Interested in expedition medicine but don't know where to start? We chat to Dr Shubhanan Upadhyay about his recent role as a dive medic in Indonesia.

1) How did you get involved in expedition medicine

During my foundation year rotations one of the registrars was involved in this - we got chatting and she recommended an excellent course in expedition medicine. I finally managed to do the course as a GP registrar.

I also have an interest in Tropical medicine (I completed the Diploma in Liverpool a few years ago) and love travelling so I thought it could be a great way to potentially get work and travel!

 

2) What did the course in Expedition Medicine involve?

I did the World Extreme Medicine course. There is the General course which is for a few days - based either in the Lake District, Snowdonia, Dorset and Slovenia. I did the course in 2014 in Snowdonia. 

There are other courses they offer as well - often a week long - Trauma and Hostile Medicine, Mountain, Polar, Desert, Jungle, Diving!

In the general course - there was a great mixture of lectures about common problems on expedition (altitude sickness, heat stroke, tropical illness, foot care, etc), improvisation techniques, map skills and geo-location and also an amazing scenario at the end where in groups we co-ordinate a rescue of multiple casualties (actors stranded on the mountain side with very realistic looking injuries!)

There are other types of courses in this field such as Wilderness Medical Training - which offers courses in Morocco and Chamonix. 

 

3) What 3 things did you learn whilst doing the course

I Learnt much more than 3 things - but 3 very memorable things were - 

1. The importance of foot-care on treks (and how duct tape cures almost all foot related ills!)
2. A scenario for helping stabilise suspected pelvic injuries with a jacket and spoon!
3. The importance of team leadership and everyone having well defined roles. 

 

4) Can you describe what your role was as a dive medic?

I am very much a beginner in this world- this was my first expedition type role (although I have done some charity work in other parts of the world).

After doing the course I really wanted to use the skills I had gained but it took me 2 years to get the time to go!

My role was with Operation Wallacea  - a conservation charity operating worldwide. They offer opportunities for school and university students to become involved in conservation projects, collecting data and learning skills essential for a career/interest in Environmental Sciences. 

I was free for a few weeks in June of this year so I contacted them and I was assigned a Marine site in Indonesia - this was great as I am a keen diver!

The role is not paid, but things like accommodation, food and of course the diving were provided.

My role was fairly broad. I was to be in charge of health and safety for the site (mainly giving briefings to the new groups), stock checking of the well supplied medicines, being available for emergencies and offering a clinic hours (1 hour at breakfast and 1 hour before dinner) where people could drop by with any problems. 

Another role was prevention - making sure everyone was hydrating, washing hands and putting on sun lotion!

 

5) Best and challenging parts of your role as a dive medic?

Best parts:

Aside from the clinic hours - if there were no emergencies - my time was my own. Diving in idyllic, pristine water twice a day for 2 weeks was sweet relief from the daily grind back home!

The chief complaints were diving related ear problems, cuts and bruises - so luckily I did not have to use the jacket and spoon technique for pelvic injuries this time. 

Getting to know the team, groups and locals - genuinely making friends for life! I am already making plans to go back next year! Also it was great to have a chance to be involved in the reef surveying, cleaning rubbish off beaches, and learning how small things we do at home can have an impact on the environment. 

Challenges:

Aside from the medications and oxygen tank we have - resources were limited. I had a young local boy who had an accident whilst fixing a water pump and amputated the distal phalanx of his little finger. 

Taking him to a local clinic where I assisted the clinician whilst she sutured a stump was eye opening - the clinic facilities were very basic. Thankfully with the aid of daily dressings, and advice via Whatsapp about stump wound healing from colleagues back home he avoided infection and the wound is healing great (so I am told by the Doc who I handed over to!)

 

6) Do you have any advice for people wanting to make a career out of this?

The advice would be to get involved - there are lots of projects like this that require medics. Operation Wallacea and Raleigh are well known among others - these are good ones to start out with as they have lots of experience and are well equipped to deal with problems. 

After a few of these some people end up getting involved in more adventurous things like TV documentaries in the wilderness or charity treks. The guys who run Expedition Medicine have recently launched a PG Cert and Masters course - so do check out the details on their site.  

Their Facebook group is World Extreme Medicine. Also PADI do a rescue diver course which I am thinking of doing myself.

7) Can you recommend any good resources?

There is a World Extreme medicine expo later this year if you are so inclined, the website is good as well. There is also an Oxford Handbook of Expedition Medicine.

 

If you love the outdoors and are looking for something different - I recommend doing a expedition medicine course going out with one of these projects to one of the many sites - it was a truly refreshing and fulfilling experience!

 

You can read more from Dr Upadhyay at his blog

For Dr Upadhyay's GP courses and events website go here: http://mygpevents.co.uk