Running the Sahara | Crossing Mauritania
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: Crossing Mauritania

by Jeffrey S. Peterson, MD

Despite having on-the-ground assistance from the scientists at the Gatorade Sports Science Institute (who had joined us for the first seven days), I was reminded that there was no way anyone was able to physically train to run 4,300 miles at a pace of roughly two marathons a day; the training for that alone would begin tearing down an athlete. In our case, each individual athlete was either going to complete the run, or he wasn’t.

It was in Mauritania, despite vigilant hygiene on our part—including frequent use of alcohol hand wash, drinking only bottled water, triply-rinsed food utensils, and well-cooked and boiled food—that our team developed a significant and long-lasting outbreak of gastroenteritis, resulting in yet more dehydration. The malady would dog us for a month, circulating several times through the camp. Each bout of gastroenteritis and dehydration was treated with oral antibiotics and intravenous boluses of normal saline. It was during this time that, despite rigorous hygiene, I finally succumbed to the infection myself. Given the fact that there was no medical provider to start an intravenous drip and administer care to me, Chuck Dale offered to do the best he could with what I could teach him. Having taught many medical students previously, I had no problem with the mechanics of starting the IV. The only problem was that I had to teach him to do it on me and I felt horrible. Chuck was allowed three tries to get the IV into my vein. Being a fast learner, Chuck amazingly hit the vein perfectly on the third attempt. After aggressive hydration and rest, I was back on my feet and ready to take care of the runners and crew once again.

Having grown used to the incredible physical demands of each day—and staying constantly watchful of hydration issues—we now began a stretch of weeks characterized by remarkable progress. The runners had an amazing ability to adapt their strides to respond to repetitive stress injuries, and at the first sign of a developing problem, they would change their shoes as the initial bulwark against further injury.

Early hands-on intervention by trainer and massage therapist Chuck Dale included deep tissue massage and trigger point manipulation. In addition, a step-wise approach (modulated to the injury) of oral ibuprofen, acetaminophen, and topical lidocaine patches over ibuprofen cream —kept more complex repetitive motion damage at bay. Due to the knowledge and experience of the runners, plus the work of Chuck Dale and me, the runners didn’t experience any profound over-use and repetitive stress injuries until the last few days of their run.

Most of Mauritania was crossed on the Trans-Mauritanian Highway, a treacherous thoroughfare with narrow shoulder and speeding vehicles with drivers unaccustomed to hosting a trio of runners along its apron. Many close calls were witnessed on the road. For instance, at one point, Charlie Engle’s elbow was side-swiped by a passing vehicle, reinforcing the dangerousness of the route.

More in Part III…

photo by Jeff Peterso

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About the Author

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