The world congress of the International Society for Mountain Medicine (ISMM) will be held in Kathmandu, Nepal this year from the 21st to 24th of November. The call for abstracts and registrations are now open. It’s the twelfth edition of the biennial meeting of over 600 experts in high altitude medicine and rescue from 45 countries around the world, but it’s the first time they have met in Nepal—high time for a region who is already feeling the impact of global warming on the frequency of natural disasters. Hermann Brugger, president of ISMM and head of the Institute of Mountain Emergency Medicine of Eurac Research, recounts the rational for the visit to Nepal and what’s new this year at the Congress.
Considering your work at Eurac Research you must be happy to see that the congress will come to Nepal this year, the first time in the history of the congress. How did that all come about?
Hermann Brugger: Eurac Research has a long history of interaction with Nepal, not only with the field of mountain emergence medicine, but also in terms of governance and autonomy. Our own Institute of Mountain Emergency Medicine initiated an educational programme back in 2005 for Nepalese rescue physicians and paramedics. For the first time we worked with mountain doctors and rescuers groups on the theory and practice of high altitude emergency medicine. We worked in South Tyrol and in Nepal, building skills and exchanging knowledge over a period of ten years. The work finished with the establishment of a core group of 22 Nepalese instructors who will continue to train doctors and paramedics in Nepal in their own language.
With such a protracted experience in the region, as president of the ISMM you must have been eager to see the Congress happen in Nepal.
Brugger: At the last world congress in 2016, when I was elected as the new president, I felt it natural that we go to Nepal for the next congress. Of course this was exciting at the time not only for Nepalese delegates, but also other delegates from around the world as well. There are so many challenges in the region that are central to the congress’ themes, most significantly disaster preparedness.
What are the issues Nepal faces in particular in regard to disaster preparedness?
Brugger: Around the discussion we will talk about what happened during the earthquake in 2015. To prepare for disasters in the future, they will need to coordinate between the military and civil protection agencies, and so forth. To this end we have invited a number of different Nepalese public agencies to the Congress to give their perspectives of the disasters of the previous years. We will explore how the local institutions were coordinated, and how they collaborated with all institutions that came in at the time from abroad during that time.
From other scientific standpoints, what can delegates expect in November 2018?
Brugger: Our topics are high altitude and mountain emergency medicine; mountain emergency rescue; and travel and expedition medicine. Within high altitude medicine we look at acute mountain sickness, high altitude pulmonary edema and high altitude cerebral edema. Last year we detected for the first time another pathology: high altitude psychosis. What’s particularly interesting this year is that we are only accepting paper presentations based on research data that resulted from studies that are not older than 5 years and will be presented by young researchers. We want to bring the focus to young scientists and researchers. Also, we want to take a particular look at the quality of research. The 2016 Nature survey of 1,500 scientists by Monya Baker demonstrated that 50% of their studies had not been reproduced. It is well-known that in our research field as well our studies have limitations due to the small sample size (a low incidence of causality and diseases) or the so-called disturbing factors of doing research in the precarious environments of high altitudes. We feel we need to take a closer look at our own research and address those areas where we need to improve upon our research practices to ensure that our science is completely evidence-based.
Is this why you have invited Professor Drummond Rennie from the University of California, San Francisco to the Congress?
Brugger: Yes, since the 1970s, Rennie has been one of the major proponents of evidence-based medicine; he will help frame the conversation about quality of research. Another important speaker will be Dr. David Molden, the Director General of the International Centre for Integrated Mountain Development. ICIMOD is a regional intergovernmental organisation that monitors the mountain eco-systems in the Himalays. Molden will discuss global warming and its effect on Nepal’s glaciers and the occurrence of disasters. The rising temperatures in high altitudes are provoking new risks of avalanches and landslides in the region. The instability of the terrain is very dangerous, and calls into question the safety of roads, for example. The Nepalese must be able to improve their situation through their own initiatives, and one of the goals of the Congress is to put in motion a discussion between the Nepalese people about disaster preparedness.
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