Archive for the ‘Antarctic Medicine’ Category

Antarctic Expedition Medicine makes its debut in JuniorDr Magazine

Tuesday, December 30th, 2008

This blog has once again served as a vehicle for raising the profile of Antarctica and in particular expedition medicine, to my great satisfaction.  JuniorDr Magazine, a print-and-online publication based in the UK and targeted at all doctors ‘in training’ (ie. before reaching specialist/consultant level) came across the AntarcticDoctor blog while researching a piece on working abroad.   I’m proud to say that an article (based on a piece which I wrote for the AEP newsletter) appears in the latest edition, and will hopefully contribute to raising the profile of Antarctic research and wilderness medicine.  You can visit to read their online content or click on the image above to read/download a copy magazine.

Another take on Health Economics

Sunday, December 28th, 2008

Warning – I’ve packed it in after a long day and am drinking sherry while I write this, so expect a degree of rambling.

The frequent discussions on CCM-L and Med-Events on health economics are a constant source of interest to me.  Bear in mind that the majority of those that argue throughout the discourse are ‘comfortably’ parked in the USA, Western Europe, etc, while I have a very different developing world perspective.  I’m sure colleagues in countries such as Brazil and India will identify when I say that we have a dichotomous economic environment; First World excess and ‘hot-and-cold running nurses’ are available to those with the personal assets to purchase such care, while the rest make do with state-supplied bare-bones service.  The split between public and private healthcare may seem odd to many, but  to us it is a way of life.  Fortunately, I can say that there are equally brilliant and egregious doctors in both systems; I trained under physicians and surgeons in the government system who are quite simply world-class, whose names you would recognise from the keynote speakers at international conferences, and I have encountered their opposites in private hospitals and remote subsistence clinics alike.  Thus, I am not as concerned as some commentators on the ‘risks’ of having a split in healthcare services between private/public, insured/uninsured, consumer/medicare, or whatever description you wish to give it – it exists already in my country, and it does function.

My regular job has always been in the public service, with the government paying my salary.  Before coming down to Antarctica (where, incidentally, I am still paid by the state) one of my jobs was working in a ‘Community Health Centre’ in Khayelitsha, Cape Town.  Khayelitsha is a township/ghetto/informal settlement (pick your politically correct label) of about 1.5 million souls, on the fringes of Cape Town (just beyond the airport, should you know where that is).  It’s poor – the older established areas have the most basic houses imaginable with tin roofs and running water as a fairly recent luxury.  The poorest areas have only shacks – many more cardboard than tin.  One particular area has the wonderful distinction that 100% of the residents acknowledged in a survey that they or a member of their immediate family support themselves through crime.  I was robbed at gunpoint by an 11-year-old boy there a few years ago, so I believe the statistic.  (I remember thinking that I was impressed that his tiny arm could support a 9mm pistol so steadily, and chalking it down to adrenaline, as he was probably more scared that I was.) (more…)

Letter home on a stormy day

Saturday, November 1st, 2008

Despite it now being November, and supposedly Spring, we are once again socked in by strong winds and snow today.  Sitting as I do now, looking through my bedroom window, I can make out the rocks east of the base disappearing into uniform whiteness about 50m away, with streams of blown snow snaking across towards me before passing under the base.  Over the sound of my music, the wind is rumbling and singing in the support beams, and every now and then a strong gust makes a shiver through the structure that I can feel through my feet.

Today I am feeling lazy and doing relaxed things.  This includes reading some medical papers, catching up on email and keeping my nose in various books (simultaneously reading a PG Wodehouse and one of Reinhold Messner’s books).  I  should be working on the month-end reports and newsletter for October… but hey, it’s Saturday 😉

I slept in short bursts last night – one of the team has a fairly nasty case of solar keratitis (snow-blindness) from working outdoors yesterday without his sunglasses, and I was up every few hours last night to put in the right drops (three different types) and give him pain medicine.  This is the first case of snow-blindness we’ve had.  It was heavily overcast yesterday, which fooled this poor character into thinking that his goggles/glasses were superfluous (it’s always an irritation to wear eye protection when doing strenuous work, because it invariably fogs and then freezes, requiring regular cleaning).  However, the UV rays that do the damage pass through the clouds and reflect off all the snowy surfaces potently.  The good news is that the corneal damage is not severe, and I expect a full recovery in a day or two, but in the meantime it is very painful, irritating, and debilitating.

We can certainly feel that the Earth is progressing on her path around the sun.  Temperatures have increased and over the last week or two have hovered in the minus teens, as opposed to the minus twenties and thirties we are used to.  The sun is nearly a perpetual companion now: sunrise is now just after 2 AM and sunset just before 10 PM.  As the sun never gets far below the horizon, even at midnight there is a blue twilight which allows one to work easily outdoors, and the southern horizon has a bright yellow-orange glow.  On a day like today, with such limited visibility and everything white outside, when I woke at 0300 to give medications there was no way to tell if it was 0300, 0900 or 1200 other than looking at my watch.

The longer hours of daylight and warming temperatures have made a big difference in our outdoors productivity, thankfully.  Work is under way to remove the wreckage of the HF radar which fell during the winter to make way for a new construction during the summer.  This is slow going, as each of the 15 16m T-shaped towers have to be lifted from their covering of hard-packed snow (accumulated over the past few months), unbolted, placed on a sled, and deposited in the summer depot near the base.  We have also moved all the 25 000 litre diesel transport tanks up to the depot and pumped out the remaining fuel stocks into our storage bladders, to prepare the tanks for our coming trip to the coast.  Also very importantly, last week we prepared our skiway to receive flights – the local DROMLAN (Dronning Maud Land Air Network) flights to move supplies and personnel for the summer kick off now.  SANAE IV is fairly centrally located in the DROMLAN area, and thus we serve a role as a way station, and perform flight following.  We almost had 15 Germans and additional flight crew here for the weekend, but the weather closed in before the flight took off.  It would have been good fun to have company, as they would be the first outsiders we’ve seen since the beginning of March.  They also have some long-awaited packages of personal goodies for the team, which are subject of much anticipation!

People frequently ask me if I’m excited about the prospect of coming home; with our return only a little more than 4 months away now and expecting the takeover/summer-expedition personnel in about 9 weeks I certainly have a feeling that the expedition is coming full circle and the end is approaching.  Although I recognise home-sickness in some of my team-mates and I do long for some simple things (fresh salad; the heat of a sunny Cape day on bare skin; a swim; petting and playing with the dog; flying my glider), moving into this phase fills me with more of a sense of sadness than joy or relief.  To those back home this might sound heartless, but it is due to the immense sense of belonging and peace that I feel in this wild place.  Sometimes, when I find myself outdoors on my own for a moment, just sucking in a deep chestful of the cold, clear air fills me with satisfaction akin to Nirvana.  It is said that religions are born in the desert, because the emptiness makes Man mindful of the presence of something greater.  Here, in this unique desert, I feel that sensation acutely, and thus the sadness when I think of going home.  I’m certainly not the first to feel this way:  Frank Hurley, of Shackleton’s epic expedition, wrote that “After life in the vastness of a vacant continent, civilisation seemed disappointingly narrow, cramped, superficial and empty.“  However, to return is inevitable and the reunion with loved ones and loved things will be sweet.  I take heart in the words of TS Elliot:

“We shall not cease from our exploration,
And the end of all our exploring
Will be to arrive where we started
And know the place for the first time.”