The annual meeting of the UIAA Medical Commission was held in late October in Are in northern Sweden. Dr David Hillebrandt reports on the discussions and developments.

The meeting was incorporated into the IKAR (International Commission for Alpine Rescue) General Assembly, to facilitate cooperation between the medical commissions of the UIAA and IKAR. The whole General Assembly was attended by about 350 people and organised by the Swedish Climbing Federation.

The UK was represented on the UIAA Medcom by David Hillebrandt (Honorary BMC Medical Advisor and Medcom Vice President) and Dr Jeremy Windsor (corresponding member). IKAR Medcom had UK representation by the IKAR Medical Vice President Dr John Ellerton, who is the medical officer for Mountain Rescue England and Wales.

During the four day meeting the UIAA Medcom had one full day meeting followed by a combined meeting with IKAR Medcom. Both John Ellerton and David Hillebrandt ran medical workshops and gave lectures on mountain rescue team member fitness and physiological workload and on the UK frostbite advice service. In addition smaller international meetings were held to discuss coordination of the UK supported Diploma of Mountain Medicine in Nepal and on further international development of this joint UIAA and IKAR project with the diploma now being run throughout Europe, as well as in Japan, Nepal, the USA and Canada. As with so many such international meetings it is the contacts made outside the formal meetings that eventually yield the most ideas and projects.

The formal UIAA Medcom meeting acknowledged that the persistent work by the UIAA and the BMC with medical journal letters by Hillebrandt and Windsor and personal contact made last year in Arequipa seem to have finally borne fruit in terms of the application of medical regulations regarding ascents of Aconcagua. From very dogmatic decisions the local Argentine doctors seem to now be looking at each case individually, giving more education and basing their care more on evidence based medical facts. This is to be welcomed.

The joint Diploma of Mountain Medicine established by the UIAA with its partners IKAR and ISMM (International Society of Mountain Medicine) continues to be a victim of its own success, with more work needed in the next year to further formalise international arrangements. The UK continues to be one of the leaders in this field with work by John Ellerton and David Hillebrandt.

After eight years as president of the UIAA Medical Commission Dr Buddha Basynat from Nepal reached the end of his period of tenure and David Hillebrandt was elected to be President with support from Prof George Rodway (USA) as Vice President. David and Buddha will continue to work together through their roles in the International Society of Mountain Medicine.

David Hillebrandt is working on further close cooperation between the UIAA Medcom, IKAR Medcom, ISMM and North American based Wilderness Medicine Society. In particular this work will continue the production of advice papers on mountaineering and climbing with pre-existing medical conditions. With an increasingly aged but active population advice for non-climbing doctors to pass onto their patients is becoming more important. Jeremy Windsor and David Hillebrandt are currently working with Enrico Donegani, an Italian cardiac surgeon member of UIAA Medcom, on advice for climbers with pre-existing cardiac conditions. It is hoped that further papers will follow on Diabetes, and respiratory problems.

As the newly elected President of the UIAA Medical Commission, Dr Hillebrandt has identified a number of projects he would like the commission to develop, including:

• increasing cooperation between the medical commissions of the UIAA and IKAR and the International Society of Mountain Medicine and Wilderness Medicine Society.
• increasing the involvement of some African countries in the UIAA Medcom, particularly Tanzania, Kenya and South Africa.
• formalising the UIAA/IKAR/ISMM diploma of Mountain Medicine, which internationally is growing.
• providing more information for patients and for doctors offering advice to the increasing number of older people with pre-existing conditions accessing the mountains.

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