Concept: You may have the opportunity to join a small and elite team of resident physicians & senior
medical students that will provide medical support for the indigenous Balti people and visitors to the
Karakorum Range area (near K-2) of the western Himalayas for the summer of 2008. Formal education and
practical guidance will be provided via highly experienced expedition physicians and medical providers. This
project is a follow on to the enormously successful 2005 National Geographic/UNMC expedition rotation we
conducted in 2005!
We will be establishing a clinic in the area of Askole, the last village that is reachable by road into the
mountains. This clinic will be 95%+ service for the local villagers, the rest dealing with mostly western
travelers in the area. You will provide full service cradle to grave care, including dental & minor surgery. This
is very remote, independent, resource-limited medicine. You will have almost no lab, and no x-ray capability.
You will have only limited medical supplies.
You will experience rough living conditions - quite possibly tents for the month, as the building we hoped to
use this year probably won’t be available. Cooking will be rough too. Solar showers. Dirt. Not many bugs at
this altitude though. Hot as stink in the day, cold at night.
There is a huge amount of malnutrition, infectious disease, and undiagnosed/ untreated chronic
conditions. Infant/child mortality is high. The people are very friendly, grateful for care, eager to learn about
you, and feel very inferior and shy and don’t want you to see how they live. Islamic tendencies are a thin
veneer over the animistic practices of the area. They keep Islamic law in public but not in private. There is a
huge interest by local women and girls about birth control, make-up, female reproductive issues, and female
health in general. There is a huge opportunity to make a difference here with female providers teaching
these issues as well as sanitation and child health.
By showing sincere caring, respect for their local traditions, and real interest in them - as opposed to the
horrible way they are treated by the tourists and climbers - these people will open up to you, and be your
friends for life. You will be far safer here than in many major cities.
This is an opportunity to practice medicine as it was meant to be practiced, in the spirit of Schweitzer,
Kirk, Cook, Walker and others humanitarian-explorer physicians. If that sounds like BS to you, look
elsewhere. If this sounds like something that you are interested in and capable of, read on…
Purpose: Per the Wilderness Medicine Society’s mission statement – “…to encourage, foster, support
or conduct activities or programs…that can improve scientific knowledge…in matters related to wilderness
environments and human activities in these environments.” To this end, participants will, by the end of the
elective, be able to:
1. Act as a medical group member in back country or other remote locations
2. Plan for the medical support of a wide range of wilderness and/or adventure activities with an
emphasis on improvised care solutions
3. Plan for special hazards unique to a variety of extreme environments
4. Diagnosis, initiate treatment, and in some cases complete treatment for the common illnesses and
injuries encountered in remote, austere, and expedition settings
5. Diagnosis and initiate treatment and transport of critical illnesses and injuries encountered in remote,
austere, and expedition settings
6. Demonstrate competence in remote travel and basic survival skills and mentality
7. Perform competently as a physician or medical specialist in search and rescue operations
8. Advise expedition and adventure travel groups concerning medical care planning and emergency
procedures
The goal, then, will be to provide the resident physicians, medical professionals and medical students with
the ultimate in an enriched learning environment – the field – with a unique learning opportunity.
Curriculum: The curriculum is based on standards established by the Wilderness Medicine Society,
National Association of EMS Physicians, United States Special Operations Command Biomedical Steering
Committee, Global Medical Rescue Services, Ltd., and other acknowledged leaders in the field. It combines
didactic, practical, and field instruction with daily provision of care to the indigenous peoples of the area as
well as climbers and trekkers in the area. Independent study modules and supervised exercises will be
conducted in conjunction with patient care and camp duties. On establishment of the base camp facility a
clinic with rotating duty schedule will be established. In addition to the participant’s educational activities,
they will also participate in education of non-medical members of the rotation and other interested parties in
basic emergency care & response. Numerous research opportunities can be made available to interested
participants as well.
Every day is different in the field, and patient presentations will guide the educational opportunities.
Learning topics and clinical exposure may include these areas:
1. Medical, expedition, & emergency leadership
2. Extreme environmental hazards & rescue safety
3. Patient assessment in austere conditions
4. Life & limb saving interventions with minimal equipment
5. Shock/trauma management & fluid resuscitation via multiple techniques
6. Field surgical skills & wound repair
7. Cardiac, respiratory, neurological, & metabolic emergencies
8. Altitude & cold diseases
9. Environmental injury/illness
10. Anaphylaxis, bites, stings
11. Austere infectious disease problems
12. Emergency obstetrics & pediatrics
13. Field dentistry
14. Field dermatology
15. Field ophthalmology
16. Austere laboratory procedures
17. Preventive health, sanitation, water purification, vector control
18. Personal & group survival skills, knowledge, and mindset
19. Patient movement, packaging, evacuation
20. Use of basic rope, hardware, & safety equipment
21. The use of improvisation & minimal/multi-use equipment
Faculty: A core group of highly experienced physicians and expedition/remote medicine providers has
committed to offering this course in its entirety and to remain with the expedition for its duration. Dr. Keith
Brown, Assistant Professor UNMC, will act as expedition & course Medical Director. The other instructional
staffs are nationally recognized wilderness and remote medicine educators and authors, and have all been
involved in teaching wilderness and remote medicine to UNMC residents and students for years. They are
well known for their professional teaching and leadership ability & are permanent faculty members of the
Belize Institute for Tropical & Wilderness Medicine as well as Global Medical Rescue Services, Ltd. CV’s of
all staff are available on request. In summary, a wealth of experienced faculty who can not only do but also
teach and have proven leadership and student safety records are available to support this program.
Participant Application: An application process will be established via the rotation Medical Director.
Only resident physicians; paramedics, medical/dental students; and second year Physician Assistant, Nurse
Practitioner, and related health professions students will be considered.
Applicants will be asked to submit academic records, health history, liability release, an essay, and a
letter of recommendation from a faculty member or rotation supervising physician. Selection will then
proceed until available space is filled. Optimum student group size is ten to twelve, depending on expedition
needs, requirements, and limitations.
All students understand and will be explicitly informed that this is a “self-funded” expedition and they will
be responsible for all transportation, food, housing, and equipment expenses. Total expenses including
airfare, ground transportation, outfitter fees and expedition fees are estimated at $7500-8500 per participant.
All participants will be graded via oral and practical examinations, participation, and attitude. These
grades will be submitted to the Dean’s Office as with any rotation.
UNMC does NOT discriminate on the basis of gender, race, religion, sexual orientation, age, national
origin, or political affiliation. Every effort will be made to ensure diversity within the participant rotation group;
however the rotation will be filled with quality applicants.
All applicants, by applying, acknowledge that the conditions of this rotation will involve physical and mental
hardship; risk of death or serious injury due to innumerable environmental and structural conditions inherent
to the programs goals, missions, and situations. All participants are expected to be in good physical
condition, capable of hiking at altitudes of 13,000 feet + with a 30 pound + pack; are released by a licensed
physician experienced in evaluations of participants of such endeavors and activities; and meet all
acknowledgements, limitations, risk identifications, and related material as detailed in the Informed Consent,
which each participant will sign as part of the application process.
Dates: Are being set. We expect to have 3-4 phases of the project, roughly 30 days each, starting 1
June 2008.
Typical Schedule: Participants will travel in a supervised, guided group & allowing for weather and
other confounders can anticipate a schedule similar to this:
- Day – 1 Depart
- Day – 2 Meet in London
- Day – 3 Fly to Islamabad
- Day 4 – Fly to Skardu
- Day 5 – Jeep to Askole
- Day 6-22– Askole and beyond. Any travel will be on foot
- Day 23 – Jeep to Skardu
- Day 24 – Fly to Islamabad
- Day 25 – Fly home
Living Conditions: You will be living and working in the field. A clinic building with housing may be
available, but may not be. You may be sleeping in tents, living in cooking & dining tents, and working out of a
portable field clinic. You will be preparing your own locally purchased food and providing for all of your own
laundry and hygiene needs. The temperatures can be greater than 100 F during the day and below freezing
at night. The altitude will be greater than 9,000’ at all times, and may be as high as 18,000’.
What Now? Read this packet carefully. Consider it carefully. Many of your questions will be
answered in this material AND it will also give you a 'feel' for what this is really about . If you
believe that you can benefit from selection for and participation in this rotation, contact us so we
can begin the screening process.
SPACE IS VERY, VERY LIMITED FOR EACH BLOCK. NOT EVERY BLOCK MAY BE AVAILABLE
TO YOU. THE SELECTION PROCESS IS FINAL. READ THE FOLLOWING & CONSIDER IT
CAREFULLY...
medical students that will provide medical support for the indigenous Balti people and visitors to the
Karakorum Range area (near K-2) of the western Himalayas for the summer of 2008. Formal education and
practical guidance will be provided via highly experienced expedition physicians and medical providers. This
project is a follow on to the enormously successful 2005 National Geographic/UNMC expedition rotation we
conducted in 2005!
We will be establishing a clinic in the area of Askole, the last village that is reachable by road into the
mountains. This clinic will be 95%+ service for the local villagers, the rest dealing with mostly western
travelers in the area. You will provide full service cradle to grave care, including dental & minor surgery. This
is very remote, independent, resource-limited medicine. You will have almost no lab, and no x-ray capability.
You will have only limited medical supplies.
You will experience rough living conditions - quite possibly tents for the month, as the building we hoped to
use this year probably won’t be available. Cooking will be rough too. Solar showers. Dirt. Not many bugs at
this altitude though. Hot as stink in the day, cold at night.
There is a huge amount of malnutrition, infectious disease, and undiagnosed/ untreated chronic
conditions. Infant/child mortality is high. The people are very friendly, grateful for care, eager to learn about
you, and feel very inferior and shy and don’t want you to see how they live. Islamic tendencies are a thin
veneer over the animistic practices of the area. They keep Islamic law in public but not in private. There is a
huge interest by local women and girls about birth control, make-up, female reproductive issues, and female
health in general. There is a huge opportunity to make a difference here with female providers teaching
these issues as well as sanitation and child health.
By showing sincere caring, respect for their local traditions, and real interest in them - as opposed to the
horrible way they are treated by the tourists and climbers - these people will open up to you, and be your
friends for life. You will be far safer here than in many major cities.
This is an opportunity to practice medicine as it was meant to be practiced, in the spirit of Schweitzer,
Kirk, Cook, Walker and others humanitarian-explorer physicians. If that sounds like BS to you, look
elsewhere. If this sounds like something that you are interested in and capable of, read on…
Purpose: Per the Wilderness Medicine Society’s mission statement – “…to encourage, foster, support
or conduct activities or programs…that can improve scientific knowledge…in matters related to wilderness
environments and human activities in these environments.” To this end, participants will, by the end of the
elective, be able to:
1. Act as a medical group member in back country or other remote locations
2. Plan for the medical support of a wide range of wilderness and/or adventure activities with an
emphasis on improvised care solutions
3. Plan for special hazards unique to a variety of extreme environments
4. Diagnosis, initiate treatment, and in some cases complete treatment for the common illnesses and
injuries encountered in remote, austere, and expedition settings
5. Diagnosis and initiate treatment and transport of critical illnesses and injuries encountered in remote,
austere, and expedition settings
6. Demonstrate competence in remote travel and basic survival skills and mentality
7. Perform competently as a physician or medical specialist in search and rescue operations
8. Advise expedition and adventure travel groups concerning medical care planning and emergency
procedures
The goal, then, will be to provide the resident physicians, medical professionals and medical students with
the ultimate in an enriched learning environment – the field – with a unique learning opportunity.
Curriculum: The curriculum is based on standards established by the Wilderness Medicine Society,
National Association of EMS Physicians, United States Special Operations Command Biomedical Steering
Committee, Global Medical Rescue Services, Ltd., and other acknowledged leaders in the field. It combines
didactic, practical, and field instruction with daily provision of care to the indigenous peoples of the area as
well as climbers and trekkers in the area. Independent study modules and supervised exercises will be
conducted in conjunction with patient care and camp duties. On establishment of the base camp facility a
clinic with rotating duty schedule will be established. In addition to the participant’s educational activities,
they will also participate in education of non-medical members of the rotation and other interested parties in
basic emergency care & response. Numerous research opportunities can be made available to interested
participants as well.
Every day is different in the field, and patient presentations will guide the educational opportunities.
Learning topics and clinical exposure may include these areas:
1. Medical, expedition, & emergency leadership
2. Extreme environmental hazards & rescue safety
3. Patient assessment in austere conditions
4. Life & limb saving interventions with minimal equipment
5. Shock/trauma management & fluid resuscitation via multiple techniques
6. Field surgical skills & wound repair
7. Cardiac, respiratory, neurological, & metabolic emergencies
8. Altitude & cold diseases
9. Environmental injury/illness
10. Anaphylaxis, bites, stings
11. Austere infectious disease problems
12. Emergency obstetrics & pediatrics
13. Field dentistry
14. Field dermatology
15. Field ophthalmology
16. Austere laboratory procedures
17. Preventive health, sanitation, water purification, vector control
18. Personal & group survival skills, knowledge, and mindset
19. Patient movement, packaging, evacuation
20. Use of basic rope, hardware, & safety equipment
21. The use of improvisation & minimal/multi-use equipment
Faculty: A core group of highly experienced physicians and expedition/remote medicine providers has
committed to offering this course in its entirety and to remain with the expedition for its duration. Dr. Keith
Brown, Assistant Professor UNMC, will act as expedition & course Medical Director. The other instructional
staffs are nationally recognized wilderness and remote medicine educators and authors, and have all been
involved in teaching wilderness and remote medicine to UNMC residents and students for years. They are
well known for their professional teaching and leadership ability & are permanent faculty members of the
Belize Institute for Tropical & Wilderness Medicine as well as Global Medical Rescue Services, Ltd. CV’s of
all staff are available on request. In summary, a wealth of experienced faculty who can not only do but also
teach and have proven leadership and student safety records are available to support this program.
Participant Application: An application process will be established via the rotation Medical Director.
Only resident physicians; paramedics, medical/dental students; and second year Physician Assistant, Nurse
Practitioner, and related health professions students will be considered.
Applicants will be asked to submit academic records, health history, liability release, an essay, and a
letter of recommendation from a faculty member or rotation supervising physician. Selection will then
proceed until available space is filled. Optimum student group size is ten to twelve, depending on expedition
needs, requirements, and limitations.
All students understand and will be explicitly informed that this is a “self-funded” expedition and they will
be responsible for all transportation, food, housing, and equipment expenses. Total expenses including
airfare, ground transportation, outfitter fees and expedition fees are estimated at $7500-8500 per participant.
All participants will be graded via oral and practical examinations, participation, and attitude. These
grades will be submitted to the Dean’s Office as with any rotation.
UNMC does NOT discriminate on the basis of gender, race, religion, sexual orientation, age, national
origin, or political affiliation. Every effort will be made to ensure diversity within the participant rotation group;
however the rotation will be filled with quality applicants.
All applicants, by applying, acknowledge that the conditions of this rotation will involve physical and mental
hardship; risk of death or serious injury due to innumerable environmental and structural conditions inherent
to the programs goals, missions, and situations. All participants are expected to be in good physical
condition, capable of hiking at altitudes of 13,000 feet + with a 30 pound + pack; are released by a licensed
physician experienced in evaluations of participants of such endeavors and activities; and meet all
acknowledgements, limitations, risk identifications, and related material as detailed in the Informed Consent,
which each participant will sign as part of the application process.
Dates: Are being set. We expect to have 3-4 phases of the project, roughly 30 days each, starting 1
June 2008.
Typical Schedule: Participants will travel in a supervised, guided group & allowing for weather and
other confounders can anticipate a schedule similar to this:
- Day – 1 Depart
- Day – 2 Meet in London
- Day – 3 Fly to Islamabad
- Day 4 – Fly to Skardu
- Day 5 – Jeep to Askole
- Day 6-22– Askole and beyond. Any travel will be on foot
- Day 23 – Jeep to Skardu
- Day 24 – Fly to Islamabad
- Day 25 – Fly home
Living Conditions: You will be living and working in the field. A clinic building with housing may be
available, but may not be. You may be sleeping in tents, living in cooking & dining tents, and working out of a
portable field clinic. You will be preparing your own locally purchased food and providing for all of your own
laundry and hygiene needs. The temperatures can be greater than 100 F during the day and below freezing
at night. The altitude will be greater than 9,000’ at all times, and may be as high as 18,000’.
What Now? Read this packet carefully. Consider it carefully. Many of your questions will be
answered in this material AND it will also give you a 'feel' for what this is really about . If you
believe that you can benefit from selection for and participation in this rotation, contact us so we
can begin the screening process.
SPACE IS VERY, VERY LIMITED FOR EACH BLOCK. NOT EVERY BLOCK MAY BE AVAILABLE
TO YOU. THE SELECTION PROCESS IS FINAL. READ THE FOLLOWING & CONSIDER IT
CAREFULLY...
| Wilderness Medicine - Expedition Medicine - Wilderness Rescue - Expedition Rescue - International Health & Medical Training |
| Global Medical Rescue Services, Ltd. |
 |
| High Altitude Wilderness & Expedition Medicine Training Rotation Karakrorum Himalayan Range/K-2, Pakistan, 2008 |