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Escape from the jungle - our first casualty evacuations

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In her second instalment on nursing in the Belize jungle, Josie Gilday gets to grips with her first emergency evacuations

Trekforce had really lived up to their tough reputation with our project. We were to cut a 13km boundary line between two national parks through unexplored jungle with a team of 10 trekkers aged between 18 and 24, a leader, assistant leader, me, and some machetes.

Entering the jungle was incredible. Waking up in a hammock surrounded by trees, with the leaves casting shadows over you, humming birds buzzing past and howler monkeys marking their territory in the background is mind-blowing.

A average day in the jungle consisted of waking up at 5.15am and changing out of the ‘dry kit’ - one of only two sets of clothes, which which is only worn at night so it’s always dry - into the ‘wet kit’, often still wet from sweat, rain or being washed the day before.

Two trekkers would have already been up since 4am to get the fire going and put the porridge on. After eating huge amounts of porridge with copious amounts of sugar, we headed off into the jungle to our boundary line, armed with belt kits, machetes, four litres of water, a packet lunch of crackers, jam, peanut butter, tinned mackerel, cheese and I’d also have the grab bag.

We would walk anything between 15 minutes and two hours before we reached the point on our boundary line where we had to continue navigating and chopping. We’d aim to return home at 5-5.30pm. It was dark at 6pm, where we’d have an hour or so for water collection, showering or sleeping before dinner.

Dinner included tinned vegetables, kidney beans, chickpeas, rice or spaghetti and a choice of tuna, corned beef, soya or spam. Who knew spam could taste so good? It turned out to be everyone’s favourite dinner, though we did have a few budding chefs who made us corn-beef burgers, chickpea balls and even pizza. For dessert we had tinned fruit and condensed milk. After dinner we’d write letters, diaries, play games and relax, heading to bed at around 8-9pm ready for another day’s work tomorrow.

Throughout our project we had four different base camps, the first with a river as a water source, the second where water had to be brought by us (seven litres per person per day, five for drinking, one for cooking and one for washing). The third camp had a swamp, where we filtered water through our socks before iodinising and drinking it.

Though with all the moving we got used to setting up camps and we even managed to build tables, chairs, storage shelves and showers.

From a medical point of view, we were kept busy with:

  • five infected blisters;
  • six incidents of nausea;
  • four incidences of diarrhoea;
  • one sprained ankle;
  • one scorpion bite;
  • two athletes’ feet;
  • one burnt hand (my own);
  • two P2 casualty evacuations;
  • one P3 casualty evacuations.

The first two casevacs occurred when we had just started our 82km trek over the Mayan mountains, through Natural Arch, the Chiquabul Chamber and ending at Caracol (an huge Mayan ruin). We were carrying all our food for the next five days and the terrain was hard. The leader and assistant leader where only too aware that if someone got ill after the second day, the only way out was by helicopter, which played a huge role in the decisions made.

On our first day one of the trekkers became very nauseous, dizzy and had extremely painful heartburn. She was exhausted by both the trek and her symptoms, so we decided to stop early for the day. We hoped her condition would improve with a little rest. If it didn’t, she might have to be walked out of the jungle, to the small village were we had begun our trek to rest and possibly receive medical treatment.

You might think we were making a bit of a mountain out of a mole hill. But it was an 82km trek, with eight hours walking each day over mountainous terrain, and the only casualty evacuation route being a helicopter winch at very specific points along the route. We had minimal medical equipment and 13 other people to consider. These conditions make small things become very complicated. If it had been something life or limb threatening, then the decision is made for us, with a helicopter needed immediately.

The decision to leave the jungle is not taken lightly. The trekkers had worked long and hard to raise the money to be there and have the time of their lives, and this had to be considered when making decisions about evacuations.

After resting overnight, our trekker still felt extremely weak knew she would not be able to continue. At this point another trekker admitted to having diarrhoea and vomiting. After trekking for an hour she realised she also would be unable to complete the trek. So I walked back to the village with the two trekkers and a guide.

From there we took a long but enjoyable bus ride to field base, where I was able to look after the trekkers with adequate medical supplies. It was here that I burnt my hand while frying tortillas. Luckily, being at field base, we had a clean supply of cold water and I was able to immerse my hand for several hours, before heading to the hospital myself to get the appropriate dressings. It was then that I banned deep fat frying in the jungle, as our water supplies were not clean or cold enough to cool a burn and the risk of infection was just too high.

The second casualty evacuation occurred when one of the trekkers got moderate exasperation of her asthma. Once again we were trekking over hilly terrain, the weather had turned cold and rainy and therefore the camp was extremely smoky, all of which didn’t help her asthma.

She began to have episodes, where she became very short of breath and had pain in her shoulder blades, as the episodes got worse her inhaler wasn’t having enough affect, so I made her a spacer out of a plastic peanut butter jar, which helped.

As her episodes got worse I started her on steroids and arranged with the leader to walk her out of the jungle the next day. As I was the only medic on the project, a staff member from field base picked her up and took her to the local hospital.

The trekkers from both casevacs recovered, returned to the jungle and played a full and important role in our project.

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