The medical preparation of expeditions: the role of the medical officer

Abstract

[Extract] The easy question ‘what is expedition medicine?’ needs to be analysed from a number of viewpoints. Firstly, there needs to be an answer to ‘what is an expedition?’ An expedition can be defined as an organised journey with a purpose.1 Such a purpose can be: an exploration of a particular location, a mission of academic or scientific research, an endeavour of personal or directed endurance, an investigation of environmental or archaeological concern, or a personal challenge. Secondly, expeditions often take place in the wilderness. Wilderness is described as ‘a wild, uncultivated or desolate region’2 and is a term frequently used in the United States where it has been additionally defined as a remote geographical location more than 1 h from definitive care.3 For the purposes of this article we will consider ‘expedition medicine’ as involving journeys to either the developing world or to very remote geographical regions where access to definitive medical care will involve prolonged evacuation over many hours or days. There is no clear distinction between those who travel either as expedition team members or others who travel to ‘wilderness’ areas and, from the definitions noted above, there will be considerable overlap between adventure travel and leisure travel. There are many reasons why travellers go to remote regions, for: • Enjoyment • Exploration and discovery • Achieving a geographical goal • Testing endurance and the element of danger • Scientific research • Education • Personal development • Cultural exchange.