2011 Semester in Wilderness Medicine

No other wilderness medicine training program provides the opportunities presented in the Semester. We strongly encourage you to confirm this by comparing our program with any other.

This is the Semester's unique paradigm:

• Learn anatomy and pathophysiology of diseases during didactic sessions taught by physicians, nurses and paramedics
• Reinforce this understanding at a cadaver lab
• Observe the presentations of these diseases and injuries in actual patients during extended clinical opportunities or scenarios
• Acquire skills to both prevent and manage the problems taught during the class.

The actual patient-care experiences alone are unparalleled. These include spending a full week running a free health clinic in Costa Rica, getting supervision and direction from our Medical Director, Dr. Greg Moore. Students will make house visits, set up a clinic in the community center, take medical histories and vitals on patients ranging in age from 7 months to 90 years. During this week, they will also participate in important community health projects. Last year, students installed rocket stoves in homes. These stoves greatly reduce carbon monoxide and particulate emissions from indoor cooking, and thereby reduce significant causes of the respiratory infections and diseases (such as asthma) that the students will observe while running the clinic.

In Montana, students continue this type of learning when they spend three days on the river in swiftwater rescue training. Not only will they understand the physiology of drowning, but by actually getting in the water and pulling people from the river they will have a unique appreciation of both the prevention and treatment of submersion injuries. In another example, students will take their knowledge of hypothermia and frostbite and apply it during three days of avalanche training in the Swan Mountains. During this time, students snowshoe and ski approximately ten miles into a backcountry yurt. Once there, they will learn about the basics of snow science and become proficient in avalanche beacon use. Through scenarios they will take this knowledge, find buried patients and care for them in extended winter scenarios.

The list of this type of training is extensive and fully outlined on our website. You can also visit the site to see more pictures of our 2010 program. The program is demanding and intense. If this type of experience appeals to you, please contact us for more information.

Highlights of our 2010 Semester

In addition to studying backcountry medicine, Semester students train as EMTs, including learning ambulance operations, hazardous materials handling, and vehicle extrication. Near the end of the Semester, students participate in an overnight, mass-casualty scenario rescue in the Swan Valley.

Care of Patients in Winter Environments

March is still fully winter in Montana's high country! Students spent several days in the Swan Mountains studying avalanche awareness and practicing rescue and care of patients in conjunction with the West Central Montana Avalanche Center. This section of the Semester in Wilderness Medicine earns students their Level 1 Avalanche certification.

Back in Montana

Three days after leaving Costa Rica, students are in the snow and freezing rain in the mountains of western Montana. Aided by the amazing cooking of our chef, Raven (participating in a scenario, first picture below), they are beginning their winter survival, Leave no Trace Trainer and avalanche training. This Tuesday they will put on skis and snowshoes for four days at a backcountry yurt earning their Level 1 Avalanche from Steve Karkanen and Dudley Improta of the West Central Montana Advisory Center. By week's end they will travel to Missoula for a full day of human anatomy instruction at the University of Montana cadaver lab and vehicle extrication with the East Missoula Fire Department.

Swiftwater Rescue Technician Training

Students spent three days in training, working with throwbags, pulling victims out of the water, setting up tension lines to retrieve boats, and treating victims once on shore.

Students practice rescue skills with Aerie and Whitewater Rescue Institute staff. For video footage of our 2009 SRT class, view this link.

Aerie instructor coaches students during a training session in swimming into and out of river eddies.

Health Clinic

Aerie students were treated to an exceptional medical education as they made house calls with Dr. Greg Moore, Aerie's medical director, here examining a patient with cataracts.

Aerie's free public health clinic operated for 2 days out of the community center, with the second afternoon reserved for house calls for anyone not able to make it to the clinic.

Clinic operations were supported by the hard work of several language interpreters, in addition to Aerie students with Spanish fluency.

Aerie students made time during the clinic to direct local elementary school students in CPR techniques.

All together, the clinic treated almost 75 patients, split between clinic visits and house calls in the local area.

Community Service Project

The community service portion of the Semester gives students a glimpse of the links between health issues and daily living. The following photos summarize some of the work done at two different homes. In one case, students' work included providing drainage from sinks, so potential mosquito-breeding pools of water are no longer collecting outside; wiring new lights into the kitchen to enable the cooks to have a light source beyond the flames of the cooking fire; and installing a model rocket stove (a wood-fired stove with low CO and particulate emissions) in the kitchen for a test drive before the family committed to a total overhaul of the current cook top: a wood fire-heated plancha. The second home received a new, permanent double-burner rocket stove made from scratch with local materials by our students and Rancho Mastatal staff.

We installed pipes to divert drain water from bathroom and kitchen sinks away from the back of the house where it collected. The external wall of the kitchen is shown here.

To create a cleaner cooking environment, we pulled this old sink out of the kitchen in one home and replaced it with a similarly-designed, albeit newer, one with a drain pipe.

To make a rocket stove, our students mixed cow manure, straw, clay, rice hulls and lime to form a soft, clay-like building material easily sculpted around the j-shaped fire chamber and vent stack.

Rocket stoves are unique designs which reduce particulate emissions in smoke that can cause emphysema and chronic respiratory problems in family members spending a lot of time cooking indoors over wood fires. They also reduce the need for fuel: this pot of beans boiled in less than 15 minutes with a small handful of twigs! The family invited several friends in to see the stove in action while we were putting the finishing touches on the electrical wiring and tending the fire periodically. This stove was built over a two day period as a test model.

Leaving Costa Rica, headed for Montana

The Costa Rica portion of the Semester ended with a free health clinic, a community service project, and swiftwater rescue training on the Pacuare river. All students are now in Montana, adding avalanche rescue and winter survival to their training.

First Week and a Half Update

Our first week and a half have gone by quickly. Students are all well and very busy. We are well into the survival, orienteering and medical curriculum. Computer time is limited, but here are some pictures.