This week at Casey is brought to you by our wintering doctor.

A visit from the outside world!

On Saturday 4 June we caught a glimpse through the clouds of a RAAF C-17A Globemaster as it flew overhead for the first ever midwinter airdrop at an Australian Antarctic continental station!

This was exciting for several reasons: firstly, there were other humans within a couple of kilometres of us! Secondly, we received 1500 kilograms of cargo from the mainland, including medical supplies, mechanical equipment, and letters from home! (Media reports gave the impression that we received food as well… I suppose it was, if you count cornflour as food). Thirdly, this is highly significant because it demonstrates that we are not completely isolated anymore, that the Antarctic Division has the ability to drop essential supplies and equipment year round, which increases the safety of being here over winter.

Keeping your cool in Antarctica

Spending a winter in an extreme and unique environment like Antarctica certainly has its challenges! The outside environment is hostile, evidenced by the fact that nearly all of the wildlife leaves for winter and no food grows here; we are completely dependent on technology and imported goods like diesel and food to survive; we can’t just leave if something goes wrong; our loved ones are thousands of kilometres away; and we are forced to interact with the same small group of people every day. Yet despite these challenges, plenty of people choose to come down here to live and work, and they come back time after time (one doctor has spent eleven winters down here!). Why is that, and how do they stay healthy and happy?

I’ve just finished studying a subject called Human Behaviour in Extreme Environments, part of my Graduate Diploma in Public Health in Rural and Polar Medicine, a degree which has been designed and is partly run by doctors at the AAD’s Polar Medicine Unit.

A large focus of the subject was how to help people cope with the inevitable stressors that are part and parcel of living and working in a place like this. The first and possibly most important step is selecting people who are likely to do well in Antarctica, which includes those with good social skills who can tolerate periods of monotony and restriction. Next, those selected undergo predeparture group education on how to get along with others which includes teamwork, effective communication, and conflict resolution; training in other areas like fire fighting and boating which helps the team learn to work together; and opportunities to bond in a relaxed, social environment in the evenings. In addition, station doctors undergo a day of mental health training focusing on some of the issues that can arise in Antarctica like sleeping disturbances which are very common, and anxiety and depression.

Another area that the unit focused on was the impact on the family of being separated (particularly partners and children), and how preparing and supporting the family for separation and facilitating communication can help the expeditioner as well as the family. The Australian Antarctic Division has an Expeditioner Liaison and Support Officer, an Employee Assistance Program, and there is a Family and Friends Association, which are all really useful resources.

Once in Antarctica the fun really begins! Maintaining a daily and weekly routine with regular mealtimes and work hours as well as weekly meetings and events like formal dinner; breaking the year into smaller chunks by celebrating occasions like birthdays and milestones like Midwinter (which we are all getting really excited about here!); striking a good work-life balance with efforts to separate the two (sometimes tricky, given that we live in our workplace); providing space for privacy; practicing good self-care with regular exercise and sleep; communicating with family and friends and home; and supporting each other, are all strategies that really help. If someone is struggling then they have access to the station doctor at any time, and to mental health experts via telephone.

Psychologically, the year in Antarctica doesn’t end on the expeditioner’s last day on the continent. The reunion and reintegration period after their return can be tricky to negotiate as both the expeditioner and those who have stayed behind at home will have changed, so preparing for that adjustment is also important.

So why do people come here? For the thrill of being in one of the most pristine, untouched and remote places in the world, to experience the grandeur of the environment, to challenge themselves, to work as part of a team with like-minded people, and to get away from traffic, insects, heat waves and debt collectors!

Go wild for life!

Speaking of the environment, we celebrated World Environment Day recently. This year the theme was wildlife. Katie, our Environmental Officer, organised an engaging and enlightening afternoon of education and entertainment. Expeditioners dressed up in animal themed costumes and displayed posters, craft projects and other items related to aspects of the environment. Katie and Jacob talked about their stint working for the Bureau of Meteorology on Willis Island off the coast of Cairns, and Adam talked about sustainable hunting in Alaska. Following the presentations we watched March of the Penguins, an excellent documentary about emperor penguins which was filmed near the French station Dumont d’Urville.

Sea icecapades

This weekend several trips were made out on to the sea ice, which was recently approved for travel. There are specific boundaries on the map within which we are allowed to travel, but the ice still has to be measured at regular intervals to ensure that it is definitely thick enough, as it can vary from year to year and even week to week.

Unfortunately the group on Sunday travelling south towards Browning discovered that the ice isn’t thick enough to travel far from station in that direction, but there are several places closer to home where it is well over 600 millimetres thick, permitting safe travel on foot, skis and quads. We even spotted a Weddell seal hauled out on the ice!

Midwinter swim and the role of the doctor

The expeditioners go through a comprehensive medical examination prior to employment to ensure that they are healthy and have no major medical problems that could get worse in Antarctica or which could pose problems during the long winter months when we are cut off from outside help. As a result I don’t have a lot of clinical work to do. I manage injuries and illnesses if and when they occur, but the bulk of my work is maintenance of the medical facility and preventative health. Every month all expeditioners have a brief medical examination, and I give them a dose of Vitamin D at scheduled intervals because it’s easy to become Vitamin D deficient during the darker months.

This month I’ve been performing specific midwinter swim medicals to make sure no one has any problems which would increase their risk of an adverse event due to the sudden immersion in the cold water during the midwinter swim which will take place next Tuesday, provided the weather is suitable and if people choose to participate. The temperature in the water is −1.8°C, which results in a cold shock reflex response similar to getting into a cold shower but multiplied! The reflex involves gasping and possibly swearing. We take extra precautions to prevent mishaps, such as tying a harness around the swimmer and providing a warm shelter for participants. I will be on site with my Lay Surgical Assistants (although it is extremely unlikely that we will be called upon).

The Lay Surgical Assistants are a group of four expeditioners who underwent a fortnight of basic training in Hobart prior to departure in how to assist during a medical or surgical emergency. Two of them specialised in anaesthetic nursing and two in surgical nursing. Every fortnight we have LSA training to keep everyone’s skills up, including my own! During these sessions we practice using equipment and running through scenarios.

Dr Rachel Hawker

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