A Postcard from the Edge

aka Postcards from the Edge 001

Postcards from the Edge is series of LITFL posts on International Emergency Medicine. Also, remember to join the International Emergency Medicine (Australasia) group if you’re on Facebook!

The first of our “Postcards from the Edge” comes from Perth, Western Australia but spans from the southern tip of the globe, through Papua New Guinea and Asia to Nepal! Associate Professor Chris Curry has ventured the globe doing things as adventurous as Antarctic expedition medicine since becoming an Emergency Physician. Currently working at Fremantle Hospital, Chris maintains a strong interest in International Emergency Medicine dedicating significant portions of his professional life towards helping support the development of Emergency Medicine overseas. He has done much work in Papua New Guinea, helping set up an Emergency Medicine training program, and he has ongoing involvement in the development of the specialty in several other countries in the Asian region. He is also the foundation chair of the Australasian College for Emergency Medicine’s special interest group in International Emergency Medicine (IEMSIG), and the editor behind the newsletter that is published electronically through this group (the newsletters can also be accessed on LITFL for wider dissemination).

Brolly – Ladakh, Indian Tibet
“Brolly – Ladakh, Indian Tibet, 2010”

Chris was kind enough to answer a few questions from the LITFL team..

Q1. What is your background in Emergency Medicine, and what inspired you to do international work?

As a student I organised elective time in several hospitals in the country of my birth, Kenya, with a view towards rural hospital generalist practice in developing environments.  On graduating from UWA I initially joined the then infant Family Medicine Training Program.  I tried to get to South Africa for developing world experience but settled for the NHS in the UK.  There I signed up for a Diploma in Tropical Medicine and Public Health, amongst other things, but got side-tracked by mountaineering.  I eventually returned to my initial objective 23 years later.

Skiing snow
“Skiing snow – Alaska – that’s gear on a sled, not a corpse… 1986”

Q2. At what stage of your career did your interest in international Emergency Medicine start?

I was interested in international  hospital generalism as a student.  I turned to EM when I went to New Zealand to climb mountains and found the delivery of emergency care there even more dysfunctional than in the NHS and at the same time found ACEM through an introduction by Bryan Walpole, a foundation fellow.  I pursued EM training to try to improve delivery of care in New Zealand.  More than a decade later an association with Antarctica led me to discovering a PNG proposal to AusAID to develop an EM training program there.  I became involved with that in 2001.  So I moved from high altitudes to high latitudes, high temperatures and high humidities.

“Little creatures – Antarctica, 1997”

Q3. Can you tell us what the International Emergency Special Interest Group (IEMSIG) is all about? How did it start? What is it’s vision and what has the association already achieved?

I was approached by Paul Gaudry, a foundation fellow and then Honorary Secretary of the Council of ACEM, to chair an IEMSIG to be launched at the 2004 International Conference on Emergency Medicine (ICEM) which was being hosted by ACEM in Cairns.

Essentially it is a loose collection of people with an interest in IEM who are prepared to share what they are doing in the hope of encouraging others.  The main vehicle of what it is about and what it is doing is the IEMSIG Newsletter.  This is accessible on the ACEM website, go Infocentre, go International Emergency Medicine (or click here for the direct link!).  There is now a Noticeboard carrying notices of opportunities that might be of interest.

IEMSIG now numbers more than 250 people who have connections of various shapes and sizes in more than forty countries, many of these being LDCs (Least Developed Countries).  ACEM is establishing an International Development Fund to expand the college contribution to IEM.

UN's Least developed countries map
UN’s Least developed countries map

Q4. Have you been on any IEM missions recently? If so could you briefly tell us what the trip was about, and share with us a few highlights and low points or challenges?

Now that the EM program in PNG is established and the country is producing its own emergency physicians I have been returning to former haunts.  I have recently (May 2011) returned from Nepal where, after several visits, the leading postgraduate medical training facility, the Institute of Medicine at Tribhuvan University in Kathmandu, is progressing towards launching an EM training program in November 2011.  A highlight is that progress is being made.  The challenges are many, as they are in all LDCs, and include matters of governance, resources, understanding, culture and will.

Papua New Guinea
“In the ED at Port Moresby General Hospital, Papua New Guinea 2003”

Q5. From your experience of work in the field of International EM, are there any words of advice you would like to give either medical students, junior doctors or registrars about getting involved in International Emergency Medicine?

There are many opportunities for those prepared to make the effort and to cope with the sacrifices involved.  IEM is an area for those who not only say they would ‘love to do that’, but also have the initiative to get up and do things for themselves.  It is an area that can be hugely rewarding in arrays of intangible ways that can vastly surpass the more tangible rewards of income, career and status that seem to pre-occupy so many in our wealthy corner of the world.  But those rewards you have to discover for yourself — by going there and doing it.

“life in the slow lane, in Kathmandu, 2011”.

Further reading

  • Aitken P, Annerud C, Galvin M, Symmons D, Curry C. Emergency medicine in Papua New Guinea: beginning of a specialty in a true area of need. Emerg Med (Fremantle). 2003 Apr;15(2):183-7. PMID: 12675629
  • Curry C, Annerud C, Jensen S, Symmons D, Lee M, Sapuri M. The first year of a formal emergency medicine training programme in Papua New Guinea. Emerg Med Australas. 2004 Aug;16(4):343-7.  PMID: 15283722.
  • Curry C. The ACEM training programme: flexibility and diversity are important. Emerg Med Australas. 2005 Feb;17(1):92. PMID: 15675918.
  • Curry C. Taking emergency medicine international: what can we learn and teach? Emerg Med Australas. 2006 Aug;18(4):313-6. PMID: 16842297.
  • Curry C. A perspective on developing emergency medicine as a specialty. Int J Emerg Med. 2008 Sep;1(3):163-7. Epub 2008 Sep 25. PMID: 19384509;  PMCID: PMC2657278.
  • O’Reilly GM, Curry C. International emergency medicine: building on a strong information-sharing foundation. Emerg Med Australas. 2010 Dec;22(6):488-92. doi: 10.1111/j.1742-6723.2010.01343.x. PMID: 21143396.
  • Pearce A, Mark P, Gray N, Curry C. Responding to the Boxing Day tsunami disaster in Aceh, Indonesia: Western and South Australian contributions. EmergMed Australas. 2006 Feb;18(1):86-92. PMID: 16454781.

Postcards from the edge LITFL 700


from the edge

Emergency Physician FACEM PhD (ANU), International Research in Toxicology and Medical Education | @trainthetrainer |

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