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All the fun of the care: St John Ambulance at the GDSF

Katie Carpenter looks at a lesser-known element of the Great Dorset Steam Fair: the medical support provided each year by St John Ambulance

The sheer scale of the Great Dorset Steam Fair site is hard to take in (image: www.lowlevelaerialphotography.com)

For five days each year at the end of August, Tarrant Hinton becomes the third largest ‘town’ by population in Dorset (excluding the unitary authorities of Poole and Bournemouth). With 25,000 people camping on site at any one time, and an aggregate of over 200,000 people visiting the Great Dorset Steam Fair (GDSF), the organisation of such an event is, to say the least, a major logistical achievement.
However, whilst the 600 acres of vintage vehicles, heritage machinery, sawing displays, funfairs, traction engines, steam-powered organs, craft stalls, food stalls and beer tents are why people visit the show, ordinary life does not stop just because the visitors are intent on having fun. People are still unwell, have accidents, eat too little or drink too much, become disoriented or get lost, get too hot, get too cold or  suffer serious illness.
This is where St John Ambulance comes in, for each year the Dorset branch of the medical charity has to deal with all manner of drop-ins to their on-site medical centre, respond to emergencies around the site and also deal with travelling show people, for whom the medical centre at the Great Dorset Steam Fair may be their only meeting with a medical professional all year.
Some of the cases St John Ambulance treat (on average there are 500 ‘incidents’ per show) may cause discomfort even in the reading. One gentleman was treated after a wrongly positioned safety harness on a bungee drop caused his testicles to be squashed; liberal quantities of ice were required to ease both the prodigious swelling and the agonising pain – it was several hours before he could walk. From the sublimely painful, to the occasionally ridiculous, St John Ambulance volunteers also had to deal with two young women were had been locked into a Portaloo, which was upended by some irresponsible young men. The fire brigade had to hose the women down before volunteers could assist them.

Working in partnership with the South West Ambulance trust, St John Ambulance volunteers can reach and stabilise patients who are in trouble

Sometimes it is a supportive role rather than a strictly medical one which the volunteers perform. One year, a young woman who was 26 weeks pregnant, was convinced that she was going into labour. One of the volunteers stayed with her awaiting the ambulance in an unlit caravan, which was tiny and, with the bed inside, left little room for manoeuvre. The woman was stabilised at hospital and her pregnancy went to its full term; she brought the baby back to the show the next year to meet the volunteer.
On another occasion, an old lady was brought into the centre after her weak cries were heard from the car park at 1.00 in the morning; she had trapped her fingers in the boot of her car and had been stuck there for three hours and was suffering from both shock and mild hypothermia.
According to Rob Harvey – who in addition to having worked at the Great Dorset Steam Fair for fifteen years is also National Pharmaceutical Advisor to St John Ambulance, it is not always once the show has opened to the public that the most serious problems present themselves. ‘During the show itself we get the usual, run-of-the-mill stings and bites,’ say Rob, who is far from a run-of-the-mill pharmacist; as a dispensing pharmacist at Poole Hospital, he can also help those visitors who have forgotten life-saving medication on their way to the show. ‘When the show is setting up,’ Rob says, ‘we get injuries from those assembling stalls and fairground rides. Last year we had a man who had got his hand crushed between two railway sleepers. If he hadn’t had safety gloves on, he’d have lost his hand.’
‘The medical centre,’ reveals Mary Buck, who is County Nursing Officer and Clinical Governance Lead for SJA, ‘is officially opened at noon on the first Saturday until noon the following Monday. The centre is open to all from 9.00 in the morning to 10.00 at night. We close the doors to deter waifs and strays coming in late at night, often from the direction of the beer tents. Most situations can wait until morning, but those familiar with the service will pop around the back doors, or we can call an ambulance. People are used to the way we run the centre and it works well.’

The St John Ambulance team ahead of another busy year at the GDSF

‘The medical centre, situated next to the Show office, consists of three large temporary buildings,’ Mary says. ‘We never know what condition they will be in; they’re on loan, often from building sites, and they have to be thoroughly cleaned before we can start to unpack equipment and medical supplies. Even so, we get people dropping in requiring various medical treatments.’
The centre deals with at least 500 patients each year: common conditions include lots of childhood diseases and conditions – usually from the showground families – including scabies, impetigo and chickenpox. ‘We also treat a great deal of burns and scalds’, says Mary, ‘generally for catering staff rather than exhibitors. Other common problems are smuts in eyes and quite a few falls. We frequently change dressings from new and post-operative wounds or chronic conditions such as leg ulcers. We can even provide dialysis for kidney patients.’
We have had to deal with several cardiac arrests over the years – hardly surprising with a population of that size.

The high dependency unit at the show's on-site medical centre

This is a far cry from the early years when first-aid provision was the responsibility of the Blandford unit, working out of a small tent on-site. One of the county surgeons was also an exhibitor, so if there was an emergency, he would leave his engine and make his way to the first aid tent. The fair was a much smaller event and as it has grown so has the presence of St John Ambulance.
Mary Buck, for example, started working at the Steam Fair twenty years ago. ‘I’ve been a volunteer with SJA since 1964, when I joined, aged ten years, as a third-generation family member. I shall be retiring from nursing end May 2012 but will do bank work and continue with SJA as a volunteer.’
George Dubois, who is Deputy County Nursing Officer for Dorset SJA started working at the Steam Fair fifteen years ago and is married to Charlotte (Charlie), an Advanced Ambulance Technician with Dorchester Ambulance Station. Both are volunteers with SJA and are key to the running of the medical centre at the Steam Fair. ‘It’s our annual holiday,’ George says. ‘I’m there for the duration – including preparation of the medical centre the week before. This includes a High Dependency Unit, which treats acutely unwell visitors – those with, for example, cardiac problems. We are able to offer advanced care before evacuation to hospital. We are faced with any situations that a large population would present. I coordinate the cover for the Steam Fair with the South West Ambulance Foundation Trust (SWAST). We have a great team on both sides, responsible for different areas.’
SWAST provides an Emergency Care Practitioner throughout the event. Between them is a seamless service and with different responsibilities but several SJA members also work for SWAST and many SWAST personnel are current or former SJA volunteers.
On show days, there is a team of around thirty members and around eight Cadets. The adults are resident on-site in caravans. They give up a week of their annual holiday to be there, often year after year. They are supplemented by volunteers who help out for a day or two during the event. There is a great deal of medical expertise within the SJA membership. The Cadets are able to work whole shifts and gain so much experience because of the range of conditions that they are presented with. Always closely supervised, they love the Fair and appreciate being given the opportunity to be useful and not just observing. It’s what attracts them to SJA and they learn a great deal.

The SJA team at a recent Steam Fair planning meeting

As well as the purely medical side of things, SJA volunteers perform other non-medical tasks, as the organisation’s case history file reveals: one evening, an elderly man on a mobility scooter went missing. The alarm was raised when he failed to return to his caravan. SJA believes he found that his mobility scooter had been stolen whilst he was using a Portaloo. It was pouring with rain and he was eventually found, several hours later, walking towards Salisbury. Volunteers from the SJA were up all night, combing the 600 acre site and surrounding area armed with torches and not much else. All got drenched. The gentleman was fine after he was taken back to the medical centre.
Welfare is as big a part of what SJA provides at GDSF. Another example from the case history file: An elderly couple set off from their car on a sunny morning, spent the day at the Fair and spent several hours trying to find their car. By 10.00 in the evening, they were exhausted and cold, near collapse. SJA looked after them whilst the site security staff located their vehicle. Despite the best efforts of all concerned, it isn’t always a happy ending. In 2007, a man fell into an artificial lake located on the outskirts of the site. Lined with plastic, it was impossible for him to climb out. An SJA volunteer swam underwater several times until he located the 26-year-old victim in the hope that he could be saved. Sadly, this was not the case; both the volunteer and a police officer, received bravery awards.
And, as yet, there has also not been a happy beginning in the form of a birth at the Great Dorset Steam Fair, but Rob Harvey says that the volunteers are still prepared: ‘Most of the team have just done childbirth training,’ he reveals.
• Visit www.sja.org.uk/sja/counties/dorset.aspx or call 01305 751169 to volunteer with, or to donate to, SJA.