Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Running the Sahara: From Libya to Egypt

by Jeffrey S. Peterson, MD

Contrary to what one would think, because of our government and military-security escorts in Libya, we were likely the safest we had been in all six “Running the Sahara” countries. Amazingly, the runners continued to pound out consecutive, 50-mile days.

Like the Niger Army solders, however, our new escorts also needed medical assistance, although at first—before I could provide treatment—they would ask me to show them the protocol in my Field Guide to Wilderness Medicine, by Paul Auerbach, MD. Eventually, trust was gained, and once again I was providing sutures, antibiotics, diabetes treatment, joint wraps, and—as always—treatment for eczema and more plantar warts, the latter which seemed to be a regional epidemic.

In Libya, while continuing to treat the runners' severe tendinitis, the psychological stresses created by 80-some successive days of extreme exertion and sleep-deprivation now reared their hydra heads. One was bottoming out psychologically. Another—the worst of the tendinitis sufferers— was worried about being left behind and wondered briefly about quitting. And the other member of the trio, after nearly quitting in Niger, had virtually retreated, talking to no one. This led to a fracturing of the running team’s dynamic, and soon the three were running on opposite shoulders of the roads, with one alone on one side and two runners on the other. Still, every day they continued further.

Six weeks later, by the time the runners had reached the Egyptian border, their bodies and systems were near full collapse. Tendinitis was now rampant, each of the three runners were now actively asking for strong pain medication that I had brought along in reserve for the last two days or for any severe injuries such as fractures and life-threatening emergencies.

Egypt brought with it a greater population density and far more crowded roads (meaning more vehicle threat to the runners). In addition, it had a robust security presence that implied a greater threat to us, as Egypt has seen aggressive anti-Western attacks on visitors in recent years.

For several weeks, the runners had been debating the possibility of running non-stop for the last week, treating the final, Egyptian segment as one long seven-day push. While the runners kept suggesting this scenario, Chuck and I felt they neither had the strength nor endurance left to treat the Egypt leg like an Adventure/Endurance Race, going 24 hours a day to the finish in a predicted time of seven or eight days. Additionally, we questioned whether the support crew also had the physical or psychological reserves to provide round-the-clock care. Thankfully, family and friends of the runners arrived to provide support, and generously and selflessly pitched in.

This support was doubly important, because the runners were near both physical and psychological collapse. Two men also continued to have gastrointestinal problems, and had been receiving intravenous hydration every few days for weeks. This gastro-intestinal condition also had left them with chronic diarrhea and abdominal fullness that made it difficult for them to ingest enough oral liquids to stay hydrated.

As they entered Egypt, one runner had blisters on his feet, but was responding well to care. Another runner, who had preferred self-care of his foot blisters throughout the trip, had developed a severe blister on the ball of his left foot. Within 48 hours of running a stepped-up schedule of 100-kilometer days, the blister on the ball of his left foot developed into a severe abscess with cellulitis, which covered the entire sole of his foot. I insisted on placing him on antibiotics, which he had previously refused.

More in Part 6…

photo by Jeff Peterson

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.