Extended Care in Mountain Medicine (and Pandemics) …..
July 22, 2020

The Third Space (r)Evolution

Overheard conversations are funny things, especially when the context of the conversation is often absent.  Documenting the small talk of a place is one of the oldest and funniest blogs on the internet; “Overheard in New York”.  One classic example goes like this: 

New Yorker, “Where are you from?” 

Tourist, “Korea”.  

New Yorker, “Oh really, North or South?”  

Tourist, “Take a wild guess”.

It was an overheard conversation about ‘third spaces’, in the pandemic world that we now live that got me thinking.  The first space being, ‘home’ and the second space being, ‘work’, the third space was seen as a place to gather, mingle and socialise that wasn’t either home or work.  Obvious examples might include shopping malls, cafes or bars, a hairdressers, a library or even a sports club.  However, in societies that remain under the influence of Covid-19 for the foreseeable future the changes to the way we live and work are profound, and that includes the importance of third spaces in our lives.

After a lockdown and the effective closing of our international borders, Kiwis like people everywhere have experienced a shrinking of the world around them in both a physical and metaphorical sense.  With that change large numbers of us have now have a renewed appreciation of our outdoor spaces.  If evidence were needed of this change, huge numbers of Kiwis have been holidaying at home, so it was no surprise when a colleague informed me recently that Queenstown Emergency Department had its busiest day on record, EVER, thanks to the July school holidays.  Elsewhere sales of bicycles, outdoor equipment and caravans are all at record levels.  Even the demand for our furry four legged friends, newly christened, ‘Covid companions’ is at an all time high all around the globe.

The outdoor community has always known about these ‘sweets spots’ where people meet and greet.  Examples that come to mind include, The Unwin lodge at Mt Cook.  Bryce’s shop and campsite at Wharepapa.  Hangdog camp at Paynes Ford.  (My personal favourite hangout is the Sheffield Pie shop – just don’t tell everyone 😉

Right on cue with the interest in third spaces, climbing and bouldering walls are set to boom here in New Zealand.  In part this is a response to growing mainstream nature of the sport globally, especially with its inclusion in the Olympics, (as and when it happens).  In the UK there are now around 1 million people who use climbing walls annually, with 60% of these climbers only ever climbing indoors – in other words climbing is no longer a fringe activity anymore.  These gyms when done well also fulfil a significant social function to a local (climbing) community.  Alongside climbing and, or bouldering they often offer a multitude of other services, commonly a cafe and communal space.  A gear shop, yoga classes, and massage and physiotherapy are not uncommon additions too.  Who would have predicted a year ago how important these kinds of places may well become, especially with new ways of working?

One of the big silver linings of the pandemic may well be a change to a more active, ‘outdoorsy’ population.   As the activities and demands of people / consumers / patients change, so too must healthcare flex to accommodate the changes.  International expeditions and adventure tourism aren’t popular choices while global travel uncertainties remain, and people continue to suffer with Covid-19.  But necessity is the mother of invention as people focus on things closer to home.  The inception of the new 29 day, 600km, “Camino De Sydney” walk is a perfect example of this.

So we may now find that the biggest third space of all, the outdoors is set to become more important than ever.  With those of us with an interest in wilderness medicine, in many ways perfectly placed to advise on it.  

We understand the effort and reward that goes into achieving good and satisfying days in the outdoors.  We know what makes for a great climb, a good kayaking trip, a rewarding day on the bicycle etc …  We’re knowledgable on blister management, getting our hydration and nutrition right for that personal best, the appropriate equipment to make the days more enjoyable and productive.  

There is a wealth of evidence, both personal anecdotal and peer reviewed scientific, for improvements in our long term mental and physical health through participation in outdoor activities.  But with our healthcare systems orientated towards the treatment and management of disease / injury we frequently minimise ‘wellness’.  It’s perhaps a bit fluffy and not academic, so it gets glossed over, or taken for granted.  

On the back of this time of huge social change, I’ll leave with a reflection.  I think we all now have a greater appreciation for many of the simpler things in life, things that we may have taken for granted in times past.  So I wonder if the time is right to (re)claim ‘wellness’ into the mainstream health sector?  Clearly the public want wellness in unprecedented numbers.  How are we in healthcare going to meet that challenge?  What kind of training and resources do we need to service and maintain a nations wellness?  

Dr Robin Barraclough.  FRNZCGP

November 2020

A perfect day out in the outdoors, followed by Coffee and Pie in Sheffield on the way home.

 

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