Remote Medicine Off the Coast of Southern China

Bird-FluI am currently deployed on a seismic research vessel off the coast of southern China. From a medical standpoint, this region presents many unique challenges to the remote provider. On this deployment, two particular areas require special attention: disease outbreaks and the overall quality of local medical facilities.

Prior to boarding the vessel, my schedule called for a few days ashore to obtain a Chinese visa. As always, the first step when deploying to a new location is to identify and research the diseases and health issues relevant to the area. In this case, the Avian Flu is of particular note as it has been widely reported for the past several years and—with this year’s recent outbreak—remains a top concern. A less obvious health concern is the appreciable spike in reported cases of hand, foot, and mouth disease (HFMD) over the past six months. While this virus is mainly seen in infants and children, a noticeable amount of adults have fallen ill and the number of reported hospitalizations has drastically increased. With these two health threats as a major focus, my crew and I received thorough pre-deployment education on prevention and treatment.

Another good reminder for any remote medical provider is to remember to check any and all reputable health bulletins. Shortly after departing for our project grounds, bulletins were released reporting an isolated dengue fever outbreak in the area where we had just been. The first cases were confirmed the day of our arrival. Together with Avian Flu and HFMD, dengue fever remains high on the differential diagnosis for any patient presenting with flu-like symptoms. While the outbreak is currently considered to be minor and the mosquitos were, thankfully, not much of an issue, the bulletin is a good reminder to monitor for symptoms.

In addition to disease outbreaks, this deployment also requires a working knowledge of the overall quality of local medical facilities. When putting together a medical evacuation plan, there are many different aspects that must be addressed. First, what type of medical infrastructure and capabilities exist onshore? Second, what is our access to these facilities in the event of a medical emergency? Third, do the closet hospitals meet accepted international medical standards; and, if not, how far do we have to go to reach quality care?

The above questions became particularly relevant shortly after my arrival in China. As part of the visa process, each person is required to undergo a medical exam at a local hospital. While doing so, it became readily apparent that the hospital I visited fell well below the accepted international standards with poor sanitation being the most obvious. Medical equipment, for example, was not disinfected between patients and few providers were practicing body substance isolation (BSI) precautions.

Fortunately, after thorough research, I determined that what I had witnessed was not necessarily representative of medical facilities countrywide. Several highly regarded facilities are within helicopter range of my vessel’s location, and they provide care that meets and exceeds international standards. With a few follow up inquires, our research was confirmed and we were able to establish acceptable evacuation plan in place.

After addressing and preparing for these key issues, I was ready to deploy. So far, all of our preventative measures seem to be working, and everyone remains healthy and hard at work. With a medical evacuation plan in place, we can rest easy knowing that we’re well prepared.