24/02/2014 Inside Out East

Coming to the rescue, a new type of doctor. I will join doctors in

Cambridgeshire leading the way in emergency care. They saved my life.

If they did not act as fast as they did, I would not be here now. I am

very grateful. Dying of ignorance, why young people are rigged again at

risk from Aids. Things are rising again. And unless we do something

about it, we will be back to where we were, or worse. And tiny

creatures no bigger than your thumb. We will reveal the latest finds of

Norfolk's chalk reef. Revealing the stories that matter on Inside Out

for the East of England. Tonight, Inside Out is in Norfolk. Hello,

welcome. Ambulance crews are out there saving lives every day, but

even their skills are limited, but thanks to pioneering work from

doctors in Cambridge, the most severely injured patients stand a

better terms of survival. It is attracting interest from all over

the world. We have exclusive access to find out how it works. All the

time you get distressed you tighten your tummy muscles and it will make

you saw. The team in orange jumpsuits are a new generation of

the emergency services, trained to deliver treatment usually possible

only in a hospital A Today they've been called to help Karen

who has a complicated knife injury in her tummy. It's in a very

precarious situation as to whether it has gone inside or not. The

chances of it going in deeper. By moving her, it is much higher. We

have managed to get intravenous access and give her pain relief so

she is stable. Observations are fine at the moment so we have got much

more time to play with at the moment. Carrying Karen downstairs is

too risky, so the Fire Service remove her from the bedroom. Usually

if you call an ambulance, you'll get a highly trained paramedic. But Dr

Monojit Choudhury and paramedic Simon Standen are pre`hospital

emergency specialists who can do even more than regular paramedics.

For the paramedics to give any strong pain relief beyond morphine

would be difficult so we give her enhanced painkillers. But if she had

deteriortaed from an air way point of view, we could have intubated her

until we reach the hospital. Pre`hospital emergency medicine can

help the most severely injured patients and it is being pioneered

here. This is the major trauma centre for the East of England, at

Addenbrooke's A unit. It is the best place to be in the region if

you are badly injured. But there are some injuries that can be treated

even before the patient leaves the scene of their accident. 11`year`old

Brandon Gravett was hit by a bus, leaving him with life` threatening

head injuries. The care he received at the roadside reduced brain damage

and kept him alive. They saved my life and if they didn't act as fast

as they did, I wouldn't be here right now. I am actually very

grateful. Basically, they said that they were going to put him to sleep,

put him in a coma straightaway at the side of the road, said they are

not going to wait until they get to hospital, we're going to do this

right now, said we want to protect his brain function and it's the

safest option for him. And to get the machine doing the breathing for

him so that his brain has very little to do.

Do you believe that had it not been for the rapid response, Brandon may

not be here today? Absolutely. Whether he got through that depended

on the care he got then and there. Because they put him to sleep, he is

still here. A relatively small number of people will benefit from

this treatment, about 700 a year. But for those who do need it,

pre`hospital treatment could change their lives. It is focused on people

who are really, really sick. I often say whose needs exceed the

capability of the normal NHS Ambulance Service responses. By

definition a relatively small group of people, but they are really

important. The first training course of its kind has been set up in

Cambridgeshire, training doctors and paramedics. It was started and

funded by medical charity, working in partnership with the NHS. Rod

Mackenzie from Addenbrooke's Hospital also worked with MAGPAS and

helped to develop the scheme. I spent several years providing care

as a volunteer doctor when I was free and I started to question what

was happening when we weren't there. Could we do this better, could we

provide a more consistent level of care and the only way to do that is

to make pre`hospital emergency medicine part of the NHS response. I

started some work about ten years ago now nationally to develop this

area of clinical medicine as a specialist endeavour in its own

right. MAGPAS is supporting five trainees in the new specialism. Dr

Nick Foster is the first of the trainees. I've always wanted to do

pre`hospital emergency medicine and when I started training as a doctor

it was to do this. So I am an emergency doctor. I have all sorts

of skills at stabilising critically ill and injured patients. My skills

are best placed as early as possible in the disease process and this is

where I can make the biggest difference. With regards to the

public, with regards to the Ambulance Service, we are people in

helicopters that fly in orange suits to get them out of trouble. But what

we're hoping to do is increase the numbers of doctors involved in

enhanced care teams of pre`hospital care and provide a more uniform

nationwide level of care. I am a paramedic. Rob Major is a consultant

from Addenbrooke's Hospital who supervises training at the MAGPAS

centre. We spend a lot of time simulating unwell patients in

training. Nick and Phil here are the duty team but in some downtime today

we're doing a training scenario very similar to the patients that they

have looked after already today. It is practising and re`practising and

going through the process of putting someone to sleep at the roadside,

which is probably one of our most risky practices in terms of what we

do. Vomits, breathes, talks, has a heartbeat, you can collapse its

lungs and put modules inside the surgical airways. You can have

broken bones sticking out, it is as realistic as it gets. So much so,

the first time I perform this on a real patient, it was only when I was

putting it in his mouth that I thought, hang on, this is a real

mouth. So we practise this a lot. The East of England is leading this

in many respects. We were the first people to get the first trainee in

pre`hospital emergency medicine. You have to have specialists training

the doctors of tomorrow and that is our role and why Cambridge has been

so important in this process. And now this new specialism and training

is being seen as a model for other regions, not just in England, but

around the world. Our colleagues in Australia are looking to now mirror

the sub`specialist area of practice or sub`speciality curriculum that we

have put in place so even in countries that have got arguably

slightly more developed systems people are looking at our experience

and saying what can we take from that and how can we apply it to our

populations. Now the course is being adopted nationally, Dr Mackenzie

believes it will improve emergency response in England. I think the

sub`specialty will make a huge difference to pre hospital care in

this country over the next ten years. Patients will be able to

access consistently a very high level of pre hospital critical care

support. Brandon is living proof that this treatment can save lives.

They say the first two years are crucial in recovery, when the most

recovery happens and he is doing very well. He is back at school,

having missed one year, pretty much is entire first year. They used my

case scenarios and example to train more people, so that others can save

lives, as well, which I thought was quite good. Of course, they asked if

it was OK with me but I was fine with it. If you want to get in touch

about what you think we should be doing a story about, you can get in

touch on Twitter, or, by e`mail. You are watching Inside Out. Still to

come, the tiny creatures no bigger than your thumb, filmed on

Norfolk's chalk reef. We have the latest on plans to protect them.

This could be the largest area of marine chalk in Europe, may be the

largest in the world. 30 years ago, Aids kills thousands of people but

thanks to a health campaign, thousands of lives were saved. It is

now feared the warnings are being forgotten all stopped hard, from

Cambridge, is determined not to let that happened. `` Todd. Frightening.

Devastating. Panic. An epidemic that was just totally unforeseen. And

here we are again. In the 1980s, we were all aware of Aids and the

devastation it caused people, their families and even communities. Back

then, Aids was the shocking killer. Celebrities Freddie Mercury, Rock

Hudson, Arthur Ashe and Liberace all died. The government's Don't Die Of

Ignorance campaign was one of the most successful ever. But are we now

at risk again? Things are really rising again, there's a lot more

ignorance and unless we do something about it, we are going to be back to

where we were or even worse. Todd, from Cambridge, was diagnosed with

HIV four years ago after being raped. He is now on a mission to

raise awareness of HIV. He knows how the stigma of this illness stops

people getting help. It took me two years to finally seek support and

help both for the rape and being HIV positive. During those two years you

didn't tell anyone? I didn't tell no`one. It just left me devastated.

I thought if I isolated myself and keep it within me, then no`one would

know what has happened and I wouldn't have to be reminded of what

happened. HIV is now so much more treatable than it was 30 years ago.

But once again it seems people still aren't seeking help through either

ignorance or fear. Here in the East, we have the highest rate of late

diagnosis in country. What that means is someone with HIV can have

the virus for years without realising itand that means it

continues to spread. Todd supports others with HIV. Andrew, not his

real name, waited 12 years before seeking medical help. I couldn't

wake up from the bed and walk to the toilet. It was so difficult for me.

He was so ashamed of having the illness, he did not try to get

better. 25 people in the region with HIV

died in 2012. One in five with the virus don't know they have it. It's

not just the stigma of HIV, that's the problem. There's a new

generation who seem almost ignorant of the dangers. OK, guys, I'm Todd.

I'm HIV positive. Todd is trying to drive the message home to these

students in Cambridge. How many of you are complacent about safe sex?

Interesting. Why is that? I don't think everyone is always complacent

about safe sex, I think it's just sometimes if we go out for a night

out, people sometimes forget. It's not that everyone does it all the

time. We do have the education. Even if we don't have facts and figures,

we know how it is transmitted and how we can stop it but sometimes

obviously on a drunken night, things happen anyway. So for how many of

you is this a wake`up call? These attitudes are typical according to

the Terrence Higgins Trust. It was set up in the '80s, to raise

awareness of the virus and the need to prevent it spreading. There are

regular surveys done on people's level of knowledge about things like

how HIV is transmitted and we know that knowledge is going down.

Because there is such poor sex and relationships education in this

country and no general awareness the average member of the public is

actually more ignorant about HIV than they would have been a decade,

or probably even two decades ago. I think the problem is that a national

advertising campaign would cost ?50 million to reproduce the impact of

the one that we did in the '80s. And that's just not there when you've

got the entire national campaign for HIV prevention is less than ?3

million. There is still no cure for HIV. But by taking pills, Todd can

slow down the damage the virus does to his immune system. But despite

the medical advancements, Todd is worried that some doctors still need

reminding it is out there. I think they have become complacent. We've

had guys go to the GP, that have explained their symptoms, down to

the point of the fact that they may be sexually very active, and not

once have they been offered or been told to go and get an HIV test. Todd

works for Dhiverse, the official HIV counselling group in Cambridgeshire.

Part of his job is raising awareness by offering training session and

posters to GPs. Take`up is low. But he's just found one that's accepted

it. Considering we have contacted 98 surgeries in this area and they are

one of the first to show willing to promote our work that we are doing

with HIV. So it was quite good, quite promising.

Why do you think people aren't willing? I believe there's still

this massive stigma involved and I also believe there's still a need

for more awareness and training. The government doesn't see a need for a

national awareness campaign for the general public. It says it's clear

that the groups most at risk of HIV infection in the UK are gay and

bisexual men and some African communities. We fund the Terrence

Higgins Trust for a national programme which targets these

groups. The slogan for the campaign was "don't die of ignorance" and

it's actually the same now. Don't die of ignorance, because you don't

find out in time that you have HIV, because HIV is a completely

treatable condition now. But you'll be taking pills for the rest of your

life and you'll have to deal with the prejudice. If Todd and Andrew

hadn't overcome their fears, they may not be alive today.

Now Andrew has a job and is preparing to go to university. Todd

has a home and a partner. I love my life now. I'm able to walk with my

head high. I'm in an amazing new relationship, I'm working again, I'm

me again. If you look up at the cliff face,

you can see chalk running through it and lumps of it are all over the

beach and out there under the cold North Sea is Europe's longest chalk

reef, home to wildlife and the several years conservationists

wanted it protected. That is proving controversial, still. On a day like

this on the north Norfolk coast, it's hard to believe you could ever

get under the waves and see anything at all. Visibility is probably

awful, but two summers ago we came here to explore Norfolk Europe's

longest chalk reef, when we were blessed with new water and the most

amazing wildlife. And here it is, a wonderful world a few meters below

the surface. Most reefs in the UK are made from hard rock and only a

view our chalk, and this is thought to be the longest in the world. We

are in a gully, between the chalk. There are so many holes here.

Everyone of them has a crab. This is crab city. The raised chalk makes a

perfect home, rough enough to support weeds and algae, many of

which are only found on this kind of rock. They provide food for other

animals and, because the rock is soft, crabs and lobsters can make

burrows. This is one of the main delicacies, a chrome `` Cromer. This

is a female. I will put her back where I found her. All around are

creatures and plants with wonderful names such as light bulb sea squirts

and the beautiful eyelash weed. We swam over valleys and arches,

valuable for wildlife and rare earth of this part of the coast. Local

divers were my guides. They have brought this hidden gem to the

attention of the whole world. It can be magical to be on the reef. When

we found the arches last year, it was a matter of luck. It was

exciting to see, the kind of thing you would imagine only seeing

abroad. It is not fully known and there is a chance that anybody on

any dive could find something special like that.

That summer, conservationists found a previously unknown sea sponge. So

little wonder they were pushing for the reef to become one of the new

marine conservation zones, an underwater nature reserve. I met Rob

a few weeks ago to find out what has happened since. It is a little bit

cold to go underwater today but you have been out to the reef since we

went together. We dive there regularly and try to keep track of

the changes. What have been the highlights? The number one

highlight, a cuttlefish. On the reef, we have been seeing little

cuttlefish, the size of a bumblebee, fearless like a tiger.

Look at that, marvellous. It is an awesome predator. As complicated as

a full`size cuttlefish. They are masters of camouflage. They hide in

the sand and they can squirt ink to distract you and will attract any

thing they think they can eat, troops in the sand, awesome. That is

a 5`star animal. Look at it, burying itself in the sand, trying to hide.

The sweetest bit is when they bring the little tentacles around to bring

the sand over their eyes, to get the disguise perfect. You had some

disappointing news. We returned to the arches you enjoyed in 2011, and

despite a couple of attempts, we cannot find the arts. There have

been impact is `` the arch. We think it has been knocked down, probably

by lobster pots. They will be broken back and you will lose habitat. I

wonder what the local fishermen will make of that. John Davies' family

have worked the see here for 200 years and relies on the reef for his

living. He took me out to see things from his point of view. We have a

reasonably buoyant fishery on our doorstep. They are trying to take it

away. We have been left alone for years and suddenly, everybody wants

a piece of what we class is our backyard. You can see the healthy

fishery. Look at the juveniles and this is early in the season. One

good thing about this, everything can go back into the water alive. It

makes you wonder how many times they go up and down in a season. Not

again! These are too small? That will be long enough. It is a male

crab. Put it in the box. Some years ago the fishermen volunteered to ban

trawling and that has helped to protect the shore. `` the talk. Are

they causing damage now? The diving community have filmed what they say

is the potential evidence of damage by lobster pots. What do you think

about it? Absolute rubbish. You can look at the promenade and look at

the damage along the sea wall and the cliffs, I did not do that with a

pot. Mother nature has a way of changing the landscape and it does

the same on the sea bed. John and his colleagues do not want a marine

conservation zone, fearing restrictions. They were glad when it

was not included on a list of locations. We were pleased, as the

fishing community because that is our workshop. We were relieved. We

know we might have only won the battle, not the war, but we are

pleased it was not accepted. It was disappointment for the divers and

conservation groups. The official word was there was a lack of

information on the extent of the reef but it is evident it is here

and there is an total evidence and a lot of diving evidence. Exactly why

it was not included is a mystery but we will continue doing a lot more

work and we are working with other agencies to fill that deficit of the

perceived lack of information. The majority of the East Coast fails to

win any protection. Conservationists hope to persuade the government the

reef should be included in the next round of zones. We know that

designating marine conservation zones and having protected sites, it

is a win for the wildlife and also fishing. This could be the largest

marine chalk area in Europe. Working in conservation, it is frustrating

that yes, we need more evidence, but it is important for wildlife. There

are species unknown to science discovered here. It will be a while

before we know whether the next bid is successful. In the meantime, the

divers are already planning exploration for this summer and I

cannot wait to see what they find. It is incredible to think the chalk

reef is just out there, teeming with wildlife. You can also get in touch

on Twitter and by e`mail. If you think there is something we

should look into. Next week, I will find out what happened after the

storms. Almost three months after the terrifying night when this home

went over the cliff, good news for them. And we meet families torn

apart by a system they say is unfair. And from the old vicarage to

a corner of a foreign field that is for ever England, the story of one

of Hello, I'm Ellie Crisell with your

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