The Origins

My name is Dr Matt Alwyn Edwards and I'm an emergency medicine registrar from London. I have been encouraged to start this blog to keep a record of this unique life experience - I am the current volunteer physician working for the AMREF (African Medical and Research Foundation) Flying Doctors based out of Wilson Airport, Nairobi, Kenya. It feels terribly presumptuous to believe anyone will want to read my musings along the way but if you are interested and you find yourself here, 'Karibu' or welcome in Swahili.

Archie McIndoe

A Bit of History...
    The story behind the origins and the inception of AMREF is truly inspirational and I encourage you to look online for further details. Back in the 1950s, three surgeons who had either fallen in love with Africa or flying or both, decided that they would try to find a way of providing much needed medical care to sporadic and disparate groups of people scattered around East Africa. These three men, Sir Archie McIndoe (yes, of the McIndoe forceps) Sir Micheal Wood and Dr Thomas Rees are really worth looking up and having a look at their respective stories.

"Sir Micheal Wood consulted the famous Dr Albert Schweitzer at his Leprosy Mission Hospital in Lambarene, West Africa. How, he asked, can we serve the 80% of rural Africans who live beyond the reach of urban medical fascilities? "Use the tools of our time," was his answer. Aeroplanes and radios were the tools of that time and became the framework of AMREF."

So in the foothills of Mount Kilimanjaro they began gathering support and flying out into the bush and hosting clinics and performing simple and lifechanging operations on cleft lip and palette, clubbed foot and even opthamological surgery for trachomas. In an interesting talk he gave about the history of AMREF Sir Wood said they knew that curative medicine was going to be of limited use in the bigger picture and that preventative medicine was the key. However few Africans at that time would see a doctor unless something was already causing a problem and by then it was probably too late, too expensive or too technically difficult to do much about it. So he started to see these outreach clinics (which people flocked to) as an opportunity to drive the bigger picture of public health and preventative medicine. A pretty clever concept and it started to work. Soon they were joined by an exceptional character, Dr Anne Spoerry or 'Mama Daktari' (mother doctor), who flew around the bush in her own little plane treating ailments such as gonorrhoea and administering vaccinations.

Dr Anne Spoerry

From there AMREF has gone from strength to strength with offices around the world and helping the people of Africa prevent and treat the diseases for which we in the developed world have probably forgotten even exist. (So when parents in the UK say 'I'm not vaccinating my child, I don't believe in it.' Come to a country where you cannot depend on the herd immunity of those around you and we will see

what you believe in then. Or 'I don't believe in modern medicine interfering in the natural process of childbirth.' Don't make me laugh. Sorry I digress slightly...) It was not long before the potential for medical evacuation became a clear and real possibility. So AMREF Flying Doctors Air Ambulance became a splinter-group  if you will, and starting bringing patients, often in critical condition, from politically unstable corners of Africa, back to Nairobi for specialist treatment. Dr Bettina Vedera took over as CEO and the Air Ambulance now operates as a company in its own right. It's 'not-for-profit' because the money it makes in profit from insurance, private companies and government organisations goes back into the AMREF charity itself. So in a way, a bit like using the 'bait' of the travelling clinics to actually get some larger scale preventative medicine done, the Air Ambulance organisation manages to help AMREF's bigger picture by demonstrating to the world how good a pre-hospital and retrieval service can be. Plus the planes are really cool.

Dr Bettina Vedera

Where do I fit in to all this...

   I've been interested in pre-hospital and remote medicine since I worked with the British Antarctic Survey back in 2008-2010 and since have become more heavily involved in expedition medicine while continuing my Emergency Medicine training. Along the way I've been lucky enough to work in the Amazon, the Himalayas and up in the Norwegian Arctic. I had never set foot on the African continent. Far too hot, far too many bugs.

Then one day an old colleague of mine (Dr Richard Crosthwaite-Eyre) said to me as we mused over a blood gas at the foot of a patient's bed, "Matt, how would you like to go flying around Africa picking up sick patients for a couple of months?" Then he told me about AMREF, outlined the story above (don't worry we had finished with the patient by then) and told me that they run a 'volunteer physician' program. He had secured a position with them but had had a slight complication. His wife had become pregnant and he could no longer go. His position was open and knowing I had a tendency to wander off and take opportunities when they arise (recently that has led me to be recruited as the physician for the first British Microlight Expedition to the South Pole in 2014. Weird how these things work out) he thought I might be interested.
To cut a long story short I took it and now I'm here, in Nairobi and I've started work. As a summary of the last few days - it's brilliant. I will share more in due course *

*obviously in the nature of medical confidentiality I will be very scant with much of the detail.