82 research outputs found
Mongolian Expedition
No full textExpedition medicine is becoming a lot more popular with travelers now, so 'tis important to
have some idea about it when advising on issues of remote travel. I was approached to give
medical expertise on an expedition to Outer Mongolia whose role was to find out how
many snow leopards are there in the region. The task sounded quite exciting actually, and
apart from my role as Expedition Doctor (ED), I figured that I would have an equally hard
task of keeping beloved Lynne, also known as 'the Memsahib', actively enthusiastic about the
journey. When I mentioned the idea to her, she was bland faced and not too much excited;
so I declined to tell her about the camping we would be doing at altitude in the snowline.
OK, so it was a mistake, more so because the region just happens to be 'quite' windy and
she hates wind. Had to be careful, else I fear that morale could dip a little on our journey.
Figured that I would take lots of happy-juice and family photos along with me.
The modern practice of expedition medicine is to encourage adventure but to attempt to
minimize the risk of trauma and diseases by proper planning involving risk assessment, preventive
measures such as vaccinations, prophylactic drugs and medical equipment, knowledge
of first aid, emergency and primary healthcare skills, communication skills, and an attitude
of caring for both the anticipated team and the anticipated cultures of the expedition. So,
the usual 'medical stuff' but with expedition planning needs to cover all contingencies: from
mild illnesses and disease to group health insurances, through to unforeseen events such
as evacuating a seriously-ill, injured or dead person. Important also in the pre-trip planning
is local knowledge of the area to be traveled. To tl1is end, the ED needs to investigate local
lmowledge in the country. This was hard to do in Mongolia, mainly because very few people
speak English and there are very few adequate medical facilities outside the main city of
Ulaanbaatar.
Many groups of expeditioners travel without a doctor, nurse or suitably qualified paramedic.
Notwithstanding this, an experienced doctor is a valuable member of any team and
has the role of looking after such medically related issues as managing pre-existing health
problems, advising on suitable immunizations and anti-malarials, assessing any travel-related
health risks, and finally making preparations for the trip that include the assembly of a suitable
medical kit. Good stuff, but hard work. Medical problems may arise during or after the expedition and the ED needs confidence in dealing with the varying demands of an
expedition team, which will vary enormously depending on the individuals, the task of the
expedition and the location
Confessions of a 'Reality TV' doc
No full textI am bulked into the middle seat on the right side of the plane while coming back to New Zealand from Namibia. On my left is a fat man with body odor 'big-time' and on my right
is a lovely French woman who has a lilt to her voice that makes your heart sing. I am
cramped - again. My long legs. For a moment I wonder whom to ask if I can rest my head
on their shoulder, but a puff of fetid breath makes my mind up for me. I snooze and reflect
on a successful journey to Southern Africa, as a doctor for 25 folk on a reality TV program.
I don't get to go on TV, damn it, but I do get to care for the group's medical needs
Plasmodium knowlesi in a traveller returning to New Zealand
No full textThe recent discovery that Plasmodium knowlesi causes malaria in human populations, established it as the fifth species of plasmodium that may do so. A case of P. knowlesi malaria is described in a helicopter pilot from New Zealand, who became ill after returning from recurring visits to Malaysian Borneo in June 2010. His P. knowlesi infection was not detected using microscopic examination and a rapid diagnostic test for malaria, but was confirmed by both PCR (polymerase chain reaction) and sequence analysis showing homology with the ribosomal RNA gene for P. knowlesi. He responded rapidly to treatment with artemether & lumefantrine combination. The evolution of a rapid diagnostic kit to diagnose P. knowlesi is needed, for early identification and appropriate anti-malarial therapy of suspect cases are both critical in the prevention of the potentially life-threatening disease through P. knowlesi. Clinicians need to consider knowlesi infection in the differential diagnosis in recent-onset febrile travellers to areas of forestation in Southeast Asia
Theory of multiple proton-electron transfer reactions and its implications for electrocatalysis
No full textThis Perspective article outlines a simple but general theoretical analysis for multiple proton-electron transfer reactions, based on the microscopic theory of proton-coupled electron transfer reactions, recent developments in the thermodynamic theory of multi-step electron transfer reactions, and the experimental realization that many multiple proton-coupled electron transfer reactions feature decoupled proton-electron steps in their mechanism. It is shown that decoupling of proton and electron transfer leads to a strong pH dependence of the overall catalytic reaction, implying an optimal pH for high catalytic turnover, and an associated optimal catalyst at the optimal pH. When more than one catalytic intermediate is involved, scaling relationships between intermediates may dictate the optimal catalyst and limit the extent of reversibility that may be achievable for a multiple proton-electron-transfer reaction. The theory is discussed in relation to the experimental results for a number of redox reactions that are of importance for sustainable energy conversion, primarily focusing on their pH dependence
Travelling to India for the Delhi XIX Commonwealth Games 2010
No full textThe 19th Commonwealth Games, conducted once in every four years since 1930, will be held in New Delhi from the 3rd through until the 14th of October, 2010. There will be approximately 17 sports on display and there will also be 15 para-sporting events. This paper focuses on health and safety issues for travellers to India in general, although it provides specific references to advice for visiting Commonwealth Games athletes and team staff, who will be travelling to the games. Whilst it needs be remembered that travel health advice can change, travellers are advised to seek up-to-date travel health advice for India, from their professional providers, closer to their departure
Setting up a travel clinic
No full textTraditionally, travel medicine has been practised on a part-time basis, most usually in the primary care setting. As it develops into a speciality in its own right, the provision of pre-travel health care is more frequently being provided in dedicated centers by specialists in the discipline. Once the decision to set up a travel clinic has been made, thorough research and consideration of the practicalities of opening and running a specialist center is are essential. This will ensure that the clinic is clinically and financially successful, and, more importantly, is able to provide the consistently high standard of care expected of such a clinic
Emergency care whilst abroad
No full textAlthough illness makes up a considerable proportion of problems encountered by travelers abroad, accidents and injury are also a significant concern. It is important that travel health advisors discuss with travellers the importance of taking out travel insurance appropriate for their destination and activities and also for any pre-existing medical and dental conditions. They also need to discuss how to access emergency assistance through their travel insurance provider and other avenues for finding medical and dental care abroad. While Although travel insurance may provide assistance with hospitalizsation and arranging for medical transport, including aeromedical evacuation in some situations, it is also important that travellers are advised how to manage emergencies until medical assistance is sourced as well and how to deal with minor ailments and injuries abroad. To this end, the contents of a traveller's medical kit appropriate for their destination and activities and for their personal health should be discussed during a pre-travel consultation and travellers advised on the use of its contents, as well as in addition to being encouraged to ensure that someone in the travelling group has undertaken first aid training
Professional organisation profile: a sub-faculty of expedition medicine for Australasia
No full textA review of the recent foundation by The Australasian College of Tropical Medicine of the Sub-Faculty of Expedition Medicine is presented. Information is given on aims, professional grades of membership,and the various activities of the Sub-Faculty, including publications and scientific meetings
Travelling to South Africa for the 2010 FIFA World Cup
No full textThe Fédération Internationale de Football Association (FIFA) World Cup, conducted once every four years since the first championship in Uruguay in 1930, will be held in South Africa from the 11th June through until the 11th of July, 2010.1 The 2010 FIFA World Cup will be the culmination of a qualification process that began in August 2007 and involved 204 of the 208 FIFA national teams.1 As such, it matches the 2008 Summer Olympics as the sports event with the most competing nations.2 An added honour for South Africa is that this will be the first time that the tournament has been hosted by an African nation.1
South Africa has a population of more than 47 million people, who inhabit more than 1.2 million square kilometres.3 The 2010 FIFA World Cup will be played across nine South African cities. From north to south, these include: Polokwane/Pietersburg, Rustenburg, Nelspruit, Tshwane/Pretoria (Administrative Capital), Johannesburg, Mangaung/Bloemfontein (Judicial Capital), Durban, Nelson Mandela Bay/Port Elizabeth and Cape Town (Legislative Capital).4 There has been a dedicated stadium building or expansion program in each of these locations. The nine stadiums can now hold crowds of between 44,530 at the Royal Bafokeng Stadium in Rustenburg to 70,000 at the Green Point Stadium in Cape Town.4 The country has many famous tourist attractions, including the numerous game parks, such as the renowned Kruger National Park, and four natural United Nations Educational, Scientific and Cultural Organisation (UNESCO) World Heritage Sites. Although various languages are spoken in South Africa, English is widely used, almost universally on signage, as least where most travellers are likely to go.3 The applicable weather will be for late autumn/early winter in South Africa.
Probably the biggest concern for the Government, officials, players, spectators and travellers alike is the safety and security situation in South Africa. South Africa was ranked 96th globally for safety and security in the 2009 Legatum Prosperity Index with a high homicide rate (543 deaths per million per year) and only 31% of South Africans feeling safe walking alone after dark.5 Although South Africa is no stranger to the hosting of high-level sporting events in such circumstances;6 however none of these come close to the potential scale of the 2010 FIFA World Cup. To improve safety and security, the South African Government has spent more than USD89 million (ZAR665 million) just on equipment, including helicopters, for the event, as well as spending USD85 million (ZAR640 million) on deployment of 41,000 South African police officers during the World Cup, amongst other measures.6 Despite reassurances of the South African Government, travellers will need to be made aware that South Africa has a high level of serious crime, including violent crime, which poses a range of risks. Travellers should also be alert to road and pedestrian safety in a country where drivers drive on the left hand side of the road. In 2008, there were over 14,000 fatal vehicle crashes in South Africa, and there remains a problem with unroadworthy vehicles and unlicensed drivers using public roads.7 Travellers should be advised to read travel advisories carefully, especially details on how to manage their own safety and security. Additionally, they should check current travel advisories before departing for South Africa. Travellers should also exercise care when selecting taxis, and finally, they are advised to seek advice from knowledgeable and trustworthy locals
A case of exposure to Bancroftian filariasis in a traveller to Thailand
No full textA New Zealander travelling recreationally to Asia became exposed to Bancroftian filariasis. The traveller had presented incidentally with gastrointestinal illness. In addition to diarrhoea, the traveller's symptoms were non-specific and there was no eosinophilia, lymphoedema, lymphangitis, lymphadenitis, or pain. The immunochromatographic test for Wuchereria bancrofti was positive indicating that there was or had been an adult filarial worm. The illness resolved completely following treatment with ivermectin
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