October 14, 2008

Stanford MD Jeff Peterson’s 111 Day Journey As Expedition Physician for Documentary Film, Running the Sahara

On an almost daily basis, Jeff Peterson, MD, would be informed that there were "beaucoup de malades nomads" --many sick people--who had come by camel in search of medical assistance. Most of them had never received any medical care before.

Peterson, who was the physician in Running the Sahara, a documentary film that chronicles the incredible journey of three runners' ultra-endurance expedition through Africa's Sahara Desert, had anticipated that such a need might arise.

What he couldn't know was the power of the need he would find. "It was during lunch breaks, as well as setting up camp in the evening that the expedition came to be so much more for me," he said, "because, at just about every camp--and the numbers became more numerous as the expedition wore on--there would be nomads who had heard through word of mouth that there was a doctor in the area and they would follow our tire tracks 40 miles, 50 miles, whatever it took."

Peterson would find five camels tied up to the expedition's Land Cruiser, with a line of mothers and children waiting for him. For most, it was the first time they had ever seen a physician, he said.

Thus Peterson, an assistant professor of surgery/emergency medicine and attending physician in the Emergency Department at Stanford Hospital & Clinics, began his unconventional medical practice. It included the three runners and the film's production crew; the natives of the local towns and villages; the nomads who populate the Sahara; and the soldiers who provided security in a dangerous part of the world.

The film, narrated by Academy Award winner Matt Damon and directed by Academy Award winner James Moll, opens nationally later this year. It follows three runners--Charlie Engle, 44, from North Carolina; Ray Zahab, 38, from Canada; and Kevin Lin, 30, from Taiwan--on their quest to become the first humans to run the entire distance across the Sahara.

Almost Two Marathons a Day

The journey began on November 2, 2006, in St. Louis, Senegal. It ended more than three months later, on February 20, 2007, at the Red Sea, just below the Suez Canal. The expedition had taken them through six countries (Senegal, Mauritania, Mali, Niger, Libya and Egypt) and over 4,300 miles. The runners had run 40 to 50 miles a day for 111 days--that's the equivalent of almost two marathons per day.

Peterson, himself a triathlete who has completed three ironman distance events, was responsible for helping the runners stay healthy. His primary duties were treating numerous injuries sustained by the runners, keeping them hydrated and pain-free as possible, and monitoring appropriate use of medications such as anti-malarial drugs and antibiotics.

The odyssey of the three men and their support crew did not begin well, with temperatures rising to as much as 120 degrees during the day and below freezing at night. Peterson saw the runners' stamina quickly disintegrate when they attempted a full day's run. "The runners were getting lost and leaving their GPSes behind, the production crew was getting lost, and I was treating everyone for heat exhaustion," said Peterson. "After the fourth afternoon, I issued a medical edict: No running from 11 am to 4 pm. My pronouncement resulted in a near-mutiny from the runners."

To Peterson's practiced physician's eyes, a new schedule was required: wake at 4:00 am, eat, run a marathon by 11:00 am; rest until 4:00 pm, stay as cool as possible, eat, hydrate and run another marathon until about 9 pm.

At the end of each day, Peterson tended the runners' gradually worsening medical conditions: tendinitis, dehydration, severe diarrhea, cramping, knee pain, shin splints, blisters and abscesses. He had an extensive array of medicines with him - lots of antibiotics and some narcotics for pain that couldn't be suppressed with ibuprofen, acetaminophen and lidocaine. He fought back against the constant threat of dehydration with daily saline solution IVs.

The runners were also drinking as many as 12 liters of Gatorade and water each day. Despite 10,000- to 12,000-calorie meals a day--they bought $700 worth of candy bars in one oasis town--all the men lost weight: the tallest almost 40 pounds and the shortest of the three 25 pounds.

Toward the end of the journey, when all three runners were showing very obvious signs of near psychological collapse, Peterson's job expanded to include protecting them against the impact of disorientation, hallucinations and psychological isolation.

Almost as constant as the blisters and tendinitis was gastroenteritis--and it attacked not just the runners but the entire expedition crew, including soldiers and other people sent to provide security. The cripplingly painful stomach cramps, diarrhea and vomiting is widespread in countries without adequate sewage treatment or even safe water. Despite vigilant hygiene that included frequent use of alcohol hand wash, drinking only bottled water, triple-rinsing food utensils and eating well-cooked and boiled food, the illness persisted. Even Peterson became a victim.

"I needed someone to administer an intravenous drip," said Peterson. "There was no other medical provider besides me, so Chuck Dale (the massage therapist) volunteered. I had no problem teaching Chuck the mechanics of starting the IV. The only problem was that I had to teach him to do it on me and I felt horrible," he said.

In Search of Clean Water

The documentary was made in collaboration with H2O Africa, a clean-water initiative with the mission of creating widespread public awareness of the water crisis in Africa and gathering support for integrated, sustainable clean-water programs in critical areas. Wells and oases are scarce. "The nomads travel for a day to get clean water," said Peterson, who had served as physician for endurance races in the Atacama Desert of Chile and the Gobi Desert in China in 2006. "The first thing they think about when they wake up each morning is, 'Let's go get water.' Oftentimes, the water they get is not clean, and it has a direct impact on their health."

Early on, Peterson realized that he was needed to fill another absence--medical care, of the simplest kind and, sometimes, that for illnesses caused by bad water or lack of good water. Word spread fast among the nomadic tribes that a doctor had come.

On the Mali/Niger border, Peterson saw a year-old baby whose mother had run out in front of an expedition supply truck to get aid for her child. The boy had been horribly burned four days earlier on his feet and shins when a pot of water, being boiled to make it safe to drink, overturned on him. The burns had blistered and were covered with abscesses and sandy, pus-laden scabs. The child was in poor condition. Helping him was not easy. When Peterson wanted to clean the baby's wounds in a bucket filled with an iodine solution which, unfortunately, turned the water red, the sight badly frightened the child. Eventually, with the baby held and comforted by his father, Peterson was able to clean the wounds and cover them with antibiotic ointments and gauze. And the father stepped up to say he could give the baby the additional antibiotics and continue the wound cleaning.

A few days later, in Niger, four young girls appeared in the expedition camp asking for help for their mother, who had given birth a few days earlier. But she was so sick she couldn't eat or nurse her child. She was getting more and more dehydrated and weak every day. Peterson traveled a mile to the family's camp, received permission to enter and discovered the woman was suffering from a severe post-delivery infection of her reproductive organs. She was subsisting on near-spoiled camel milk. Peterson gave her four antibiotics, an anti-nausea medicine and many liters of Gatorade. When he checked on her the next morning, she was nursing her baby and looking much better.

The expedition's security guards came with their own set of ills. Peterson provided sutures, antibiotics, diabetes treatment and joint wraps, while also treating eczema and plantar warts of the Niger Army soldiers. While heading northward toward Libya, in a region where smuggling and rebel activity persisted, the expedition team picked up an 18-man Army of Niger attachment to provide security. Peterson treated everything from broken teeth and a severe case of bronchitis to cutaneous anthrax, eczema, stomach ulcers, conjunctivitis and plantar warts. "They kept me busy," said Peterson, "but more than returned my care by keeping us safe from bandits."

More Than an Expedition

After receiving treatment, many of Peterson's new patients would ask him when he was returning to the Sahara to help them again. Peterson promised to return to the region, and as a result of his time there, he created his own charitable foundation, Sahara Relief (SaharaRelief.org), in late 2007. His goals include bringing together modern medical techniques and supplies with local expertise, establishing a system of heath care stations in the Sahara region and West Africa with sustainable delivery programs and medical education. Building a hospital for the Tuareg people of Niger is also a major goal of Sahara Relief.

It was his experience not with the runners, but with the people of the Sahara that moved Peterson most deeply. When the runners and crew were "starting to bottom out emotionally" on day 63, Peterson said, they reached the oasis village of Fachi, Niger and were quickly greeted by a group of about 50 children whose innocent enthusiasm was the perfect tonic for the tired runners and crew.

"They just started running with us, singing and chanting in French. Everyone fed off their energy," recalled Peterson. "It was at this time that I knew the expedition wasn't just about us crossing the Sahara. It was about them helping us cross the Sahara and about me helping them."

Additional information

To learn more about the film, Running the Sahara, and to preview the movie trailer:


To learn more about Sahara Relief:


Photos available for publication:

Contact Carole Morse at [email protected]

About Stanford Hospital & Clinics

Stanford Hospital & Clinics is known worldwide for advanced treatment of complex disorders in areas such as cardiac care, cancer treatment, neurosciences, surgery, and organ transplants. Ranked #16 on the U.S. News and World Report annual list of "America's Best Hospitals," Stanford Hospital & Clinics is internationally recognized for translating medical breakthroughs into the care of patients. The Hospital is part of the Stanford University Medical Center, along with the Stanford University School of Medicine and Lucile Packard Children's Hospital at Stanford. For more information, visit www.stanfordhospital.com.