World Extreme Medicine News

When many people consider humanitarian aid in disaster situations, they think about the media’s coverage of the crisis: people being rescued, aid packages being delivered, shelters being built. But what happens when the cameras leave?

Peter Skelton, a London-based Physiotherapist and Rehabilitation Project Manager with Handicap International, a charity which remains in a disaster-affected region for months after the public’s attention has moved on tell us what it’s like.

Peter specialises in helping people injured during emergencies, often in countries with limited resources and support frameworks and through his work with Handicap International, he has worked alongside disabled and vulnerable people in situations of poverty and exclusion, conflict and disaster. Peter has previously spent 10 years combining physiotherapy with medical anthropology (the subject of his first degree), balancing work in the NHS in London with projects in Africa and South East Asia.

Peter’s current role involves working in partnership with UK-Med and the UK Government to train and integrate rehabilitation professionals into the UK Emergency Medical Team – a team of UK-based health professionals who can be rapidly deployed in response to global emergencies.

Speaking about his work, Peter said:

Most people’s experiences of physiotherapy in the UK come from their own direct interactions with a physiotherapist, normally because of a sports injury, back pain or a similar issue. That experience is completely different if you’ve had a major accident such as a spinal injury or an amputation when you will see a very different side to physiotherapy.

In many ways, the work we are doing in disaster situations is not markedly different from what we would do in major trauma centres within the UK. The difference is linked to the resources we have available, and the situations in which people find themselves.

Invariably, in the UK when you provide treatment, you know that people can get access to the follow-up care that they need, you know that they’ll have support from social services if they need it, and they’ll generally have a supportive family around. There are all sorts of systems set up to support people while they are unwell and throughout the recovery process. In a disaster zone, you generally don’t have access to these.

We aren’t dealing with disaster injuries in isolation. Frequently, patients will have not only experienced a catastrophic injury, but may also have lost their home, their business, family members, friends. The country itself may also be experiencing severe upheaval so they are unlikely to have the same social support that we expect to be available in the UK.”

Peter Skelton spoke at the 2018 World Extreme Medicine Conference focusing on the issue of psychological first aid. The Psychological First Aid training package was developed by the World Health Organisation, and is targeted at anybody that is helping out in response to a disaster: humanitarian aid workers, medical professionals and even laypeople. It is designed to give a basic framework that they can use to deliver immediate support to people in disasters.

Peter said:

There is a misconception that the victims of disaster are always traumatised. Actually, my experience has been that people in disasters are incredibly resilient. What they really need is access to things like shelter, food and water, and if you can help them to meet those needs then they’re going to be fine. It’s only a much smaller number of people that require any specialist intervention and psychological first aid comes in one level below that.


Mark Hannafordfounder of World Extreme Medicine, the conference organiser added:

Peter is a hugely respected figure on the UK humanitarian scene, and his perspective is of particular interest because of his experience of the long term rehabilitation of disaster victims.

World Extreme Medicine was founded around a campfire in Namibia, and we coined the phrase ‘World Extreme Medicine’ as an umbrella term for all practices of medicine outside of a clinical environment, whether it is pre-hospital, disaster and humanitarian, endurance, sport, expedition or wilderness medicine.

Our message is that there is a great diversity of careers in medicine, and that traditional hospital environments are not the only option for a fulfilling career. To put it into a layperson’s terms, there’s never been a more exciting time to work in medicine.

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