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Gold, incentives and meh

A rewarding


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Working as a dive expedition doctor in Madagascar not only gave GP Vik Mohan access to stunning coral reefs but also an insight into a desperately poor community

Expedition medicine is a growth industry, with an increasing number of organisations needing doctors to look after their volunteers ­ be they diving, mountaineering or doing other challenging activities. I have recently returned from such a posting, working as the medical officer on a coral reef conservation expedition in Madagascar.

I was working for Blue Ventures, an award-winning charity that runs a project to preserve the coral reefs in a remote part of south-west Madagascar. The site was beautiful, with endless unspoilt beaches backing on to 'spiny forest', a habitat unique to this part of Madagascar and home to the baobab tree.

As the doctor, my primary responsibility was the health and safety of the expedition team. Most of what I saw was standard general practice stuff, with the difference that my consulting room overlooked palm-fringed beaches. But because this was a diving expedition, I had to familiarise myself with dive medicine and the infectious diseases one might come across in Madagascar.

Major challenge

The biggest challenge was not the nature of the medical problems in themselves, but the remoteness of the environment. The nearest recompression chamber, for example, was in South Africa.

Madagascar is one of the poorest countries in the world. And the coastal communities of the south-west part of the country are among the poorest and most remote. Health care provision for the fishing community we were working with was virtually non-existent.

As a compassionate health professional, I wanted to offer as much medical care to the community as possible. But providing health care for the locals was an ethical minefield. However, we managed to develop a satisfactory framework, in conjunction with community elders, within which we could offer some medical assistance.

As well as becoming involved in providing health education for the community, I looked after individual patients. This provided a different set of challenges ­ not least because I often had to consult in French ­ but was intensely rewarding. At times, I really felt I was having a positive impact on one of the poorest communities I have come across.

For me, the biggest perk was the diving. Every day we would be dropped off into water ­ with a temperature of 30 degrees ­ to survey the beautiful coral reefs and fish life we found. To survey the reef properly, we received training in species identification, reef ecology and conservation methods. Now that I understand coral reefs a little better, diving has become infinitely more rewarding.

The rest of my time was filled with teaching English at the local village school; getting involved in some of the other terrestrial and marine science work; swimming; exploring the surrounding area; and resting in my hammock. Not a bad life.

I was drawn to this sort of work by realising I was passionate about conservation. I also loved travel and scuba diving. So working on coral reef conservation projects seemed like a great way to use my medical skills.

The hardest part is coming home. Back in England, I struggle through my morning surgery of coughs and colds, and my life as an expedition dive doctor feels as though it's from another world.

Important part of portfolio

But although the experience has little bearing on what I do day to day when I'm back here, it's an important part of my professional portfolio, and allows me to pursue what I'm passionate about.

Apart from the expertise I have acquired in dive medicine ­ which has occasionally come in useful back home ­ my life as a GP is immeasurably enriched by the broadened horizons and sense of perspective these trips give me.

I'm reminded of how privileged we are to have such an excellent health service, refuse to be distracted by the sort of trivia that can blind us to what is really important in life, and do what little I can to campaign for the protection of our precious planet.

And memories of spectacular diving sustain me until my next adventure.

Vik Mohan is a sessional GP in Exeter

Fancy a trip like that?

· Many companies organise dive expeditions, and they like having a medic on site

· Medical officer's expedition costs are usually covered, so you only pay for flights and insurance

· Consider undertaking an expedition medicine course and/or learning some dive medicine before you go:

· Common problems you will encounter include gastroenteritis, minor injuries, wound management, environmental problems (sun, heat, mosquito bites), otitis externa and minor dive injuries

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