Many industries by the nature of their business have to locate themselves in remote locations often distant from urban centres. This remoteness creates many challenges, not least in the provision of medical care, and in the practice of occupational health for the employees. During this session we will look at different aspects of medical and occupational health care in these remote settings and how some of the challenges can be overcome. My colleagues will discuss the provision of medical services in remote locations, and the particular features of the provision of occupational health services in Russian Siberia, in the Deserts of the Gulf Region in the Middle East and in Malaysia.

Before looking at the examples we will examine elements of the Health Risk Assessment (HRA) that should be carried out to enable the formulation of the Health Plan. Ideally the HRA should be carried out well in advance of the commencement of operations, but that does not always happen. Elements to be considered include:

• Health Hazards of the operation and project

• Local climate

• Patterns of diseases and illness, in the community and local work force

• Levels of education in the local workforce, including awareness of health and safety

• Standards and access to local health care

• Availability of National Medical and Nursing staff – requirements for local employment

• Availability of drugs and medical equipment

• Routes for medical evacuation

• National Legislation

• Industry and International Standards

• Access to food and drinking water

• Security Situation

• Potential Community Health Projects

All these elements and more need to be considered to formulate and execute a comprehensive medical and occupational health plan.