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Health and safety: Danger zone

Fieldwork often involves significant threats to safety.

Evolutionary biologist Christopher Dick was collecting seeds in the Brazilian Amazon when he was bitten by a fer-de-lance (Bothrops asper), one of the rainforest's most notorious venomous snakes. He and a field assistant were 1.5 kilometres from camp and 90 kilometres north of the city of Manaus. They had no mobile phone or Global Positioning System (GPS) device (it was the 1990s) and the supply vehicle wasn't due for two days.

Christopher Dick is well versed in the dangers posed by snakes on field trips. Credit: Jason Houston

Using a venom-extraction kit, Dick picked out some coagulated blood from the bite marks on his ankle. Then he walked back to camp. While he waited for an emergency pick-up, one local tied a piece of bark to his ankle, another offered to spit in his mouth and a third suggested that he drink the local alcohol. He declined the offers.

Arriving hours later at a small hospital, nurses injected him with anti-venom. Dick spent the night on an operating table under fluorescent light. Then he was moved to a bed in a roomful of people who had various tropical diseases. The bathroom had no toilet paper, no one had cleaned his wound and a nurse told him he would need to stay for two weeks to be monitored for secondary infections. He found a pay phone and hailed a cab so that he could join his colleagues in Manaus, where he slowly regained his health. When Dick returned home to Massachusetts several months later, medical tests revealed that he had three diseases, including German measles.

Dick recovered completely, but gained an appreciation of the risks that come with fieldwork in his discipline, and for the need to prepare for them in advance. “I want to go over all of the potential pitfalls and dangers and have plans available for contacting me or someone else who can help immediately,” he says of the graduate students at the University of Michigan in Ann Arbor, whom he plans to bring to Brazil next summer.

Opportunities to do research in the field attract many scientists who are eager to experience adventure while making discoveries. But travelling to foreign lands and working in remote places carry risks of injury and illness that are often difficult to predict and are challenging to navigate.

There seems to be no central database to log illnesses, injuries and deaths among scientists in the field. And many mishaps are likely to go unrecorded because researchers either don't see the need to report what happened, fear putting their funding at risk or want to avoid the hassle of the reporting process. You cannot prepare for everything, and it's important to accept that some accidents, such as those triggered by freak occurrences, are unavoidable, just as in all workplaces. But researchers who travel into the field recommend preparing detailed analyses of, and action strategies for, everything that could possibly go wrong — from riots to malaria. If calamity strikes, a sound plan could make the difference between tragedy and escape (see 'Be prepared').

Advance planning

Cultural anthropologist Christopher Kovats-Bernat, an explorer-in-residence with the National Geographic Society who lives in Allentown, Pennsylvania, says that advance knowledge of potential dangers in the field would have helped him to avoid and deal with them better when he started his career. He began studying violence among children in Haiti during a particularly bloody period in 1994. Kovats-Bernat's research on street children and armed gangs has taken him into a Haitian ghetto called Cité Soleil, once described by the United Nations as the most dangerous place on Earth. He developed a traumatic brain injury and partial hearing loss when his shoulder was used as a gunrest, and got shrapnel lodged in his eye during a gunfight between child soldiers.

Kovats-Bernat has had a life-threatening anaphylactic reaction to a spider bite, three cases of malaria, a persistent case of giardia infection and three bouts of dengue, including one that coincided with a chikungunya virus infection and landed him in critical care for a week. And his work and its fallout have left him with post-traumatic stress disorder, a risk to researchers who work in dangerous places that he thinks continues to be unaddressed and underacknowledged by educators and by his professional anthropology association. “I was never told anything about dangers during undergraduate or graduate training,” he says.

These days, Kovats-Bernat teaches his students about all the risks and dangers associated with fieldwork and how to prepare for and deal with them. He trained as an emergency medical technician, and in advanced first-aid and triage trauma care, to deal with mishaps in the field. He carries a trauma kit that includes intravenous drips, injectable lidocaine, sutures, a military field surgical kit, bandages and rehydration salts, along with 32 prescription and over-the-counter medicines. His pack also contains enough cash, clothing, food, water, self-defence gear and other supplies to last for four days. And once he knew that he would be spending a lot of time in Haiti, he learned the Haitian Creole (Kreyòl) language so that he could understand what locals were saying to — and about — him. boxed-text

A sound plan for averting disaster on field trips should include staying in top physical condition, says Laurent Godin, a structural geologist at Queen's University in Kingston, Canada. And like Kovats-Bernat, Godin recommends taking emergency medications, clothing and other supplies, as well as working with experienced local guides and having direct contact with drivers and emergency services. The strategy paid off during a research trip to India in 2008 to date rock formations. One morning, Godin climbed up a steep, snow-covered slope to collect some rocks. On descent he hit a patch of ice, slid and twisted his ankle by 100 degrees.

His fitness and advance planning helped him to navigate the subsequent gruelling challenges. After taking some ibuprofen from his well-outfitted pack, Godin worked out his GPS coordinate, tightened his boot to support his ankle and donned mittens. Then he crawled for a couple of hours until he reached two colleagues, who helped to transport him to camp (and returned for the rocks). After a painful night, Godin struggled onto the back of a donkey for a six-hour ride to the nearest road. He was then driven in a jeep to Leh, where he bought a cane and booked a flight to Delhi and then home. At the hospital in Canada, he learnt he had torn three of his ligaments but had not broken any bones; he raced in a triathlon a couple of months later. “If all hell breaks loose, you know you've got a body you can count on,” he says.

Fitness might be less relevant, however, in the face of disasters unrelated to extreme circumstances: researchers also need to be wary of seemingly mundane risks such as road conditions. Ecologist Douglas Yu, of the University of East Anglia in Norwich, UK, was driving with his wife and their dog along a slippery mountain road in China in 2012 to view flying squirrels. The car skidded, tumbled down a ravine and rolled over several times. Although the car landed upright, his wife was unconscious with concussion and had broken some bones. But their safety strategy prevented tragedy — their car had a sturdy frame, seat belts and air bags, and had been carefully packed to prevent injury from loose equipment.

Know when to say no

To stay safe, researchers sometimes need to breach local social protocols or act in ways that might seem rude. Medical anthropologist Patricia Omidian, co-director of Focusing Initiatives International, a non-profit organization in Monsey, New York, once broke a tooth while working in Kabul. At a recommended dentist's clinic, she saw no sign of soap, alcohol cleansers, gloves or disinfectants. Drills went from one mouth to another without getting cleaned. She left immediately. “Don't be nice,” she says. “If it's not hygienic enough, you're out of there.”

Similarly, Yu observes the behaviour of drivers when he's on research trips in the Peruvian Amazon and China, and if he suspects the drivers have been drinking, he politely sniffs their breath for alcohol. He tells them to slow down if they're driving fast. “You have to be a little bit bossy,” he says. “That will save your life.”

“There are no rocks worth losing your life over.”

Indeed, one unfortunate experience can be an effective teacher. “There are no rocks worth losing your life over,” Godin says.

But despite the hazards, researchers point to a range of rewards of fieldwork — from publication in influential journals to personal growth. Omidian, for example, has discovered deep wells of human compassion that have helped to inspire her. A woman she met in Liberia during the height of the most recent Ebola outbreak was caring for nearly two dozen people without health-care facilities or equipment — just plastic bags, chlorine and soap. “Even in the worst situations, people can be kind and generous,” Omidian says.

Omidian remained in Liberia during the worst of the Ebola outbreak in 2014, to gather data about people's health concerns, because she believed in the importance of her work. “Everyone was scared, people were dying — it was really frightening,” she says. But after her team had been talking and listening to local residents, the emotional tenor shifted. “People started saying, 'We're a community. We have to deal with this.' To be part of that was really special.”

Such inspirations and experiences keep researchers coming back to the field again and again. Six months after his snake bite in Brazil, Dick returned to the rainforest, where another fer-de-lance lunged for his waist. This time, it missed.

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Sohn, E. Health and safety: Danger zone. Nature 541, 247–249 (2017). https://doi.org/10.1038/nj7636-247a

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