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In this episode, host Eoin Walker is joined by Clare O’Brien, a registered nurse whose career spans more than three decades across the NHS, humanitarian crises, and global health leadership. From intensive care and organ transplantation in the UK to frontline deployments in South Sudan, Myanmar, Sierra Leone, and Ethiopia, Clare shares what it really means to work in extreme, resource-limited environments. She reflects on her experiences responding to cholera outbreaks, Ebola, and neglected diseases like Noma, and the ethical realities of delivering care in conflict zones. This conversation explores leadership under pressure, resilience in crisis, the importance of community-led responses, and why hope can be just as powerful as medicine. Clare also speaks candidly about returning home after deployment, sustaining purpose beyond the frontline, and what aspiring expedition and humanitarian clinicians should consider before stepping into these roles. A thoughtful, grounded discussion on compassion, governance, adaptability, and what global healthcare can teach us about ourselves. A quick update from the podcast team We’re hitting pause on the podcast for a short while. In the meantime, you can still access a wide range of recorded sessions, talks, and content online — perfect if you’re catching up or revisiting past episodes. Thanks for being part of the journey so far. We’ll be back when the time’s right.

In this episode of the World Extreme Medicine Podcast, host Eoin Walker sits down with infection control specialist Muhammad Halwani to explore what it really takes to prevent and manage infectious disease threats in extreme environments. From the early days of MERS in 2012 to the global arrival of COVID 19, Muhammad walks through the realities of outbreak response in Saudi Arabia, the challenges of training frontline teams, the role of rapid diagnostics, antibiotic resistance, and how public health systems adapt under pressure. Together they discuss:• The lessons learned from managing MERS and how they shaped COVID 19 preparedness• Diagnostic challenges and the evolution of infection control protocols• Training healthcare providers to work safely in high risk environments• Public health communication, leadership, and societal compliance• How antibiotic resistance shapes care in the field• Why extreme environments require unique infection control approaches They also explore the growing appetite for extreme medicine training in Saudi Arabia, and the need for specialised courses, fellowships, and international collaboration.

From remote surf camps in Indonesia to some of the most isolated islands in the South Atlantic, Gemma van Huyssteen has built a career shaped by curiosity, adaptability, and medicine far beyond hospital walls. In this episode, Gemma shares her journey as a GP with extensive experience in remote, wilderness, and marine environments. She talks candidly about working in settings where evacuation can take days, resources are limited, and clinical decision-making relies as much on preparation and judgement as formal protocols. You’ll hear about:• Providing medical care in remote Indonesian surf communities• Managing hazardous marine and wilderness injuries in austere environments• Life and clinical responsibility aboard highly isolated research vessels• Teaching and working around dive and marine-related injuries in challenging settings• Why stepping outside conventional medical career pathways can open unexpected doors This conversation explores what real-world remote medicine looks like, the nuance between training and lived experience, and how surfing, science, and medicine intersect in places where help is never close by. Follow more of Gemma’s work:Surfing Doctors Association: https://surfingdoctors.com/Instagram: @gemstargazer – https://www.instagram.com/gemstargazer Connect with Marcus:https://www.linkedin.com/in/marcus-stevens A thoughtful, grounded discussion about building a meaningful medical career off the beaten path, and being honest about what experience really looks like in extreme environments.

In this episode, Sarah Spelsberg speaks with Luca Carenzo and Laura Leuci from Humanitas University in Milan about their research into the pre-hospital management of accidental hypothermia across Italy’s helicopter emergency medical services (HEMS). Their nationwide survey, published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, offers a detailed look at how hypothermia is managed before hospital arrival—revealing system-wide gaps, training opportunities, and practical steps for improving patient outcomes. In this episode: How a medical student led a nationwide HEMS research project Why hypothermia management must start before hospital arrival The biggest equipment and training gaps identified The role of the “burrito wrap” in field insulation How to balance standardisation with adaptability Why education, simulation, and consistent training are key to progress Read the full open-access paper:Pre-Hospital Management of Accidental Hypothermia: A Nationwide Survey Among Italian HEMSScandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2025)

In this episode of the World Extreme Medicine Podcast, host Eoin Walker speaks with Corinne Palma, a recently graduated veterinarian from University College Dublin and Vice President of the International Veterinary Students’ Association. Together, they explore how veterinary medicine extends far beyond the clinic — from field anaesthesia innovations and drone-assisted wildlife monitoring to the ethical challenges of intervention and the growing importance of One Health. Corinne shares insights from her experience across small animal clinics, conservation projects, and research labs, and discusses the traits and training needed for the next generation of veterinarians working in extreme environments. You can connect with Corinne via social media: Instagram LinkedIn.

In this episode of the World Extreme Medicine Podcast, host Eoin Walker speaks with Simon Robinson, former Royal Marine Commando Paramedic turned Head of Clinical Development in Urgent Care. Together, they explore the evolving role of paramedics in primary care, from emergency response to diagnosis, prescribing, and leading multidisciplinary teams. Simon shares insights on: The transition from frontline emergency work to primary care Independent prescribing and clinical autonomy Training, mentorship, and building multidisciplinary teams The challenges and opportunities paramedics face outside traditional ambulance roles Whether you’re a student paramedic, an experienced clinician, or simply curious about the future of urgent care—this conversation offers an honest, practical look at how the profession is growing beyond its emergency roots. Find out more about the College of Paramedics.

In this episode of the World Extreme Medicine Podcast, we explore one of the most talked-about studies in pre-hospital trauma care: “Beyond IO and IV - Trauma Lines in Pre-Hospital Haemorrhagic Shock.” Host Eoin Walker is joined by Paolo Pallavicini, final-year medical student and research fellow with London’s Air Ambulance and the Centre for Trauma Sciences, to unpack a groundbreaking study analysing over 8,000 trauma patients. They discuss: Why standard IV and IO access can be inadequate in exsanguinating trauma How trauma lines can double pre-hospital blood delivery rates Success, complication, and survival outcomes from the study The future of central venous access in pre-hospital care Paolo also offers key insights into the realities of working in a chaotic roadside environment, the importance of governance and training, and how clinical risk-benefit decisions are made when every second counts. Read the paper here. Find out more about London Air Ambulance Service.

From conflict zones to refugee camps, from neonatal units to global health leadership—nurses are at the heart of humanitarian medicine. In this episode, host Eoin Walker is joined by Elsa Afonso and Marcus Wootton from the Royal College of Nursing’s International Academy. Together they bring decades of frontline and strategic experience with organisations including MSF, UNICEF, and academic institutions worldwide. We explore: What drives nurses into humanitarian work Lessons learned from conflict zones, HIV & AIDS programs, and neonatal care The power of education and capacity-building in fragile health systems Leadership, advocacy, and cultural adaptability in global health The future of nursing in humanitarian response A powerful conversation about resilience, leadership, and the global role of nurses. Important links: RCN International Academy Phoenix Nursing Myanmar RCN Report: Care Amongst the Chaos – The Voices of Nurses Working in Conflict (PDF)

At just 28 years old, Rachel Smith is preparing to make history. Diagnosed with type 1 diabetes before her third birthday, she has never let her condition define her limits. Already having summited the highest peaks in South America, Africa, and Australia, Rachel now sets her sights on Mount Vinson, Antarctica’s highest peak at 4,892m. In this conversation with host Eoin Walker, Rachel shares her remarkable journey: Growing up as the first child in Northern Ireland to use an insulin pump How evolving technology has supported her ambitions in medicine and mountaineering The unique physiological challenges of managing diabetes at high altitude and in extreme cold The balance between risk, resilience, and pushing human potential Her partnership with Breakthrough T1D and the importance of raising awareness This is a story of grit, adaptability, and proving that chronic conditions don’t have to hold you back from extraordinary goals. Learn about Rachel and follow her journey here. Find out more about Breakthrough T1D.

In this episode of the World Extreme Medicine Podcast, host Eoin Walker speaks with Leif Rognås (consultant anaesthetist and clinical lead with the Danish Air Ambulance) and Karina Damsgaard (psychologist specialising in emergency medicine and resilience in high-performance teams). Together, they unpack the concept of Compassionate Debriefing, an approach designed to replace traditional “honest debriefs” with something more supportive, psychologically safe, and effective for learning. The discussion explores: Why traditional debrief models can fall short in complex, high-stakes environments How compassionate debriefing fosters resilience, retention, and psychological safety Practical steps for shifting from critique to care in post-mission reflections What further research is needed to embed this approach into HEMS and beyond A must-listen for clinicians, leaders, and anyone interested in the future of healthcare culture, wellbeing, and team performance. You can read Karina's paper 'Common Mental Health Symptoms in Personnel Working in Helicopter Emergency Medical Services: A Systematic Review' here.

In this episode of the World Extreme Medicine Podcast, host Eoin Walker is joined by Hannah Lock, an emergency medicine doctor, expedition specialist, and seasoned mountaineer with experience across six continents. Together, they go beyond the basics of acute mountain sickness (AMS) to explore the lesser-known high-altitude illnesses and how they’re managed in the field. From HAPE and HACE to retinal haemorrhages, chronic mountain sickness, high-altitude cough, frostbite, and the impact of altitude on muscle mass and sleep, this deep dive unpacks the realities clinicians and expedition leaders face at altitude. Hannah also shares insights on managing risk in clients with comorbidities, new technologies shaping safety in the mountains, and practical strategies for hydration, acclimatisation, and performance at elevation. Learn more about Hannah and her work here.

In this episode of the World Extreme Medicine Podcast, host Eoin Walker speaks with Luke Apisa about his extraordinary journey from wilderness medicine to space medicine. Luke shares insights from treating climbers at 14,000 feet in Nepal, supporting ultramarathon runners in the deserts of Arizona and Utah, and helping to develop future medical capabilities for space exploration with NASA and SpaceX. From designing innovative altitude breathing devices to researching pulmonary edema treatment at high altitude, Luke’s career sits at the cutting edge of medicine in extreme environments. Discover how wilderness and space medicine connect, what it’s like to practice in the Himalayas, and the challenges facing long-duration spaceflight.

In this episode of the World Extreme Medicine Podcast, Eoin Walker sits down with chef, explorer, and researcher Mike Keen to unpack an extraordinary Arctic journey. Mike kayaked the entire 3,000km length of Greenland’s rugged west coast, surviving solely on a traditional Inuit diet of seal, whale, dried fish, and wild foraged plants. Working with researchers at King’s College London, he tested how an ancestral, high-fat, low-carb diet impacts health, endurance, and resilience in one of the most extreme environments on Earth. We explore: The science behind ancestral diets and their potential to improve health and performance The physical and mental challenges of solo Arctic travel Climate change impacts on Greenland’s ice and wildlife Lessons from indigenous communities on food, sustainability, and survival Follow Mike’s work: Website Instagram

In this episode of the World Extreme Medicine Podcast, host Eoin Walker is joined by Luca Carenzo, intensive care consultant, and Federico Emiliano Ghio, critical care nurse and medical lead for high-altitude emergency services in Livigno, Italy, one of the busiest ski resorts in the Alps. From sub-zero slopes and altitude-induced illness to managing cardiac arrests at 2800m with no hospital in sight, Federico and Luca explore the real-time challenges of delivering care in extreme alpine environments. Featuring: Advanced pain relief protocols in –20°C conditions How fluids freeze, defibs fail, and ventilators adapt Why governance matters when you don’t have paramedics Planning for the Milan-Cortina 2026 Winter Olympics The future of ski patrol: drones, slope-side diagnostics, and real-time triage This is high-acuity medicine, on ice. 📍 This session was recorded remotely in December 2024.

In this episode of the World Extreme Medicine Podcast, host Eoin Walker speaks with Mardi Steere, Executive General Manager of Medical and Retrieval Services at the Royal Flying Doctor Service, about a groundbreaking innovation in rural healthcare delivery, the Virtual Emergency Centre (VEC). Operating in one of the most remote regions of Australia, the VEC integrates telehealth, remote diagnostics, and trained layperson intervention to deliver hospital-grade care in areas where no medical staff are physically present. Mardi shares the origins of the project, the role of technology like Starlink and wearables, and how the model is saving lives and reducing retrieval costs. We discuss the governance and logistics behind delivering high-risk medications remotely, the scalability of the model, and how learnings from Africa, India, and Rwanda are being adapted to suit Australia’s unique geographical challenges. Mardi also reflects on the future of healthcare innovation, from drone-delivered AEDs to virtual ultrasonography and beyond. Learn more about the VEC and the work of the Royal Flying Doctor Service: https://www.flyingdoctor.org.au