Dr Ian Quigley: The mountain rescue GP

North-east London GP Dr Ian Quigley worked in Nepal with the local rescue service.

Earlier this year, before the Nepal earthquake, my practice nurse wife Tracy and I spent three months working for the Himalayan Rescue Association (HRA).

We were given a week's training in relevant medicine and language skills, in Kathmandu, then trekked for seven days to Manang, a remote village of about 3,000 people, halfway round the Annapurna trekking circuit at an altitude of 3,540m.

We spent 10 weeks working in Manang alongside a doctor from Canada, looking after local people and trekkers.

We charged the trekkers fees, starting at US$45 for a consultation. This allowed us to provide subsidised care for the locals, who were charged about a dollar if they could afford it, nothing if they couldn't.

The HRA provides these services during the autumn and spring trekking seasons. At other times, there is very little medical care available to the local people.

We treated trekkers with altitude problems, including acute mountain sickness and the potentially life-threatening high-altitude pulmonary oedema and high-altitude cerebral oedema.

Some were looked after in the clinic, others needed to be evacuated by helicopter to hospital in Kathmandu. We saw other conditions that are rare in the UK, such as typhoid fever and amoebic dysentery.

As well as treating patients, we gave a daily lecture about high altitude. We spoke to trekkers and their guides (average audience 25) about what it can do to the body, how to recognise the warning signs and what to do about them.

In 1983 I spent a gap year working for a leprosy charity in Tanzania. Since then, I have always wanted to go back to some sort of voluntary work in a developing country.

On a trek to Everest Base Camp, I visited the HRA clinic in Pheriche and decided this would be an opportunity to work abroad for a short period.

Some organisations, such as VSO or MSF, require volunteers to commit to long periods abroad, whereas the HRA only asks for three months, which is far easier to fit into one's work as a GP partner.

Now, having worked with the HRA, I will be better prepared in future if I want to take on a longer commitment as a volunteer.

Mountain medicine

The Expedition and Wilderness Medicine training faculty has close links with the HRA, so doing the mountain medicine course enabled me to meet people involved in the work of the HRA. I applied to work as a volunteer via its website, www.himalayanrescue.org

I took 14 weeks away from work as a GP principal. Of these, four were annual leave. I then employed a locum, at my own expense, for the remaining 10 weeks.

My posting was entirely self-funded, although I did negotiate a discount in my RCGP membership fee and a significant reduction in my Medical Protection Society indemnity subs for the three months I was away.

General practice in the UK is about trying to reach government targets for managing chronic conditions, while trying to provide an adequate service for people who feel ill. It was good to escape this briefly and focus, simply, on doing what we trained to do, which is to look after people who are ill.

What we learned in Nepal will help us to advise people planning trips to high-altitude locations. We also learned that a diet of simple food and no snacks offers a good way to lose weight.

I am part of the British government's emergency disaster response team, so there may be a time in future when I do more voluntary work abroad. For now I am enjoying being safely, and warmly, back at work in Romford.

  • Dr Quigley's book, 'Mountain Medicine, in Nepal with the Himalayan Rescue Association', is available on Amazon Kindle for £2.94, or free for subscribers to Kindle Unlimited.

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