Wilderness Treatment of Severe Infection: a First Hand Account

May/June 2012 ISSN-1059-6518 Volume 25 Number 3


While I was recently back in Zambia at Overland Missions teaching another Missionary Wilderness First Responder course as part of the Advanced Missions Training course that they do twice a year. I caught up with Mariel and after many hugs she told me this story and showed me the bone fragments from his finger, which she had saved for me to examine. I asked her to please write down this marvelous event, so we could share it with our readers.


Mariel is a staff member and one of the expedition leaders for Overland Missions based at Rapid 14 on the Zambezi River in the village of Nsongwe, Zambia. She is a great example of why we do what we do at SOLO. She recognized a life-threatening infection and applied the skills that she had been taught in her Missionary Wilderness First Responder course that she had taken at the Overland Missions base in Nsongwe the previous year. She saved his life and I am sure she will see him again on her return trip.

Frank Hubbell, DO
Medical Editor
Wilderness Medicine Newsletter

The Path to Peter

by Mariel Brantley


Winter in Africa will always take you by surprise. Your mind has to slightly bend to equate cold and Africa in the same realm. However, no matter how long it takes you to catch up with the paradoxical weather, it doesn’t change the fact that come morning, you will struggle to get your blood flowing again because of the cold. It was day two of our expedition. We hit the dirt path at 9am and had no plan of returning until we found what we were looking for. Equipped with a team of five and one translator, we were searching for the unreached. We pushed ourselves to go faster, further, and harder than the day before. I knew we were finally meeting our goal when we found ourselves on the far side of the hills, delicately dangled in the balance of a broken log and four slippery stones while crossing one of the river beds.

If I had any doubt in my mind if I was awake, it definitely went away as we walked into the first village. As I stood there looking at the villagers, it was as though my sense of smell overpowered my sight. I immediately knew something was wrong. After all, the scent of decaying flesh is unmistakable. Before I could get the words out, I was already making my way toward a man standing in the back. I said, “Who is hurt here? Someone is sick. You sir, what is wrong?” The man looked up at me with the look of shame and fear.  I approached him and saw a dirty, tattered strip of cloth covering his finger and asked him to remove it. He slowly removed the cloth to reveal an extremely swollen and infected finger.  I asked his name and what had happened. The man said his name was Peter, then explained he had been in a fight and was bitten by the man who attacked him. He said that it had happened about two months prior. My eyes darted across every detail I could absorb like one of those rapid freeze frame shots you see in a movie. I observed the wound and could clearly identify the track mark of the infection trailing all the way up his arm, past his elbow and to the middle of his bicep.  Severe infection + closed wound + clear track line + raised body temperature = serious trouble. I looked up at him with a sense of urgency and said, “Sir, please, you must come with us to our camp.”

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Indo-Pacific Lionfish

March/April 2012  ISSN-1059-6518  Volume 25 Number 2

The INVASIVE Indo-Pacific Lionfish

 By Frank Hubbell, DO

Illustration by T.B.R. Walsh


While recently in the Caribbean, we became acutely aware of a major problem for the spectacular underwater world of the Caribbean Sea – the invasive Lionfish.


The problem is that Lionfish do not belong in the Atlantic Ocean or the Caribbean Sea. They are an Indo-Pacific predatory fish, and that is exactly where they belong – in the Indian and Pacific Oceans.


In the 1990’s, they were unintentionally introduced into the Atlantic, probably in the bilge water of ships returning to the Atlantic side of the world from the Indo-Pacific side. Today they have spread, as an invasive species, along the East Coast of the USA.  In addition, they can be found in the Mesoamerican Barrier Reef System and the wider Caribbean Sea.


A highly invasive species, they do not have any natural predators in these waters. In fact, in these marine environs, their only predator is we humans.




Pterois volitans and Pterois miles are the two species, out of nine, of Lionfish that have invaded the Atlantic Ocean and Caribbean Sea. They have multiple spines in their fins containing toxic barbs.


The toxin in these barbs is a complex protein mixture of neuromuscular toxins and a neurotransmitter, acetylcholine. It is the acetylcholine that causes the untoward effects on the heart.


Hazard to Humans


Because they are not an aggressive fish, they will not attack you. However, they still present a hazard to humans who handle a caught fish or step on a fish and are impaled by the toxic spines in the fins.


Injuries are not uncommon in the Indo-Pacific Oceans, with about 30,000 – 40,000 injuries beings reported annually. But, the envenomation is rarely lethal.

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Trichinella spiralis

November/December 2011 ISSN-1059-6518  Volume 24 Number 6

Somedays You Eat the Bear and Somedays the Bear Eats You


 By Frank Hubbell, DO

EMS call: Your squad is asked to respond to the home of a 35 year old male who states that he is very sick and needs to go the hospital, as he is to weak to drive himself.

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The problem is simple: ticks are little cesspools, and they can spread a wide variety of potentially serious illnesses. Ticks are the leading cause of insect vector-borne disease in the USA and second only to mosquitoes worldwide. In fact, 95% of all insect vector-borne diseases in North America are spread by ticks.


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