About Where There Is No Doctor
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"A community health worker may find a single copy of Where There is No Doctor, adapted and written in the local language, more useful than access to thousands of international journals." – Goodlee et al. in The Lancet, 2004.
Where There Is No Doctor was written in 1970 in Spanish for a village health program in rural western Mexico. It has been regularly updated, and adapted by community health programs globally. It is a useful and humane book.
New Where There Is No Doctor is a complete rewrite, currently in process. Numerous street medics helped with the first aid chapter, including one of our trainers (Grace) and long-time street medic and family nurse practitioner Ann Hirshman.
New Where There Is No Doctor’s first aid handbook is the best first aid reference available for street medics. However, it isn’t perfect:
- It recommends antibiotics and other drugs. Street medics don’t prescribe or administer drugs, but the information is helpful for health education.
- It describes spinal injury assessment – useful if you’re more than four hours from definitive care, but it can do harm. We teach you to assume spinal injury if the mechanism was present and let the hospital emergency department do a safer and more accurate assessment.
- It teaches how to reduce a dislocated shoulder. We teach you to refer the person to the hospital or other qualified care.
- Its post-rape care discussion assumes you’re somewhere with a hostile healthcare system. We teach you to use hotlines for options counseling and referral to hospital for injuries or if rape kit or other documentation is desired.
- Its mental health emergency recommentations are not all evidence-based, and less humane than ours. This may improve after we send our next round of comments.
We have opinions about other first aid guides.