by remarkable works of modern art, chic glass and metal tables, and all the other apparatus of the fanciest and grandest of London city firms.
The only thing that differs from a London city office is that this barn, instead of being cramped into some tiny keyhole-space amidst the grime and noise of city life, is surrounded by some of the loveliest of West Dorset’s hills and by the charm of Thorncombe’s little streets.
The business that is going on in this remarkable environment is, in itself, remarkable. Known as “Across the Divide”, it is an organisation devoted to arranging outdoor activities across the world for charities, voluntary bodies and corporations that are raising money for charities. From all over the country, experienced travellers and skillful medics are brought together to lead expeditions that venture not only along the heritage coastline of Britain but also to the North Pole and the Amazon .
The range is vast: an expedition to refurbish a decaying school in South Africa; a tour of a great city by night; the ascent of some dangerous peak; wherever, whatever and whenever - and all quietly and efficiently arranged from this barn in Thorncombe.
Ten years ago, it would have been quite another matter. Twenty years ago, it would have been quite impossible. But today, with broadband communications (mercifully available in Thorncombe, unlike some other parts of West Dorset), it can all be done exactly as efficiently as in a big city office, and with a vastly higher quality of life for those involved.
Those who say that rural areas are inevitably going to be left behind in the fast-moving global economy should pay a visit, and repent !
WWWeather4expeditions
 WorldWideWeather4Expeditions: support your expedition with weather forecasts.
Weather plays a key role in the success of an expedition. Every other element such as food, clothes, gear, physical and mental preparation and medicines, can be perfectly prepared before departure. But the weather remains an uncertain element.
Of course you can pray, or burn a candle to make the weather gods happy. This may work, if your name is Mother Theresa...
WWWeather4expeditions is a service to support your expedition with professional weather forecasts. This will put you in the possibility:
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to take advantage of the best winds to kite long distances,
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to travel with good visibility to see perfectly crevasses or other dangerous elements
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to avoid severe storms or other hazardous weather phenomena
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to make the best possible planning
Recently, weather models have improved significantly. Even in remote areas the resolution of certain models is incredibly large which leads to quite impressive forecasts of the different parameters.
WWWeather4Expeditions is a team of three experienced meteorologists, each with their own speciality:
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Marc De Keyser: Arctic and the Antarctic weather
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Tom Elegeert: weather in mountains and tropical areas,
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Fritz Buyl in all around the world sailing races or trips.
They produce ‘ready-for-use-weather forecasts’ sent daily to your phone by SMS-service or email. On top of this you can contact them if needed. In order for your expedition to be successful, consider weather support. You can surf to the website www.weather4expeditions.com or contact mdekeyser@weather4expeditions.com for more information and talk about possibilities and arrangements.
Extreme Series
.gif) We now have six ultra races in our extreme series of events these include:
Costa Rica 24hour Adventure Race
Namibia 24 hour Ultra Marathon
Al Andalus Ultra Race - Spain
Iceland Ultra Race
Taj Mahal Marathon
Namibia Marathon
For further information visit the website
Situations Vacant
, Inca Trail to Machu Picchu, Sacred Valley, near Cusco, Peru2.jpg) We have some exciting new job opportunities for 2008 on our website, these include:
The British Schools Exploring Society are now looking for volunteer medics for their 2009 expeditions. BSES is a youth development charity organising challenging scientific expeditions to a remote and adventurous locations. The Extreme Arctic expedition to Svalbard leaves in early April for 10 weeks and BSES is looking for a doctor who is confident leading young people in difficult conditions and has some mountaineering experience. Positions also exist for qualified doctors on summer expeditions to the Ladakh region of the Indian Himalayas, the Peruvian Amazon rainforest and Arctic Norway (on both a kayaking/mountaineering expedition and a Leadership Development Programme). Each of these expeditions lasts 4 to 5 weeks in mid July to mid August. For more information please look at www.bses.org.uk or contact us on expeditionmanager@bses.org.uk
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 2009 .
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 blog
We have set up a blog here at EML, feel free to have a look and add a comment or two. We have videos, course write ups, photo's and much more so take a look.
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