Page 65 - RADC Bulletin 2021

ACHIEVEMENTS
Academic Diploma in Travel Health – Military Healthcare in a Wider Context
Lt Col A Thomas
Having completed the Diploma in Mountain Medicine in 2008, and the International Mountain Leader qualification in 2015, I have been providing pre-expedition health advice and medical preparation to those departing to the Greater Ranges. However, being ‘a dentist’, I recognised the need to keep up to date to ensure I was providing up-to-date advice and begin to bring in relevant references to support evidence- based recommendations. In short, I was yearning for a ‘top up’ course to consolidate my knowledge, give me confidence and hopefully widen future career opportunities.
Whilst it had been on my Personal Development Plan for many years, the opportunity had continually slipped by. However, in early 2020, COVID-19 struck, and Public Health England gave instructions for dental facilities to close and urgent care dentistry to be available only, due to the potential risks of transmitting the virus to staff due to aerosol generating procedures. My role changed dramatically, initially focusing on acquiring enhanced PPE and facilitating associated training, along with implementing new IPC recommendations across my dental practices. Later, it changed to monitoring COVID-19 trends, travel restrictions, testing and vaccination coverage in the Overseas and Operational spaces. However, it also freed up time
to look again at the Diploma in Travel Health. It also seemed wise to update my understanding of viruses, the host response, vaccination protocols, public and travel health advice.
I applied and, despite their initial caution of accepting a dentist, was given a place
on the course. Very soon, I was building on my clouded memory of immunology and vaccine preventable diseases. We were placed in small sub-groups of students from around the world. Each of the four modules were delivered by a blend of online videos and PowerPoint presentations, references to read, supplemented with online tutorials and knowledge checks. This was confirmed by 3-4 short written submissions at the end of each module.
For the first module, on Travel Vaccine Principles and Practice, focused heavily on vaccine-preventable diseases, each of us were tasked to record the advantages and disadvantages of a selection of vaccines, highlighting any risks and contraindications. We also had to write notes on a selection
of vaccine preventable diseases. We were then to add constructive comments to our
colleagues’ submissions, thus learning from one another. The collaborative products were then marked by the moderators.
The second module was on Health Governance and Safety in Travel Health. We looked more closely at the requirements
of providing a good travel health advice service, medicines management and maintaining cold chains. It exposed the problems with forced cultural practises such as human trafficking, modern slavery, and female genital mutilation. Again, this was assessed by theoretical case studies and collaborative working. Personal reflection began to take prominence, something with which I was less familiar than my doctor and nurse colleagues.
The third module focused on Malaria Prevention in Travel Health. Again, we worked through several theoretical cases studies, increasing in complexity, expecting constructive feedback from one another, before submission of stand-alone travel risk assessments.
The fourth module concentrated on other Hazards in Travel Health, such as long-haul flights, road traffic accidents, travellers’ diarrhoea, altitude, heat, and cold illnesses. Once again hypothetical cases needed to be risk assessed and submitted. The traveller’s objectives and relative attitude to risk also needed to be considered.
Whilst none of the course work directly contributed to the final marks, the submissions needed to satisfy the examiners that sufficient understanding had been gained prior to being allowed to sit the examination. This consisted of a one-hour ‘open book’ MCQ, to try to simulate a travel health appointment. A broad background knowledge was expected, but the ability to very quickly access a resource to answer the less commonly known facts was also
vital. Finally, there was a written submission of a reflective account of a ‘complex’ patient’s travel health risk assessment, with a comprehensive reference list to support the advice given. I selected a child traveller to Belize who would be living there for approximately 3 years. Bizarrely, I later came across a family in Belize who were having issues with accessing dentistry, who matched my case scenario exactly.
The timing of this online Diploma in Travel Health worked well for me, with
the moderators applying leniency when competing COVID-19 pressures meant a deadline would not be met. It has certainly helped me with my role as Overseas COVID-19 Liaison Officer and encouraged closer working with the Defence Global Practice (previously the Global Medical Support Cell) and RCD(Overseas). It has been a fantastic opportunity to broaden my knowledge again and I hope it may help open new opportunities for wider employment in the future. I recommend it to those working in general practice or for those thinking of working in travel clinics or overseas in humanitarian or expedition medicine.
RADC BULLETIN 2021 63