Harvesting Divers Update

On the front lines of decompression illness

Honduran lobster divers regularly dive far beyond safe limits. These divers come primarily from the communities of Miskito Indians living in eastern Honduras and Nicaragua, and they make as many as 14 to 16 dives a day to 100 feet or more for 12 straight days. On occasion they dive as far offshore as four days' steam from land. The Miskito divers often ignore minor aches and pains, reporting symptoms of decompression illness only when their condition becomes so bad they can no longer stand, walk or urinate on their own.

In 2010 the Honduran government declared lobster harvesting using scuba would end after the 2010-11 season. Pressure from various groups convinced the government to extend the season for two more years, largely because no steps had been taken to provide the Miskito Indians any alternative means to make a living. There are no plans to extend the lobster diving beyond 2013, but lobster boat captains hope if they improve their safety records and operational practices over the next two years they will convince the government to allow the harvesting to continue.

Realizing the need to change the way they do business, the Association of Industrial Fishermen of the Atlantic Coast of Honduras (APICAH) mandated diving first aid programs for all boat captains prior to the reopening of the 2011 diving season. Local physician Dr. Elmer Mejia and DAN® staff members provided specially tailored education in oxygen administration, recognition of decompression illness, outfitting first aid kits and use of Foley catheters. More than 60 boat captains participated in the training.

In addition to conducting training to help prevent injuries, DAN is also supporting efforts to provide care. DAN sponsored Mejia's attendance at a hyperbaric safety director training course in the United States and sent staff to Honduras to provide training to chamber attendants and operators at the three hyperbaric chamber facilities closest to the Miskito Coast. DAN is also working with doctors at the UCLA Gonda Center for Wound Healing and Hyperbaric Medicine to send medical residents and fellows to Mejia's clinic on a rotating basis. According to Dr. Matias Nochetto of DAN, "If a hyperbaric doctor sees five cases in a lifetime like those Dr. Mejia regularly treats he can say he has significant experience dealing with serious DCI cases." The support these physicians will give Mejia will improve the care the divers receive, and it will provide tremendous educational and practical experience for tomorrow's hyperbaric doctors.

In June 2011 at the annual meeting of the Undersea and Hyperbaric Medical Society, Nochetto presented a poster and abstract based on Mejia's work at his chamber in La Ceiba, Honduras. The data were based on 130 Miskito Indians who were severely injured during the 2010 diving season. These data, analyzed by Dr. Petar Denoble, DAN senior research director, will serve as a baseline of information against which DAN researchers and the Honduran government can compare subsequent years. The lessons learned from these severe cases are contributing to an improved understanding of decompression illness that can benefit all divers, perhaps even the lobster divers.
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© Alert Diver — Winter 2012
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