Take a look at our latest newsletter to find out more about the amazingly adventurous Dr Andrew Peacock
Not many things you can say that change your life! Attending the Wild Medicine course was one of those events. Amazing set of people and a fantastic opportunity to learn about conservation and desert medicine.
The kind of odd things we learnt…
– Take blood from a cheetah,
– Learn about (and touch – optional) many poisonous snakes,
– Sleep in a desert, walk 14km through a dry river canyon,
– What are the problem animals with Rabies? (A: Kudu),
– How can carnivores live outside conservation areas & not get killed by farmers &
– How to build a vineyard in a desert … what?!..
And the thing that changed our lives? Meet the Bushmen and see their need for healthcare! My wife and I are volunteering at Naankuse to run the Bushmen medical services. The real thing we learned? There are many people out there that can benefit from our skills …
Oh and by the way Namibia is amazing you get to see loads … but you can also get a 4×4 and do a week or so trip before the course.
The race covers tough but beautiful terrain, invariably with high temperatures and humidity. The route is classed as a category “black” marathon – a marathon where serious consideration should be taken to safety provision. For this reason medical support is vital. Over the last 2 years, under the guidance of the Medical Director, groups of medical professionals from across the world have travelled to Sierra Leone to help out. When joined by local medics and nurses, mining corporation paramedics and medical students, this team have provided essential cover to the marathon. More importantly, previous teams can testify that they have have had an amazing adventure, providing a great talking point for grand rounds on their return!
Most of the action for the medical team takes place on race day, where teams set up makeshift medical stations around the course, providing first line medical care to the runners. This is co-ordinated from Medical HQ, the headquarters for ongoing treatment, and communication centre to each of the medical stations.
Sierra Leone is very much a developing country – supplies and equipment are limited and expertise is varied. This is a challenge, but one worth taking on. Outside of race day, the medical team will be involved in procuring equipment, medical briefings to international runners, and manning clinics offered to local runners on registration day. Another important job for the team is spending time chatting to the runners before the race, providing reassurance and advice, usually over a local beer!
We would like people who like the sound of this event to travel out to Sierra Leone for between 1 and 2 weeks to help us organise the 2014 Sierra Leone Marathon. We do ask that you fund your own trip (flights and accommodation only, all transport and meals will be free) but in return we will give you your own ‘experience of a lifetime’ seeing and assisting with Street Child projects in urban and rural Sierra Leone, taking part in a week of festivities in Makeni and you still get to finish on a high joining our West African beach party and 2 night beach hut retreat!
Dates are pretty flexible, the marathon is on Sunday 25th May so an 8 day trip could fly Wed 21st May and return Wed 28th May 2014. Direct 6 hour flights from London are available from Gambia Bird Airlines and BA.
To enquire or apply please send your details to [email protected]
*For applications to the role of Medical Director, the role will be to provide leadership and direction to the medical team. A return flight from London will also be provided. Minimum dates Mon 19th – Wed 28th May 14.
Matt Edwards Blog working in remote medicine
One of our locum doctors was on his way in to help out but was a little way off in the infamous Nairobi traffic. The tiny Cessna plane arrived from Lewa and taxied to us. The little girl had improved on the journey and was now wriggling away from stimulus. It was a good sign; lots of little kids respond like that after a significant head injury. I see mostly insignificant head injuries in children back home, and often I have to physically catch them from the play-area in the waiting room to assess them. We packaged her up while calming the parents and sent her off to the hospital for a scan of her head to exclude a neurosurgical issue. I am told she awoke fully on the way to the hospital and is doing fine.
It took about an hour to get to this gold-mining town in Kahama, Tanzania and on the way, while being bumped around by the thermals coming off the baked ground, we did our standard checks and discussed our plan. Given that we were expecting to be escorted to the patients bedside, we thought we would have a little time to assess and plan in the relatively safe and sheltered environment of the hospital. As we taxied around at the dusty runway, I noticed an ambulance sitting just outside the gates on the other side of the airstrip. I wandered off in the baking heat to have a pee (I am always totally convinced I am going to get bitten by a snake when I do this) and Kisito the flight nurse explained to the airstrip’s official that the ambulance needed clearance to enter. It seems no matter where you go in the world you will find irritating ‘jobsworths’. It’s just that in Africa they tend to back up their obstinate behaviour with an AK-47. Kisito gave up and beckoned the ambulance to bring some people to help us hump the equipment the 500m over to the gate. I lifted a few pieces of equipment out of the aircraft and then noticed he had started running towards them.
Unfortunately the relatives could only afford a flight with our caravan. We could have been there in 20 minutes in a jet. Two hours and a bumpy road journey later we were at the patient’s side to discover the doctors had intubated him despite the advice of the guys in the radio-room. They had intubated and sedated him but had no capacity to give him positive pressure ventilation. So he was basically in a worse state than if he had been left to his own devices. He was sedated, driving down his own appropriate urge to breathe rapidly and the tube was merely providing an extra long windpipe, like a rather thin snorkel, just making the work of breathing more difficult with the froth from his chest bubbling out the end periodically. I’ve never seen this done to a patient before. Without the benefit of assisted ventilation I simply don’t understand what they were hoping to achieve.
As I settled down to a well-earned sleep that night, little did I know that, across the other side of the country, something terrible had just happened. The storm was about to get worse…
Stay tuned for the next signal….
About; AMREF’s vision is for lasting health change in Africa: communities with the knowledge, skills and means to maintain their good health and break the cycle of poor health and poverty. We believe in the inherent power within African communities – that the power for lasting transformation of Africa’s health lies within its communities.
Interested in working in remote medicine? Courses of interest
Here we highlight a medical elective scheme they have been running at one of their field bases in Madagascar…
Liz and I arrived at Coco Beach at the beginning of September, ready to undertake our medical elective (a six-week placement in a “healthcare setting that differs from the NHS”- cue a mass exodus of fourth-year med students to the 4 corners of the globe…). The plan was to join up with the FISA (family planning) project set up by BV in 2007 and conduct our own research project focusing on the clinic’s interaction with young people in the local area. Our first 3 days fortuitously overlapped with the end of Medical Director and family planning project founder Vik’s latest stay, so we were rapidly immersed in a crash course in family planning, dive and expedition medicine and the importance of making the most of our idyllic setting and local rum! His enthusiasm was contagious and we were soon planning our own project. However we were both surprised and a little daunted to learn that the educational intervention to be developed as a consequence of our research would be a play; written, produced and directed by us! Drama not being a core module in our particular medical course, we were initially politely positive about the idea but Vik’s unfailing enthusiasm and the sincerity and concern with which he spoke about the issues facing the young people of the region won us over.
We have attended family planning clinics here in Andava as well as the satellite clinics in Belovenoke in the north and Tampilove in the South, collecting the demographic info from patient records and hearing the stories of the women who come to access contraception and counselling from Fanja (the Malagasy lady who runs the clinics). I am continually shocked by the number of children many of these women have had and by how young an age- I’m beginning to feel that I have some catching up to do! The journeys to the clinics make the ease of my daily trip to the hospital in Brighton almost laughable. Normally reached by motorized pirogue (the local fishing boats), Belovanoke is, it transpired one morning when the expected boat captain failed to arrive, a 6-hour round-trip by sereti cart (i.e. a high wooden cart on dodgy-looking wheels and no suspension pulled by 2 zebus in dire need of Imodium). The mattress we were cunningly advised to put on the floor softened the ride a little but nothing can prepare you for the flying zebu poo and the inadvertent head-bashing when you are thrown on to your fellow passengers. We finally arrived home battered, bruised, sunburnt and more than a little delirious.
On another memorable occasion, the usually wet and choppy pirogue trip to Tampilove was stopped in its tracks by the unforeseen low tide. We spent the following hours trekking through the mangroves, sitting and waiting for the channel to fill and finally pushing the boat whilst dodging evil-looking sea urchins and slimy algae patches. On the upside, it seems pirogue-pushing is an excellent workout for the thighs…
We have now run 2 focus groups with the young people of the village and, having asked them about their use of family planning and the dynamics of their relationships, we have constructed the basis of our play. It has been designed to let teenagers know that the clinic service is available to them and that if they complete their education and have children later on, they have that choice. It is to be performed by ‘vazaha’ (us!) in order to create a bit of a spectacle and attract as much attention as possible. The latest batch of vols have proved suitably enthusiastic and, all going well, our directorial debut should go ahead on Saturday 10th October.
Explore WEM’s range of expedition medicine courses.
The clinic was set up in 2003 and is based in Epukiro, approximately 120km North of Gobabis and 400km East of Windhoek. It’s a small community made up of mainly Herero, cattle rearing people, and a small group of San Bushman who are traditionally nomadic hunter gatherers that live in small family groups.
Sadly, San are treated as second or even third class citizens in Namibia and providing free and accessible primary healthcare to this community really is a lifeline to many. People walk hundreds of kilometres to receive medical care when they are sick and unfit to travel these distances. The clinic was set up to provide free medical care to the San Bushmen community. The majority of our patients are San who receive all their treatment free at the clinic (84% of consultations). The rest of the consultations are for fee paying locals, mainly Herero (16%).
The doctor’s role is extensive in nature but is extremely satisfying. The clinic is primarily open Monday- Friday, 8am- 5pm with a lunch break from 1pm-2:30pm. Patients are seen on an open access basis. We also provide an outreach clinic to a large primary school with 150 San pupils and to a village 40 kilometres away. We also run a community program which is in its infancy and consists of training and supporting community health workers in several San Bushman settlements in the area.
Many of the San come from the surrounding regions and may travel several hours to reach us. 40% of the patients we see are children. We see a lot of TB, respiratory infections and diarrhoea. We also see trauma, domestic violence, alcoholism and malnutrition. Patients who need to be admitted to hospital are transferred via our clinic car/ambulance to Gobabis Hospital, 120 km away, mainly on gravel roads. On some occasions they need to be taken straight to Windhoek which is a 4 hour drive away.
Facilities in the clinic are very good and include a microscope, ultrasound machine, computer facilities and the internet. We have a good relationship with the state clinic and mutually support each other. The Lifeline clinic is entirely funded by charitable donations. It is part of the N/a’an ku se foundation which also has a wildlife and conservation sanctuary just outside of Windhoek. The farm is 320 km away from the clinic, mainly on tarmac roads.
The doctor is responsible for the clinic staff, currently consisting of a nurse, receptionist, translator, cleaner and gardener. The doctor works with Anna Daries, our wonderful Namibian nurse who has been with the clinic for approximately eight years. She has good local knowledge of the San community and is well respected by them. The doctor also looks after the medical volunteers who come from all over the world and stay for a period of two weeks upwards, provides teaching & projects for them to undertake and ensures they are looked after. They are vital to the financial aspect of the project. The doctor/ partner picks the volunteers up from the farm and then drops them back at regular two weekly intervals. This also allows for a few days leave from the clinic itself.
Accommodation is attached to the clinic and is shared with the nurse and medical volunteers so there is not a lot of privacy. The accommodation is comfortable with a fully equipped kitchen, electricity, solar heated water, a television, a garden and two small affectionate dogs. Regular visits to Gobabis are undertaken to pick up food and provisions.
Other responsibilities include keeping regular updates for the management team, writing reports to obtain further funding (working with the fundraising manager), ordering the medications for the pharmacy and generally maintaining patient records.
There is often a lot of driving involved, some of it on gravel roads, but the clinic car is a Nissan X-Trail in good condition and reliable and safe to drive. You do need to be able to change a tyre as punctures will occur!
Namibia is one of the safest African countries to visit; the main nuisance is petty crime. Driving around Namibia is quite safe as long as you keep to a sensible speed and avoid driving in the dark. The roads are not busy.
It must be stressed that this is a remote area of Namibia in a small but friendly community. There are frequent power and water cuts particularly in the rainy season. Accommodation and food are all provided. There is also a small monetary remuneration of N$5000/ month (about £400/ month). The job would be suitable for a single doctor or a couple (not necessarily two medics).
This very rewarding role would suit a doctor with a passion for people, who would be prepared for the remoteness and heat of Eastern Namibia and who can be flexible and embrace all aspects of the role.
For more information about N/a’an ku sê please visit www.naankuse.com.
N/a’an ku sê Foundation, P.O. Box 99292, Windhoek, Namibia.
T: +264 (0) 817 438 505
Having participated in an Expedition and Wilderness Medicine training course can open up a whole network of contacts and opportunities, not only do expedition, media and travel organisations look more favourably on EWM trained medics who have participated in one of our courses we a have an incredible network of contacts who are constantly on adventures, working remotely and who need remote medical cover.
Recently expedition medics have been working with UNICEF and with a well known charity challenge compamy to provide medical cover on thier fundraising adventures – they are off to Namibia next and you can find out more about UNICEF’s fundraising expeditions here.
Our foreign courses always run on a fairly fluid timetable, but this year’s Desert Course in Namibia was certainly more fluid than expected. Having never seen rain in the desert before, we had rain every day bar one, most of it torrential. A storm on the second night tried its hardest to blow down/away most of the tents and the large tarps put up by Faan, our local agent. His cooking staff had never experienced such a storm and then still managed to produce a hot meal for us all shortly afterwards.
We still had a great week. The group included some extremely experienced medics and everybody contributed to the learning. A fascinating demonstration of snake handling from Stuart involved his venomous and non-venomous snakes and a parabusis scorpion.
We trekked in some seriously hot conditions and at times were lucky with cloud cover. One unexpected bonus was coming across a deep pool of water in a bend on a (usually permanently dry) riverbed giving us the chance to swim in the desert – magical. The view from the high peak of the Doros Crater Rim was well worth the walk in. Out final night out was luckily under the beautiful Southern Cross and the other stars as the clouds finally relented. We walked past fresh rhino tracks and saw herds of zebra, springbok and flighty ostriches as we drove out. Faan looked after us impeccably as usual.
Mother Nature surprised us again at the end of the course when the volcanic ash prevented Mark and I, and many of the course participants from flying home at our intended times. The latest person home was 10 days late and one participant endured an epic 3 day flight/train/train/ferry/train/ferry/train journey. At least we are all getting used to the unexpected.
We’ve just heard from the Namibia Ultra Marathon race director Steve Clark, that everyone is now back in Swakopmund. Steve said the race was very tough with temperatures getting up to 42 ºc. Winner Darren Roberts was very surprised and shocked to hear he won the race but once it sunk in he was delighted. Tom Adams very nearly caught Darren up at the finish line which made it a nail-biting finish.
Namibia 24-hr Ultra Marathon Results are as follows:
1st Place – Darren Roberts 20hr 28
2nd Place – Tom Adams 20hr 29
3rd Place – Tom Maguire 21 hr 05
4th Place – Emma Rogan 21 hr 27 – First female to complete the Namibia 24-hr Ultra Marathon
5th Place – Jerry Haywood 22 hr 30
6th Place – Nick Tidbull 23 hr 17
7th Place – Nicholas Wright 23 hr 45
8th Place – Helen Skelton 23 hr 50 – BBC Blue Peter Presenter
9th Place – Adrian Crossley, Stuart Moore, Kellie Power & Michael Skakesheff 25 hr 07. These guys all crossed the line together holding hands, they were all just outside the 24 hour deadline but all were allowed to finish.
Dr Amy Hughes will when she’s back write up about the medical situations she was faced with on the race and how people coped with the extreme heat.
Dr Sean Hudson explains why we’ve chosen Namibia to run our new Desert Medicine Course.
There truly aren’t enough superlatives to describe how beautiful Namibia is. Hence when we came to choose a destination for our new desert medicine course, there was only one possible choice.
As a group, Expedition Medicine have been working, travelling, holidaying and honeymooning in Namibia for over 10 years. It has a quality which is becoming increasingly rare and difficult to find in Africa. It still remains exotic and predominantly unspoilt, tourism is increasing but slowly.
The diversity of the country is its strength, whether you yearn for endless deserts, exotic mountains, huge dunes, canyons, rivers, a myriad of game parks or the most remarkable coastline in the whole of Africa, it is all here. All set to the backdrop of German efficiency, which has created a medical infrastructure which can support any expedition.
Caroline and I first worked in the Namib as guides and medics in 1998 and fell in love with the country. We have returned many times and are very excited about the desert medicine course. It’s a beautiful location, with Brandberg as a backdrop, and the opportunity to encounter the remarkably adapted desert elephants which often can be found in the Uhab River.
The team are quite exceptional, and I can’t wait to learn from them and their vast experience, in this and other desert environments around the world. If you want to camp in one of the oldest deserts in the world, in the shadow of a mountain which has been a refuge for desert nomads in hard times for over 6000 years, track elephant, learn how to survive and treat medical conditions common in this environment, then there is no question you would enjoy our trip to Namibia.
Dr Sean Hudson
Find out more about the Expedition Medicine Desert Medicine training course in Namibia.