Welcome to the World Extreme Medicine Podcast. Our host, Dr. Ffyon Davies, an emergency medicine and expedition doctor, speaks with Dr. Benjamin Alba. Ben has gone on to be the doctor for an Everest Base Camp trek and has just finished a season as one of the Everest Base Camp doctors. Following his experiences at Everest Base Camp, he was inspired to write an open essay entitled 'Everest 2023: The Season of Death,' highlighting some of the misconceptions and challenges on Everest.

By the end of the season, there had been 12 confirmed deaths, with 5 missing, assumed dead, bringing the total to 17. Since the 2010 season, 114 people have been killed on Everest. The average number of deaths per season is 8. Besides the avalanche of 2014 that killed 15 and the earthquake of 2015 that killed 20, this makes this season the worst on record for deaths on Everest without a natural disaster.

From the jungles of Cambodia during the final days of the Khmer Rouge in 1979 to the chaos of Baghdad in 2016, Combat Civilian is the powerful story of the response to human catastrophe over four decades.

Turning his back on the convention of a comfortable career in a family business, Gilbert Greenall has quietly dedicated the last four decades of his life to helping others through forty humanitarian aid missions and the delivery of British emergency assistance in eighteen conflicts.

He charts the changes in humanitarian assistance, revealing contradictions and triumphs, from the uncoordinated activities of a few small charities to the multi-billion dollar operations of today. The book guides the reader through wars, famines, earthquakes, floods and volcanic eruptions, yet there is time for humorous observations of misadventure and the absurdity of some decision making.

Greenall describes how it feels to race down the Mostar road under fire in Bosnia and the difficulties of changing a wheel on a Boeing 727 in the midst of a battle in the Angolan highlands, as he risks his life for the goal of humanitarian assistance.

Combat Civilian is a fast moving narrative, an emotional journey and a true-to-life description of the military risks and political constraints demanded by international relief work.

Welcome to the World Extreme Medicine podcast. In today's conversation, we'll tackle a complex question: How do we define excellence in emergency care?

We'll explore the idea that true excellence isn't just avoiding mistakes - it's actively balancing safety and proficiency. We'll look at how individuals and teams evolve in crisis situations, becoming more excellent versions of themselves. And we'll address the unique challenges of cultivating excellence among "swarm" teams that rapidly assemble for emergencies.

To guide us, we have a remarkable guest: Dr. Dan Dworkis, founder of The Emergency Mind Project. As Chief Medical Officer at the Mission Critical Team Institute, Dan knows a thing or two about achieving excellence under pressure. He's a board-certified emergency physician, assistant professor of emergency medicine at USC's Keck School of Medicine, and completed his residency at the Harvard-affiliated emergency medicine program at Massachusetts General Hospital and Brigham Health. With an MD and PhD in molecular medicine from Boston University, Dan brings a wealth of clinical and scientific expertise to our discussion of excellence today.

In this episode, we will hear from Mohamed Abu Breeg about the recent flooding in and around the Libyan coastal city of Derna. In the early hours of Sept. 11, residents of Derna woke up to loud explosions before floodwaters swept through the Mediterranean city. This was due to heavy rain fall and the breeching of two dams releasing 3 million cubic litres of water. This wall of water was up to two stories high and swept entire neighbourhoods out to sea. The deluge proved deadly for thousands in just seconds, uprooting apartment buildings and washing away roads and bridges.

 Libya’s Red Crescent has said at least 11,300 people have been killed and an additional 10,000 are missing. After earlier reporting that same death toll, U.N. Office for the Coordination of Humanitarian Affairs is now citing about 11000 people killed and 9,000 missing.

 Joining us to give insights on the ground is Mohamed Abu Breeg. Mohamed is originally from Sirte in Libya, following the 2011 civil war he actively collaborated with Save the Children to contribute to post-war recovery efforts. In 2013, during the challenging period of Ansar Al Sharia's control in Sirte, Mohamed worked in security operations with a French company at the city's main power plant. He has seen the emergence of ISIS in Sirte and the subsequent arrival of Derna ISIS in 2015. In August 2015, as a result of ISIS, Mohamed become an internally displaced person (IDP) within Libya. He became an integral part of the LTI4 project, where our collective efforts were dedicated to post-conflict rehabilitation. He currently serves as a security consultant for the region.

You can find more out about Mohamed here

Welcome back to the World Extreme Medicine podcast. Today we have a fascinating conversation with Scott King, a highly experienced paramedic and instructor. He has trained individuals in hostile environments around the world with NGOs and militaries.

We delve into the challenges of preparing teams for these demanding conditions. Scott shares insights on effective training approaches, drawing on his vast experience. He highlights tailoring the training to the audience, incorporating high realism through simulations, and the power of kinaesthetic learning.

Topics include:

If you want to learn more about operating in hostile environments, be sure to check out our new Hostile Environments Medicine course. It's the perfect way to gain crucial hostile medical skills following Scott's insights.

In this episode we will look at the benefit and utility of Methoxyflurane, more commonly known as Penthrox. Penthrox is a volatile, self-administered inhalation analgesic indicated for short-term pain relief. Penthrox is a portable, lightweight, non-invasive inhaler for self-administration of the Methoxyflurane vapor. The Methoxyflurane vapour provides analgesia when inhaled at low concentrations. At analgesic therapeutic doses, pain relief can reduce and mitigate even severe pain yet has a short half-life. In this episode I will be speaking to Will about it’s use and limitations within the expedition environment and how and when it can be optimally used as either a sole adjunctive pain relief agent or as part of a larger pain relief strategy.

Will is our Joint Medical Director and provides clinical oversight for all World Extreme Medicine’s activities. Will is a jobbing Devon based GP, educator and adventure addict who thrives in wild places with newly formed teams and limited resources.

He has provided medical cover for dozens of very different expeditions and projects; including commercial high-altitude treks in The Himalayas and The Andes, a luxury Trans-Siberian private train, a reality TV show in the South Pacific and he has worked with UNICEF out in forgotten corners of Myanmar.

We speak to some of the most extreme medics in some of the world's most remote locations, due to this there can sometimes be an issue with sound quality, so there are a few quality dips in this episode, but we felt it was an important conversation to share.

Welcome back to the podcast that explores the exhilarating world of extreme medicine. In today's episode, we delve into the impact of PTSD and PTSI on individuals in high-stress professions like the military. Boxxy shares personal experiences and insights, emphasising the importance of acknowledging emotional trauma and fatigue and the need for early intervention and open communication about mental health. Join us as we uncover the evolving landscape of military medicine, survival training in extreme environments, and the rewarding nature of saving lives. Stay tuned for an adventurous journey into the world of extreme medicine.

On this episode, our guest Klara Weaver talks about Wedel seals farting in her face in Antarctica, peeing in a Nalgene in the middle of the night (and the need to practice in the shower), sexism in expedition medicine, the role of social media in expedition medicine self promotion and keeping it grounded, the importance of ‘mentally’ unpacking after expedition, shout out to our supportive family friends and partners who put up with us! And her love affair with grass post Antarctica. 

We also discuss the allure of buying new kit for hobbies and how it has inspired her side hustles. Klara shares her passion for arts and crafts, being outdoors, and her interest in business and small businesses. Klara also talks about her foray into carpentry and making things with power tools when converting a campervan. During her time in Antarctica, Klara learned crochet as a distraction and a way to quiet her mind. She emphasises the importance of having something outside of medicine, whether it's a hobby, sport, or other skill. Klara believes that having a side hustle can bring valuable skills back into medicine and make it more interesting. She mentions the potential for quality improvement projects in medicine inspired by business practices. Having diverse interests makes one a more well-rounded doctor and makes the less exciting aspects of medicine more enjoyable. Klara shares that her family and friends have a short attention span when it comes to her experiences in Antarctica. She highlights that people often want her 20-month expedition to be condensed into a few sentences, not fully understanding the challenges and intensity of the experience. She warns that social media can give a misleading perception of expeditions, emphasizing the behind-the-scenes work, anxiety, and potential risks involved.

In this episode, we sit down with Dr. Shawn Rowland, a Hawaiian physician who stepped onto the frontlines of the intense Lahaina fire disaster. Dr. Rowland, a board-certified Family Medicine physician and the founder of Jase Medical, brings a unique perspective to the challenges of disaster response.

On this episode, join host Eoin Walker as he sits down with Jim Bond, an experienced consultant in travel and exhibition medicine, to discuss the critical decline of the African wild dog population across Africa. Jim shares his extensive knowledge and passion for one health, particularly in the context of the rabies risk reduction scheme. Together, they explore the various threats facing the African wild dogs, from persecution and poaching to diseases and habitat loss. They delve into the importance of vaccination and the challenges of reaching remote areas with low population density. Jim also discusses his plans for conducting a real-world prospective study on rabies vaccination in African wild dogs, comparing different methods of vaccination. Throughout the episode, they highlight the need to engage local communities, address vaccine hesitancy, and implement community-led public health approaches. As they wrap up the conversation, they emphasise the urgency of prevention and the goal of eliminating rabies from Africa by 2030. Tune in to this eye-opening episode to learn more about the fascinating African wild dogs, their unique social structure, and the efforts being made to protect this critically endangered species.

Jim Bond is a passionate wildlife enthusiast who has dedicated his life to studying and protecting the African wild dog, also known as the painted wolf. With over 50 names associated with this unique species, Jim is fascinated by its distinct characteristics that set it apart from other members of the dog family. Having diverged from other wolf-like species millions of years ago, the African wild dog's four toes on its front feet allow for an extended stride, making it the most efficient carnivore predator in Africa. Jim is amazed by the success rate of the African wild dog, with a remarkable 70% to 80% success rate in hunts. He is particularly captivated by their large, round ears, which possess an incredible sense of hearing. Jim never ceases to be astounded by the beautifully patterned coat of the African wild dog, which comprises a random mix of blacks, whites, browns, yellows, and even reds. Lastly, Jim admires the species' specially adapted teeth that are second in size only to the hyena's, enabling them to quickly tear apart their prey. To Jim, studying and protecting these fascinating creatures is not only a duty but a deeply rewarding experience that highlights the intricate beauty of the natural world.