Staying Healthy in the Wilderness
Excerpted from Wilderness Medicine by Wm. Forgey, M.D.
Do not presume that medical problems will be the most significant challenges which you will encounter on a wilderness expedition. They are, frankly, leadership and expedition behavior issues. Any breakdown in this area can, and does, lead to the most significant of wilderness accidentsaccidents that can easily magnify into serious medical disasters.
Most trips are not able to take into account the psychology and social skills of participants, but if this is possible it can avoid the stress and conflict that can make a dream project turn into a nightmare. I have found that a ten-day preparatory trip is generally enough to identify idiosyncrasies that might indicate incompatibility.
The great outdoorsman Calvin Rutstrum once summed up this problem when he mentioned to me one day, "How do you tell a guy you hate his guts by the way he holds his fork?" It is simply amazing how personal habits and quirks can grate on you. In reviewing many successful (and not so) relationships during stressful trips, I have come to the conclusion that the most favorable relationship is one of respectit surpasses love, hate, fear or any other human emotional form of interaction. If you truly respect a trip partner, you can tolerate mannerisms and faults that would otherwise be unacceptable.
Plan a time schedule that allows for weather as well as terrain. Many accidents in the bush result from having to take chances while running out of time, food, etc., thus turning the expedition into a retreat, or worse, a retreat into a rout.
Proper pre-trip physical conditioning cannot be stressed too highly. While trying to survive exposure, a major factor is the ability to generate heat, which is directly related to the ability to produce work. This is achieved through physical conditioning, not by how much food one stuffs into one's face.
Obtain a pre-trip dental exam well in advance of the trip, thus allowing adequate time for possible needed corrections.
While a thorough physical examination is indicated for everyone, going to the extreme of cardiac stress testing (treadmill) is not required in persons without symptoms of chest pain. The exception would be the sedentary individual who was planning on significantly increasing the amount of exertion that he or she normally experienced.
Be certain that orthopedic deficiencies, other impairments, and allergies are addressed in the medical history. Be capable of coping with the identified deficiencies by adjusting trip plans or personnel.
The pre-trip physical should include attention to immunization schedules that vary, depending upon the region of the world to be visited. At a minimum, each trip member should have a current tetanus booster.
Make sure that everyone has had an eye examination within the previous three years. For those over forty, I recommend an eye exam (including glaucoma check) within the previous year. If significant vision impairment exists, carry spare glasses or contact lenses. Adequate eye protection, usually sunglasses, is a must for everyone.
Prepare an evacuation plan. Obtain adequate medical insurance, particularly if foreign travel is contemplated. And assemble a medical kit.
You're going to need some help.
The more that you read on this subject and the more medical training that trip members receive, the better off everyone will be. I particularly recommend that you obtain a copy of Medicine for the Backcountry by Buck Tilton and Frank Hubbell.
A frequent lament that I hear from prospective expedition members is not knowing a physician who could help by writing prescriptions for an adequate expedition medical kit. It is for this reason that the first edition of this book had an extensive non-prescription medical kit designed to handle most problems that one might encounter in the bush. A list of suppliers of the non-prescription medications and virtually all of the instruments and high-tech bandaging material described in this book can be obtained by writing to:ICS Books, Inc.
P.O. Box 10767
Merrillville, IN 46411-0767
I have personally tried to help each and every person writing me for advice in obtaining requisite medical supplies.
And prepare yourself mentally to enjoy the trip. Be expecting both adversity and monotony on any long expedition. A wonderful publication that shows the insight necessary for this to succeed is a little book by David Scott, Paradise Creek. I believe this book epitomizes what a long expedition is all about. Since I helped prepare and sponsor David and his partner, Scott Power, for their expedition, you'll even learn a little about me in there, too.
© Article copyright ICS Books Inc. All rights reserved.
Details mentioned in this article were accurate at the time of publication