The health care of remote industrial communities
The main part of the introduction illustrates the health care provision made in the past for workforces of the oil and gas industries functioning in remote places usually associated with an environmental hazard. Much of the past work has been carried out in the North Sea and the provision made there has been reviewed in some detail together with the gradual development of health care in the United Arab Emirates for both the offshore and the onshore oil-related workforces. There follows a short review of the provision made for two analogous situations - Newfoundland and Labrador and the British Antarctic Territories - since the developments there are of direct relevance to the Middle East situation. The main environmental hazard in the Middle East is heat and so the physiology and pathology of thermal balance in man are addressed in some detail. The first study is on the identification of the particular thermal problem which occurs in the offshore workings on the Abu Dhabi oil and gas companies, namely heat cramps. This problems had not been previously identified and the work done in determining its presence and its management is duly reported, indicating the problems of accepting health education material designed for one environment by another. In the development of systems of health care for both oil and non-oil related remote populations, the importance of training of the population at risk has been repeatedly emphasised. The perceived problems in that area are skill retention by laymen and the acceptance of the guidelines of the European and US Resuscitation Councils. A second study was therefore carried out to examine skill retention in laymen together with the feasibility of carrying out resuscitation manoeuvres in high temperatures.