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Exploring the outer limits of nursing with Raleigh International

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‘Nothing can describe the feeling of reaching the summit of South East Asia’s highest peak,’ says nurse Louisa Worsfold. Trekking through rainforests and climbing mountains may sound like unusual roles for a nurse, but they are all part of the job for Ms. Worsfold, medical co-ordinator for Raleigh International.

‘Nothing can describe the feeling of reaching the summit of South East Asia’s highest peak,’ says nurse Louisa Worsfold. Trekking through rainforests and climbing mountains may sound like unusual roles for a nurse, but they are all part of the job for Ms. Worsfold, medical co-ordinator for Raleigh International.

Raleigh International is a youth development charity that takes people from all backgrounds and nationalities on expeditions around the world. The climb up MountKinabalu in Malaysia was the culmination of a seven-day challenge that involved kayaking, abseiling and trekking through the jungle.

‘It left me with an immense sense of achievement,’ says Ms Worsfold. ‘Not only had I made the 4100m high journey, I’d helped 60 people to meet Raleigh International’s Kinabalu challenge head on, as well as provided nursing and mental support along the way.’

Ms Worsfd joined Raleigh International two years ago [2003]. Having covered general medicine and care of the elderly, she went on to work in paediatrics, intensive care and A&E. She also worked as a repatriation co-ordinator and gained ‘in the field’ experience with a private medical company that supported large outdoor events. But what drew her towards the challenging and unusual career of working for Raleigh International?

‘I wanted to do charity work, and was particularly interested in youth work,’ she says. ‘I have always loved the outdoors and Raleigh combined the two. For me it’s the ultimate job.’

Raleigh run ten expeditions a year for venturers, volunteers and staff. They also have programmes in Chile, Costa Rica & Nicaragua, Ghana, Namibia, Borneo and Fiji. As medical co-ordinator, Ms. Worsfold has a diverse and challenging job. ‘I am responsible for the well-being of every person that goes on expedition, including the medics.’

As well as providing guidance, advice and first aid training to the venturers and volunteers, it is her job to do an assessment of the host country. Prior to an expedition taking place, Ms Worsfold must ensure that adequate medical care can be given in safe and sanitary conditions, and that the means to evacuate and repatriate patients are available, should the need arise. Because the expedition party often mixes with local tribes, she also checks for potential health risks within the local community.

There are usually between four and seven medics on an expedition, both doctors and nurses, and all are treated equally. ‘Every one of Raleigh’s volunteer medics is selected because they have particular attributes,’ explains Ms Worsfold. ‘They have a sound working knowledge of A&E practice, can canulate and suture and have tropical disease and or expedition medicine experience.’

Her first mission was to Costa Rica & Nicaragua. ‘Nothing can prepare you for your first overseas programme as a medic. I’ve worked in extreme terrain and through severe weather conditions to administer medical assistance.’

Therefore it is important that medics have confidence in their abilities. To help them get ready for a mission Ms Worsfold runs ‘mini expeditions’. ‘Medics have to be able to work within a team or be autonomous. They have to be comfortable using their skills outside the hospital environment.’

These weekends of challenging situations involve team building and problem solving exercises, management skills, radio training and trekking. A mock emergency situation will also be created to see how the medics cope under pressure.

Once in the field, medics are responsible for the health & safety and hygiene management of the expedition, first aid training, and diagnosing and treating casualties and illnesses. ‘Although there are occasional cases of dengue fever or malaria, most of the time you deal with minor injuries such as twisted ankles, heatstroke, insect bites and minor cuts,’ she explains. ‘You may also have to deal with minor trauma like leg or arm fractures.’

A lot of Ms Worsfold’s job involves supporting other medics in the field. Back at base, she is on hand to answer queries and give advice when needed. ‘It is my role to be the reassuring voice on the end of the phone. I may provide a second opinion on diagnosis, view digital images of skin infections on the web, or support the medics in their decision to evacuate a patient.’

However, she can be called upon to go into the field if necessary, and there is always a crisis management team available. She also still goes on at least one or two expeditions a year: ‘I like to keep my skills fresh and review the services out in the field.’

Working with Raleigh International’s Motive 8 programme, created for youths who are considered at risk, has been particularly rewarding for Ms Worsfold. ‘Young people who’ve had a difficult time work alongside fund raising venturers, gap year students and host country venturers,’ says Ms. Worsfold. ‘It pulls everyone together, creating a unique cultural experience.’

Planning and preparation are fundamental to her job. ‘Ultimately, my role is about risk assessment. I ensure every person who goes on an expedition, be they a 17 year old venturer or a 57 year old staff volunteer, is fit to go both mentally and physically.’

This was particularly important when in partnership with Diabetes UK, Raleigh took ten diabetic patients on a three-week expedition to Borneo. ‘It was extremely challenging. Preparing, supporting and fitting the right staff to the young people.’ But her hard work paid off, resulting in one of the most memorable expeditions of her career with Raleigh.

‘Because of their diabetes, they had always been told they couldn’t do things. We proved everyone wrong. The expedition gave them a new lease of life, proving that doors can be opened to them with the right planning and preparation.’

Working as a medic for Raleigh International can provide great opportunities for career and personal progression because more employers are now recognising the value of career breaks and traveling experience.

‘It is seen in a favourable light,’ she asserts. ‘Rather than lose their staff, employers are more willing to free them up for three months and let them expand their knowledge.’

‘On an expedition, medics have to have a mature approach, be quick thinking and independent. Reflecting on their skills and abilities, they return to nursing with a renewed confidence and a new sense of purpose,’ she adds.

Although skills such as tropical disease management and expedition experience are desirable, Ms Worsfold will recruit medics without these skills, as long as certain courses can be completed prior to the expedition. ‘An expedition simply can’t run without medics and I therefore have to be flexible, without compromising the safety of the participants,’ she stresses. Currently there are about 25-30 nurses working for Raleigh, but Ms Worsfold is always keen to recruit more.

When not co-ordinating an expedition, Ms. Worsfold is constantly improving her own skills and qualifications. Having completed a Diploma in Tropical Nursing, she is now undertaking an altitude medicine course. She is also preparing for the next Diabetes UK expedition to Ghana in July 2005.

But it is being ‘at one with nature’ that she loves best. ‘Waking in the dead of night to the sound of a waterfall, and a herd of water buffalo beside a river, is a truly magical experience.’

Louisa Worsfold, medical co-ordinator for Raleigh International.

Is this the job for you?


Medical co-ordinator with Raleigh International


G grade

What it entails

• Risk assessments of all expedition participants and host countries

• Health & safety and hygiene management of an expedition

• Providing guidance, advice and first aid training to venturers and volunteers

• Training and supporting medics

• Recruiting medics for expeditions

• Diagnosing and treating casualties and illnesses

• Tropical disease management


• A&E background, at least six months is essential

• Repatriation and expedition medicine experience

• Tropical disease management experience

• Canulation and suturing skills

• To be able to work as an individual and in a close team

• To love the outdoors and be prepared for an adventure


• Full time, 9-5 pm, Mon- Fri

• On call every third weekend of the month

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