(Left) Master Sgt Trevor Pittman (Centre) Dr Marc Shaw and (Right) Squadron Leader Steve Hall (NZ Air Force)

  • The time is around 2000 hours – our Malaysian Colleagues are having their celebration of EID which is the equivalent of our Christmas. Leon comes across to me and says that he has just had word of a serious injury to one of our American Colleagues. ‘A neck injury is coming in within a half hour’, he says. So, we prepare for the injury in the best way that we can. The patrol that the man is with is quite far away and we are not able to get too much detail from the initial radio contact. He arrives and we step into action: history of ‘was in a patrol vehicle travelling at 55 kms / hr, with the usual ‘in car’ prevention – seatbelts and the like. The vehicle crested a hump in the road and the patient sitting in the back of the vehicle whacked his head on its roof. Due to the unexpected nature of the impact, the patient’s head then slammed into the back of the seat in front and the side window on his left. He was pretty seriously knocked around, and the first response of the team on patrol was to stabilise his head so that no further injury could occur. For me, as the Doc, the serious part was that our man had developed reduced movement in his left hand and pain on the left side of his neck radiating down to the left arm. This was a pretty severe discomfort. Although he denied being knocked out, there was significant evidence that he had developed concussion. My concern was that our patient has sustained a fracture of the cervical spine in the neck.
  • Well, with such a diagnosis as a possibility, we then had to get our man to a higher medical facility for radiology and further neurological assessment. Now was the time for me, as the Doc, and for Leon, Blue and the other members of the medical team to ‘step up’ and prepare the case for evacuation to Bagram. It was time for me to report to the US Command about our patient, their soldier. I addressed them with the standard ‘we have a situation here…’ and then proceeded with the objective assessment of their warrior.  I then continued to tell them exactly what was going to happen and how it should pan out with their help in ordering a casevac. At this stage I got a bit ahead of myself and threw in a few newly learned acronyms by mistake but the US officers were very tolerant of my errors an then proceeded to throw in a few of their own. I was on slippery ice here – but fortunately no one noticed my improvisation, such was the intensity of the communication. An aircraft was ordered up and it was arriving quite soon.

  • Blue, Leon and I readied our patient for the flight by considering the further practical issues such as how the man would travel and with what medical support, pain relief, intravenous support and the like. Good pragmatic medical sense.
  • Then we get the word that the aircraft is overhead and whoosh, we hear it. I get around some guys to help me (Sqd Ldr Steve Hall, Allan Kelly and Master Sgt Trevor Pittman) and we truss our patient up in a blanket and with a ‘silver heat-retaining blanket’ around him. On a stretcher and spinal board he goes, and then onto our portable ambulance we transfer him down to the nearby airstrip where the plane has just landed, in the dark. Brilliant stuff!
  • Fortunately not a very cold night tonight. We wait on the airfield for the plane to come up to us. Meanwhile deployed on the field are our troops to secure and protect our airfield and the perimeter of the aircraft. THIS is very impressive – they have strategic points covered and are there waiting for my patient. We get the word from the Sgt-Major and drive off to the ‘airframe’ (Army talk for ‘an aircraft’) in the distance – we cannot see it at this time, just hear it! We travel with out headlights on and see before us dust rising but no plane – it is in the darkness. We are aware of something huge in front of us. An occasional speckle of LED lights presents itself to us. An about turn and then a quick reverse back to the down-ramp at the back of the plane. I look around and am so impressed with the professionalism that I see before me. In a perimeter around the craft and with hot aviation fuel odours in my nose, there are a number of persons, fully armed and with aviation helmets on, on either side of the ramp. They are guarding our presence. I grab my corner of the stretcher and up the ramp we go to deliver the patient. One of the medics comes over and I give him the update ‘We have a situation here …’ They are happy with my presentation, and with a quick ‘farewell’ to our patient I head back down the ramp to our vehicle. We drive off into the dark, with the aircraft quickly disappearing. Just the sounds of the props remain.
  • Back down the airfield just in front of the camp entrance we pause and wait for the plane to take off. Shortly after, it does – night-time take off and very impressive. The whole imagery of the evening with our patient and the transportation of him to the aircraft was something that will never leave me – VERY professional and absolutely exciting to be part of!

Overlooking Bamiyan Town


The cool day is sun-filled right across the hills of the Bamiyan valley, to the snow that adds a frame to the remarkable picture’s scene. The Padre (Ra) and Allan Kelly, a civilian such as myself, and I head off to the nearby Foladi Valley. The journey to our planned destination was anticipated to take around 40 minutes . It was to the farthest medical clinic up the valley, but I don’t think any of us anticipated the state of the roads that took much negotiation and rocky-road manoeuvres. Our caution in thusly travelling was countered by the speed of the local police who seemed to be on ‘blue light flashing’ every time they took to passing us on the  rutted dusty roads.  Cautiously we drive, and an hour later we feast our eyes on a most lovely village that looked as though it was from way back in ancient Medieval times.  We were presented with often huge houses that had stunning walled architecture, and which gave home to 5-6 families living there. The walls of these not unattractive constructions were made of mud – brick or stone and concrete.  Often they had lattices on windows and sometimes there were occasional windows blocked in to conserve warmth against the bitter cold.

The narrow streets of this village gave the image of quaintness as women walked the streets with their chadors, the days washing perched in perfect balance upon their heads. By the sides of the road and thrusting like fingers into the ploughed fields were water-trails nurturing the land and all the village’s washing, at the very least – dishes and clothes, seemed to be done in such water courses. 6-9 inches deep these tracts meander delicately and rather picturesquely across fields and along poplar lined fields planted in rows to stake out boundaries or emphasise forests. Just beautiful,  and made more so as we were lucky enough to travel to the region the day after there had been rain and so there was little dust – even the trees had shed some of their dust and were another  cleaner, purer colour today.  Children were playing in mud and in the streets, whilst some were doing the dishes for their parents. All stopped to look at us as we passed and most would run away to prevent photographs being taken, yet everywhere we looked to snap another image told ‘a thousand words’ and we wanted to capture them all.

Finally we found our destination medical clinic that had over the last week been taken over by the International Red Crescent (IRC ) and  we were told that it had a Doctor, a Nurse and a Vaccinator. A couple of packages of goodies –  woollen clothes, dolls, and toys made by generous Kiwis back home –  that we gave  to the clinic  prompted smiles in gratitude. This was the only reward that the Padre, Allan and I could ever have wanted. A few photos on the way back, man and donkey, women walking the roads, children by the sides of the roads and scenes of a majestic country present themselves to us in the winter’s sun heightened , again, by the reflection of the snow upon the hills.

Business travellers have a job to do. Protecting the health and safety of your staff travelling overseas is a responsibility and necessary to getting the job done.

“This includes prior knowledge of the risks an employee is likely to face in particular locations, including health, security precautions, travel vaccinations and medications.” Evan Slade, Department of Labour NZ.

Correctly managing the health risks of travelling employees and their families can significantly reduce productivity loss and avoid disruption to major projects.

WORLDWISE Travellers Health are New Zealand’s travel health specialists offering expertise and services to prevent such problems.

With clinics throughout NZ, WORLDWISE has the flexibility to cater to all individual company requirements.

Contact Rachel to find out how WORLDWISE can assist your business with its travel health needs:

PH: 09 520 5830

info@worldwise.co.nz

www.worldwise.co.nz

Travel and Tropical Medicine is a growing  specialization. With around 2 million kiwis travelling overseas per year, Travel Health Professionals need to be regularly updated in global travel health information.

The WORLDWISE ONLINE Seminars have been annually presented for the last 12 years, and are the longest ongoing regular ‘open’ travel health meetings in Australasia.

This year’s WORLDWISE ONLINE conference offers Health Professionals a solid platform on which to learn and up-skill knowledge in this exciting specialization. It is aimed at all Primary Health Care Practitioners (General Practitioners, Public Health Physicians, Infectious Disease Specialists, Military medical Staff,  Pharmacists) with an interest in travel medicine. Primary Healthcare Nurses who have attended previous WORLDWISE ONLINE Level 1 courses are also invited to attend this annual meeting.

This year, the primary focus of the Conference will be on Corporate travellers and families travelling to the Asia – Pacific region. Special focus will be on

i) ‘rabies in our region’

ii) the safety of travel

iii) how to develop a risk analysis of a travel itinerary

iv) Women and children travellers

There are to be special sections on ‘country based   requirements’ for travel to South East Asia and Oceania.

The conference will be hosted at Hotel So in Central Christchurch. A hotel which implements sustainable business practices that reduce its ecological footprint.

LEARNING OBJECTIVES

  • To understand safe practice in the delivery of health care to intending travellers, particularly to those travelling to the Asian and Pacific region
  • To update knowledge on current pertinent travel health issues and its relevance to current medical practice
  • To understand and develop knowledge base in Travel and Geographical Medicine  practice
  • To identify when it is vital to refer patients/travellers to specialty services
  • To understand the advice that corporate travellers need to keep them well on overseas  deployment
  • To understand what responses are needed in global emergency

PROGRAMME AT A GLANCE

  • Travelling groups and corporates      – Risk assessment
  • Life style issues of Travellers – Sex and STI’s
  • Medical Tourism – The Thailand Experience
  • Update on Dengue Fever – Current thinking and into the future
  • Food and Water borne issues – The family holiday, outbreaks
  • Woman and children travellers     – management, the pregnant traveller
  • Mosquito borne diseases
  • Wilderness weather extremes and travel – Creepy Crawlies , the essence of management
  • Region specific destinations – Asia, Pacific
  • Post natural disaster outbreaks – Thailand and Samoa experiences
  • Update on Malaria – Future developments
  • Rabies – devising a management plan, the Bali experience

WORLDWISE Post Graduate Conference Advanced Level – The New Zealand Advanced course in Travel, Tropical and Geographical Medicine for Travel and Primary Health Care Practitioners – has been endorsed by The Royal New Zealand College of General Practitioners (RNZCGP) and has been approved for up to 13.25 Hours CME for General Practice Educational Programme Stage 2 (GPEP2) and Maintenance of Professional Standards (MOPS) purposes.

For more information, full programme details or registration, please contact Clare at online@worldwise.co.nz or 09 520 5830

We look forward to seeing you there!

Source: New Zealand Herald

New Zealand born Taylor Laird, 17, has spent two terrible nights in a Thai prison for carrying drugs he did not know were illegal.

On a trip away to celebrate graduating high school with 10 other friends, Taylor was on a motorbike taxi on his way home after a night out. The taxi was pulled over and Taylor was found with a packet of Diazepam pills which he was shocked to learn, were illegal.

Under Thailand’s Psychotropic Substances Act 1974, possession of a “schedule IV” drug such as diazepam is illegal without a prescription. The maximum penalty is one year’s imprisonment, with a fine of 20,000 baht ($800). But drugs such as Diazepam and Alprazolam are available at some pharmacies in tourist spots.

A Phuket Public Health Office source said the department allowed small amounts of the drugs to be sold. “It is illegal to possess these drugs without a prescription, but in Phuket we’re not very strict as this is a tourist destination” he said. “we grant permission to the pharmacies to sell the drugs”.

“I was told by people you could get Valium if you wanted to go to sleep and it was legal to buy it,” Taylor said. “Then they took me to the cop lock-up which was like a living hell.”

The first 24 hours behind bars Taylor sat cramped and alone in a windowless “shoebox” cell. For the second he was moved to a juvenile jail where he forced himself to stay awake – too scared to sleep as the only foreigner. “They were trying to get me to go to sleep which was pretty much what I wanted to do,” Taylor told NZ Herald, “They could have ripped me apart and probably would have if I’d stayed there any longer.”

Taylor is still stranded in the country, waiting to be called to court. His parents have spent about $10,000 on flights and accommodation to support him.

This is a good example of why WORLDWISE believe it is important to make sure you have any medication you plan on travelling with prescribed and accompanied by a medical certificate before you leave.

WORLDWISE also suggest exercising caution when purchasing ‘over the counter’ drugs in third world countries, particularly as many of these drugs have been known to be fraudulent.