The indigenous fisherman divers of Thailand: in-water recompression.

BACKGROUND: The Urak Lawoi, part of the Sea Gypsies of Thailand, have been diving using surface-supplied compressed air for more than 30 years. Their dive sites range from one hour to several days from their villages. Similar to other indigenous fisherman divers, the Urak Lawoi suffer from a high incidence of decompression illness. Their methods of in-water recompression were investigated.

METHODS: In December 1998, available divers in two Urak Lawoi villages were asked if they had ever been treated using in-water recompression following decompression illness. If the divers responded positively, a questionnaire-based interview was carried out. Divers were asked to recall the cause of the accident, their diving patterns of the day, the parts of the body affected, the depths and times of in-water recompression and whether the problems were resolved as a direct result of this action.

RESULTS: Eleven divers, aged 19-52, were interviewed. Causal factors listed by the divers included diving pattern 55% (6/11), rapid ascent 27% (3/11), and equipment failure 18% (2/11). Divers were recompressed in water using surface-supplied compressed air. The time between surfacing from the accident-related dive and being put back in the water ranged from immediately to 60 minutes. Depth and duration of in-water recompression ranged from 4 to 30 meters and 5 to 120 minutes. Outcomes reported by the divers were: improved or resolved at depth with no return of symptoms at surface in 64% (7/11), improved or resolved at depth with a return of symptoms at surface in 18 (2/11), and not resolved at depth in 18% (2/11).

DISCUSSION: Health-care workers in the villages may be able to provide basic first aid but, for some villages, a medical doctor may be as much as 10 hours away and a recompression facility as far as 16 hours in good weathier. In-water recompression has, within the diving population, proved to be an appropriate first-aid measure for decompression illness. A future project activity will develop consensus guidelines for determining under what circumstances in-water recompression using surface-supplied air should be carried out and identify appropriate methods that the Urak Lawoi can apply.