Adventures — 14 February 2015 at 12:36 pm

Escape to Sabah – The Land Below The Wind

Dr Joanne Eagleson is a Emergency Medicine trainee determined to take the more interesting, winding path. She took the opportunity between F2 and ST1 to escape to the lowland Rainforests of Borneo with Raleigh International.

Although set in my ambition to pursue a career in Emergency Medicine I, like many others at my stage, made the decision to take time out after Foundation years before commencing higher speciality training.  For me, it was not because of any doubts about my chosen profession, or about indecision in terms of speciality.  It was a conscious choice to take the path less travelled, and to continue medical training at my own pace, in doing so hopefully avoiding the burnout that is becoming much too common in doctors.

Expedition & Wilderness Medicine Course

A week-long course run by Expedition and Wilderness Medicine opened my eyes to the vast world of opportunities in medicine which lie outside NHS hospital grounds.  The course is run in several beautiful natural locations (mine in the Lake District) and serves as a great introduction to Expedition Medicine.  As well as lectures by field experts, a good proportion of the week is spent in practical sessions including mock cas-evac scenarios out on the hills. With the course under my belt I had the means (and the nerve) to apply for medical adventures outside of the Emergency Department before knuckling down to specialty training.

Raleigh International

Volunteering with Raleigh was suggested to me by a friend, who had recently volunteered with them and could not have been more full of praise for the organisation, the country, or the experience in general.  I hadn’t heard of Raleigh before but was really impressed by their website and by the insight I gained attending an open evening a few weeks later.  Founded in 1984, Raleigh was established with a vision to give young people opportunities for self-development and discovery through exploration and community service overseas.  30 years on and over 36,000 volunteers later, Raleigh International continues to work with local partners in countries worldwide, delivering sustainable development goals whilst also crucially helping to shape a global community of young people with a shared interest and commitment to changing the world we live in.

My mind was made up, I submitted an online application and now, around a year later I find myself at Glasgow International Airport, waving goodbye to my loved ones and setting off for a summer in Sabah: “the land below the wind” and home to Raleigh Borneo.

The Trip

Two long flights later and I touch down in Kota Kinabalu, the principal city of Malaysian Borneo.  The city itself is a sweaty, soulless and completely forgettable place yet I am completely buzzing; my adventure has truly begun!  I make my way to Raleigh HQ on the outskirts of town and here I meet the 30 other newly arrived Volunteer Managers (VMs) who will fill a variety of roles for the upcoming expedition.  The majority of us (including the medics) will be Project Managers (PMs) working on various project sites across Sabah.  Other roles include Logistics, Communications, Administration and Photography.

Raleigh Borneo works on a variety of community and environmental projects across Sabah.  The community projects include building gravity-fed water systems, learning centres and toilets in remote rural villages as well as running sanitary education programs for the communities. The environmental projects are based in nature reserves and areas of protected forest and involve building trails, paths and bridges with the aim of making these areas more accessible and attractive to visitors, thereby boosting eco-tourism.  For my time with Raleigh, I will be working at Taliwas Forestry Reserve, an area of Class 1 protected lowland rainforest in the east of Sabah.

My Role

As a team of 7 medics our first responsibility is to provide basic medical training to the other VMs.  In just a few weeks, they will head up 9 volunteer teams being deployed to some of the most remote parts of Borneo, so getting their training right is crucial.  We cover basic first aid, wound care, illness prevention and also touch on disaster and trauma management.  Our aim is to instil confidence in the VMs though and obviously not to make them soil their underwear, so getting the balance right on the level of knowledge imparted is a tricky call.  Other tasks in the first few weeks include carrying out staff medicals and preparing group medical kits for the upcoming adventure.  Pre-expedition training for the VM team lasts almost 3 weeks; there is just so much to cover!  From survival skills (navigation and shelter-building) to soft skills (coaching and conflict resolution) the training is comprehensive and really does prepare us well for what is ahead.

With VM training complete we head to the airport to welcome the 109 keen young “Venturers” (the name given to a Raleigh volunteer aged 17-24) arriving from all over the world.  A quiet sense of wonder envelops me as they first trickle and then flood out into the arrivals hall to meet us.  So many eager young people, all from different walks of life, all with their own story to tell are uniting here in Sabah with the shared vision and hope of making a real difference.

Between the 7 medics we conduct 109 fairly uninteresting medicals.  The odd curveball livens things up: the Swiss doctor’s advice to one Venturer to only take anti-malarials should he start feeling unwell, and the doctor’s daughter carrying considerable amounts of opiates and benzos in her personal first aid kit (bearing in mind that Malaysia strictly enforces capital punishment for drug offences) are a few worth mentioning.  The Venturers’ training and induction lasts 4 days, during which we run sessions on first aid, wound management and health promotion.  We try our best to instil a sense of ownership to each Venturer for their own health.  The most common ills that will befall this lot in the coming weeks are preventable – diarrhoea and vomiting, heat exhaustion, dehydration, athlete’s foot – but of course they are much more interested in the gory stuff!

Deployment

Finally, deployment day arrives and a keen group of 14, now known as “Alpha 9”, depart for Taliwas reserve.  The nine alpha groups spread across Sabah are supported by a Fieldbase team – logistical and medical support is available 24/7 at the other end of a crackly, temperamental HF radio.  3 of the 7 medics spend a 3-week “phase” at Fieldbase to provide this support.

The environmental project at Taliwas Forestry Reserve involves working with the local Rangers on two ongoing projects – a wetland boardwalk and an educational walkway through an area of planted endemic tree species.  Improving the infrastructure of protected areas is vital for their sustainability; tourism brings much needed financial support to the area.

The way of life at our rustic “Raleigh Camp” is truly blissful.  We sleep in canvas hammocks, we wash and drink from the river and make our own entertainment.  The forest is by no means quiet though – we share with close to 1 million different species of insects, and their nightly cacophony would rival the buzz of any city centre rush hour!  As well as creepy crawlies, the forest is home to some incredible wildlife – one night, in the wee hours, we have a VERY close encounter with a herd of pygmy elephants.  With no mobile phone signal for miles, our only contact with the outside world is our twice daily “comms” with Fieldbase over the radio.  Although the crackly, temperamental thing is in some ways the bane of our lives, in an emergency situation it will be our lifeline to the outside world.

On the medical side of things we deal with a wide range of complaints: red eyes, D&V, fungal infections, heat illness, unexplained fevers, chest pain and even a case of leptospirosis.  The challenge most often is not really about making treatment decisions but making risk assessments and logistical decisions on how best to manage these things in austere environments.  Taking someone off of expedition due to illness can be devastating for them when they have worked towards it for so long.  But of course safety must come first.  One of my venturers unfortumately comes down with conjunctivitis; at home a fairly trivial complaint.  Although our medical kit has the eye drops she needs, keeping her hands and eyes clean in a remote jungle is an almost hopeless pursuit and after 2 days with no improvement we have to send her out for almost a week for things to settle.

Personal Development

The experience for me was more one of personal development than professional development but I do believe I have gained in that way too.  The ability to make safe objective decisions in difficult situations.  The PM work, liaising between our volunteer group and the reserve manager, helped me to become more assertive.

My two month expedition with Raleigh International was the best possible way to round off an incredible “gap year” of truly mixing business with pleasure.

A really worthwhile summer!

Getting Involved

The journey to become a Raleigh medic is a fairly long but enjoyable one.  After completing a basic online application form you are invited to attend a “selection weekend”.  The weekend is shrouded in mystery (which I won’t unveil), but if Raleigh is right for you then you will find it lots of fun: I did!  From there, a phone call from their London office delivers the news if you have been selected and then it is a case of finding the expedition that is right for you.  A fundraising target of around £1000 helps to cover expedition costs and you are also required to pay for your own flights.  STA offers a 10% discount to Raleigh volunteers, as do a whole host of high street retailers when it comes to buying your personal kit.  Indemnity cover is free if you are with MDU or MPS for doctors, RCN for nurses or Unison for paramedics; in each case you just have to inform them of your plans.  Raleigh provide fairly comprehensive medical kits for the expedition groups so this is not something you have to worry about