FREC / MIRA Level 3 Training by IQARUS

Tim Ansell and tarantula undergoing training

My new friend ‘650S’. In honour of the McLaren Spider of the same name

An Englishman, a Welshman and a Scotsman walk into a bar

I’d been looking for a while for an excellent first aid course which would focus on dealing with medical problems in areas far from hospitals or clinics, so as to be better prepared for my travels in Africa, and a chance meeting in Dubai earlier in the year led to my finding just that. I had bumped into Dai Jones during a night out with a Scottish friend in February, and when he heard me talking about my plans, he introduced himself and explained that he had been the medical advisor on the “Long Way Down” video featuring Charley Boorman and Ewan McGregor. As a consequence he had good knowledge of the region, useful contacts, and a lot of advice he could give me. A few days later he came round to my office to discuss my adventure in more detail and I learned that the company he works for, IQARUS, regularly runs training courses for expedition medics, for journalists heading to hostile areas, for people working offshore, and many others.

First Response Emergency Care / Medicine In Remote Areas     Level 3

The ongoing delay to my departure from the UAE (there is, finally, light at the end of the tunnel but I’ll write about that in more detail in a later post) meant that I was still in Dubai over the summer, so I made a fairly late decision to attend their FREC / MIRA Level 3 course in the UK in August, though I took some convincing by Dai and a number of his colleagues since I was not at all sure I could cope. IQARUS’ own website describes the course as an “industry-leading programme specifically designed for medical practitioners operating in challenging environments.” which will “challenge the most seasoned remote/hostile environment/expedition medic. Students who pass the course will leave with updated and new skills as well as 2 accredited certificates from QUALSAFE and the ROYAL COLLEGE OF SURGEONS EDINBURGH respectively. The course has been designed by Industry and Special-Forces veterans”.

Perfect then, for a non medically trained guy who doesn’t like to watch ‘Casualty’ in case they cut someone open!!

See the IQARUS video below to give you an idea of what it was I signed up for.

Who dares, wins

So as I walked into IQARUS’ training centre in Hereford (their staff are all former Special Forces medics – there’s a reason they’re in Hereford….)  I was very nervous to say the least. Little did I know that just four hours later I’d be performing an emergency tracheostomy – I felt pretty queasy at first, thought I might be going to throw up as I watched the demonstration, then remembered I was surrounded by ex military guys from the world’s most elite fighting regiment and figured I’d better man up! Getting that operation right first time certainly boosted my confidence and over the course of the five days I learned, and put into practice,  more about remote medicine and patient care than I could ever have imagined possible. The list below shows just SOME of the topics we covered – the amount of coursework (and revision at night, and in the early mornings before going to the training centre) was quite incredible.

– Roles/Responsibilities of the remote medic
– Catastrophic haemorrhage management
– Advanced airway management including surgical airways
– Chest injury management
– Shock management including sternal intra-osseous access
– Management of fractures/dislocations/sprains/strains
– Minor injury management
– Intermediate life support of adult/paediatric/infant/third trimester pregnant patients
– Altitude and Polar medicine
– Jungle and Desert medicine
– Poisons
– Burns & scalds
– Remote pharmacology
– Triage and mass casualty incidents in the remote setting
– Prolonged fieldcare
– Bites & stings (with industry experts and live specimens)
– The most immersive moulages currently available in the UK

The ‘moulages’ are realistic training exercises carried out in the “High Street” which is within the IQARUS’ facility (see my video) and also in the immersive suites which simulate desert, arctic and jungle environments. This means I was dealing with situations not in a nice clean, air conditioned training office, but on rough, sandy ground, or on the jungle floor with a river running nearby for example, forcing me to deal with environmental risks and problems, as well as the patient’s medical condition and safety.

Testing, testing, 1,2,3

There were also four written tests to complete and on the last day, another moulage, which was evaluated to ensure I was putting into practice what I had learned. I had signed up for the course with a view to simply being a little better prepared in Africa, but I have to be honest and say that the relief, and feeling of achievement, when I was told that I had passed the course, was quite immense. I found the whole thing very challenging, but deeply rewarding, and I would now have a great deal more confidence in being able to cope – and offer genuinely useful assistance – if confronted by a medical emergency or road traffic accident for example.

If, as I did, you believe you would benefit from rather more advanced training than your average one day first aid course, I cannot recommend the training offered by IQARUS highly enough. I consider the money I spent on the course, the flight back to the UK and the local accommodation, to be exceptionally well spent, a genuine investment in my own well being and safety, and that of others around me.

The video below, other than the intro, was recorded just minutes after I had completed the course. I don’t think I realised just how excited and ‘pumped up’ I was at the time, so I apologise in advance for my motor mouth, especially during the first interview with Andy Fraser, who doesn’t get a word in for several minutes. Sorry Andy!

Tiger, tiger, burning bright

Sophie Sorella putting the finishing touches to T-24

A lot of people have questioned my choice of cabin colour for TTT over the last few months, with comments ranging from ‘when are you planning to put the top coat on’ to ‘it looks like a prison van’ – and a couple were less polite than that! However the simple reason I chose, what I agree is a fairly non-descript unobtrusive colour, is precisely BECAUSE it doesn’t stand out. The idea is that it just doesn’t draw attention to the vehicle, it hopefully will blend into a blur of delivery trucks and refrigerated vans on the road and doesn’t scream ‘look at me, I’m an overland truck full of camera gear and laptops”

For the same reason, I have decided not to decorate the cabin exterior with images of globes, African wildlife, compasses etc, as so many overlanders choose to do. For sure I can’t completely hide the fact that it’s a living cabin – any time I’m parked up in a town or outside a roadside café, that fact will be obvious to anyone walking by, but the aim is that when I’m driving down the road, even if TTT isn’t going to completely disappear, at least it won’t seek attention.

But that did leave me with a problem, namely that if TTT is to be my home for many years, I really wanted to personalise it in some way, ideally with some imagery which had meaning to me. I also wanted something which others might find of interest, maybe to strike up a conversation, or to distract an officious customs officer for long enough that he won’t bother inspecting the whole vehicle for an hour. So I hatched a plan to have a painting, inspired by a favourite photo of mine which I took of a male tiger in Ranthamhore India, in 2010, crafted onto the main door of TTT. Whenever I’m parked up at a campsite that door will be open much of the time, so I knew anything painted there would be highly visible.

Sophie Sorella by TTT in my warehouse in Dubai
Sophie by TTT in my warehouse in Dubai.
I am very lucky that I know – in fact, am related to – an incredibly talented wildlife artist by the name of Sophie Sorella, who is originally from the UK but now lives in Queensland Australia. Sophie spent two years traveling around Africa herself, and attended a wildlife painting masterclass in Ranthambhore several years ago, so I knew she would be the perfect artist to add a not just a splash of colour but a genuine work of art to my truck. By good fortune Sophie was traveling through Dubai on her way back to the UK recently, so in return for board, lodging, wine and unlimited swimming pool access, she kindly agreed to put her considerable skills to good use on TTT.

The original plan was to paint the door in situ, with the truck parked inside a warehouse (for shade) at my company office in Dubai. Although on Day 1 Sophie drew out the outline sketch there and started to add the first flourishes of colour, it soon became clear that in temperatures of 42C and at 90+% humidity, not only was Sophie suffering, but the acrylic paints she was using were drying almost instantly on the GRP surface, so she was unable blend colours or make the brush work for her the way she wanted.

Part finished painting, with the door removed for Sophie's comfort!
Part finished painting, with the door removed for Sophie’s comfort!
Clearly she couldn’t continue that way, so the following morning I removed the whole door, transported it to my house, and set it up on a temporary easel made from a folding ladder and a couple of bits of timber. Now Sophie could work in air conditioned comfort, and the paints started behaving themselves! After a total of 5 days of work (less a couple of dips in the pool and nights out on the vino), the amazing painting you see here, was complete. I am absolutely delighted with the image – if you think these photos of it look good, please trust me when I tell you that if you see it close up, the detail and intensity of the painting are even more phenomenal. It has already received a number of complements from my friends and I am quite sure will continue to do so as I travel. If you would like to see more of Sophie’s work, please go to her Etsy page here. In amongst the paintings of kookaburras and cockatoos, you’ll see that she also decorates a mean Texas Longhorn skull !

TTT Tiger door
TTT now has its very own, magnificent tiger guarding the door
Incidentally, wildlife photographer and owner of the Ranthambhore Bhag hotel Aditya Singh, tells me that the subject of my photo / Sophie’s painting is a tiger formally identified as T-24 but known locally as ‘Ustaad’ which in Hindi means ‘guru’ or ‘teacher’, particularly of music. Ustaad was the first tiger I ever got truly close to, to photograph, and was clearly a beautiful, powerful presence in the Rathmbhore reserve. I was blessed to be able to see him in his natural habitat since five years later, Ustaad sadly killed four villagers, who were (probably) gathering firewood inside the reserve, which they are entitled to do, but clearly is not without its risks. Sadly Ustaad is now kept in an enclosure to prevent a recurrence, so I’ll just have to make sure his image enjoys plenty of freedom on my travels.

Motorcycle license obtained – now I’m learning to ride!

Tim in the desert on a KTM 500 EXC.

A few months ago I realised that it would make sense if I was to go out and get my motorcycle license. In Africa, sooner or later I was likely to want to rent or borrow a motorcycle, either to join a group of biking travelers for a day or two, or simply because there might be one I could borrow to nip into the nearest town or city. That’s got to be easier than driving a seven metre long truck into town, when all I want to pick up is some provisions, or a visa for example.

So I booked up for lessons at a school in Dubai near my office. Frankly the eight hours of ‘lectures’ I had to attend were truly awful, with training videos obviously stolen from both UK and Australian training schemes (so the vehicles were on the other side of the road to the way we drive in Dubai – very helpful if you are just learning!) one video taken from a UK comedy show (No, I am not joking) which was full of obscene, profane language from start to finish (it was supposed to highlight the dangers of driving when angry….go figure) , an instructor whose English was so poor I could barely understand him – despite the fact that this was the “lessons in English” class – and instructions for road use which were downright dangerous, stupid and just plain wrong!

Having taken the subsequent ‘Knowledge Test’ I was then entitled to learn to ride, and I’m sorry to say that with only very limited advice (ha!) from my instructors, I was a bit slow on the uptake. Specifically my clutch control just wasn’t very subtle – I guess 35 years of using my left foot to control the clutch had not left me with much finesse when it came to using my left hand instead. Still I eventually got the hang of it and passed the two handling skills test and the road test first time, so was finally able to add Motorcycle to my Light Vehicle and Heavy Truck licenses.

But I know that obtaining a license is NOT the same as learning to ride – it’s just the first step, so the first thing I did once I’d passed my test was to sign up for some off road riding lessons. My work as the official photographer to the Emirates Desert Championship means that I’d plenty of contacts with the MotoX riding community here, so I contacted Sam Smith of Big Red Motorsports and asked him for four hours of one to one instruction. You’ll see from the video just how I coped – the difference between my first few minutes of nervous riding, and my belting through rough tracks and the dunes just 90 minutes later, is clear to see.

My Thanks to Sam Smith, but also to my business partner Ian Barker for the loan of his Go Pro camera, and to Graeme Chart, my drumming tutor, who put together the great music track you’ll here on this, and all future videos I make for this page.