Wilderness medicine in South America and Africa: Dispatch from WMI Instructor, Mike Moxness

Posted by: Leslie van Barselaar on 10/15/13 4:52 AM

I am a registered nurse living in Anchorage, Alaska. I spent much of my career in the emergency room. I got my Wilderness Emergency Medical Technician (WEMT) from NOLS Wilderness Medicine Institute (WMI) back in 1999 in preparation for a tour of duty up with the mountaineering patrol on Denali in 2000. I started teaching for WMI in 2001, mostly WEMTs with a few Wilderness First Responder (WFR) courses up here in Alaska.
Mike Moxness
Mike Moxness and Daniel DeKay, WMI Instructors, and Matt Medich, WFR, in northwest Nicaragua 2011
About 5 years ago, I started signing on to medical teams going to developing nations, and once I started, there was no looking back. I've worked in Guatemala, Nicaragua, Honduras, Uganda and Kenya on multiple occasions. I am typically a member of a small expatriate team sent in to support local medical staff during emergencies. My last two trips have been to Uganda at refugee camps along the border with Congo. In January, I'll be back in Honduras, teaching at a rural hospital.
My work has been with Medical Teams International, located in Portland, Oregon, and MEDICO, located in Austin, Texas. There are quite a few good outfits out there, but these two have been good fits for me. I've also been seconded to World Concern (on the Somalia border) and worked in multi-organizational teams with Médecins Sans Frontières (MSF) and Humedica.
Mike Moxness
Kenya-Somalia border in 2012
The wilderness medicine model is extremely useful in these assignments where resources are few and problems are many. Wilderness medicine is a context of practice: improvised or inadequate gear, inconsistent or non-existent communication with outside support, challenging environments for patient and caregiver, and independent risk-benefit decision-making.