SOUTHAMPTON MEDICAL SOCIETY
President: Dr Nigel Dickson FRCGP
A meeting of the Southampton Medical Society was held on the 2nd of November 2022.In the President’s absence the previous President was in the chair. The minutes of the last meeting were approved.
He introduced the speaker, Dr Matthew Dryden who spoke to the title “A penguin in the clinic - remote public health care for the Falkland Islands with occasional visits to check on the fauna as well”. He said the Falklands are so isolated that historically infections were only introduced from people on ships. In times gone by whalers brought in measles and diphtheria but in modern times cruise ships bring in Norovirus or HIV. During the early days of the Covid pandemic the islands closed their borders and cruise ships were excluded. There was a small outbreak amongst army personnel but it didn’t reach the population because the army cases were isolated promptly. In April 2022 the borders were opened and a wave of cases followed. However the population had all been vaccinated and no-one was hospitalised.
The Falklands consist of two main islands and numerous small ones. Our speaker had visited most of them over the years. They team with wildlife. Port Stanley is quaint, like a 1950s village on a Scottish island. It has two memorials of note; one to the WW1 battle of the Falkland Islands and another in memory of the 20,000 whales killed in the past. There are two mountains, Mts.Tumbledown and Kent. The final battle of the 1982 Falklands war was on Mt Tumbledown.
Stanley Sound has picturesque wrecks but there are still mines on the beaches there, and elsewhere, that were laid by the Argentinians during the Falklands war in 1982. Neither penguins nor sheep, which roam freely, set off the mines. Elsewhere the mines are being removed gradually by Zimbabweans. The British army is based in the Mount Pleasant Barracks near Port Stanley. Most travel on the islands is by plane.
The population is 3,000 and 75% live in Port Stanley. The islanders make most of their money out of fishing which is tightly managed. There is a new 28 bed hospital which is staffed by 3 GPs and a visiting surgeon. Trauma represents a large part of the work with frequent RTAs, due to the extremely large drainage ditches alongside the roads, fishing accidents and even wounds from elephant seal bites. Major trauma and obstetric problems have to be flown out to Chile or Uruguay or Southampton General Hospital. The list of medical problems is large: Elderly care, mental health, alcohol, diabetes, TB, hydatid disease are all endemic. Introduced infections are of concern too such as HIV, STDs, MRSA, ESBLs, Norovirus, Covid and the possibility of Zika virus and Ebola being brought in.
X-rays are available in the new hospital not only for humans but for egg bound penguins, injured dogs, a land mine to see if the detonator is still present and even fish.
Dr Dryden’s role covers advice for treatment, food and water standards, infection control policy, antibiotic formulary and policy, immunisation and microbiology services.
He is concerned to try and break the links of hydatid disease. Dog tapeworms are frequent as the dogs eat sheep offal lying around and humans stroke the dogs. Somehow the links have to be broken. Port health is another of his responsibilities with which come a variety of problems. In 2012 a diplomatic incident was caused when a cruise ship carrying 3000 passengers coming from Argentina arrived with a large outbreak of Norovirus. It was decided not to let the passengers ashore which was taken as a snub by the Argentinian government. Then a naval ship with a case of TB arrived and it had to be decided whether to let the crew ashore or not. The MOD insisted they did due to the crew having served a long period at sea. There were 27 close contacts and 250 BCGs were done and everyone had to fill in a questionnaire. Five cases of persistent cough were discovered which had to be X-rayed.
Dr Dryden finished with a gallery of wildlife photos which highlighted the very rich natural environment in the Falklands.
The President then thanked Dr Dryden for his excellent talk.
There being no other business the meeting was closed.