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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: The Trip Begins


Allow me to introduce the first guest blogger at Medicine for the Outdoors. My good friend and colleague, Dr. Jeffrey S. Peterson, is an Assistant Professor of Surgery in the Division of Emergency Medicine at Stanford University Hospital. He is also the Founder and Sports Medicine Physician at Innovative Sports Medicine in Mountain View, California, and is a Medical Specialist Instructor of Urban Search and Rescue for the State of California Office of Emergency Services, as part of the Federal Emergency Management Agency. Jeff has long had a great interest in wilderness medicine, and in particular, athletic events conducted under challenging environmental conditions. In 2006 he served as a Race Physician for endurance races in the Atacama desert of Chile and the Gobi desert in China. An avid triathlete, he personally has completed two Ironman triathlons. Jeff was asked to serve as physician for the recent Running the Sahara event, in which three runners ran for 111 days through Senegal, Mauritania, Mali, Niger, Libya, and Egypt, covering more than 4,300 miles (6,920 kilometers). Jeff graciously agreed to share a bit of his diary with us, which will be presented here in six installments.

RUNNING THE SAHARA, by Jeffrey S. Peterson, MD

Part 1


On November 2, 2006, a team of three runners stepped from the Atlantic Ocean and onto the beach at St. Louis, Senegal. Their intention was to run all the way across the Sahara desert and end at Suez, Egypt, in hopes of publicizing the water needs of the people of the Sahara to the larger world. Water in the region is running out - wells today have to be dug as much as 10 times as deep as in the past, due to a rising population and more industry depletion of the Sahara’s ancient and virtually un-recharging aquifers.

This expedition was followed by a film crew, to be made into a documentary film. I was the physician for the runners, their support teams, and the film crew. Once acclimatized, all three runners planned to cover 75 to 80 kilometers (49 to 52 miles) each day. As their physician, I was part of a larger support team that allowed the runners to concentrate on the hard work of logging their daily mileage. For all involved, the task was prodigious, and I’m happy to report that all three runners - Charlie Engle (44 years old), Kevin Lin (31), and Ray Zahab (38) - succeeded in their 6,920 kilometer (or 4,300 mile) quest.

Prior to departure, everyone was properly vaccinated and immunized for hepatitis, typhoid, tetanus, diphtheria, pertussis, and yellow fever. Malaria prophylaxis was provided, in our case Malarone, as all four varieties of malaria exist in West and North Africa. Still, several of the Africans providing services for the expedition had to be treated for malaria during the trip, using a three-day protocol of 4 Malarone tablets taken orally. In every instance, the treatment was successful.

Beginning in Senegal, extremely unhygienic conditions on the starting beach (human excrement and dead animals littered the sand), plus a mid-autumn heat wave that the runners were slow to acknowledge, nearly ended the run before it even began. Multiple film-crew members were treated for heat exhaustion.

In order to protect the runners and the expedition from succumbing to the heat, after the fourth afternoon I issued a medical edict: No running from 11AM to 4PM. My pronouncement resulted in a near-mutiny from the runners. It was on that day that I looked at expedition leader Donovan Webster, and simultaneously we said, “Looks like we’ll be home for Thanksgiving.”

Yet, remarkably, the edict held, and within days the expedition began to find its rhythm. On Day 10 of the trip, the runners notched their first 80 kilometer stretch, following proper acclimatization and a new schedule: wake at 4 AM, eat breakfast, beginning running at 5AM for roughly 50 kilometers, break for lunch and a rest, and finish the day’s run in the late afternoon and evening.

By then, we had entered Mauritania, where I continued to treat heat-related illness, mostly for Kevin Lin of Taiwan, who was not accustomed to these scorching conditions. Eventually, I was forced to provide twice-daily intravenous drips of normal saline over three days to relieve cramping and severe dehydration.

More in Part 2…

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About the Author

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

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