The Challenge of Medicine in Parks

No Resources, Harsh Conditions

 

As with many Wilderness environments, in Parks, there are no doctors. In fact, there’s no medical infrastructure at all – no paramedics, no clinics, no nurses. No medications, no supplies, no equipment. Mostly, not only are these resources unavailable in the Parks themselves, they are not even available near the Parks. And definitive medical care relies on getting someone to the nearest city. 

 So when things go wrong medically, there is no external medical infrastructure to rely on – people on the ground are it.

 In addition Parks present harsh environments – climates can be extremely hot, extremely cold or both (as in desserts). Some Parks are at high altitudes, others in areas of extreme humidity, still others are very dry and dusty. These factors can introduce medical complications, change medical management, and affect supplies and equipment in unpredictable ways.

 The activities in Parks further introduce risk. Rangers facing down violent poaching groups are at much greater risk of violent harm than those in villages. Both Tourism and Conservation are dealing with large animals in their day to day business, and usually involve outdoor activities that may be unusual for the travellers undertaking them. While these are well managed, they introduce an element of unpredictability. 

A Six-Factor Problem

 

 Tourism operating in an Unusual Environment, performing Commerical Activites with a Lack of Resources – this unique situtaion createst a Six Factor Problem for businesses operating in Parks.

Read more about the unique medical challenges facing tourism in parks.

The Usual Band Aids Don’t Work Here

First Aid Wasn’t Built for This

First Aid being taught today focuses on Urban environments. It relies on the rapid arrival of professional medical help, and focuses on a sometimes confusing array of techniques to buy minutes, rather than hours. 

The teaching methods of First Aid – sit in a classroom and read a manual – haven’t evolved for the last 100 years when the concept was first introduced. The science is clear that this method of teaching, often repeated only once every two or three years, has no good effect on knowledge retention, and definitely doesn’t create retained skills. A little, vaguely remembered knowledge might be ok in the city when the paramedic will be there in 10 minutes, but it doesn’t help in Parks where the layperson is the only help for miles.

Parks need methods designed with the lack of resources, long timelines and harsh conditions in mind. Just sending people on a First Aid course every three years comes nowhere close to addressing this need.

Insurance Doesn’t Help you Here

Many tourism destinations rely on insurance to get them out of tough medical situations. They insist that travellers take out Travel Insurance, hoping it will sort out any possible problems.

It’s not that Insurance is bad – it will pay for medical help and hospitals. It’s just that there aren’t any in Parks. Insurance isn’t help, it’s just money to pay for help.

Insurers cannot guarantee a speedy evacuation, and they cannot fill the medical gap created in Parks – if something bad happens, it will still fall to the people on the ground first.

After many years of experience, we know that insurers can only help once the victim is at the nearest hospital. Their procedures and processes don’t function before that point – they aren’t built for the fact that there are no doctors and no medical reports in the middle of nowhere.

So People in Parks need a way to address the gap between Parks and the first professional medical care – a gap that can be many hours and many miles long.

No Helicopter will Save the Day

The strategy in the past was rapid aeromedical evacuation to a hospital. 

But this is not the military – it’s Parks.  It’s one eighth of all the land on Earth. We have 2.2 million square kilometres of Protected Areas on Earth.  

To achieve even a 15 minute response time would require 22 000 helicopters and $30 billion a year budget. That’s just not plausible.  

We know from thousands of cases that the reality is that evacuations are far away. On average they take 4 – 8 hours. Timelines of 12 – 24 hours are not unusual – especially for incidents occurring at dusk or night.  

If we can’t buy that time with the medical help we give on the ground, then by the time the helicopter arrives, there’ll be nothing for it to do. 

We know that people still look to the sky, hoping for a rapid evacuation as the solution to their medical problems in Parks. We also know that it never happens – to really be able to help you need to be able to fill that timeline with proper medical capability located on the ground.