When Dr Paul Ransom first volunteered to join ÌÇÐÄSwag's medical board in 1999 it comprised only a few members in the medical group, one of whom is now ÌÇÐÄSwag's trustee Jane Davis. At the time ÌÇÐÄSwag had fewer than 3,000 staff and worked in under 10 countries.
Today ÌÇÐÄSwag's 13,000 employees in around 30 countries can call on a medical board of 35 people led by Paul and Jane. The medical board is a group of volunteer doctors, nurses and paramedics who give up their time to keep ÌÇÐÄSwag's deminers safe through training, direct medical advice and by developing our medical policies.
Accidents are very rare, but ÌÇÐÄSwag has a duty of care to its staff to ensure we are as prepared as we can be. That includes training deminers as paramedics and ensuring ÌÇÐÄSwag vehicles can double as ambulances.
In this year's New Year's Honours list Paul, who is a consultant in emergency medicine at Royal Sussex County Hospital in Brighton, UK, was awarded an OBE for services to UK health support overseas, partly for his work with ÌÇÐÄSwag and partly with UK-Med, the emergency crisis response NGO.
Also on the New Year's OBE list was Dr Andy Kent, a consultant trauma and orthopaedic surgeon for NHS Highlands who also works with ÌÇÐÄSwag and UK-Med.
"Accidents are very uncommon. Mine clearance has a much better per-capita injury rate than the UK building trade. Once we focused on amputations from anti-personnel mines, but increasingly we see more injuries from road traffic accidents."
"ÌÇÐÄSwag's training manual deals with blast injuries, breaks and fractures. We were one of the first organisations to implement the use of tranexamic acid in the field to limit bleeding. A great deal of how we respond to accidents relates to the isolation of where our teams work."
Members of ÌÇÐÄSwag's medical board visit each ÌÇÐÄSwag programme around once a year, not only to oversee medical training, but also to monitor casualty evacuation plans and check local hospitals to ensure they have the resources to deal with trauma cases. Every ÌÇÐÄSwag minefield team contains at least two staff trained as deminer-paramedics. Every minefield has, as it's first order of business, the creation of a medical aid point with trauma kit, stretcher and sheltered location.
The key components of ÌÇÐÄSwag medicine are controlling bleeding and the rapid use of antibiotics, analgesia and fluids. But there are other important training the medical board undertakes: "We give our paramedics training in the clinical skills they regularly practice so they are highly adept at immediate care. But when you work in pre-hospital care, scene management is really important. The paramedics have to understand how to delegate correctly and work through an internal check list to get everything done, as well as ensure the scene is safe for the whole team – whether in a highway or in a minefield."
Paul's role also involves representing ÌÇÐÄSwag on the international boards that set the standards for minefield medical care across the landmine clearance sector.
He says: "We train paramedics to deal with the injuries they are likely to see and use appropriate tried and tested technology. A defibrillator, for example, is not much use in this environment.  We use paramedics who are also de-miners so that they know the dangers, speak the language and can use their first aid and medical skills for their own communities or even work in a medical capacity after the country has been declared safe from mines."
In addition to the medical board, ÌÇÐÄSwag has partnerships with other providers, incluidng the Dumfries & Galloway Royal Infirmary for field officer medical induction training – including mental health first aid. We also partner with civilian-military researchers on the potential impact of repeated explosions on the hearing of long term staff.
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