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Diving for All: the HSA Dive Buddy Course

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The Handicapped Scuba Association (HSA) is dedicated to improving the physical and social well-being of people with disabilities through scuba diving and at Bolton Area Divers (BAD) we’ve just qualified ten HSA Dive Buddies to help us to open up scuba diving to those with disabilities.

It all started when Bolton Area Divers successfully ran Try Dives for children with disabilities. This inspired the BAD Dive Centre Manager, Shereen Roberts, to give all divers of all abilities the same opportunity to scuba dive. To achieve this, she contacted the HSA via Diveability as HSA gives certified training for disabled divers and Shereen and four other instructors from BAD went and received the HSA Instructor training from none other than the founder of HSA himself, Jim Gatacre.

Now, able to instruct in Bolton, Shereen asked the club members if any of us would like to be an HSA Dive Buddy and ten of us said “Yes!”. We were split into two teaching groups and I was part of the first. The theory element of the HSA Dive Buddy Course turned out to be a lot more detailed than I expected, in particular when it took us through the disabilities that can affect people, but in most cases, it was encouraging to find out that they could still go scuba diving!

The practical part of the HSA Dive Buddy Course involved us simulating three different disabilities (blindness, paraplegia and quadriplegia) in order to give us first-hand experience in dealing with different disabilities as well as a greater empathy for what it is like to dive with a disability.

We first started practising our skills in the pool before moving onto open water and before we did so, we all had to learn to communicate with blind divers by using tactile signalling. I was surprised at how little mollycoddling a disabled student would get – basically none! Even a blind diver would be expected to assemble their diving equipment without it being laid out in a specific way for them, therefore I was expected to kit up from all my equipment that had been hastily thrown into my mesh bag the night before, whilst using a blacked out mask and therefore unable to see. I’m very grateful for being familiar with my kit.

I found that I use my core muscles more often than I realised when I was trying to be the ‘paraplegic’ diver as I had to concentrate on not correcting my body position in the water and let my feet drag along the swimming pool bottom instead of instinctively keeping them up. My buddy and I also found that we equalise differently whilst we took turns being the ‘quadriplegic’ diver. My ears evidently needed to be equalised much more than my buddy’s and my nose is smaller than his – both factors led to me breaking out of character, swimming quickly to the surface and explaining that he was pinching just the tip of my nose and that was far from sufficient.

Pool skills completed, the next step was to repeat them in open water and open water meant Capernwray. In January. All of us, questioning our sanity about why we chose to do this in January, took turns kitting up once again as a blind diver, but this time we were each led to the end of the pier to do a giant stride, blind, into the water. When it was my turn, I learned that I have serious trust issues! Especially when I’m told that the edge of a pier is about one and half metres away. I literally inched my way to the edge from that point onwards. For the record the giant stride itself wasn’t a problem; just the 1.5m preceding it.

Over a cold two and a half hours we proceeded to replicate the skills we had practised in the pool. We found that controlling buoyancy of two people is difficult and that any positive or negative buoyancy had to be corrected immediately. We found that when simulating being blind, using gloves meant we were less sensitive to tactile signalling. We also found swimming without the use of our legs was very tiring whilst simulating being paraplegic. Having ironed out most issues in the pool, most of us found the quadriplegic simulation went smoothly, except for me as I had lost all feeling in my lips on account of being in cold water for over two and a half hours – orally inflating my buddy’s BCD after a CESA proved tricky. With the practical skills completed, we took a few days to thaw out and took the final test, which was thankfully multiple choice!

The HSA Dive Buddy Course was more than any of us expected. It took all of us out of our comfort zones and challenged us to be better divers, to be more considerate and aware and to hone our skills, especially our buoyancy. It also challenged our preconceptions on what people with disabilities are capable of…. I would highly recommend it.

Yo-Han Cha is a member of the Northern Underwater Photography Group and started taking underwater photos with a Canon Ixus 980 IS before upgrading to an Olympus OM-D EM-5 two years ago. He has a BSc (Hons) in Biochemistry and works as a Network Engineer for a telecoms company, neither of which is relevant to his underwater photography. Well, the job pays for the kit and trips, so it’s kind of relevant. He learned to dive whilst backpacking in Australia as he thought it would be the best way to see the Great Barrier Reef, and when he got back, started diving in the UK as he wanted to dive with seals. He is a member of both Bolton Area Divers (PADI) and Manchester University Sub Aqua Club (BSAC) as he finds it difficult to turn down diving opportunities. He loves going diving and is usually at his happiest when either taking photographs of nudibranchs or of seals. He prefers scenic diving but concedes that wrecks make lovely artificial reefs.

Dive Training Blogs

Deptherapy returns to its Roots – Part 4

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Join Richard Cullen from Deptherapy for part 4 of his Blog about the charity’s recent expedition to Roots Red Sea, El Quseir, Egypt.

We are all back to the house reef today; the weather is lovely, the sea calm, the tide will soon be slack, so a great day’s diving in store.

A few yards away from the beach dive centre, on the Roots’ beach is their day time restaurant. It is where we take lunch when diving, and there is a continual supply of tea, coffee and soft drinks, and some marvellous lunches.  There are also male and female toilets and a fully accessible toilet for those using wheelchairs.

A few thoughts around working with amputees and those who have paraplegia. Firstly amputees – the part of the limb remaining is known as the ‘stump’, and we have worked with a substantial number of bilateral leg amputees (both legs), single leg amputees and single arm amputees.  The level of amputation can be above or below the knee or elbow, or through the knee. In one case the amputation was transpelvic and in another through the shoulder.  Some like Chris Middleton have one leg amputated above the knee and one below the knee.  This is rare, but each type of amputation offers a different challenge.

Many people think the amputation is clean and the skin neatly tidied up after surgery. Although that occurs in a few cases, in most the stump is rather rugged.  Elasticity of the skin around the stump is often exceptionally poor and can easily be damaged.  Some of our beneficiaries, as they were injured as young men, suffered from heterotopic ossification – this is where the bone tries to grow after amputation and often penetrates the skin, resulting in further surgery being required to cut back the bone and of course the stump needs to be restitched.  Very often stumps are sealed with skin from elsewhere on the body.

Swars kitting up

Few divers have never experienced a graze or cut underwater but such an experience for those with amputations can have serious consequences.  Stumps are more likely to get cut or grazed as the skin is so tight. We all know that there are lots of infections in seawater and if infected the cut or graze can cause very serious problems for the amputee.  Tailored wetsuits are one preventative measure, as are daily stump checks, making sure there is no damage and if there is, applying medication and or protecting the stump.

Those with paraplegia provide an additional challenge, not being able to feel their lower limbs they can easily damage them, so cuts, abrasions, and even sunburn can go unnoticed.  Donning a full-length wetsuit can be a challenge as toes can easily be broken and hairs pulled out of legs.  On the Deptherapy Education Professionals’ Course we show how to fit a wetsuit properly.

In recent discussions between our dive medicine advisor Mark Downs and our VP Richard Castle, who is a consultant psychologist, we have been looking at areas for further medical research in terms of diving for those with disabilities.  One area of suggested study is thermoregulation. The theory is that those with amputations and those with paraplegia suffer more with the cold as their body is unable to regulate heat. Certainly, in Corey’s case, he feels the cold more quickly than those diving with him. Chris Middleton can feel the cold more quickly than others with amputations but that may well be that Chris is muscle and bone where, to put it nicely, others have a more substantial covering.

Some AMEDs and Dive Referees will not sign off amputees as being fit to dive. That is their professional opinion and although we can show that even triple amputees are more than capable divers, capable of progressing to Rescue Diver standard even, they still refuse to sign them off. Last year Oli and Mark invited us to speak at the UK Annual Hyperbaric Medicine Conference in London where Josh Boggi, the world’s first triple amputee Rescue Diver and a Deptherapy beneficiary spoke about how amputees can become safe and successful divers.

Corey, Swars and Michael

For Corey, he wears full leg coverings and diving boots in the water; as he cannot use his legs there is no purpose in wearing fins.

Another point around amputations is that most of the general population make an assumption that a leg amputation is the result of a traumatic incident.  That is incorrect; by far the majority of leg amputations in the UK are the result of diabetes. Those whose legs are amputated as a result as diabetes are more likely to have poor healing of the stumps.  This also presents an issue of comorbidity that may well result in an AMED or Dive Referee declining to sign them off as ‘fit to dive’.  If signed off you would need to be very aware of the health of a stump; I certainly would not take someone with an open wound diving and the fact that they will be on medication for the diabetes.  You also have to be aware that they may well be on other medication to manage pain etc.

You need to be very clear with those who have paraplegia and other conditions that they must let you know if they start to feel cold.

Managing air – diving just using your arms for propulsion can, for many, be very tiring and a considerable amount of effort is required.  This, plus other factors, may result in enhanced air consumption by the diver.  This may increase if a current is encountered, even one which most divers who have use of their legs and dive with fins would not cause the least concern.

Within Deptherapy we very much work on the ‘rule of thirds’ – a third of your air to get you down and to see what you want to see, a third to get you back to the surface and a third in reserve.  This in most circumstances will ensure no ‘low on air’ or ‘out of air’ situations.

Say if we have 210 bar in a cylinder that means 70 bar out, so turn on 140 bar, 70 bar to return and to the surface so we should have 70 bar reserve at the surface.

We also work our students through SAC rates and looking at the air consumption of others in their team.

Checking the team’s air frequently during a dive is stressed to all our Pro team.

Keiron became very engaged with this concept as the result of the online RAID study for his Master Rescue Diver.

On expeditions we normally dive in small teams, a DM/TDM with three programme members.  They work as a team and understand each other’s air consumption. Of course, they also dive as buddy pairs.

Today offered perfect conditions for diving, and Keiron, Moudi, and this time TDM Oatsie were kitted up and in the water within minutes.

Pause for thought… those with paraplegia will have different toileting arrangements to those who do not have the condition. This also applies to some who have suffered traumatic limb loss.  They may use catheters for urination, some may have Stoma bags etc.  This all has to be planned into your dive schedule to ensure the safety and comfort of your student.  For young people talking about these very personal arrangements may be very difficult.  Those with Stoma bags may be embarrassed by people seeing them.  This is another part of seeing beyond the injury or condition – it is the person inside that you are dealing with.

Corey on the Roots House Reef

So, Corey, Michael and myself were joined by Swars.  Swars, although he joined the DM programme at the same time as the other guys, because of work commitments was unable to join us in September 2019 at Roots where we ran a DM introductory programme alongside the crossover of our Pro Team to RAID.  Swars has become a really good mate; he is a great diver, with an engaging personality.

Michael and Oatsie were a known quantity to me as they had been on the September 2019 programme and both have travelled to my home dive centre Divecrew in Crowthorne, Berkshire, to work on courses, pre-COVID.  During COVID Michael and I, plus a few of the guys from Divecrew, have dived at Wraysbury together.

Just as Roots is our base in Egypt, Divecrew is our base in the UK, and through this relationship, Martin (who owns Divecrew with his wife Sue) is one of our trustees. Together they have established a centre where pretty much 100% of the Pros are Deptherapy Education trained.

I asked Swars straight away to brief a dive for Corey. I gave him the briefing slate, a few tips and then ten minutes later he came back with a perfect briefing… and I mean perfect.  So, a great briefing under his belt; now to watch him work with Corey in open water. He looked the Pro, he knew what he should be doing, he understood his role. We assigned Michael as Corey’s buddy and said he would lead the dive. I was there to assess the TDMs and supervise very closely Corey’s skill demonstrations.

Again, it comes as no surprise that many beneficiaries in Deptherapy can move straight into dive management, as several were NCOs, as was Swars, and they are used to briefing individuals and teams.

We had decided that we would mix up the dives required to complete Corey’s OW 20 RAID dives with some general diving as trim and swimming arm action are all important. We also needed to concentrate on spatial awareness.

We agreed a signal for horizontal trim and Swars reinforced the swim stroke that Corey needed to do to get propulsion.  Every time Corey moved out of horizontal trim Swars was there reminding him about trim and reminding him of his swim stroke.

The Roots’ House Reef is amazing – at a metre you encounter a shoal of black Damselfish, at 3 metres a shoal of Unicornfish, there are Butterflyfish and all manner of other fishes in great profusion.  The coral is in great condition. It really is a place of beauty and tranquillity.

Oatsie and Swars relaxing by the Roots pool after a long day

Although we had problems getting Corey underwater again, once we got him in skill demonstration mode his anxieties disappeared.  We then took him diving. Steve Rattle, the owner of Roots joined us and was taking photos that provide a great record of the week’s diving.  Steve commented on the quality of Swars and Michael’s supervision and control underwater of Corey and gave them feedback on how impressed he was.

Meanwhile on the RAID Master Rescue Course, Oatsie who was in the same Regiment, same Platoon and Section as Keiron in Afghanistan was more than willing to be a very uncooperative victim for his brother-in-arms.  I think Keiron gave Oatsie some feedback about this!

For me this was a hard week, combining running the RAID OW 20 for Corey but also the assessment of our three TDMs.  A week underwater but no opportunity to dive for myself.  People often think Deptherapy Expeditions are holidays for the Dive Team; they are not, it is hard work and I mean hard work.

Tomorrow is Day 4 in the water Day 5 of our trip. We are on the House Reef again, and things are starting to come together. Join us back here on Monday 26th October…

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Dive Training Blogs

Scuba Diving Instructor Ranks Scuba Specialty Classes… the good, the bad and the rubbish!! (Watch Video)

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Scuba Diving Specialty Certifications! Which ones are worth your money? And which ones are just rubbish?!

This professional Scuba Instructor has strong opinions about Scuba Specialty Courses, and he’s sharing them with you!

Wreck Diver, Deep Diver, Nitrox, Buoyancy, Boat, Ice, Dry Suit, UW Photography… the list goes on and on. With so many choices for Specialty certs to get you to Master Scuba Diver level, how do you know which dive courses are of value, and which are a waste of time?

We ask 3 simple questions of each Scuba Course and rank each course’s value for you. So before you sign up for your next PADI e-learning course, WATCH THIS VIDEO!


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