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Building an 'extreme' community

Mark Hannaford - World Extreme Medicine founder - talks to us about his journey, pandemic problems, travel with children and more.

Back in December, I had the pleasure of speaking to Mark Hannaford - founder of World Extreme Medicine.

Over the past 20 years, WEM have run courses all over the world. From Jungle Medicine in Costa Rica to Polar Medicine in Arctic Norway, you would be hard pressed not to find one that piques your interest. Amongst his many other achievements, Mark was also instrumental in founding the world’s first MSc in Extreme Medicine at Exeter University, UK.

Hot off the press, Mark also told me about the brand new Fellowship of Extreme and Wilderness Medicine, which will provide a benchmark of values, competencies and experience for health professionals working in extreme environments.

I received more than one message from friends and colleagues who were envious that I had the opportunity to speak with Mark – he is somewhat of a legend in the extreme med community - and we are very grateful to him for making the time. I conducted the interview during a trip in our (very) compact campervan. I was hunched at our tiny table with internet so terrible it could barely cope with transmitting audio. Luckily Mark is used to working in chaotic environments!

The pathway to extreme

I kicked off by asking Mark what led a non-medic to the world of extreme medicine. He started at the beginning, telling me of a desire for adventure that has driven him for as long as he can remember. He attributes this to having grown up with a sea-captain father and ‘witnessing that peripatetic style of life early on’. A geography graduate, Mark realised that there were ‘certain horizons that could only be reached by utilising expeditions and more adventurous travel’. So, after spending time working as professional mountain guide, he established his first expedition company, Across the Divide Expeditions, which quickly became successful. It was at this point he began to realise the responsibility of taking people into extreme environments; or, as Mark more succinctly phrased it, wanting ‘to make sure our clients came back with all their bits attached!’.

We wanted to make sure our clients came back with all their bits attached!

As a result, Across the Divide Expeditions were one of the first exped companies to employ doctors on the majority of their trips. It became clear that working in extreme environments was a hugely positive experience for medics, resulting in better preparedness for the challenges of everyday life. Doctors reflected that they felt ‘more confident in their leadership and problem-solving skills, and with a renewed appreciation for the system they work within’.

Our community see bridges rather than rivers; they are on the same wavelength

However, in time Mark and his team realised that although all their medics were passionate for the work, they were used to practicing in a more typical clinical setting with all its accompanying luxuries – abundant resources, support staff, concrete walls… It was at this point Mark identified the need to develop targeted training to ‘prepare our doctors for an environment where all that stuff was removed’.

Initially, training was provided for in-house staff with the goal of preparing them for their respective expeditions. Courses combined expedition skills with scenario-based teaching focussed on practicing medicine in extreme environments. After a while, it was suggested that such courses would be applicable and interesting to doctors outside of the company. Mark, ever humble, was not convinced – ‘why would these amazing doctors want to come to our course?’ It turned out his worries were unfounded; over 60 people turned up to the very first event and Mark realised that courses such as this could be a great ‘segue to having amazing adventures whilst building skillsets and knowledge’.

Often the key to your next opportunity could be sitting right next to you

Over time, it became clear that course attendees tended to be ‘the same type of people – adventurous, with a positive mindset. They were people that saw bridges rather than rivers’. However, without the course they might never have met as they came from all different walks of medical practice. Mark realised that the missing link was a community for medical professionals interested in extreme medicine.

It was from this realisation that the idea for WEM stemmed; the desire to ‘build a community of people where people could break out of their silo and meet others with similar interests and share experiences’. Mark continues, ‘many people undervalue networking. But it is incredibly rewarding to share your passion with others that feel the same way. Often the key to your next opportunity could be sitting right next to you and you just need to connect with them’.

You never know where your next contact might find you!

As WEM expanded and flourished, Mark realised that many doctors stop pursuing their interest in expedition medicine as they dive deeper into their careers. He has found that engaging doctors with the WEM community has not only kept them in the field but also contributed to ‘keeping their passion for medicine alive’.

Extreme medicine AND a family - is it possible?!

One of the other common reasons for ceasing to work as an expedition medic is starting a family. This is a topic close to our hearts. One of the main reasons we have waited until our now almost-mid thirties before considering children is our shared passion for travel, adventure and desire to work in low-resource environments. Something we ask ourselves regularly is whether having a family would put a stop to this.

I can honestly say that travelling with children is an enriching experience

Luckily, Mark blasted our concerns out of the water. ‘I can honestly say that travelling with children is an enriching experience and they are incredibly adaptable. We started travelling with our kids when they were five months old. Yes, you need more of a plan, you need contingencies if things go wrong. For example, when the kids were young, we never travelled to malarial zones. We would check the state of the local healthcare system and make sure we had good insurance. But it is achievable’. He continues, ‘your aim should not be to instil your own passion for travel and adventure – that is their choice. However, what you will instil is the ability to chat to anyone, be happy in virtually any environment and have a good sense of inner security’.

He admits that not everyone views travel with small people with a positive lens– ‘we’ve had some funny looks and judgments over the years’ – however, he attributes much of this to ‘fear of the unknown’. He also reassures us that ‘after the first trip, it all gets much easier’.

Navigating the post-covid world

We concluded our conversation with a discussion about the impact of the dreaded ‘C’ word. ‘Yes, Covid-19 has certainly presented a challenge!’. Beyond the obvious barriers to international travel in 2020, WEM also run the largest extreme medicine conference in the world. This clearly was not going to be possible during a pandemic. Undeterred, the team took the entire event online. Mark admits he was initially ‘unsure’ about the endeavour but was delighted to find it was still possible to infuse passion and excitement remotely. This approach also made the event far more accessible - ‘we had people logging in from all over the world and could make more people aware of the amazing opportunities that exist for medics in this space. It was amazing’.

Taking WEM online

One specific positive Mark took from the experience was the change-up in networking. Like many of us, he admitted he would find himself naturally gravitating towards familiar faces during coffee breaks. However, in the digital world the team could set up various break-out rooms that attendees could ‘visit’ and engage in multiple conversations.

Covid-19 has certainly presented a challenge!

The event worked out so well that WEM are planning to hold a concurrent digital programme with their (hopefully) face-to-face event in 2021. This is great news for those of us in the Southern Hemisphere who can’t make it in person! It also happens to be WEM’s 10th Anniversary conference.

Lockdown did provide WEM with a gift that we have also appreciated – time. Time to take stock and work on the too-hard for right-now column we all have with projects. It has also resulted in technological leaps as companies scramble to take their entire enterprises online. For WEM, this combination of time and access to better online platforms led to the development of a WEM academy, a treasure trove of digital resources, most of which is free to access. We have had a good explore and can definitely recommend it to anyone interested in adventure.

With that, my 4g truly began to give up the ghost and we said goodbye. It was a real pleasure to hear Mark’s passion for what he does. He has essentially made it his mission to make health professionals happier and experience medicine outside-the-the box. And that is very BYS!

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