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At the heart of general practice since 1960

Diving in at the deep end

Dr Lou Millington recounts her experiences working as a medic for a diving company in Tobago

‘Why not look into that diving company that so-and-so worked for?' This was the suggestion from a friend of mine when I was complaining I'd had it with general practice – a full six months after completing my VTS training. With the wonderful power of hindsight I can definitely say it was one of her better ideas – as I'm writing this now on a deserted beach in Tobago.

During one of my lengthy locum lunch-breaks I visited the Coral Cay Conservation website, which was advertising jobs for medics in the Philippines and Tobago. My mind was made up before I'd finished looking at the site. That same day I completed the online application form, attached my CV, sent them off with a covering email to the director of operations in London and fixed up an interview.

The conservation role

Coral Cay Conservation is a non-governmental organisation ‘providing resources to help sustain livelihoods and alleviate poverty through the protection, restoration and management of coral reefs and tropical forests'. The projects are run by a core of five voluntary staff members (including a medic) who come out for anywhere from three to six months, depending on the post, and any number of volunteers who pay to be dive trained, science trained and then participate in the surveying, for a minimum of three weeks.

Medics are required for safety purposes at the marine sites because of the amount of diving that is undertaken and the remoteness of some of the sites. CCC employs doctors and nurses with expedition training or experience or A&E experience, and paramedics. All staff must have a minimum of PADI Advanced Diver certification but training is available on site at a greatly reduced rate.

The Tobago site is a new venture and being here to help set things up has been an interesting challenge. The medical officer's role involves ‘providing healthcare and emergency medical treatment to all company personnel, expedition volunteers and counterparts, and the maintenance and stock control of the company's medical supplies and equipment.

Shark! Just kidding...

My knowledge of diving medicine was confined to what I'd seen in films or the stories I'd heard when I learned to dive a few years ago. Before I came out here I had nightmares that I'd be dealing with a neverending stream of shark and deadly jellyfish attacks and complicated cases of the bends or lung overexpansion injuries that I'd misdiagnose.

Three months down the line I'm relieved to say that that isn't the case at all; the one victim of a Portugese Man of War was the scuba instructor who had a wealth of experience in such matters and knew immediately what to do. There is plenty of literature about diving medicine should you need or wish to consult it, as well as the specialists at the Diving Diseases Research Centre (DDRC) in Plymouth, which you can contact any time if you have a problem as it has very experienced staff who are happy to offer advice.

Volunteers are generally young and fit (they have to get health clearance from the DDRC before they are permitted to join an expedition) and most of them have done the decent thing and not been ill while I've been out here. Officially I have surgeries for half an hour before meals but in reality I'm available throughout the day for advice or consultations, most of which are wound-based (cuts, bites, stings) or ear problems.

Daily life, Tobago-style

An average day involves helping out with the usual expedition tasks (meals, washing up, tidying and cleaning), overseeing the hygiene and safety on site (are the toilets and kitchen being cleaned to my satisfaction and has there been an outbreak of D&V overnight?) and helping to ensure that things are running as they should (food and alcohol deliveries as expected, chores being completed, survey forms and dive logs filled in).

I get to dive once or if I'm lucky twice a day, doing reef surveys and data collection or at least being around or available while the volunteers are diving in case of any problem. There's also usually some time during the day for a spot of ‘liming', Tobago's favourite pass-time of just relaxing, chatting, reading or listening to music.

My tour of duty here is 14 weeks in all. Predictably enough, the time has really flown by. There are certain things that I miss from home; Lindt chocolate, decent tea and coffee, a nice glass of Chablis or the latest series of CSI, but emergency relief parcels from friends and family at home usually ease those cravings adequately.

On the plus side, I haven't even thought about NICE, QOF, appraisal or my accounts for more than two months. I've erased from memory all of the normal values for FBC, U&Es and LFTs and replaced them with pudding-wife wrasse, knobby brain coral, flamingo tongues and Christmas tree worms. I can spot coral and gorgonian disease a mile off and I know what makes a healthy reef and when it's in trouble. The biggest stress here is sitting on the toilet and discovering nobody has replaced the old loo roll or realising we're getting low on porridge oats.

Broader horizons

This expedition has helped me see that being a GP doesn't mean spending the next 30 years banging my head on the desk repeatedly in a Portakabin consulting room in Barnsley. CCC is just one of many charities that have projects requiring medics and if you're prepared to work as a volunteer you can go pretty much anywhere in the world for as long as you wish.

Working here has added a new dimension to my persona – I am now Lou the conservationist, and I hope always to remain so. Coral Cay Conservation has helped to turn me into a more than competent diver and made me much more aware of the threat that the reefs are under as a result of pollution, climate change and habitat destruction. I've met some inspiring people and made good friends, added to which I have a wicked tan!

Would I recommend this to other medics? Definitely. Would I consider working for CCC again? Well, I'm off to Uganda now for two years as a volunteer with Hospice Uganda but just maybe the Philippines marine project will be calling me when I return. After a week or two back in that Portakabin in Barnsley, of course...

If you have any questions regarding Coral Cay Conservation that are not answered on the website www.coralcay.org, email the organisation at info@coralcay.org or Dr Millington at loumillington@doctors.org.uk

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