Preface:

Should the urge to explore, enjoy, and carry out research in wilderness environments be constrained in any way by issues of health, safety, the environment, and the well-being of the local inhabitants? We think it should, but please read on. Expedition medicine (known in North America as ‘wilderness medicine’) is concerned with maintaining physical and psychological health under the stresses and challenges of expeditions to remote and challenging places. Its aim is to encourage adventure but, at the same time, to attempt to minimize the risk of trauma and disease by proper planning, preventive measures such as vaccinations, the acquisition of relevant medical skills and sensible behaviour. Responsible attitudes towards the environment and the welfare of indigenous peoples and other local helpers in the area of travel are also of great importance. This book is a product of the Royal Geographical Society (with IBG) Expedition Medicine Cell, which was formed to provide medical advice to RGS-IBG expeditions and those seeking advice from the Society.
In it, we have collected and summarized the experience and skills accumulated by explorers, expeditioners, researchers, and remote area travellers from all around the world. The first edition, published in 2008, was designed to be a practical and portable guide to the prevention and treatment of those medical problems most likely to be encountered in extreme and remote environments. We are delighted that it proved so popular and has been used during the course of expeditions by doctors, nurses, paramedics, and first-aiders, as well as by non-medical expedition members. The second edition builds upon this foundation, but includes additional topics. Since prevention of disease and accident is fundamental to working in remote and potentially hazardous areas, the sections on risk management have been expanded. To help decision-making, we include more treatment algorithms. We recognize that travel in remote areas is no longer limited to the young, fit, and experienced traveller. Historically, exploration and wilderness travel have proved distinctly dangerous. Admiral Anson circumnavigated the globe in 74–742, losing five of his six ships and 626 of his 96 crew, a disaster eventually mitigated by the capture of a Spanish treasure ship which left him and his surviving sailors wealthy men. All 24 members of Sir John Franklin’s ill-fated voyage to the North-West passage died. During Stanley’s great trans-Africa expedition from Zanzibar to the Congo (874–847), 4 of his original 228 expedition members died from battle, murder, smallpox, dysentery,