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Healthcare in Ghana – The Harsh Reality of a Developing Country

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Trixton May shares his experiences of healthcare in Ghana

Background

‘Yaw’, that was the local name given to me as a male, born on a Thursday; one of many traditions the locals live by here in Takoradi, Ghana. My independent venture to West Africa during my second year of student paramedic studies was a challenging decision. Still, one I will always hold as my most significant life experience to date. With aspirations to serve in areas less fortunate in my future career, this step was the first of many more to come within humanitarian medicine. Ghana was a country I had no motives behind travelling to, I wanted to walk into a new culture and health care system blinded to learn to survive.

Ghana is a standout country compared to other West African cultures, with 40% of the population signed up to a National Health Insurance Scheme (NHIS). On paper, these schemes seemed beneficial to the Ghanaian Government. However, in practice, they have been shown to fail. Many factors play a role in funding health care in Ghana, the primary source being the country’s oil production capabilities. The Government of Ghana is pushing to have a healthcare service beyond aid, meaning they are moving not to become donor dependant.

Due to the adversity of Covid-19, I had multiple barriers travelling and working in Ghana, which resulted in having my trip condensed. I have no concerns that the few images displayed in this article will talk enough for themselves about the working conditions. Additionally, I must warn you that some topics and visuals may be disturbing. However, I strive to summarise my experience of the healthcare system in Takoradi, with the attempt to highlight the privilege for which we withhold having a free and established, yet unfortunately abused, healthcare system in the United Kingdom (UK). My end goal is to encourage others to see the beauty that we refer to as the National Health Service (NHS) and change the approach we all view and use the NHS.

Click here to read Trixton’s full Ghana experience > 

Live Session: “The Duracell Bunny” – Oncology, Elite Triathlon, and 5k Your Way

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Wednesday 22nd September at 7.30pm (BST)

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Guest

Lucy Gossage – Oncologist, 14 times Ironman champion and co-founder of 5K Your Way, Move Against Cancer, based in Nottingham, UK.

Overview

With little sporting background, Lucy entered her first triathlon as a dare while working as a junior doctor in 2006. Over the years she became one of the most well-known, popular and successful professional long-distance triathletes in the world. She calls herself an ‘accidental pro’, is referred to by the triathlon press as the Duracell Bunny, and is renowned for her unique finish line celebrations, #doingalucy. 11 of her 14 Iron distance wins were achieved while working part-time as a doctor.

Live session: Pedals 4 Parks

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Thursday 30th September at 7.30pm (BST)

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Overview

If the recent year has shown us anything, it is that we need our green spaces as a place to escape the fast-paced and unpredictable changes of the modern world. For many, 2020-21 has offered an unusual opportunity to explore the landscapes around us and engage with nature in new ways. However, how much do we really know about our green spaces and the impacts that human interference has on their survival?

Enter the Pedal 4 Parks team, who are on a mission to answer these questions and show the incredible importance of the UK’s green spaces for humans, wildlife and the future.

The team of 5 environmentally aware eco-warriors set out on a two-week cycling journey, using hand-built bamboo bikes, across six of the UK’s National Parks, fuelled by their passion for green space conservation and the desire to unearth what more we can do to save them. Along the way, the team met with numerous experts and devotees in the environmental and sustainability space, to help us understand how humans are interfering with these landscapes and what scalable solutions there are for regenerating and restoring our natural outdoor spaces. The relationship between green space and wellbeing is one that all of the team feel has been central to both their physical and mental health.

Setting off in June 2021 the team completed the famous JOGLE (John O’Groats in Northern Scotland to Lands End in Southern England) with a unique twist, making it a world’s first! The team’s journey started at the northern tip of the Orkney Islands, cycling all the way to the Isles of Scilly, pedalling an impressive 1,200 miles. More still, cycled across land, but also across 50 miles of water using specially made water bikes.

Guests

Issac Kenyon:

Isaac (AKA Mr.Enthusiasm) pursues the extraordinary and inspires others with his infectious enthusiasm and philanthropic approach to life. Isaac comes from Luton where he says his school failed and was shut down and reopened with some help from the government. In short, Isaac didn’t have an easy entry to adventurism with little access to outdoor green spaces. Isaac’s parents were very protective and wouldn’t trust the local green spaces/parks to hang around in as they were usually full of gangs and unsafe, so he spent much of his childhood indoors either swimming in an indoor pool, at school or at home.

It was only at university Isaac started to learn about the outdoors in a safer area with plenty of green spaces and he immersed himself in it and never looked back. Unusually Isaac started the Duke of Edinburgh award aged 20 years old reaching Silver alongside his degree, he says it wasn’t promoted at school and had never even heard about it until it was mentioned at university. Since completing a degree in Geoscience Isaac has become an adventurer and outdoors ambassador working with social groups like the Scouts/schools in poor communities inspiring them to connect with nature and the outdoors. Previous challenges have included a swim across the English Channel, Mt.Kilimanjaro Summit, Three Peaks Challenge twice and an unsupported row across the Atlantic ocean.

 

Alex Pierrot:

Constantly curious and committed IT Infrastructure Engineer actively pursuing my career interests in cutting-edge low latency Linux Infrastructure.
Skilled in Linux Systems Administration, Systems Engineering, Technical Communication and Western European languages.

Lukas Haitzmann

As a child, Lukas suffered a lot from Dyslexia. He was pulled out of sports and his favourite subjects to learn to read and write properly. He wasn’t performing well in school, and was missing out on the things that made his days at school fun- just to ‘catch up’. It defeated him and it kept him down. It wasn’t until his secondary school days that one short moment changed his life.

This brief moment in time led to Lukas eventually rowing 3,000 miles across the Atlantic Ocean completely alone and unassisted in the Talisker Whiskey challenge. At the age of 18, he spent almost 2 months alone at sea. Rowing for 16 hours a day. Every day. For what seemed like an eternity.

The adventure offered a different challenge to the one Lukas had become accustomed to – dyslexia and surviving school – instead, the fight was against waves the size of 2 story buildings, mind-numbing solitude and hallucinations. All that aside the biggest battle was the one to purely stay alive. There were no timeouts, no ‘comeback tomorrows’ – Lukas had no place to hide and it was time for his to step up. To no longer be the kid that couldn’t read, but the man that rowed across an ocean.

This challenge sparked his interest in extreme sports and adventures. Lukas realised the importance of challenging yourself on a regular basis and jumping out of your comfort zone. The opportunities for growth and the exponential learning curve far outweighs any negatives.

Lukas decided to join this cycle as he strongly stands behind the crucial message of the challenge, and has no doubt he’ll learn a lot from it.

WEMLive session: Rocky Mountain Medicine

Another fabulous Monday, FREE #WEMLive session on Mountain Medicine that you will not want to miss out on!!

WEM Founder Mark Hannaford is privileged to be speaking with ace-medics from the Grand Teton National Park; Firefighter & Paramedic Kevin Grange award-winning author of ‘Wild Rescues’, and Dr Will Smith, Medical Director of the US Nationals Park Service.

On July 21, 2010, Will was the medical director in a search and rescue operation to find three separate parties of 17 people who were stranded above 13,000 feet near the summit of the Grand Teton during a lightning storm. It was the largest rescue event to occur in Grand Teton National Park. He was the medical supervisor for 16 of the 17 people rescued. The next day, the rescue operation continued to retrieve the one person who died after being struck by lightning and falling 3,000 feet. The rescue involved two helicopters, a dozen climbing rangers, two mountaineering physicians and numerous other responders. “It was a monumental test of rescuer skills and stamina, combined with incident command management ability,” said Fire Rescue Magazine.
Kevin’s book ‘Wild Rescues’ is a fast-paced, firsthand glimpse into the exciting lives of paramedics who work with the National Park Service: a unique brand of park rangers who respond to medical and traumatic emergencies in some of the most isolated and rugged parts of America. In 2014, Kevin Grange left his job as a paramedic in Los Angeles to work in a response area with 2.2 million acres: Yellowstone National Park.
Miss the FOMO and become a maverick medic and join us Monday 21 June: 11:00 / 18:00 BST
Sign up right here: https://bit.ly/3wGzm3e 
This session will be available afterwards on the WEM Facebook page and the WEM Academy website.

Interested in Mountain Medicine?
Discover our WEM Mountain Medicine course; the ultimate Mountain Medicine Nepal course, where you’ll follow the Everest Base Camp Trail from Lukla along the Khumbu valley to base camp, situated in the shadow of the world’s most iconic peak.

Myanmar Coup: Statement of Solidarity

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We, the undersigned and the organisations we represent, express our grave concern regarding the situation in Myanmar and the persistent abuse of human rights. We are particularly alarmed by the targeting of medical professionals, including those engaging in their human right to protest against the illegal military coup. We stand in solidarity with them and all those who are impacted.

On 1 February 2021, the Myanmar Armed Forces, the Tatmadaw, seized control of the government. Many have protested and medical professionals have been at the forefront, setting up their practices in makeshift health centres and clinics instead of government hospitals. The Tatmadaw have responded with appalling brutality including targeting medical professionals and interfering in their activities, which is an abuse of the principle of medical neutrality, enshrined in the First Geneva Convention.

Myanmar security forces have shot at health workers without provocation, arbitrarily arrested many, assaulted some, and forced others to flee their homes. In Yangon alone, at least a hundred medical students have been arrested.

This is a gross violation of the rights of doctors and it is also detrimental to the healthcare of patients, diminishing their right to the highest standard of health which is guaranteed by the International Covenant on Economic, Social and Cultural Rights which was ratified by Myanmar in 2017. Not only is medical care being provided in makeshift health centres with limited resources and facilities, but actions by the Myanmar military, such as cutting off internet access for large sectors of the country, further harm the ability of doctors and nurses to offer the highest level of care.

As doctors, and representatives of medical professional organisations, we are appalled by the treatment of peaceful protestors, especially our colleagues, and the resulting impact on healthcare. Members of our organisations are currently providing support to healthcare professionals in Myanmar and the reports we have received from them and others paint a damning picture of the actions of the Myanmar security forces.

We strongly urge the Tatmadaw to release all those they have arbitrarily arrested, to respect the right to freely protest, and to respect the principle of medical neutrality: allowing medical professionals to provide healthcare unimpeded. We urge telecommunications companies to extend coverage throughout Myanmar (to counteract the steps taken by the Tatmadaw) and the international community to explore coordinated action to oppose the abuse of human rights.

We have included resources at the end of this letter that may be of use to medical professionals looking to support colleagues in Myanmar and may also be of some help to doctors in Myanmar.

Sincerely,

Dr Chaand Nagpaul CBE
Council Chair, British Medical Association (BMA)

Dr John Chisholm CBE
Chair, BMA medical ethics committee

Dr Kitty Mohan
Chair, BMA international committee

Dr Adrian James
President, Royal College of Psychiatrists

Dr Katherine Henderson
President, Royal College of Emergency Medicine

Mr Edward Morris
President, Royal College of Obstetricians and Gynaecologists (RCOG)

Miss Ranee Thakar
Senior Vice President for Global Health, RCOG

Professor Martin Marshall CBE
Chair, Royal College of General Practitioners (RCGP)

Dr Helen Crawley
International Medical Director for Membership and Networks, RCGP

Professor Andrew Goddard
President, Royal College of Physicians (RCP)

Dr Mumtaz Patel
Global Vice President, RCP

Professor Neil Mortensen
President, Royal College of Surgeons of England

Professor Helen Stokes-Lampard
Chair, Academy of Medical Royal Colleges

Dr Jeanette Dickson
President, Royal College of Radiologists

Mr Ben Simms
Chief Executive, Tropical Health and Education Trust

Mr Chris Jones
Chief Executive Officer, British Medical Journal

Dr Tanya Bleiker
President, British Association of Dermatologists

Professor Adrian Gelb
President, World Federation of Societies of Anaesthesiologists (WFSA) and WFSA (UK)

Mr Julian Gore-Booth
CEO, WFSA and Secretary, WFSA (UK)

Mr Amal Paonaskar
Head of Programmes, WFSA

Dr James Brockbank
Myanmar-UK GP Health Action

Dr Sonny Tin Tun Aung
Myanmar-UK GP Health Action

Dr Bethany Moos
Medics 4 Myanmar

Mr Mark Hannaford
Founder & Managing Director, World Extreme Medicine

Ms Evelyn Brealey
Director, Cambridge Global Health Partnerships

Dr Emma Mitchell
Global Health Roots

Dr Nazaneen Nikpour
Global Health Roots

Resources
• Videos on providing first aid care (narrated in Burmese): https://youtube.com/playlist?list=PLJgobuRNCrM0W1E2T7zSW1KxCefRWJduo
• Myanmar clinical guidance, including virtual support for Myanmar doctors and nurses: https://www.myanmarclinicalguidance.com/
• Support for Myanmar: https://www.isupportmyanmar.com/
• Action Aid, Myanmar: https://www.actionaid.org.uk/about-us/where-we-work/myanmar
• Médecins Sans Frontières (Doctors Without Borders), Myanmar: https://www.doctorswithoutborders.org/what-we-do/countries/myanmar
• UK GP skeleton statement for writing to your MP on the issue (can be adapted by other clinicians also): https://www.gponline.com/uk-gps-helping-support-doctors-myanmar- following-military-coup/article/1711338
• Webinar series ‘Medics 4 Myanmar’: WEMAcademy and WEM Facebook page

Skin in the Game – The Risk and Reward of Mountain Rescue

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Mountain RescueWEM Faculty share what it means to be part of a Mountain Rescue Team

The mountains were once the domain of farmers, shepherds, road builders and quarrymen. There for necessity, rather than pleasure, the harsh surroundings acted as a constant reminder severe injury on the hills would most likely result in death. Despite best efforts and good intentions ad-hoc, makeshift rescue by members of the local community, over difficult terrain, was far removed from the 21st Century Mountain Rescue service we are now familiar with.

It wasn’t until the birth of modern mountaineering in the late 18th Century when walking and climbing became a past-time of the rich, rather than a chore of labourers, that organised mountain rescue was even conceptualised. Yet, it took a fatal accident in the Peak District during 1928 to formulate the structured teams we rely on today.

Hidden among World Extreme Medicine Faculty, and the medical professionals you serve with, are the exceptional volunteers that transition their skill-set from a traditional medical setting to a challenging, outdoor environment.

Jamie Pattinson: Paramedic

The first thing I always say is, “I’m Jamie from Mountain Rescue, I’m here to help you”. I try to make sure we keep them informed, “There’s going to be a bit of noise as we get close to the helicopter, it’ll be a little bumpy as we move you, I’ll be at your left shoulder the whole time though”.

I’ve been part of countless incidents, some with positive outcomes, some not. Every time we get called out the stark reality of the situation is always on my mind, going to the aid of someone who, but for the grace of good fortune, could easily have been me. There is a huge sense of pride when we get the job done, I’m not ashamed to admit the high fives and buzz after a successful rescue. And, as the Medical Officer, responsible for ensuring the medics of our team are well-equipped, competent and confident, the sense of pride and reward when the team comes together is second to none.

We are called out in the harshest of conditions; long hours in the cold, wet and darkness. The risk to ourselves, while mindfully managed, is nevertheless a feature of the work. Every single member of the team cares, and it is that vulnerability that enables us to give our all when required, both for the casualty and for the team. Mountain Rescue is a family and the bond that you forge with each other, over the hours of training and live operations, is one of the closest I have ever experienced. Ultimately, this is what makes my role so rewarding, overcoming the challenges and obstacles to get the best outcome for the person. Mountain Rescue has given me the career, friends and experiences that shaped who I am.

Wayne Auton: HEMS Paramedic and Specialist Retrieval Practitioner

When you finish the job and are having a cup of tea back on base, knowing each other performed during a difficult rescue, the bond is formed. It gets stronger and stronger the more time you spend on the mountains. Respect, admiration, camaraderie.

Adversity brings people together in a way you only get from the most difficult of experiences. Mountain Rescue offers that type of experience; looking after yourself and the casualty in an austere environment, post-avalanche or white-out is a good example. The challenge. You’ve got to have your mate’s backs and you have to know they have yours. The trust. When you get the call there’s a little niggle of fear and excitement, no outcome is certain when you head out, everything plays out in real-time and you have to respond because people are relying on you. The responsibility. Every decision you take has an impact on the result but it’s a pressure you secretly enjoy which is one of the pulls of this job. We’re so fortunate in the U.K that we can go into the mountains knowing there are a group of professionals willing to give up their time to help us, to be part of that is a great privilege.

Ben Cooper: ED Charge Nurse and Advanced Nurse Practitioner

01 January 1993 I had my first introduction to Mountain Rescue the hard way. I fell climbing, plummeting into a waterfall plunge pool. I woke up wet, in pain, and bloodied. I looked around, my climbing partner suffered massive facial trauma, his helmet split in two. I opened my backpack, grasped for the whistle and started to blow the emergency distress signal. I’m still friends with the Mountain Rescue called to my location that day, I was the 4th incident they dealt with, they inspired me to join.

It was exciting, I was 20 years old and getting to know my team who were all like-minded climbers and mountaineers. I got invited to engagement parties, weddings and birthday parties, treated like a member of their families. Mountain Rescue is a fraternity and often teams are made up of multiple medical professionals, at one point 12 of us worked together in the mountains and also the same hospital.

Yet, despite experience, the worst outcomes never fail to touch you. We got a call to a fallen climber on a crag very local to where we were. Within 20 minutes we were on scene, within 21 minutes I was doing everything I could as a 4-year qualified senior staff nurse to save a young climber’s life. The Sea King helicopter arrived and whisked us off to the hospital where I worked in A&E. I handed the casualty over, but after a time the young climber was pronounced dead. The sister on duty put her arms around me and said, “You’re going to help me clean this young man up and prepare his last offices as part of your grieving process”. Afterwards, we had a debrief as a team in the local pub. Later, over the following weeks, I was called regularly to make sure I was OK. That’s what happens on Mountain Rescue, you look out and after each other. It’s more than just rescuing people, it’s more than a team… it’s a family, a big family with a huge heart.

How to Volunteer for your local Mountain Rescue Service

There are many ways to support your local Mountain Rescue from being a part of operations to fundraising. Even an hour or two a week makes a huge difference.

Mountain Rescue England and Wales: www.mountain.rescue.org.uk/how-to-volunteer/

Mountain Rescue Scotland: www.scottishmountainrescue.org

Mountain Rescue Northern Ireland: www.communityrescue.org/about-us/

If Mountain Rescue isn’t your bag other volunteer emergency services include the Royal National Lifeboat Institute: RNLI lifeguards and lifeboat crew,  (https://rnli.org/support-us/volunteer/how-you-can-volunteer), Coastguard Service (www.gov.uk/volunteer-as-a-coastguard/what-to-expect-as-a-volunteer), and fire service (www.fireservice.co.uk/recruitment/retained-firefighters/).

Up-skill to Volunteer for Mountain Rescue

To apply for volunteer positions the following core skills courses may be a useful addition to your portfolio:

Expedition and Wilderness Medicine (Keswick, Plas Y Brenin, Corfe Castle and Slovenia): www.worldextrememedicine.com/products/all-courses/

Ocean Medicine (Plymouth): www.worldextrememedicine.com/products/all-courses/

Introducing the FEWM Fellowship with NASA Astronaut Dr Mike Barratt

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The FEWM Fellowship is introduced by lifelong student of extreme medicine NASA Astronaut and Flight Surgeon Dr Mike Barratt.

A fellowship built to serve a community of professionals committed to medicine in the most challenging environments.

World Extreme Medicine is excited to announce the FEWM Fellowship! (Fellowship Extreme and Wilderness Medicine).

This movement is OURS
And our time is NOW

What is it?
A standardised framework of experience, competencies, and values that denotes a benchmark for practitioners of Extreme Medicine.

What does it add?
This is a Fellowship like no other. A fresh approach, built to serve the dynamic, inclusive, and diverse global community of Extreme Medics from all walks of life.

It’s a fellowship that recognises and elevates the key members of this community: teachers, role models, and thought leaders who are forging the path for the next generation. You don’t need to be part of any existing ‘old boys’ network’ to join.

There’s no requirement to be nominated by an existing member. The criteria are clear and simple.

Whatever your background, wherever you are in the world, if YOU’ve made a significant contribution to the care of patients in extreme settings, YOU can apply.

Who can join?

All health workers and allied professions that directly support the delivery of medicine in extreme settings are eligible to apply. You will need to demonstrate how you meet the required level of competency and experience through an online application form.

What are the benefits?

– Become an integral part of a dynamic and cohesive global community
– Gain instant access to a network of like-minded, highly skilled professionals
– Use the post-nominals FEWM
– Gain full access to the closed FEWM forum
– Gain full access to the WEM Academy CPD platform
– Gain discounted access to WEM courses and conferences

What if I want to be part of this, but I don’t have enough experience quite yet?

There is also a ‘membership’ level for more junior clinicians and students who would like to be involved and find opportunities that will open the doors to an extreme career. You are entitled to many of the same benefits above, although members are not entitled to use the post-nominals ‘FEWM’.

For pricing and more information head to the FEWM website.

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Medical Volunteering in Moria Refugee Camp

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Doctors Flora Burns and Rose Brenna discuss and share their own experiences of medical volunteering in Moria Refugee Camp – December 2020

In September 2020, devastating fires at a refugee camp on the Greek Island of Lesvos were reported in the news. This once again brought to the forefront of people’s minds, the desperate situation of many people fleeing their native countries and seeking asylum abroad. In this article, we provide a firsthand account of our experiences volunteering as doctors at this very same camp earlier in the year. We hope that it provides the reader with a useful insight into current conditions in these camps, and perhaps even provides inspiration for action.

Mória Refugee Camp, on the Greek Island of Lesvos, was built in 2015 to accommodate 2,200 of the growing number of refugees escaping conflict and poverty across the Middle East and Africa. There are currently between 12,000 [1] to 20,000 [2] people living there. Owing to the camp’s overwhelming growth many inhabitants have been forced to spill out into the surrounding olive groves; building makeshift homes out of whatever they can find. This is an area known as ‘Mória Jungle’ [5]. Once named ‘the worst refugee camp on earth’ by the Field Coordinator of Médecins Sans Frontières (Doctors without Borders), many of those living there have waited for over a year for interviews to further their asylum process. Of the asylum seekers arriving in the Aegean Islands, 46% are from Afghanistan, 18% from Syria and the remainder from countries including the Democratic Republic of Congo, Somalia, Iraq and Iran [3].

In 2017 the risk of tension between communities living in the camp was rated as ‘red’ by the United Nations Refugee Agency. A number of other factors at the camp were also assigned this status including the nutritional value of food available, access to cooking equipment, and participation of school age children in formal education [3]. It is estimated that between 6,000 to 7000 camp inhabitants are children under the age of 18 [2].

We travelled to Lesvos in the summer of 2020, to volunteer as doctors with Medical Volunteers International (MVI). MVI is a non-governmental organization that has been providing medical care to displaced people in Lesvos, Thessaloniki and Athens since 2016 [4].

After arriving in Lesvos, we were required to follow a strict two-week isolation to minimize our risk of spreading Covid-19 in the camp. Covid-19 has had devastating effects on what is already a tough life for those living in the camp. However, the Greek government’s strategy to reduce transmission between the camp and the local population of Lesvos has included introducing strict lockdowns in the Camp which has exacerbated tensions.

Neither of us knew what to expect when we eventually started work. On our first day in Mória, as we entered the barbed wire enclosure under the watchful eyes of the Greek armed police, we both sensed an overwhelming feeling of tension and desperation.

The camp’s medical ‘centre’ consisted of a few isoboxes (large storage containers) with 2-3 clinic rooms in each, separated by curtains, and a small pharmacy which relied on donations from NGOs and local Greek pharmacies. In addition to this, there was a separate triage area used to screen anyone with respiratory symptoms of Covid-19. Using WHO criteria, those we identified as medium or high risk would be sent for further tests or isolation and contact tracing.

To prepare us for work at the camp, we spoke to friends and colleagues who had worked in humanitarian settings. The overriding advice we received was to identify our personal reasons for going and keep them in mind day-to-day. The importance of this became evident as our time in Mória progressed. As we talked to refugees and learned about their individual horrific stories, we found ourselves becoming despondent, saddened and powerless considering the scale of the crisis in Europe and beyond.

Upon reflection, it would be fair to say some of our incentive for volunteering was curiosity. Our work in emergency medicine in the UK often sees us treating patients who were once asylum seekers and are now living and receiving healthcare in a very unfamiliar system. It is often difficult to empathize with what they have been through before arriving in the UK. Volunteering in Mória provided a good opportunity to gain an insight into their world, as well as get some firsthand humanitarian experience.

In reality, what we learned in Mória went far beyond our expectations. Of course, we gained experience and knowledge around acute medicine in crisis settings, some of which is outlined below, but perhaps more importantly, we came away with an understanding of the human side to this ongoing tragedy. We hope that our accounts of specific cases will provide you with a true insight into the impossible and complex mess of challenges being faced by people living in Mória, as well as those attempting to work there.

Common conditions in Mória Refugee camp

  • Gastrointestinal – reflux, constipation, gastroenteritis, IBS, intestinal worms
  • ENT – otitis externa and media, traumatic bilateral ear drum perforations
  • Women’s health – thrush, weak pelvic floor, antenatal care
  • Dermatological – bacterial and fungal skin infections, scabies
  • Respiratory – ‘Mória flu – chronic cough due to open fire smoke and dust’, suspected tuberculosis
  • Psychological – insomnia, panic attacks, PTSD, memory loss, low mood, drug and alcohol use
  • MSK – back pain, injuries from torture
  • Other – dental caries, visual impairment, poor nutrition, weight loss

The above list is by no means exhaustive but lists some of the more common problems we saw. Something we quickly realised is many of the medical complaints were secondary to or exacerbated by living conditions and mental health, e.g., gastritis caused by poor diet but exacerbated by stress.

Thought-provoking cases from Mória

Rose: ‘One patient that really summed up the challenges of Mória for me was a woman from Afghanistan in her 40s who presented with the quite common heart sink list of problems including gastritis, back ache and difficulty sleeping. Her main problem was pain in her joints. She had been seen several times before and advised she would have to wait several months until blood tests were available for potential rheumatoid arthritis. When she saw me blood tests were still not available and she was on all the simple analgesia we had to offer as well as a trial of steroids. When I explained there was no more I could currently do she became very upset saying “you’re not helping me here at all, I wish I had never left my country, Mória is much worse”. At this point I felt so helpless, I was doing as much as I could, but she was right, I wasn’t helping, it did not feel fair at all.’

 ‘Another case that really stuck with me was that of a young woman from the Democratic Republic of Congo who was here on her own, which was unusual for a woman. She had come with abdominal pain, something she had had for the past year and had been investigated with an ultrasound but nothing was found. On questioning her further she opened up about being horribly abused by her ex-partner, to the extent he had caused a traumatic miscarriage which was subsequently delivered by caesarian section. The pain had been ongoing since then. Through listening to her story and exploring the reasons behind her symptoms, I was able to refer her on to the domestic and sexual violence support available in the camp’

Flora: ‘The most difficult case I was involved with while medical volunteering at Mória was a prepubescent boy from Afghanistan who presented with genital ulcers. He was accompanied by his concerned father, the young boy was tearful and quiet. With the invaluable help of a translator’s sensitive questions, we ascertained that the family were living in an old bus in ‘Mória Jungle’ along with two other large families. We tried our hardest to get the young boy to open up about why he was tearful and if anyone had hurt him in any way. We asked the father to leave the room for a bit and the boy became even more tearful. He said some other boys had been throwing stones at him and chasing him but denied anyone touching him in a way they shouldn’t.

In the UK, a case like this would appropriately trigger red flags to social services to ensure the child was not a victim of sexual abuse. Genital ulcers can be a symptom of other acute illnesses in children however sexually transmitted infections such as herpes simplex virus should be investigated. I was struck with the heartbreaking realisation that the best I could do for this boy, alongside treating the ulcers with the antiviral medication that the clinic thankfully had, was give him and his dad the time and space to talk about their social situation and try and create a ‘safeguarding plan’ there and then. The anxious father listened and agreed to be more watchful of him. They then disappeared back into Mória. This was one of my last days working in the clinic so I handed the patient over to another volunteer who was able to follow him up.’

Challenges of working as a humanitarian doctor

Medical volunteering in Mória refugee camp presented several challenges that we had not experienced working in UK emergency departments. A key difference was working with translators. We had to modify the way we spoke to allow the translators to understand. In addition, sometimes, despite the patient talking at length, the translator would only provide a few translated words – things definitely got lost in translation! Culturally, we faced challenges when the combination of female patient and male translator arose; neither party would be comfortable discussing intimate problems. On top of this, the majority of the translators were asylum seekers themselves and had been through similar situations to the patients. It was important to be mindful of the underlying factors that may affect the translator and try to avoid potentially burdening them further. Between clinics we had the opportunity to chat with the translators and learn about their stories as well as how they had ended up in Mória.

Access to investigations and secondary care was almost non-existent. There was a several month wait for any blood tests unless it was an emergency (each case would be assessed by the sole Greek doctor in the clinic). The same applied for secondary care referrals, this was again on an emergency-only basis. In terms of mental health support there were only two psychologists, so subsequently only the most severe cases could be seen. This difficult situation was exacerbated still further as, while we were there, much of the community support was unavailable due to Covid-19.

On a more personal note, due to the heartbreaking and desperate situations that we witnessed every day, turning off at the end of a shift and not becoming too emotionally invested was difficult. Working under camp conditions but living in NGO accommodation amongst local Greeks living their everyday lives was a strange juxtaposition. We had to fight an urge to try and force change. We were only there for a short time, and although the system was flawed, we were never going to fully understand it and bring about long-term changes. We had to appreciate what we were able to do both there, and back in the UK. Coming home and going back to work in the comparatively well-resourced NHS, we have realized the importance of perspective when it comes to how people experience ill health and hardship.

How can you get involved?

It was by no means just doctors that were needed camp Mória. Integral roles at the camp included allied health professionals such as paramedics, nurses, psychologist, physios, as well as people with an aptitude for people management skills and logistics. The wider group of NGO workers include teachers, plumbers and lawyers. Medical volunteering in Moria is challenging and not always the most rewarding experience, but overall it is something we would definitely both do again. Even the relatively small changes you make can be significant for people at a very difficult time in their lives.

Top tips

  1. There is no pressure to do things and remember your own limitations. Never agree to work in a situation where you feel unsafe or you are working outside of your competence. You will be working alongside doctors and nurses from many different countries with various backgrounds and levels of experience. The ‘professional hierarchy’ we are used to in our native healthcare systems no longer exists. We were lucky enough to have a consultant in the UK who was happy to answer clinical questions and support us. Don’t be afraid to question practices that you are not familiar or happy with.
  2. Write a risk assessment. Consider your personal and health insurance including any vaccinations and professional indemnity.
  3. Prior experience in medical volunteering – having some experience in primary care or emergency medicine is invaluable. To work with organisations such as Médecins Sans Frontières, the Diploma of Tropical Medicine and Hygiene is an absolute requirement however it is also a very useful qualification to have in many humanitarian settings.
  4. Be self-sufficient – find below a ‘kit list’ we found useful
  5. Don’t be naïve. Do as much background research as you can about the organisation you are working with, the political situation in the country, the outlook for the asylum seekers, cultural backgrounds of translators and patients. Try and remain sensitive to the variety of cultures and religions through your behaviour and dress.
  6. Focus on the small changes you might be making on a case-by-case basis. Strive to be patient. Sometimes the most useful thing you can do for someone is just sitting and listening.
  7. Many of the asylum seekers come from countries where they had very good levels of health care. They have high expectations – managing these can be incredibly challenging and frustrating at times.
  8. The translators are invaluable! We were constantly reminded how vital it is to look out for the translator’s welfare and ensure they remain neutral within a consultation.
  9. Remember your personal reason for going. Keeping in mind your specific aims is useful for maintaining your own morale.
  10. Coming home – debrief and spread the word through reflecting and talking about your experiences.

Kit List

All medical kit below was available in the clinic, except the stethoscopes. However, it may be of questionable quality or not always working.

  • Pulse oximeter, temperature probe and manual blood pressure monitor
  • Ophthalmoscope and otoscope
  • Urine test kit, pregnancy tests and blood glucose machine
  • Any medication you can bring including any over the counter medication that we take for granted in the UK including simple analgesia, diarrhea and constipation relief, multivitamins, antihistamines, cough syrups
  • First aid kit and suture kit
  • Personal protective equipment – the clinic was well equipped with PPE however it was nice to not use up their valuable supply
  • Food and drink – make sure you are self-sufficient you never know when you might be able to get a break
  • A positive mindset!

References

  1. Melissa Godin. Blaze That Destroyed Greece’s Moria Refugee Camp Symbolizes Breakdown in E.U. Over Future of Migrants. Time [Newspaper on the Internet]. 2020 Sept 10 [cited 2020 Dec 01].

Available from: www.time.com

  1. Aegean Boat Report. [Weekly statistics update on the internet]. Dec 2020, [cited 2020 Dec 09]

Available from: www.aegeanboatreport.com

  1. The United Nations High Commissioner for Refugees. Aegean Islands Weekly Snapshot. [Internet]. 23-29 November 2020 [cited 2020 November 03].

Available from: www.data2.unhcr.org

  1. Medical Volunteers International What we do? NGO website [cited 2020 Dec 09] Available from: www.medical-volunteers.org
  2. Bill Frellick. Greece: Refugee Hotspots, Unsafe, Unsanitary. Human Rights Watch. [Internet] 2019 May [cited 2020 Dec 09]

Available from: www.hrw.org



Other blogs that may be of interest include: 

World Extreme Medicine Founder honoured in Iconic Explorers Club Top 50

The iconic #ExplorersClub has recognised WEM Founder Mark Hannaford as one of 50 people worldwide who is actively changing the worldWith 400 nominations received from 48 countries12 judges composed of international Explorers Club members had the monumental decision to select just 12.5% of the women and men nominated for the inaugural ​Explorers Club 50 (EC50)​ program. Strict criteria and the following questions were considered:  

  • Does this candidate’s work involve an outstanding, innovative, and impactful mode of exploration and inspire a greater understanding of the world around us?  
  • Does their work impact the communities they live in, in innovative ways?  
  • Would this recognition help expand the definition of exploration and further promote the Club’s mission? 

The extraordinary findings and stories can be read in this special edition of The Explorers Journal (Mark is on page 15). 

Mark comments: What an honour it is to be part of the prestigious #ExplorersClub and to be recognised as one of 50 people changing the world – thank you so much, Shawna Pandya, for my nomination.  

I feel humbled by the outstanding contribution and work my fellow awardees are making to our society and it’s an honour to be counted amongst them. It’s such an eclectic and vigorous community of explorers, scientists and thought leaders – it is great to see Marc O’Griofa physician, aquanaut, fellow WEM faculty member and friend on the list too. 

I feel privileged to have been invited to become an Explorers Club Fellow. It is also fantastic international recognition of World Extreme Medicine’s work in pushing the boundaries in expedition, wilderness, and remote medicine. Thank you.”   

Richard Wiese President of The Explorers Club says: “I could not be more pleased with the group selected to represent this first class. Every honouree featured [here], as well as the hundreds of other nominees, are exploring, inspiring, and creating the future – the future of the planet, the future of food security, of palaeontology, of biology, what our communities should look like, and so much more. The EC50 was established to not only reflect the great diversity of exploration, but to give a voice to these trailblazing explorers, scientists, and activists doing incredible work.”  

 

What is The Explorers Club? 

Founded in New York City in 1904, The Explorers Club promotes the scientific exploration of land, sea, air, and space by supporting research and education in the physical, natural and biological sciences.  

Past members include astronaut Neil Armstrong, Peter Freuchen (Danish explorer who escaped an ice cave armed with his bare hands and frozen faeces)President Teddy RooseveltSir Edmund Hillary (first to the summit of Mount Everest) and aviator Charles Lindbergh (first aviator to complete a solo transatlantic flight)  

Today the prestigious Club has approximately 3,500 members representing every continent and in more than 60 countries, comprising 34 chapters around the globe; amongst them is astronaut Buzz Aldrin, primatologist Jane Goodall, CEO of Tesla and SpaceX Elon Musk, Amazon CEO Jeff Bezos, film director James Cameron – and now Professor Mark Hannaford Extreme Medicine Pioneer, founder of World Extreme MedicineAcross the Divide ExpeditionsMSc Extreme Medicine (Exeter University) and the world’s largest subject matter conference (#WEM21). 

Doctors for Nepal: Online Auction

folder_openExpedition & Wilderness Medicine, Expedition Medicine, Nepal
turned_in_not,

Our friends over at Doctors For Nepal are hosting an online auction to raise funds urgently needed to provide healthcare workers with much needed PPE, as they serve on the frontline of the COVID-19 pandemic in some of the most remote parts of Nepal.

There are some fantastic prizes to be won – including a flight in a private plane, a unique ‘Glamping’ experience, a week’s rental of an amazing house in the south of France, plus loads of gorgeous handmade Nepalese goods.

Doctors for Nepal is a small UK based charity that raises funds to support some of Nepal’s brightest, but most impoverished students, to train to become doctors, nurses, and midwives. They are bonded to work back in their remote districts, to provide essential healthcare to tens of thousands of patients.

Currently, they are working in terrible conditions, and are in desperate need of outside support to cover basic protection for themselves and their teams. By bidding in this auction, you will help provide essential PPE, and ensure that Doctors For Nepal are able to support the continued training of their students.

Click HERE to start bidding!

All aboard! Life as a Ships Medical Officer supporting an offshore conservation campaign

A few months ago, Arav Gupta replied to an advertisement on our Facebook page – Sea Shepherd were looking for a Ships Medical Officer to support an offshore campaign against illegal and unreported fishing (IUU) in Gabon. He took some time out of his busy life onboard to tell us more about how he got involved, the lessons he’s taking from this incredible experience and how it’s changed his outlook on life…

***

It was within touching distance. Four years since that first taste of expedition medicine on my elective and my FY3 was running as smoothly as I could ask for; I’d finished a fantastic ICU fellowship and in front of me stretched eighteen months to dive into expedition medicine before speciality training began. Countless emails had landed me four trips which had me beyond excited for all the adventures around the corner. Then, the Pandemic arrived. And just like that, a meticulously planned year was looking more unsure than Dominic Cummings’ eyesight. With my trips cancelled, it was back to the upsettingly empty drawing board.

I was on the verge of accepting a fellowship that in truth my heart wasn’t set on when in landed an email containing the most leftfield job offer I’d ever received: the chance to work as a Medical Officer (MO) with marine conservation charity Sea Shepherd Global. The mission? An offshore campaign against illegal and unreported fishing (IUU) in Gabon, an equator-straddling nation on the Atlantic coast of Africa. I’d applied in response to a Facebook post advertised through World Extreme Medicine (WEM), never considering I may actually get the gig. I had to do some reading…

Sea Shepherd has earned a reputation since their foundation in 1977 for their fearless and direct approach to defending marine wildlife from illegal whaling and fishing activity across the world, from the sweltering equatorial Atlantic to the unforgiving polar Southern Ocean. If you ever watched Whale Wars on Animal Planet you’ll be familiar with their historically confrontational methods. They’re not without controversy, but if recent societal issues are anything to go by, tangible progress is driven by radical change, and Sea Shepherd’s results are quite phenomenal: for example being the major player in the cessation of Japan’s whaling programme in the Southern Ocean. It was an offer I couldn’t refuse.

***

Fast forward a fortnight and I was already in the port of Las Palmas, Gran Canaria, where the M/Y Bob Barker, a former Norwegian whaling vessel and my new home, had been moored throughout Spanish lockdown. After a short quarantine, it was already time to get on board. The twenty-something crew I would live with are a community of passionate volunteers from all walks of life who have perfected the constant process of maintaining their 55-metre queen of steel fit for purpose. Many fit into dual roles on board and I am no different, working also as a Quartermaster, which involves a nightly watch on the bridge of the ship (the equivalent to a plane’s cockpit but with binoculars instead of aviators).

And just like that, we were at sea. I had assumed (I thought quite reasonably) that I had turned my back on night shifts for some time to come. How wrong I was. Every night begins at quarter to midnight when my alarm goes off in the cabin following an hour’s kip. As I pull my shoes on, I imagine they’re Jon Snow’s and whisper “Night gathers, and now my watch begins” which hypes me. The stairwell to the bridge door is steep and eerily illuminated by a flashing red light reminiscent of a post-apocalyptic Call of Duty map. At the top, a heavy door opens into the wide bridge and my pitch-black watchpost for the next four hours. My time is spent studying the matrix-green radar, plotting our coordinates on the charts and keeping vigilant for errant fishing vessels crossing into the marine parks. It’s not difficult to imagine that we’re pushing new galactic frontiers when the windows are shut and the bridge is silent. There’s no time for caution.  I’ve even learnt how to steer and hope to get signed off on some basic proficiencies before I go home. On my fourth night, muscle memory had me relieved that it was my last night. I then realised these aren’t ICU nights, and there are no zero days here. This is my routine now and will be every night while we’re at sea. The constant fine tuning and elements of risk management has me drawing parallels with anaesthetics and ICU, as does the regular data plotting. Perhaps that’s why the watch so far has been an oddly satisfying experience.

Of course, my main role is that of the ship’s medical officer and I’m lucky that there is a nurse-turned-deckhand on board too. On arrival, I was surprised to find out we’re stocked with full capabilities to intubate a casualty! Initially, this made me nervous, but I’ve since reflected that equipment present does not necessitate use, and if I’m not trained to perform certain procedures at home, I need to know my limits here as well. Furthermore, what would be the post-intubation plan without a ventilator?

Speaking of ventilators, let’s discuss a good old pandemic. Have you heard of Covid-19? It’s a virus that grows on 5G masts and dies if you drink bleach. My one reservation in working with Sea Shepherd presently was of course Covid-19, a virus I’d had the pleasure of befriending in ICU earlier this year. My short notice arrival was partly due to the NGO’s desire to have a doctor on board to enact Covid-19 precautions and in the worst case, manage an outbreak. I already had access to a comprehensive risk assessment of crew activities, a safety protocol for boarding fishing vessels and a large supply of PPE. For all the paperwork in the world however, reality has an uncanny way of playing against the rules.

At the end of our two-week transit from the Canaries to Gabon via the pirate-infested Gulf of Guinea, we arrived thirty miles outside the port of Libreville. Under the cover of darkness, we dispatched our two RIBs (small powerful mercenary boats that we use to board vessels) to collect six marines and four government officials from shore. We were told they had self-isolated for two weeks and would have negative Covid-19 tests. As the ships medical officer I am on perpetual standby and was woken up at 2300, quite literally the 11th hour, to come to the bridge.

Our initial information was that one of the marines due to board had tested positive and had been sent home. They had all travelled to the clinic in the same vehicle. The RIBs were already in port, loading up the other nine. A myriad of questions was flying through my mind, trying to ascertain level of exposure, test details and RIB logistics. Should we allow boarding? Why had this information only just arrived? At some point during the meeting, a call came through with more intel: it was a serology test. A collective sigh of relief from the others in the room but my suspicions were still raised – why had he been sent home based on a serology test? I also realised we still didn’t have the PCR results for the rest of the marines. After a prolonged brainstorm with incoming drip-fed updates, we decided to radio the RIBs to leave the marines in port and delay collection by a day until the PCR results came through. We finally got through to them after several attempts when they were already one mile from shore with the marines already on board. To add to that, one of the RIBs then broke down and was finally recovered at 0430. Talk about Sod’s Law. Luckily, a full house of negative swab tests was received the following morning and a significant campaign delay was avoided.

Living offshore is the ultimate amnesic for Covid-19 and the night’s proceedings had served me a hefty slice of reality check pie. With our Gabonese colleagues now on board, patrols and therefore vessel inspections were soon underway. Illegal fishing vessels in the area are often crewed by multiple nationalities, both local and from afar. Language barriers and working conditions mean it’s virtually impossible to guarantee their Covid-19 status. With an ethos of “control the controllable”, we’ve taken doffing to a new level, converting the bow into a hot zone for decontamination upon return to our ship after boardings. It’s not perfect, but expedition medicine by nature isn’t.

A successful expedition medically is one where I have to treat very little. Minor illness is however inevitable and I’ve managed presentations that would be common in primary care such as pompholyx, sciatica and stubborn traumatic olecranon bursitis. Exciting as malaria prophylaxis and hand hygiene are, every medic relishes the idea of having a slightly hairy situation to manage (The chest rash doesn’t count). There have been flashes of so-called expedition medicine: Removal of a chigoe flea (Tunga penetrans, a local parasitic insect) from a beneath a toenail and a swim stop resulting in stings from a mop of wayward jellyfish filaments come to mind, not to mention plenty of seasickness. Awkwardly, the most acute injury was my own, crushing my finger under a rung of the rope ladder back onto our ship after a boarding, held down by the full weight of the RIB below me. Thirty seconds of increasingly loud calls for the RIB to move away left it numb and misshapen, but a buddy strap and time has done the job – it could have been much worse!

***

The pace of life onboard has created more personal headspace to think analytically about processes around me, often using past NHS experience as a comparison. One of the most eye-opening experiences so far was less to do with human medicine, but rather human factors, the bane of junior doctor teaching that I never thought I’d admit an interest in. Human factors describe the infinite number of psychological and behavioural influences that allow a group to work efficiently and safely towards a goal. In healthcare, we often learn about it in the context of aviation and how recognition of human factors has made the industry many times safer in recent decades.

One muggy evening the call came down from the bridge: a live net had been spotted in the water. It was the end of a busy patrol day, several crew had been out in the RIBs for hours and were exhausted. It had just started to rain. It was one hour till dark. Insert pathetic fallacy here. Nevertheless, within minutes, most of the crew were out on deck peering over the bow at the fishing buoy. A snappy decision was made to snare the line and retrieve it. Fast forward ten minutes and I felt as if I’d been transported to a Sunday fish market. Our crew of passionate volunteers was hauling up the line, large eels hooked on at one-metre intervals – alive. Two crew members experienced in marine biology became impromptu surgeons, using pliers and tweezers in the fading light to remove hooks and toss the dazed fish back to the murk. It was noisy, dark and chaotic to say the least. I had a strong sense of too many cooks and decided to take a step back to process what was unfolding in front of me. We had a fishing line of unknown length (it turned out to be nearly 5km), innumerable fish waiting to be hauled up, a team of variable experience and no overriding plan.

“Unsustainable” sprang to mind. The mammoth effort for me was summarised when instead of an eel, the next animal on the line was a hammerhead shark. It was devastating to see such an iconic and majestic creature, a species I’d spotted swimming freely earlier that day, dragged up on several hooks. It was immediately clear that the poor shark was dead, yet precious time was spent removing the hooks when it was futile. The crew were mucking in with admirable enthusiasm, but I couldn’t help but compare it to my experiences at in-hospital cardiac arrests. There, the team leader is trained to step back for perspective and allocate roles to staff. This helps team members avoid the trap of getting sucked into tasks that they may be comfortable with but are counter-productive. I headed to the bridge to relay my observations. If this were a terrorist attack, we were doing the equivalent of randomising all victims into a queue and treating the person at the front with all our resources, regardless of injury severity and blind to what was coming next. Mass casualty triage is a nightmare scenario for any expedition medic and one that requires a head-not-heart approach. With a crew of dedicated conservationists who care so much for ocean life, this was the real deal.

Eventually, the focus started to change and the approach became more systematic, perhaps in part due to the thoughts I relayed to the captain, but mainly due to the innate gravity humans have towards order and improvement. Our approach became more rational, prioritising faster line retrieval and humanely killing eels with hooks embedded too deep, ending their suffering and enabling us to remove the lethal snares rapidly. In this way, they could be returned to the sea to become safe food for predators. When the line finally became stuck under our hull four hours after it was spotted, it had to be cut and left to sink to the ocean floor, sadly condemning all the remaining anonymous animals to a slow demise.

***

The whole experience was an exponential learning curve for us all. This was my first time at sea, I told some of the more experienced conservationists the next day. I don’t know how to retrieve nets or operate on fish (or for that matter people!) but I have had human factors drilled into me once a month for 3 years (a slight exaggeration). If this or any new challenge were to arise again, a step back and a deep breath before diving in would do wonders for our work. I’ve often said that my mantra is “there’s always time.” Normally, that refers to my chronic refractory FOMO and wanting to say yes to everything that comes my way. Now, however, it took on a more salient meaning. Even in the most headless of times, there is nearly always time to step off the gas, stick your head into neutral and apply a little handbrake to your situation. It may just be the headspace you need to save a fish.

The illegal line retrieval has so far been a one-off occurrence, although for some Sea Shepherd campaigns ghost-net recovery is the focus of the mission.  The crux of our work in Gabon is the international issue of illegal, unreported and unregulated (IUU) fishing. This umbrella term refers to activities that contravene fishing and conservation laws, including unlicensed vessels, improper management of bycatch (unwanted species such as sharks, cetaceans and turtles) and falsifying records to maximise revenue. These processes destroy ecosystems and have brought hundreds of species to the brink of extinction. Incredibly, some sources suggest that 25-40% of global seafood catch could be traced to the IUU industry. In recent years, Sea Shepherd has been working collaboratively with several West African governments in Gabon, Benin, The Gambia and Liberia to assist them in enforcing their fishing regulations. Gabon’s laws are strict compared to its neighbours but enforcing them in the open ocean is a tall order. By providing our ship, crew and experience, we help to facilitate law enforcement through fishing vessel inspections and making arrests when appropriate. At our campaign’s half-way point, we’ve made two arrests, detaining a pair of trawlers caught with nearly one tonne of illegally finned rays and keeping endangered species for commercial use. I recently read a BBC article that this year’s closure of Southern African safari tourism has led to increased poaching activity. I can’t extrapolate to West Africa’s coastal waters, but what is clear is that the pandemic has not stopped marine poachers from recklessly damaging this fragile ecosystem. That said, our overriding approach seems to be working; this is our fifth year in Gabon and the number of illegal vessels caught annually is showing signs of decline.

***

Without a doubt, this year has been a force for reflection for the majority of us. In a year where no one’s plans have come to fruition, we’ve had a rare opportunity to stop and reevaluate what’s important to us in our lives and how we interact with the world around us. Back in January, I was off skiing when that flurry of offers for expedition medicine jobs came through. I arrived in France with one and left with four – I couldn’t believe my luck! In the last months, four became three, two, one and then finally none. I’m extremely lucky to have replaced them with this incredible conservation campaign in Gabon, a trip I could have neither predicted nor committed to if Covid-19 hadn’t reared its ugly head.

The silver lining has got me thinking about what I’ve lost and gained: I’ve missed out on adventure tourism trips to Kilimanjaro, the Amazon and the Himalayas but found an eye-opening replacement. As well as the very nature of the campaign, living with others who care so much about our impact on the environment has got me thinking about the direction I want to head in with future expedition endeavours. Adventure tourism can be one of the most exhilarating ways to experience a country’s natural landscapes, but also bears the risk of damaging them and their inhabitants.

All companies recognise this and go some way to mitigating these risks, promoting the idea of eco-tourism, sustainable development and fair treatment of local staff. Some do this better than others, and in the future, I will be doing more to sound these attitudes out before committing to a trip. Life at sea and long discussions with my officer have also prompted some thoughts about pushing out into the world of humanitarian medicine. Her long-standing work with Sea Watch is inspirational. It’s an NGO committed to rescuing stranded migrants in the Mediterranean and will certainly be getting my look-in. Pushing my own career is possible while minimising the negative impact on the world around me. Not saying I’ll be going vegan, but it’s food for thought.

***

Last week I persuaded Spotify to work and had the pleasure of listening to a WEMcast interview with adventurer Anna McNuff. I related to her story immensely: Her rowing career took her painfully close to Olympic selection, reigniting memories of my experience with the Oxford vs Cambridge Boat Race whilst at medical school. After this ‘failure’, she stepped back and reassessed what was fulfilling her in life, finding a new direction through her legendary human-powered journeys. She had some very thought-provoking ideas about how so much of what we do nowadays is goal-directed while focusing little on the journey – the idea that the end rather than the means will bring us happiness. She ventures that if you surround yourself with experiences and people that make you happy, your end-game may be unknown but it will inevitably be a good one. It has to be a balance of course, especially in medicine where so much of what we do is goal-focussed and there are so many boxes to tick. But it’s hard to shake Anna’s reflections, which is why after this two month whirlwind of new adventure, I’ve decided to extend my time here by a month.

Who knows where it’ll take me, but I have no doubt it’ll be a whale of a time.



Other blogs that may be of interest, include:

#VirtualWEM20 Conference Tickets Launched!

Having reviewed COVID-19’s impact on large gatherings, we have come to the decision to move WEM20 over to the online arena and for it to become VirtualWEM20 (book your ticket here!).

While we understand you may be saddened to not be attending Dynamic Earth this October (we are too), everyone’s safety must take priority.

That said, we believe your continued access to new learning opportunities is also a priority, so we have a remedy…

Introducing: The Virtual World Extreme Medicine Conference 2020

For the first time in WEM history, we’re hosting a virtual conference – so you can be inspired from the comfort of your sofa (or, frankly, from wherever in the world you can get online).

Split over two action-packed days, you’ll encounter the biggest and best content at VirtualWEM20 that we had planned for the stage at WEM20, plus we’re adding brand new panel sessions and speakers.

We’ve worked hard to make sure you still have a first-rate conference experience, meaning most of what you love about attending a WEM conference in person has been moved to the virtual space:

  • The reception area where you’ll find your schedule, updates from the WEM Team and our fantastic sponsors
  • Live group breakout spaces for our WEM roundtable panels and collaboration with fellow delegates
  • Networking hubs that allow you to search for and discover people to chat to, where you can then jump into a one-on-one private live video conversation
  • Our virtual exhibition hall featuring showcases from our exhibitors and a dedicated chatroom where you can find out more from them directly
  • Your personal profile, where you can share information about yourself with other delegates, upload your picture and be discovered via our networking hub

Conference-specific details, including session times, speakers and how you can get actively involved, will be released via our social media channels and email – so keep your eyes peeled!

Book WEM20 Now

I’m a WEM20 ticket holder – what happens now?

As a paid-up WEM20 ticket holder, you have a couple of options:

  • First refusal on tickets for our 10th anniversary WEM21 conference next year
    Contact us to request that your place be transferred to WEM21 and secure your spot months before they go on sale to the public (you’ll also receive a 10% discount on a place at VirtualWEM20)
  • A full refund for those who can’t commit to WEM21
    You can request a full refund at any time (no need to decide right now, so no rush). We aim to process refunds within 30 days.

Why transfer a WEM20 ticket to WEM21?

A good question deserves an even better answer: because next year signals the 10th anniversary of the World Extreme Medicine Conference!

And since last year was a sell-out (leaving us with an extensive waitlist), transferring from WEM20 to WEM21 now guarantees that place – which means zero FOMO at what promises to be our most extreme event yet.

Do you have information on WEM21?

We’re still working out the details so, for now, picture this:

  • A jam-packed schedule featuring the most prolific convention-breaking, discipline-blending, boundary-shattering medics this side of the known universe.
  • Evening events where rubbing shoulders with those same maverick medics is a must – and at which we may even consider switching our waterproofs for black tie (shocker!)
  • Plus, every detail that makes a WEM Conference so career-defining: tonnes of networking, ‘get your hands dirty’ workshops, outdoor ‘rain or shine’ technical sessions, and bracing morning runs with our team to kickstart your day.

We’ll be heading back to Dynamic Earth in Edinburgh from 13th – 15th November 2021.

Can I buy my ticket to WEM21 yet?

Tickets aren’t available right now, but after the #VirtualWEM20 conference in October, you’ll be able to register your interest with us so we can update your progress and notify you when tickets go on sale.

If you’re a current WEM20 ticket holder, you can ask us to transfer your ticket to WEM21.

We’d like to sincerely thank you for your continued support and patience during what has been a trying experience for us all.
If you have any further questions, please get in touch.



Refund Terms & Conditions

  • If the VirtualWEM20 Conference is cancelled for whatever reason, you will receive a full refund, although you can choose to transfer your funds to the following year which guarantees your space at what we expect to be a sell-out conference.
  • For all delegates who purchased a WEM20 ticket before 22nd July 2020, we are offering you 10% off your #VirtualWEM20 ticket.
    • Please note you can only purchase up to 10 tickets (unless your original booking was of a larger size).
    • Should you choose to transfer your ticket/payment from 2020 to WEM21, and later decide to cancel, our standard cancellation terms will apply. You would also lose your 10% discount for #VirtualWEM20 Conference.
  • Refunds will be processed in line with PayPal’s terms of 30 days. Once received back from PayPal, WEM will issue the refund within 2 days.
  • WEM reserve the right to refuse the purchase of tickets and/or transfer of funds should they deem this necessary.

COVID-19 FAQs for World Extreme Medicine (WEM) Courses

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What are the symptoms of COVID-19?

As stated on the NHS website the main symptoms of coronavirus or COVID-19 are:

  • a high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
  • a loss or change to your sense of smell or taste – this means you have noticed you cannot smell or taste anything, or things smell or taste different to normal
    Most people with coronavirus have at least 1 of these symptoms.

What happens if I start showing symptoms on the course?

  • Inform a member of WEM Faculty at once
  • Look to quarantine yourself at once (facilities will be provided where possible)
  • Should this be the case, we will assess on a case by case basis against several factors, i.e. our location (abroad or within the UK), how far into the course we are and your personal situation and feelings

What information is collected for courses?

WEM Faculty and Delegates:

  • Full name
  • Contact phone number, full home address and email address
  • Date of visit, arrival time and departure time
  • List of which Delegates are assigned to which WEM Faculty members

Third parties:

  • Main contact who work at the premises
  • Contact phone number
  • Dates and times of WEM’s attendance at the training facility

All information is collected in advance where possible. If not collected in advance, this information will be collected at the point of entry to the premises, or at the point of service.

Why do you record arrival and departure times?

Recording both arrival and departure times (or estimated departure times) will help reduce the number of Delegates and WEM Faculty needing to be contacted by NHS Test and Trace. We recognise, however, that recording departure times will not always be practical.

What happens if the course is cancelled and I have already paid?

You will receive a full refund and our usual terms and conditions apply.

I have paid for the course, but am showing COVID-19 / respiratory infection and can no longer attend – what are my options?

You will be able to transfer the course fees to another course of your choice within 12 months.

The customer will be liable for any charges which cannot be refunded by host organisations or agents. WEM will aim to minimise this by working closely with customers and agents.

Are the WEM overseas courses still going ahead?

Yes. We will plan and prepare each course as if it is going ahead to be fully prepared for all possibilities and eventualities. Whether courses go ahead depends on UK and foreign government guidelines, quarantine periods and border and airbridge rules.

(For overseas courses, we suggest you book and plan as normal and we will keep you informed on the situation. If the course is cancelled, you will receive a full refund).

What do I need to bring in addition to the usual course requirements?

  • Suitable face coverings
  • Hand sanitiser for the duration of the course – where practical WEM will provide this for the full group, but we suggest brining your own supply.

I am unsure whether to attend a WEM course or not during this time, what do I need to take into consideration?

  1. All courses that go ahead have been risk assessed and considered safe
  2. Every WEM Faculty member has been briefed on the new safety precautions and logistical changes
  3. If you wish to discuss your concerns or have further questions before booking, please call our WEM team who will be happy to help

How many people are on each course?

The course number varies depending on the course, the location, and the type of experience. Please email us if you would like to know real-time attendee numbers or the attendee in-take cap. Please be reassured that we have taken the right precautions to reduce numbers so we can social distance as much as possible.

What parts of the course have changed due to COVID-19?

  • Part of the course may need to be carried out through online learning. You will be informed of the schedule to complete this task once you have booked. To get this information before you book, please contact us
  • Course numbers of Delegates and WEM Faculty have been reduced
  • Risk assessments (and reassessments) for each course are taken to ensure your safety

FREE WEM Academy Live Session #9: Expedition Medicine Careers Panel  

Find out how you can break into the incredibly rewarding world of Expedition Medicine Careers by hearing from our extreme panel of specialists who have done it all

Host: Mark Hannaford

Joined by: Emma Figures, Luca Alfatti and Taryn Anderson

When: Now available to watch on the WEM Academy site.

Length: 1 hours 30 mins

Ideal for: Health professionals of all grades, stages and training backgrounds

You’ll hear from WEM head honcho, Mark Hannaford, who is joined by Trainee GP Emma Figures, Paramedic Luca Alfatti and Nurse Taryn Anderson to cover your answers on expedition medicine careers, including:

  • What experience and qualifications do I need?
  • What kind of personal qualities are important for expedition work?
  • What resources are available for me to upskill?
  • How do I fit expeditions around my other clinical and family roles?
  • Where do I stand with medical indemnity?
  • How will this pandemic change the expedition and travel landscape?

Here’s why these maverick medic panellists are worth listening to…

Panellist Bio’s (Medic’s like you – so why not you too?)

Emma Figures – Trainee GP & Expedition Medic

In her life before medicine, Emma lived in a caravan in Wales, worked as a healthcare assistant, travelled solo around the world having never been on a plane, hiked the Himalayas, studied Geography at Cambridge and volunteered in Nepal, China, India, Sri Lanka and Zambia (Teaching, Tsunami relief and TB hospices). After graduating, she taught in Geneva and undertook an internship at the UN and WHO, where she attended the Human Rights Council and World Health Assembly.

She then returned to Cambridge to study Medicine and ventured to Borneo for her elective (in a busy city ED and rural jungle clinic). After Foundation training in Cornwall and a Mountain Medicine course in Morocco, Emma returned to Kathmandu with Nepal Critical Care Development Foundation and has subsequently pursued a colourful career in expedition medicine and education.

Her expedition medic work has taken her on charity cycles in Vietnam, Cambodia, Laos and Sri Lanka and hiking challenges in Iceland, the Grand Canyon and Kilimanjaro. She also had the chance to work in Fiji with the famous Dr Joe for the US reality TV show Survivor. Closer to home, she has worked as an Event Medic for a Children in Need Ramble and in the Brecon Beacons with Across The Divide.

Emma completed a PGCE during her clinical teaching fellowship at Birmingham University, before flying off to warmer weather (and Category 5 hurricanes) in the Caribbean, where she was as an Assistant Professor at Saba University. She is now back in the UK for GP training, but continues to dream of faraway places and enthusiastically teaches on expedition medicine courses dressed as a magical unicorn – true story!

——————————–

Luca Alfatti – Paramedic & Expedition Medic

Luca is a HCPC registered Paramedic, who currently holds a Diploma in Paramedic Practice and is hoping to complete his BSc by the end of 2017. When in the UK, which admittedly it is not often, Luca works as a Paramedic in the North West and South West of England.

In addition to this, he is a Fellow of the Royal Geographical Society, Wilderness Expedition Medicine Faculty Member, PHTLS instructor, Mountain Leader and Water Rescue Technician. Luca is also a HEFAT instructor, delivering hostile environment training to journalists both in the UK, before deployment and in-country, during deployment.

Luca also works as a volunteer and fundraiser with Team Rubicon, which is a disaster response humanitarian organisation working both in the UK and overseas.

Luca had always dreamed of travelling EVERYWHERE and in 2005 he eventually drove his own Ford Probe from New York City to Panama City and he never looked back! Luca became an overland driver and mechanic and during this time worked and travelled in over 100 countries across 5 continents. In 2015 Luca was then looking for a new venture and qualified as a Paramedic, with a view to combining this with his love of travel. In the last 2 years Luca has gone on to lead expeditions in places such as Afghanistan, Iraq, Iran and Chad just to mention a few.

Thanks to all those years working on the road his dedication was recognised, with him winning the Wanderlust Expedition Leader of the Year Award in 2012 and awarded a bursary. Luca then used this to set up a sustainable, income-generating, community project in Antigua, Guatemala to support women and their children who have been victims of domestic abuse. This project continues to run to this day.

Luca’s work has featured in magazines like ‘Trek and Mountains’ and ‘Adventure Travel’. His world first crossing of the Dash e Lut Desert, in Iran, in 2015 was featured in the National Geographic Traveller. Luca is also currently writing a publication for ‘Paramedic Insight’ narrating his experience as an expedition medic, for an unsupported winter snowshoe crossing of Spitzbergen.

Luca does not only lead all his trips but, has often designed the trips himself and acts as either expedition leader/medic or both.

——————————–

Taryn Anderson – Nurse & Expedition Medic

Taryn is a qualified nurse who trained in Australia and spent the first part of her career working as a Nursing Officer in the Australian Army. During her time in the military, she completed her Master’s in Public Health and Tropical Medicine and began providing healthcare to in complex remote environments including Kenya, Papua New Guinea and remote Australia.

Moving to the UK in 2015, Taryn began to seek out further clinical challenges and responded to the Ebola epidemic in West Africa as both a Clinician and the Senior Nurse overseeing the Ebola Treatment Centre, which involved developing protocols for stringent infection prevention and control procedures and a comprehensive training program for staff.

During the battle for Mosul, Taryn worked with the World Health Organisation (WHO) as Clinical Coordinator over the course of 12 months helping to establish and run three field hospitals providing damage control resuscitation for trauma patients and two maternity hospitals to provide obstetric care to the people of Mosul.

Taryn has also responded as part of disaster relief efforts providing medical cover to teams deploying to Haiti, Nepal and Mozambique but most recently has been working for WEM providing medical support to the CBS Survivor series in the South Pacific. She continues to regularly return to work in Australia as a Remote Area Nurse providing medical support to some of the remotest areas of the country and is currently enjoying exploring the South of England after a recent move.


 
An edited version of this session can now be located on the WEM Academy site along with a mass of other valuable interviews, resources and lectures to inspire your expedition medicine career.

MSc in Extreme Medicine Focus: Meet Current Student Nikki McLeary

We catch up with current 2nd year student Nikki McLeary as she shares her insights about the world’s first and only International Diploma / MSc in Extreme Medicine course that encompasses Expedition Medicine, Disaster & Humanitarian Medicine and Extreme Pre-Hospital care.

What’s your background?
Extreme sports science and medical publishing, 20 years ago I was working with athletes like Vendee Globe sailors and Formula 1 drivers before ‘extremes’ became sexy! I then spent 15 years overseas operating my own adventure company across desert, winter-mountain, and ocean based locations before returning to the UK 2 years ago to start my MSc in Extreme Medicine at Exeter University. 

What inspired you to sign up for the MSc in Extreme Medicine programme?
It combines adventure, academics, science and medicine, which encapsulate my skill set into something tangible that I can use for businesses purposes. Plus, as a developing field of study new opportunities are continually present. I also liked the fact it is linked to Exeter University which is well-respected.  

What were the main aspects that appealed to you?
It’s uniqueness. I’m self-employed and so always looking for engaging experiences that open doors and this felt like a positive pathway. Plus, the networking opportunities are amazing… WEM literally has an address book of who’s who!

Has it met your expectations so far? 
The faculty are superb. WEM have been really careful about who they have teaching, for example I recently completed Polar Medicine and Professor Chris Imray, leading expert on cold injury, was one of the staff. You definitely get your monies worth in terms of the level of education and the experts delivering. 

What’s been the highlight so far?
Actually, it’s the small things that add value, regardless of your level of experience and knowledge you gain from the programme as it is so multifaceted. But I doubt I would have booked to trek up to Everest base-camp independently just due to time and other plans, on this Master’s programme it can be chosen as a module which is pretty cool by anyone’s standards!

Who else is on the programme?
A mixed bag of newly qualified paramedics, GPs, humanitarian nurses, midwives, and senior anaesthetists! Interestingly, the clinical aspects of the course are tailored towards operations in austere environments with minimal kit so the teaching is suited to any healthcare level and can be adapted dependent on experience. The diversity amongst the students enhances the experience.

What modules have you chosen and why?
I’ve chosen Polar Medicine in Norway and Mountain Medicine in Nepal. I don’t particularly like the cold despite working in it so thought it would do me good to be uncomfortable, but in reality, Norway was awesome. The people were good fun, plus there was a sauna and bar we all embraced outside of building snow holes, sledging with the huskies, and pulk pulling to the middle of nowhere. I’m really looking forward to Nepal once lockdown is over. The university and WEM have been brilliant about juggling everything during COVID-19, they’ve gone above and beyond.

How will this help your career/future plans?
I’m already utilising my involvement in the programme; I’ve secured contracts with high profile universities for academic business collaboration in addition to the position of Content Editor for one of the British Medical Journal titles. I really believe this MSc offers credibility in a way bog-standard programmes cannot.

Nikki added:

Admittedly it’s not a cheap academic option but if you want to make that step towards offering care to others outside of a hospital environment preparation is key, and there is a wealth of experience to be gained within the multiple practical modules each academic year. This is a programme that consolidates knowledge, practical skills, and confidence to achieve objective.

 


Ready for an MSc experience that could change your life?

With the increased awareness of global burdens such as humanitarian crises and sudden onset disasters, more than ever there is a need to be delivering healthcare in highly complex and demanding situations.

The world’s first and only International Diploma / MSc in Extreme Medicine is the most flexible, modular and specialised Extreme Medicine programme in the world. Operated exclusively in partnership with the University of Exeter Medical School it provides the perfect bridge to bring your passion for medicine and adventure together.

You will learn the practical skills, knowledge and understanding needed to perform at the highest possible level in the field of extreme medicine. You can also choose to undertake a specialism based on your interests including Cold and Altitude Environments, Hot Environments and Humanitarian Relief.

Be inspired and find out more!

A Call to Arms for all Extreme Medics!

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Medics.

Mavericks.

Fighters.

An invisible enemy is at our gates.

And with it, the single greatest global humanitarian crisis in a hundred years. 

History reminds us that those fearless women and men who came before us withstood the spearhead of disease, facing it on the field at greater disadvantage than we do today.

They lacked the resources, knowledge, understanding and communication that we do now.

They fought an invisible enemy, blind and in darkness.

Yet – in that darkness, armed with courage, perseverance and unyielding community they sparked a light.

They fought tirelessly. They fought fearlessly. They fought together.

Light bloomed.

And humanity thrived.

Their monumental efforts armed and prepared us better than we could ever have hoped.

Because not only do we possess that self-same fearlessness, tirelessness and togetherness

But their battle armed us with resources, knowledge, understanding and the most powerful weapon in our arsenal – our secret weapon – instant communication on a global scale.

And we’ve learned to wield that weapon with unyielding dexterity.

We will harness it, together with our fellow medics around the world, to do our part and help illuminate the path to victory.

WEM’s tactics have, therefore, adapted…

All courses are postponed until further notice.

Those men and women are needed elsewhere right now.

Instead, we will turn our undivided attention to the heroic front-line troops; arming them with freely available online content, including training resources and invaluable tools, provided by leading experts across multiple disciplines that form the ranks of extreme medicine.

Over the weeks, we will stock our WEM Academy and WEMcast armouries with potent video and audio podcasts that focus on mental health, resilience, psychological impacts, human factors, leadership and self-care – each inspired by countless successful expeditions to remote locations, survival in extreme environments and accomplishments during humanitarian crises.


Share your voice.

Sharing real-time situations can have a huge successful result

We understand that not many will have time to do this, but if possible, please share your stories, your encouragement and your expertise – when you can, however you can. Your insights and inside experiences, whether deep behind the lines, treading the trenches or supporting from the rear, will help to rally and bolster the resolve of those who need it now more than ever.

Instructions on how to share will be announced soon.


WEM20 ‘Inspiration Beyond the Ordinary’ will proceed as planned.

While it remains sensible and safe to do so.

Dynamic Earth in Edinburgh will still play host to #WEM20 from 17th – 19th October 2020. We will monitor the situation as it evolves and take necessary action if required. But, right now, we remain steadfast that you will get to benefit from our epic line-up of speakers and workshops – so long as it remains safe.

This pandemic only fortifies the vital importance of the World Extreme Medicine Conference; a place where the experiences shared are never ordinary, and the lessons learned are always extraordinary.


Right now, through communication and collaboration, we can wield the power of humanity to its extreme, protecting our friends, our families and all humankind from threat.

We will bring this war into the light.

And we will defeat it as one.

Mark Hannaford
WEM Founder & Honorary Associate Professor,
University of Exeter Extreme Medicine Program


NEW WEMcast episode: Eoin Walker and Will Duffin on Coronavirus Part 2: COVID-19 Discussions. Perspectives, Protection and Positive Mindsets

NEW WEMCast episode: Eoin Walker and Will Duffin - CoronavirusIn our latest podcast, Eoin (WEM Trauma Lead) and Will (WEM Education Lead and Conference Content Director) consider the potential impact of the Covid-19 pandemic on healthcare services, how this may force us to adapt and innovate, and contemplate the differing impacts this is having on their roles as a Paramedic and a GP.

The pair also discuss how we can apply tips, tricks and lessons learnt from working in remote and extreme environments to the current pressures facing the NHS.

Improvise, Adapt and Overcome – that’s what it’s all about!

Listen, share and let us know your thoughts! > https://bit.ly/2xIVGQd

Ocean Medicine Course: Meet our expert teaching faculty

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We’ve brought together a remarkable teaching faculty for our Ocean Medicine course taking place in Plymouth; a group of world-renowned ocean explorers, sports people and logisticians, all with an amazing depth of experience, and achieving notable success in the face of extreme challenge and adversity. They will be sharing their extensive knowledge and skills to give you a comprehensive understanding of how to lead and provide medical cover in an aquatic environment.

Meet this highly specialised team who will be delivering an unrivalled syllabus of content on our ocean medicine course:

Dr Nick Carter, Doctor and Expedition Yacht Skipper

Dr Nick Carter - WEM facultySince he graduated from medical school in the late 1980s, Nick has pursued his career in musculoskeletal medicine through the British Military. He underwent much of his specialist training in Oxford and also as a research Fellow in Sports Medicine in Vancouver. In the past 10 years, his passion for high latitude sailing has brought an additional enthusiasm for expedition medicine

Nick has always loved sport, whether it be rugby, as a Canadian qualified snowboard instructor or, in the last 20 years, sailing. He has sailed over 60,000nm and across some significant ocean passages including the Southern Ocean around Cape Horn, the Antarctic peninsula on a couple of occasions, the Northwest Passage and various trips to the Arctic. More recently, he has sailed into the Central Arctic Ocean from Alaska to greater than 800 North and also with expeditions including research into elements of ocean advocacy including cetaceans and sea ice.


Dave Pearce, TV and Film Producer and Safety Consultant

Dave Pearce - WEM facultyDave has travelled the globe during his military service of 25 years as a Royal Marine Commando and in his current profession of 14 years, as a television and film producer and safety consultant. He predominantly works with presenters going to extreme, dynamic and hostile locations, including working on approximately 90% of shows presented by Bear Grylls.

He was very proud to serve in the Royal Marine Commandos for over 25 years, seeing operations across the globe including a number in Afghanistan, former Yugoslavia and Northern Ireland. As a Commando he was embedded in many operations during the cold war and has also trained Commandos in tac-tics and specialist warfare as well as combat survival and evasion.

Dave embraces challenges including summiting Everest in 2003, returning again in 2006 as well as being a member of the first successful British ascent of Kangchenjunga, the world’s third highest mountain. He made an early British ascent of El Capitan, joined Bear Grylls as a team of 5, navigating a RIB through the North West Passage and have had many other extreme expeditions. As well as being a published author and a volunteer the Sidmouth lifeboat team.


Laura Penhaul, Physiotherapist and Ocean Rower

Laura Penhaul - WEM facultyLaura Penhaul is passionate about helping teams or individuals to perform at their best and she draws on her extensive experience, both personally and professionally, in high performance sport and expedition.

She was the Team Leader of the Coxless Crew who set 2 World Records in January 2016 rowing unsupported across the Pacific. 9,000nm, taking 9 months to complete and 4 years to prepare for. This remarkable expedition was captured in the documentary “Losing Sight of Shore”.

Laura previously was Lead Physiotherapist for the Paralympic Programme of British Athletics and worked at Vancouver, London and Rio Paralympic Games. Currently she is Lead Physiotherapist for the Olympic British Sailing Team, supporting them through to Tokyo 2020.

In 2017, Laura was the Performance Manager for Mark Beaumont, where she supported him in his preparations and during his World Record achievement of cycling the World in 78 Days. Alongside this, Laura was the Performance Lead for the Adaptive Grandslam, where she has supported the first ever veterans with disabilities to summit the 7 peaks and 2 poles in their Performance preparation.

In her spare time, you’ll find Laura on the North coast of Cornwall, where she’s a RNLI lifeboat crew volunteer and loves to stay active running or swimming on the coastline. 


Beth French, Ocean Swimmer

Beth French - WEM facultyFrom wheelchair bound to world class athlete, Beth French stretches the horizons of her own possibilities, tackling seemingly impossible feats of endurance and adventure. Beth suffered with ME from the age of 10, and by 17 she was in a wheelchair. Overcoming debilitation, she forged a path to ultimate health her own way.

Beth spent 8 years adventuring and studying natural health practices abroad, apprenticing with some of the world’s leading indigenous health practitioners and even spending a year ordained as a Buddhist nun in Thailand.

Over the last 8 years, she has taken on some of the world’s toughest swims, and even charting her own pioneering routes including:

* English Channel
* Molokai Channel
* Cornwall to Isles of Scilly
* Catalina Channel
* Cook Strait
* Straits of Gibraltar

She has recently turned her attention from distance to temperature and swims in waters down to zero degrees, with plans to take on polar swims, without a wetsuit, in the very near future.

Accolades:
* First British woman to swim Molokai channel
* Only woman to swim Molokai Channel twice
* First person to swim Cornwall to Isles of Scilly
* Current joint record holder for most Oceans 7 channels in a single year – 4


Nikki McLeary, Adventure Medicine Business Owner & University Lecturer

Nikki McLeary - Ocean Medicine Course WEM FacultyNikki has a background in Sports Science, Human Performance and Science Publishing previously working with elite extreme athletes such as Vendee Globe sailors and Formula 1 drivers in the areas of sleep, stress, nutrition and fitness.

She then spent 15 years overseas, across multiple locations, operating her own adventure company (winter mountain/desert/ocean). She is the founder of R.R.A.M (a training platform for non-medics to learn life-saving skills for remote travel) and was recently appointed Honorary Senior Lecturer (Sports & Health Sciences) at Exeter University with the purpose of developing training programmes for field scientists operating in challenging environments.

Nikki has numerous published articles in outdoor adventure publications, is a qualified Swiftwater and Flood Rescue Technician, plus keen windsurfer, kitesurfer and sailor. But she isn’t a pirate… yet. Still time!

 


Grant Walkey, Owner and MD of Trident Training & Consultancy and Paramedic

Grant Walkey, Ocean Medicine Course WEM FacultyGrant Walkey has been involved in search and rescue for over 20 years, specialising in water rescue combining skills as a former firefighter and as an RNLI lifeboat crew, beach lifeguard, and Flood rescue team member and adding advanced skills clinically as a paramedic.

Grant is the owner and managing director of Trident Training & Consultancy which specialises in Rescue, Medical and Safety and also works as a bank paramedic for both SWAST and SCAS ambulance services in Cornwall, Dorset and Hampshire. Grant also teaches for a number of other companies specialising in maritime training and STCW certification.

Grant was a full-time staff member of the RNLI for 11 years serving initially as a sea survival and lifeboat trainer then as a Casualty care trainer and finally as the Clinical Training Manager, managing a team of paramedic trainers delivering the RNLI medical courses.
Grant maintained training others throughout this time for the RNLI but also on the ATACC faculty and for SLSA GB.

Grant maintains his operational rescue skills by also volunteering for his local lifeboat station at Mudeford in Dorset and being on the RNLI Flood rescue team.

Grant shares his knowledge, skills and experience as a consultant and trainer specialising in maritime rescue, safety and medicine wherever he can to help educate to help others or themselves.



Join us in Plymouth; learn with this incredibly experienced and knowledgeable team, and be part of something amazing.
Book your Ocean Medicine Course place today!


Other Ocean Medicine course blogs that may be of interest, include:

WEM Antarctica: Exploring the National Geographic Explorer ship

A visit to Antarctica is like no other, equally challenging as it is rewarding, the awe-inspiring landscapes and superb wildlife-viewing opportunities make for a once in a lifetime trip. Taking at least 2 days just to cross the Drake Passage to reach the Antarctic Peninsula, it is one of the furthest and most unique places to visit and on our Antarctic Extreme Medicine mini conference cruise you travel in style aboard the National Geographic Explorer ship.

As one of the most recognisable expedition vessels in the world, she has won awards for the quality of her itineraries, the like of which you will experience during this conference cruise as well as for the high calibre of staff onboard – we guarantee you won’t be disappointed. The National Geographic Explorer offers the added luxury of comfort and delivers a quality of shipboard life designed to relax and rejuvenate body, mind, and spirit.

Here is just a small selection of the highlights on board the National Geographic Explorer ship, that will help bring extraordinary adventure and amazing experiences to your trip:

  • A full set of exploration tools including 5 landing Zodiacs and 36 two-person kayaks that can be deployed at a moment’s notice in order to take advantage of unplanned sightseeing opportunities, as well as undertake scheduled excursions and landings ashore.

  • Remotely operated vehicle to see beyond the range of any diver and uncover the secrets of the deep.

  • A range of photography equipment including high definition cameras and a crow’s nest camera to provide footage to your in-cabin TV as well as projected into the ship’s lounge.

  • 3 underwater microphones to hear the marine mammals and experience remarkable ‘chatter’ in real time

  • The opportunity to visit the captain and their officers on the bridge and learn more about what it takes to navigate a ship in the polar regions

  • A highly trained National Geographic expedition team comprised of a veteran expedition leader, an undersea specialist, a certified photo instructor plus a team of 8 naturalists with specialities including zoology, geology and polar history. This experienced team will lead a daily programme of briefings, excursions and insightful lectures.

Upon embarking the expedition ship in Ushuaia, Argentina on Day 2 of the itinerary, your adventure at sea will begin and for the next nine days will be your home away from home. The ship plays host to 148 guests and you will soon make yourself comfortable in one of the 81 cabins spread across the ship’s Main, Upper and Veranda Decks; an inviting sanctuary, perfect after an active day. For those choosing a cabin with a private veranda, take a moment (or two) to watch the spectacular scenery drift by in slow motion.

Once on board, life is very casual. Feel free to roam the ship, exploring the nooks and crannies, mingle with like-minded new-found friends and head out on activities led by the naturalist whose interests mirror your own. You are free to do as much or as little as you like with experiences and activities tailor-made to your requirements which makes each day of your expedition uniquely yours, and deeply rewarding. No one day will be the same during your explorations, and day-to-day itineraries will change depending on conditions, allowing you to take advantage of rare wildlife sightings, watching whales feed off the bow, or even enjoy a pre-dinner kayaking excursion.

National Geographic Explorer ship

You’ll discover the lounge is the heart of the expedition community; where you can gather and discuss the day’s events, sort out your photography files with the resident photographers or simply just sit back and relax with binoculars at the ready. The bow is also a great place for staff and guests to converge, to scope out the landscape and scan the water for marine mammals or those seeking a quiet corner, escape to the windowed library with its abundance of books.

When you can find time amongst your busy schedule to eat, breakfast and lunch are buffet style and dinner is served. Whether you choose the dining room or one of the ship’s more casual dining spaces the food is delicious, all freshly prepared with ingredients often sourced from local ports and fisheries. You’ll always find an open station for hot and cold beverages, plus afternoon tea and cookies for when you’re feeling a little peckish in between excursions.

For the early birds, greet the polar mornings with a pre-breakfast stretching session led by the wellness specialist or sleep in and use the fitness centre at your own pleasure. There is even an onboard spa where you can take advantage of one of the many massage therapies and body treatments available, the perfect relaxation after an active day of exploring.


 

Inspired? You too, could be joining us on this truly epic expedition, experiencing jaw-dropping scenery, amazing wildlife encounters and learning from some of the world’s experts. Take your career to the next level!

Other blogs that may be of interest:

WEM Dive Medicine: where you can train like a NASA Aquanaut

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In a unique collaboration with Florida International University and Aquarius Reef Base, we have developed THE ultimate Dive Medicine course for you. As well as focusing on dive medicine and hyperbaric emergencies, you will be learning from one of the world’s most experienced Dive Medical Teams and have the opportunity to follow in the footsteps of NASA astronauts and stay overnight in the world’s only permanent underwater science habitat Aquarius Reef Base; the place where NASA astronauts through the NASA NEEMO space analogue programme train for missions onboard the International Space Station.

Using the Aquarius Reef Base, an underwater world located off the Florida Keys in the Carpenter Basin on the floor of the Atlantic Ocean, the incredible WEM faculty team will introduce you to the exciting world of dive, undersea and hyperbaric medicine. It’s here you’ll learn to work with the environment, overcome the obstacles of the water, increase your knowledge and skillset and experience a once in a lifetime opportunity of being able to train like a NASA aquanaut.

Throughout your time on the course, the educational methodology will include fascinating lectures and training from dive medicine experts at Aquarius Reef Base (ARB), NASA NEEMO and the Department of Defense, who bring with them an incredible wealth of dive and medical knowledge. You’ll listen to and discuss real-life case presentations, have printed support materials to enhance your learning, plus the opportunity to enjoy practical ‘hands-on’ exercises out in the field.

As with all the World Extreme Medicine courses, we’ll provide a practical training course that endeavours to make those attending more comfortable using the medical skills they already have in an austere environment.

Our Dive Medicine course enables attendees to:

  • Be better equipped and confident in recognising and providing the right assessment and treatment when in an undersea environment.
  • Acquire and develop dive medicine skills to ensure you have the necessary working knowledge to evaluate and manage diving medicine injuries in an operational environment.
  • Enhance knowledge and skills relating to understanding, diagnosing and treating illnesses in an underwater environment such as decompression illness, inert gas narcosis, oxygen toxicity and high-pressure nervous syndrome, acute dysbaric disorders, plus understanding the thermal considerations of diving.
  • Understand and develop new dive techniques such as saturation and hard hat diving to further enhance your skillset.

What will I learn on a WEM Dive Medicine Course?
The Dive Medicine course trains physicians and healthcare professionals to recognise, evaluate and treat diving medical and hyperbaric emergencies in one of the world’s most unique locations – Aquarius Reef Base. In addition to lectures on the physiology and medicine of diving, you’ll receive highly practical experience operating and working hyperbaric recompression chambers, and the use of commercial and military diving equipment, which will include an introduction to scientific, hard hat and saturation diving.

At the conclusion of this course, participants will have a working knowledge to evaluate and manage diving medicine injuries in an operational environment. Plus, all course attendees will receive a Diver Medic Technician qualification issued by the National Board of Diving and Hyperbaric Medical Technology.


Who should attend this course?
This course is ideal for medics (Physician, Doctor, Nurse* or Paramedic*) wishing to pursue a career in Hyperbaric Medicine, who currently work or would like to work as a Dive Expedition Medic and who are working on remote or recreating on remote dive sites. This dive medicine course offers a unique learning opportunity, whether you are looking for a one-off experience or need to learn new skills for your job.

* 3 years post-national registration


If you need any further guidance, here are 4 excellent reasons to attend our Dive Course:

  • Expert team – our team are one of the world’s most experienced Dive Medical Team with a huge pedigree in the field. They will be drawing on their own extensive and personal experience, sharing their extreme knowledge and skills and giving you a comprehensive understanding of evaluating and managing diving medicine injuries.

  • Once in a lifetime opportunity – when else are you able to dive and stay overnight on the world’s only underwater habitat – Aquarius Reef Base. So unique, fewer people have stayed here than have summited Everest!

  • Hands-on experience – enjoy practical ‘hands-on’ experience working hyperbaric recompression chambers, and the use of commercial and military diving equipment to include an introduction to scientific, hard hat and saturation diving.

  • Further your career – enhance your knowledge and increase your skillset to ensure you are in the best position possible to further your medical career and become a more effective and highly valued practitioner. For those attending and completing the course, accreditation will be offered (we estimate 40 hours of CPD) through the Royal College of Surgeons of Edinburgh. After successful completion of the course exam, participants will be awarded the Diver Medic Technician qualification issued by the National Board of Diving & Hyperbaric Medical Technology.

WEM Founder, Mark Hannaford says:

“There is nothing quite so surreal as living and breathing on the bottom of the ocean and staying in the Aquarius Habitat ranks as one of life’s most amazing experiences. This has to be the most extraordinary of WEM’s already exceptional courses with world-class dive medicine teaching delivered by some of the worlds most experienced experts, using a mix of emergency decompression chambers combined with living on the ocean floor! Also, you end the week with the title ‘Honorary Aquanaut’, which is a pretty standout achievement!”


 

Our Dive Medicine Course comes highly recommended from past course attendees:

Dr Shawna Pandya, Dive Medicine – Aug 2019

Find out more about our Dive Medicine courses and take your medical career to the next level – book your place today! 

#WEM19 Speaker Sacha Dench Appointed as UN Ambassador for Migratory Species

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We’d like to extend a huge congratulations to Sacha Dench (former WEM conference speaker) who has recently been appointed as a UN Ambassador for Migratory Species.

Sacha Dench is a pioneering conservationist, champion sportswoman and record-breaking adventurer, famously named the “Human Swan” for her paramotor journey following the Bewicks swan migration from the Russian Arctic to the UK – has been applauded for her creative and daring approach to highlighting the issues surrounding the plight, and tragic decline of many migratory species.

Sacha joined two other appointees – conservationist Ian Redmond OBE and award-winning Bollywood actor and expert equestrian Randeep Hooda – all three in recognition of their achievements in raising awareness of threatened migratory species and their habitats.

With a 20-year track record as a conservationist and motivational speaker, Sacha is the co-founder and CEO of “Conservation without Borders”, a charity that supports leading conservationists and scientists by creating media, public and political support for their work.

Sacha’s flagship project was a courageous three-month expedition called the “Flight of the Swans” that brought international attention to the conservation status of the Bewick’s Swan. She flew a paramotor solo over 7,000 km across eleven countries from the arctic region in Russia to the United Kingdom. The Bewick’s Swan is a European endangered migratory bird that is subject of an International Single Species Action Plan developed under the African-Eurasian Waterbird Agreement.The expedition engaged millions of people along the flyway, gaining public interest and significant media attention.

Sacha plans to replicate the success of the “Flight of the Swans” with a new expedition called the “Flight of the Osprey” that aims to highlight the threats faced by migrating Osprey and other wildlife. This paramotor expedition will follow the Osprey’s western flyway from the UK, across the Mediterranean Sea and finishing in Ghana. This mission will provide a unique bird’s-eye-view of the Osprey’s migratory route whilst collecting vital data on the challenges faced along the way. As a champion free diver Sacha will also investigate the underwater world so important to the fish-eating ospreys, including sampling for pollutants and plastics at critical sites.

Sacha Dench said:

“Many vulture species will actively fly with a paraglider, sharing thermals. It is amazing to be so close to these magnificent creatures and get a glimpse into their world of moving air and thermals that is invisible to us from the ground. Flying with them in key areas could also give us unique and engaging insights into our world below from their point of view – from why power lines and turbines are a problem in certain areas and what we could do about it, to understanding their preferred routes and roosting sites, and what senses they might be using to identify food, and why they are subject to poisoning. And on their long journeys, what other threats might they face that scientists might not yet have seen from the ground”. 

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