Wilderness medicine seen as avenue for sustainable aid work

Before attending medical school, Will Galvin volunteered for the Peace Corps in a small west African village in Senegal.

At night, he sat in a circle with the villagers, scooping food out of large communal bowls with his hands and soaking in warmth from the fire.

During the day, he helped them plant trees in fields and gardens. Battling encroaching desert from the north and deforestation from the south, they grafted fruit trees and planted seedlings to salvage the remaining habitat. In a collection of mud huts that housed 150 people and two wells, one which dried up regularly, there wasn’t much to save.

Throughout the year, Galvin worked alongside aid organizations and religious groups that bombarded the community for a week and left before the machines they donated ran out of gas or newly-dug wells trickled water.

“Is aid work doing good for people or actually holding them back?” he began wondering in 2010. “In the Peace Corps, you try to help the people help themselves, but other aid work hampers your ability to do that.”

Galvin saw similar aid struggles when he spent time in Ecuador, Peru, Thailand, Cambodia, and non-touristed parts of the Bahamas. For him, medical school became the answer to episodic aid work.

“It’s hard to argue that going into a country after a natural disaster or war or genocide and providing health care is doing harm,” he said. “In those areas, wilderness medicine is it. You’re in a resource poor environment and have to be creative about treatment.”

Galvin, a second-year student in the University of Georgia-Georgia Regents University Medical Partnership, plans to study emergency medicine and focus on wilderness medicine. He is one of more than 1,500 students in the country who decide to pursue the emergency medicine specialty each year, and the field is growing.

Between 2000 and 2010, the emergency medicine field grew by 44.6 percent, according to the Association of American Medical Colleges. Following internal medicine/pediatrics — a new combined specialty — and geriatric medicine, emergency medicine saw the third largest increase in the past decade, jumping from about 20,000 to more than 30,000 active doctors.

In addition, emergency medicine residency numbers jumped in the past decade, up 21 percent, AAMC reported. Following the primary care specialties of internal medicine, family medicine, and pediatrics, emergency medicine falls third in line behind general surgery and anesthesiology specialties in first-year resident numbers.

Within the emergency medicine specialty, “wilderness medicine would undoubtedly benefit from wider recognition and attention,” said Gwynn Curran-Sills, from University of Calgary’s Family Medicine and Primary Care Research Office in Alberta.

The field emerged in the 1980s when three California doctors created the Wilderness Medical Society to adapt medical principles to mountains, jungles, deserts, caves, marine environments, and space. Now doctors discuss specifics such as wilderness dermatology and ophthalmology, dive and high altitude medicine, and snake and spider bites. Several U.S. groups offer Wilderness First Aid, Wilderness First Responder, and Wilderness EMT certifications, and Galvin has nabbed all three.

Despite its growing popularity in medical schools, “robust educational experiences (medical school electives, fellowships, and accredited CME) are vital if we hope to attract sharp, adventuresome minds to this field and to continue to cultivate its development,” Curran-Sills said.

For Galvin, this means organizing a wilderness medicine rotation on his own and pursing rare residency opportunities, including a fellowship offered by Harvard University.

As this year’s president for the medical school’s emergency and wilderness medicine student interest group, Galvin encourages classmates to consider the specialty as well. He sets up meetings that feature practical skills labs, invites members to regional wilderness medicine conferences, and coordinates the school’s team for Medwars, an adventure race hosted in Augusta where emergency medicine students navigate coordinates and address scenarios such as animal bites, poisonous berries, or climbing injuries. The Athens team has won second place for three years in a row, and Galvin is determined to grab first place in November.

Galvin also spends time with his two second-year medical school roommates — one specializing in oncology who spent the summer mountaineering in the North Cascades and one specializing in emergency medicine who spent the summer with the Himalayan Health Exchange. They leave town for northern Georgia or North Carolina on the weekends for rock climbing, backpacking, mountain climbing, and horseback riding.

“I have to do something that forces me to focus on what’s happening in the moment,” Galvin said. “I can’t study while doing these things. My life is literally in my own hands in those moments.”

When studying for exams, the three camp out in their dimly-lit downstairs living room stacked with books and papers. Three mountain bikes lean against the stair banister, ready to go out the door at a moment’s notice. Photographs of mountains already summited during past travels and to be climbed in the future line the walls.

“Aid work holds back the citizens in Africa in a lot of ways. But you’re also stuck in this limbo,” he said. “If you discontinue aid, you’ll kill a lot of people right away. But if you continue this level of aid, you’re killing more people overall.”

One night sticks out to him in particular. Gathered around the communal food bowls as usual, Galvin looked toward the mountain ridge that surrounded the village valley. As the sun sunk below the horizon, a spray of reds, oranges, and yellows saturated the sky.

“This is my home,” he thought. “I live here.”

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