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 the Niger-Libya Border

by Jeffrey S. Peterson, MD

In Agadez, Niger—roughly the center of the journey—the runners were doing magnificently, still logging their usual mileage with little in the way of great difficulty beyond the fact they were running two marathons a day. It had become a rare day when they didn’t get in their 80 kilometers, and the need for medical care was present, but not terribly demanding.

Because we were now headed on a more northward track toward Libya, we picked up an 18-man Army of Niger attachment to provide security, owing to smuggling and rebel activity in the region. The security detail members had many of their own physical problems, and I was more than happy to provide medical care to them, out of respect to the hard lives they lead. Their diet was minimal, and their clothing not completely suited to the boiling temperatures of the day and the freezing cold nights. Across the group, I treated everything from broken teeth to cutaneous anthrax, eczema, stomach ulcers, conjunctivitis, and plantar warts. They kept me busy, but more than returned my care by keeping us safe from bandits.

A week-long sandstorm buffeted the group, and because the runners were now starting to run a long, gradual, uphill grade for hundreds of miles off-road and overland, guided by GPS with all of the running across deep and soft sand, tendinitis became a serious issue for two of the runners. To treat this more-severe pain, Chuck Dale increased his concentration of massage to the affected areas, while I began to prescribe short bursts of prednisone at different times.

As we exited Niger for Libya—being released from the country at the guard station at Madama, which has since been assaulted by rebel troops with 13 casualties and 47 hostages taken—we entered Libya, a wealthy and oil-rich nation where good, flat, smooth roads stretch to every border.

Before we could enter Libya, so that the runners could enjoy the firmer footing of paved roads, two things happened. As we approached the border-guard station at Toumou, we heard on the BBC World Service radio program that six Bulgarian nurses and a Palestinian doctor had been sentenced to death (for a second time) in Benghazi, for allegedly “infecting” several hundred Libyan children with HIV. There was clearly a lot of internal national politics about this, but it didn’t make our group, as foreigners - and especially me as a health-care provider - feel any safer.

Then, literally at the border guard station, as I was finishing my treatment of the Niger Army soldiers before they returned to their base, I was informed that one of the Libyan guards was sick and required medical attention. Given the fact that I’d just listened to the BBC, the prospect of this made my heart race and stomach churn, and tightened several other muscles in my body…to say the least.

Fortunately, the guard had severe bronchitis trending toward pneumonia, which would respond to an inhaler and the antibiotics we were carrying. For this, I was rewarded with a glass of screamingly hot, sugary, and mint-infused tea, and a firm and sincere thank-you handshake.

More in Part 5…

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About the Author

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