The Medical Director for Expedition & Wilderness Medicine might be on deployment with MSF to northern Sri Lanka but it doesn’t stop the BBC from featuring her work.
The work of an expedition medic is varied and ecletic – watch as the BBC features presenters Helen Skelton epic attempt to complete the infamous Namibia Ultra Marathon with Amy in support- http://www.bbc.co.uk/i/kc4wv/
Sarah Outen who we first meet through Expedition & Wilderness Medicine when we provided her with medical training for her Indian Ocean row has just crossed over the border from Kazakhstan into China as part of her epic round the world journey.
My journey is all about human power – to make a complete loop of our planet using only a rowing boat, a bike and a kayak. It is simple in theory, but in practice it will be monumentally challenging. The distance, the logistics, the unknowns, extreme climates – it will be huge in all respects. But it will also be an incredible experience with lots of stories, which my team and I plan to share with people all over the world.’
… find out more about Sarah and her grand adventure;
I am Sarah Outen, a young(ish) adventurer at 2.5 decades old, hooked on life and wild places, and inspiring others to follow their own dreams.
One day I will be a teacher,be it in a classroom or not, and for now I am enjoying the opportunities to share my experiences and encourage other people to find and redefine their own boundaries.
I love adventure – the feeling of not quite knowing if or how you will make your destination, of pushing the limits and testing yourself against yourself and the elements. My love of the wild led me to a degree in Biology at the University of Oxford and in 2009 took me out to sea on the biggest adventure of my life, rowing across the Indian Ocean. It is this that has inspired me to go on to more crazy, wonderful journeys. http://www.sarahouten.com/
(L-R) Tom, Ed, Ollie and James moments after arriving on land
On Tuesday 6th July 2011, Tom Kelly, James Kayll and Brothers Ed and Oliver Wells, collectively known as “Team Indian Ocean 3100”, completed their Indian Ocean crossing from the West Coast of Australia to Mauritius.
3,100 nautical miles, 76 days and some 11 hours later they were greeted 3 miles off the coast from the Grand Baie Yacht Club in Mauritius by anxious family, friends and loved ones packed into a chartered yacht and speed boat. After 2 hours of anxiously straining to see the tiny rowing boat break above the swell they were finally spotted…and once the coloured flares were deployed by the four adventurers there was no denying they had truly arrived (although this did follow a swift telling off by the local coast guard for the latter!). The boys were home.
What can occur over 76 days in a 29 foot carbon fibre rowing boat? Well, quite a lot it seems: The crew endured extreme isolation, hallucinations, ‘sleep rowing’, infections, unforgiving weather (and sometimes equipment), swimming with a minke whale (after double checking it wasn’t a shark, of course), and even avoided a collision with a tanker than nearly put an end to their crossing – and to their lives. In short, the crew stepped off Indian Runner 4 and onto the dock in Mauritius with a newfound respect for the Ocean and a story that many will want to hear and watch – for it was all caught on the boat camera.
There is another story here too – the story of the body and mind. What does 76 days of rowing night and day do to a person as the natural wear and tear of the very fabric that makes the human body and mind is blown out of all reasonable proportion by such demands. Team Indian Ocean 3100 were kind enough to help begin to answer those questions. Throughout their voyage, they performed simple tests on their bodies for myself (the team trainer and researcher) to analyse – and through collaboration with Cambridge Cognition, performed detailed cognitive tests on a laptop normally reserved for the pharmaceutical industry. So, I encourage you to watch this space as I hope to bring to you a digestible story of science, medicine and adventure with Team Indian Ocean 3100.
What do you do when you have just achieved a record unsupported crossing across the Indian Ocean, having survived on 6,000 calories of ration pack food each day and desalinated water? That’s easy, go to the hotel buffet.
For more information about the crew, race and research please visit www.indianocean3100.com or type “Team Indian Ocean 3100” in your internet search engine.
Dr Nick Knight
University Liaison for Expedition & Wilderness Medicine
As our CME accredited Diving and Marine Medicine course in the Maldives hoves into view in October Dr Rob Conway, founder of award winning marine conservation charity Blue Ventures, looks at Malaria and its risks to diving.
An increasing number of us are heading to more remote areas to discover that dream dive, which means that you may be exposed to an increasing number of diseases. 
Malaria is common and caused by the parasite Plasmodium. There are several different types that effect humans, most commonly Plasmodium falciparum. The others are less common and cause a milder form of the disease that is rarely fatal.
Malaria is transmitted by female mosquitos (Anopheles sp) that bite from dusk. Males feed on plant nectar and so do not transmit malaria. They transmit the parasite whilst feeding on your blood. These migrate to the liver and over 7 to 30 days multiply before bursting and infecting red blood cells in waves. Therefore an infected individual may feel waves of fever that are characteristic of the disease. Other symptoms include severe headache, shivering, arthralgia (joint pain) and vomiting all of which may be confused with a diving related illness. Signs include enlarging of the spleen and anaemia. In severe cases there is blood in the urine, renal failure, seizures, coma and death.
If you are heading to an endemic area be smart. Avoid getting bitten by using a suitable repellant, wear long sleeves and trousers from dusk and sleep under a net. Take an anti-malarial medication for the correct amount of time. The most common drugs include mefloquine (Lariam), doxycycline (an antibiotic) and a combination of atovaquone and proguanil (Malarone). There is no evidence that any of these are contraindicated in SCUBA, but efloquine is not universally accepted by all doctors and there is little data on Malarone at depth. Each has its own benefits and pitfalls. Some require you to take them for a period of time before and after a trip, remember, the parasites life cycle can be over a month. Consult a physician before departing.
If you suspect malaria, seek medical treatment immediately. Look for flu like symptoms from 7 days after entering a malarial area. Work along the lines of it is malaria until proven otherwise. I evacuated someone from Madagascar on a diving expedition with convulsions, I had no idea at the time of the cause, it turned out to be malaria. If you are going remote then there is a rapid test available (ICT kit) and take a stand by emergency treatment with you such as artemether-lumefantrine (Coartem) or quinine plus doxycycline.
Action Challenge is currently recruiting adventurous and travel savvy expedition medics to join us on our challenge events. We require doctors to provide remote medical care for our participants and staff, as well as assisting with other aspects of the expeditions. Wilderness medical training and previous Kilimanjaro or high altitude experience is preferable but not essential.
Immediate 2011 dates are below:
Mount Kilimanjaro 01st – 11th September
06th – 15th October
09th – 18th October
Tour du Mont Blanc 02nd – 10th September
More 2011 and 2012 dates are available. If you are interested in joining the Action Challenge team please send a CV and covering letter to [email protected] or call us on 0207 354 1465. www.actionchallenge.com
“Of all the paths you choose in life, make sure some of them are dirt…”
Wilderness Medic Training Courses
Extreme Medicine Conference. The International ‘World Extreme Medicine’ Conference and EXPO will focus daily on all core aspects of advance medicine in remote environments but each day will have a key theme:
With Expedition & Wilderness Medicine’s Medical Director Dr Amy Hughes on a mission for Médecins Sans Frontières in Sri Lanka we are going to feature the projects and oppurtunities that working for Médecins Sans Frontières MSF (Doctors Without Borders) presents.
MSF have asked us to feature the TB&ME is an MSF blogging platform, created to help patients suffering from multidrug-resistant tuberculosis (MDR TB) share their stories. Over the coming months and years MSF will campaign for better treatment/services for TB sufferers. TB&ME enables MSF, and others, to learn where improvement is most needed and provides a much-needed support network for patients. http://msf.ca/blogs/tb
We feature one of the MSF’s Citizen bloggers Christiaan Van Vuuren AKA the Fully Sick Rapper, was diagnosed with tuberculosis in December 2009. In 2010 it was 
discovered that Christiaan actually had multidrug-resistant tuberculosis. After spending nearly seven months in isolation, plus many more taking a host of TB drugs, Christiaan is nearly at the end of his treatment. Here, he blogs his experiences for TB&ME. http://msf.ca/blogs/tb/author/fullysickrapper/
Dr Amy Hughes, Medical Director of Expedition & Wilderness Medicine headed off on the weekend to northern Sri Lanka on a Médecins Sans Frontières MSF placement. Its the fulfillment of a long held ambition for Dr Hughes and we wish her the best of luck with posting. In her absence Dr Sean Hudson, co-founder of Expedition & Wilderness Medicine, will be taking over temporarily as our Medical Director.
Whilst Amy is in place we are hoping to provide you with some updates of the work she is taking part in as well as featuring the work of Médecins Sans Frontières.
Médecins Sans Frontières
MSF is an independent international medical humanitarian organisation that delivers emergency aid in more than 60 countries to people affected by armed conflict, epidemics, natural or man-made disasters or exclusion from healthcare.
In emergencies and their aftermath, MSF rehabilitates and runs hospitals and clinics, performs surgery, battles epidemics, carries out vaccination campaigns, operates feeding centres for malnourished children and offers mental healthcare.
When needed, MSF also constructs wells, dispenses clean drinking water and provides shelter materials, such as blankets and plastic sheeting.
Through longer term programmes, MSF treats patients with infectious diseases such as tuberculosis, sleeping sickness and HIV/AIDS and provides medical and psychological care to marginalised groups, such as street children.
Founded by doctors and journalists in 1971, MSF is now a worldwide movement with offices in 19 countries and an international coordination office in Geneva, Switzerland.
As an independent and self-directed organisation, MSF’s actions are guided by medical ethics and the principles of neutrality and impartiality. This means that MSF offers assistance to people based only on need and irrespective of race, religion, gender or political affiliation.
MSF strives to ensure that we have the power to freely evaluate medical needs, to access populations without restriction and to directly control the aid we provide giving priority to those in most grave danger. MSF does not take sides in armed conflict and insists on unhindered access to patients.
When MSF is witness to massive and neglected acts of violence against individuals and groups, we may speak out publicly based on eyewitness accounts, medical data and experience.
The work of MSF is carried out by over 25,000 health professionals, logistics experts and administrative staff who run projects in approximately 65 countries around the world.