Passionate about medicine in the wildest corners of this planet? Australia has a lot more of those corners than most, and they also have a medical society dedicated to it: the Australasian Wilderness and Expedition Medicine Society (AWEMS). Read on to hear about this year’s conference.
AWEMS is an organisation established with the goal of connecting Australasian wilderness and expedition medicine practitioners, and supporting the growth and profile of this field. They aim to represent quality, Australasian-specific experience and practice on the world stage and provide locally appropriate and evidence-based knowledge, guidelines, and skills to practitioners. Following the success of their virtual conference in 2021, the team planned and delivered an action-packed programme for this year’s in-person event.
Gathering in Hobart
The AWEMS inaugural face-to-face conference was held in Nipaluna / Hobart in October 2022. A jam-packed long weekend saw 110 healthcare professionals gathering in this picturesque city on the edge of Tasmania’s great wilderness, to share and extend our knowledge of healthcare in wild and remote environments.
Hobart is one of the Antarctic Gateway cities and is a veritable hub for everything Antarctic, including the Polar Medical Unit at the Australian Antarctic Division. The Australian research stations are far more remote, isolated, and challenging to access than many of those on the Antarctic Peninsula. The conference offered attendees the option to gather and share experiences and stories around the campfire, as well as providing virtual attendance opportunities for those unable to travel to the event.
Researchers, expeditioners, and medical professionals renowned in their respective fields gathered to speak throughout the weekend. From his office at Mawson Base in Antarctica, Dr David Tian shared his unique experiences as the sole medical officer for an 18-month Antarctic expedition, including training an electrical engineer to be a surgical scrub nurse! Joining us from the front line in Ukraine, Dr Jenny Beesley shared her experience as ‘a soldier first and medic second’. She described the patterns of injuries she is treating and the unique resourcing challenges that come from operating in an active war zone. Professional expeditioner, explorer, wing-suit base-jumper, and documentary filmmaker Dr Glenn Singleman also shared his vast and varied experiences in these fields, discussing how to optimise performance in extreme environments and circumstances.
Other trail-blazing presenters included intensive care flight paramedic Shaun Whitmore, who described his experiences of deployment to international natural disasters as a part of the Australian Medical Assistance Team (AUSMAT). He focused on the mental processes he has utilised to be an effective leader in poorly resourced environments when faced with an overwhelming number of casualties. We were also joined by Dr Kate Baecher, extreme sports psychologist and mountaineer, who explained the psychological effects of exposure to extreme situations including high altitudes and combat. Her exemplary work in this field focuses on the mental training and tools needed to survive and thrive under external pressure. Following on, fresh from filming their new shark documentary, Sunny Whitfield (expedition paramedic and natural storyteller) and shark ecologist Dr Johan Gustafson (aka. Dr Hammerhead) described the injuries and illnesses they faced whilst isolated in the middle of the ocean.
Alongside in-person talks and videoconferencing from medics working remotely, the conference was complemented by fantastic hands-on workshops covering a wide array of skills. Ultrasound expert and paramedic Aidan Baron delivered teaching on point-of-care ultrasound, demonstrating techniques used in remote Nepal to provide timely diagnosis and definitive care. Dr Edi Albert (Expedition Doctor and Adventure Medic patron) introduced us to haematoma blocks as safe and effective analgesia for long bone fractures on expedition. As a senior lecturer from the University of Tasmania’s Healthcare in Remote and Extreme Environments Faculty, he shared his experiences and lessons learned over a decade-long career in expedition medicine. Meanwhile, Andrew Bennett, a remote area paramedic, and tactical medicine instructor had participants practicing commercial and improvised tourniquet application along with rapid wound packing of critical bleeds. Finally, our new wilderness skills were drawn together under the experienced eyes of wilderness paramedic Adam Kershaw, who taught us how to construct effective pelvic and long bone splints out of clothing, hiking poles, and even mountain bike tyres.
Around the campfire
On Friday and Saturday evenings formal conference activities gave way to the equally important opportunity to sample Hobart’s best local beers, meet like-minded medics, swap stories, and network with world-leading presenters. The AWEMS conference provided an incredible chance to meet and share opportunities beyond the walls and corridors of a hospital or clinic, inspiring a future in healthcare that is so much more than we could have imagined.
Lessons Learned, Brynton Ashton
Diversify your skill set / Your expedition skill set is as important as your clinical aptitude and will often determine whether you’re selected for expeditions. Whether it’s being experienced and competent in climbing/ropes, deep water diving, or mountaineering – having these skills to offer when applying to work for expedition teams will make you stand out. Dr Glenn Singleman attributes his trailblazing career (which includes working as a dive medic alongside James Cameron on Avatar II, as well as multiple National Geographic documentaries), to the decision to obtain a university degree as a cameraman after already completing his studies as a medical doctor. He is also an experienced wing-suit skydiver with multiple world records! When recounting the process of building his own oxygen system for one such attempt, he said ‘it does not take skill to skydive once, but it does to do it twice!’. However, when it comes to helping out on an expedition Sunny Whitfield (wilderness paramedic) drew the line when his good friend Dr Gustafson asked him to hold on to a shark’s head during a tagging procedure. Sunny decided to defer this role to another expedition member with a prosthetic right arm following a previous shark attack, reasoning that the man’s prosthesis could take a bite much better than his own arm. He was shocked as his colleague instead used his left arm to hold the head of the feared ocean predator!
Time spent outdoors is seldom wasted / Whether it’s camping, hiking, climbing, trail running, mountaineering, kayaking, ocean swimming, or mountain bike riding – get outdoors as much as possible. Not only is being active outside one of the best medicines available, but the experiences you acquire will help you overcome the challenges you’ll face when treating a casualty in austere environments.
Advances in technology are more readily available / Portable ultrasound is becoming increasingly accessible. When a helicopter is hundreds of kilometers and thousands of dollars away, being able to differentiate with certainty between sinister conditions (such as AAA, ectopic pregnancy, or a ruptured appendix) and benign conditions such as constipation, is invaluable for both saving lives and utilising scarce resources appropriately. The future of wilderness and expedition medicine is in pushing the boundaries to assess and deliver treatment in the most remote and austere places. Skills practiced in hospital today could be achievable on the side of a river or in a cave in the near future, so get practising.
Join us next year
AWEMS has done an incredible job establishing its conference as a must-attend event on the calendar for any doctors, paramedics, nurses, and students looking to pursue an exciting career in remote, wilderness, and expedition medicine. The next AWEMS conference is to be held in October 2023. Clear your schedule and join us to explore the most exciting career that medicine can offer!
With thanks to Dr Sophie Ootes, the team at AWEMS, and their sponsors for a fantastic conference.
Photos credits: Sam Walters, Dr Molly Cargill, Kelsie Herbert, Dr Kasia Grela