Incidents in 2009

Throughout the 2009 season in Honduras a medical team consisting of 8 doctors, 2 nurses, and three paramedics, in addition to medical students, provided vital support to the Operation Wallacea field teams. Staff kept detailed records of all incidents, illnesses, and near misses that occurred during the 10 week season. The data were used during these summer months for purposes of feedback and evaluation, allowing staff members to take appropriate action to further reduce risks.

Illnesses and accidents were classified into the following categories:

Category 1 Death

Category 2 Emergency evacuation with subsequent repatriation for medical attention (This category is intended to refer to potentially life threatening situations which results in the volunteer/staff member taking no further part in the expedition).

Category 3 Non - emergency evacuation to home/medical facility beyond the local area. (This category is intended to refer to non life threatening situations which none the less required medical attention outside the local area).

Category 4 Hospital treatment required in the local area

Category 5 Treatment on site - serious illness/injury

Category 6 Treatment on site - moderately serious illness/injury

Category 7 Treatment on site - minor illness/injury

Category 1 Incidents

There were no category 1 cases.

Category 2 Incidents

There were no category 2 cases.

Category 3 Incidents

There was one category three case in 2009 in Honduras. A volunteer arrived on site having been unwell previously to leaving home, after no treatment given on site solved the problem they were taken to the hospital for further tests. Some of the results came back out of range and showed that the patient was anaemic. Further tests were required and although these could be done in country the volunteer decided it would be easier for them to make a swifter recovery and get the tests done at home.

Category 4 Incidents

There were 7 cases where treatment at the nearest major hospital was required: 

One incident involved a volunteer who had to be treated at the nearest hospital for a dislocated shoulder. With a previous history of dislocations in both shoulders the volunteer had suffered a fall while crossing a river. Unable to put the joint back in place on site the medic administered pain relief and the patient was taken to hospital for treatment. They were able to rejoin the projects a couple of days later. 

A student presented with a deep laceration to his hand and was taken to hospital to have the wound checked for tendon damage to the fingers. After further investigations it was found that there was no such damage and he was instructed not to dive to give time for the wound to heal. 

Further investigation at the hospital was required when a student arrived on site having taking the wrong dose of their anti-malarial medication. After a discussion with our medic on arrival it was decided that that close monitoring and tests were required to ensure there were no lasting problems caused by such a large quantity of the medication. After two days the student was able to rejoin the group. 

Other category four incidents included treatment for an infected abrasion, investigation of possible appendicitis, a tooth repair and administering a rabies booster.

Category 5 Incidents

There were 2 incidents in this category in 2009. One of these was a bite from a bat sustained whilst handling the animals. Rabies vaccinations were required and onsite medics could administer these. 

The other was a serious case of diarrhoea and vomiting. Although this could be treated on site it was a severe case presenting with a fever. The patient made a full recovery after treatment and a few days rest.

Category 6 Incidents

There were 19 cases that were regarded to be moderately serious but treatable on site. 

Cases of diarrhoea and vomiting made up a significant proportion of these, the majority of which received treatment with antibiotics and recovered within a few days. 

There were five cases of middle ear barotraumas from diving that were considered to be moderately serious and required treatment. 

Other treatable incidents included exacerbation of asthma, allergic reactions and infected wounds or abrasions. In all incidences the individuals were treated successfully and appear to be without further complications.

Category 7 Incidents

There were a total of 189 cases considered as minor. 112 cases were reported at the forest sites and 77 from the marine islands of Cayos and Utila. 

There were numerous cases of bites from insects, particularly from sand flies. Treatment normally consisted of oral antihistamines to help prevent itching. The majority of category 7 incidents at the marine sites were minor ear problems as a result of diving, these consisted of around three quarters of the overall category 7 incidents reported on Utila and Cayos Cochinos. 

Cases of diarrhoea and abdominal pain were common category seven incidents reported at the forest sites, accounting for 42%. Due to the terrain at many of the forest sites knee problems were also common as were general cuts and abrasions.

Conclusions

Given the 11,949 man days spent in the remote forest and reefs of Honduras, the level and number of incidents reported over the season is very low. The average levels of incidents in the various categories were;

0.00 Category 1 incidents per 1000 man days

0.00 Category 2 incidents per 1000 man days

0.08 Category 3 incidents per 1000 man days

0.59 Category 4 incidents per 1000 man days

0.17 Category 5 incidents per 1000 man days

1.59 Category 6 incidents per 1000 man days

15.82 Category 7 incidents per 1000 man days

This data would indicate that coming on an Operation Wallacea project to Honduras is safer than participating in activities such as a rave, rock festival or a marathon. (Hodgetts and Cooke 1999)