Mountain sickness

Mount Kilimanjaro, the highest peak in Africa at 5,895 meters (19,341 feet), presents a unique set of challenges for climbers. The most dangerous of these challenges is altitude sickness. As you ascend, the body faces a reduced oxygen supply and changing environmental conditions, which can lead to serious health issues if not managed properly. Safety on Kilimanjaro is our number one priority.

Understanding Altitude on Kilimanjaro

Kilimanjaro is often chosen by climbers because it allows hikers to experience a high-altitude summit without requiring technical skills. However, being a “walk-up” mountain, many underestimate the potential dangers associated with the altitude. While Kilimanjaro’s summit is considered “extreme altitude,” it is not on the same level as Everest or K2, where acclimatization is impossible.

At the summit, the oxygen levels are about 49% lower than at sea level. While the percentage of oxygen remains the same (around 20.9%), the reduced air pressure means there are fewer oxygen molecules in each breath. This lack of oxygen affects the body in several ways, leading to the risk of serious conditions like High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE).

Types of Altitude Sickness

Altitude sickness manifests in three main forms: Acute Mountain Sickness (AMS), High Altitude Cerebral Edema (HACE), and High Altitude Pulmonary Edema (HAPE). AMS can vary in severity, from mild symptoms that can be treated easily to severe, life-threatening complications.

Acute Mountain Sickness (AMS)

AMS can affect anyone above 6,000 feet. Symptoms often begin with a headache, which is similar to the signs of dehydration or over-exertion. If left untreated, AMS can worsen, leading to more serious complications.

• Mild AMS: Symptoms resemble a hangover: headache, nausea, fatigue, and loss of appetite. These can often be managed with rest and hydration.
• Moderate AMS: Symptoms worsen with persistent headache, dizziness, shortness of breath, nausea, and vomiting. This stage requires descending to a lower elevation for recovery.
• Severe AMS: Symptoms can escalate, leading to life-threatening complications like HAPE or HACE. Immediate descent is crucial.

High Altitude Pulmonary Edema (HAPE)

HAPE occurs when fluid accumulates around the lungs due to excessive pressure on lung arteries. Symptoms may include:

• Coughing up blood or mucus
• Difficulty breathing and extreme fatigue
• Bluish lips and confusion

HAPE requires immediate descent and the administration of supplemental oxygen.

High Altitude Cerebral Edema (HACE)

HACE occurs when fluid builds up around the brain, causing confusion, loss of coordination, and difficulty walking. It’s a very dangerous condition and requires immediate medical attention and evacuation.

Diagnosing Altitude Sickness

To monitor for altitude sickness, Kili2sere Adventure guides perform daily health checks using a pulse oximeter to measure blood oxygen levels and heart rate. They assess symptoms using the Lake Louise Scoring System, which evaluates:

• Headache: Ranges from mild to incapacitating.
• Gastrointestinal symptoms: Includes appetite loss, nausea, and vomiting.
• Fatigue: Ranges from mild to severe.
• Dizziness/light-headedness: Evaluates the severity of dizziness.
• AMS Clinical Functional Score: Assesses how symptoms affect activity levels.

Acclimatization: The Key to Preventing Altitude Sickness

Acclimatization is the process by which your body adapts to the reduced oxygen levels at high altitudes. As you ascend, your body begins producing more red blood cells to carry oxygen, increasing the efficiency of oxygen uptake.

To avoid altitude sickness, the best strategy is to:

• Take a longer route: Choose a route that includes acclimatization days, where you “hike high and sleep low.”
• Climb slowly: As the Swahili phrase “pole pole” advises, always take it slow to conserve energy and avoid exhaustion.
• Stay hydrated: Dehydration impairs acclimatization, so make sure to drink plenty of fluids.
• Eat carbohydrates: Studies show that carbohydrates help maintain energy levels at high altitudes.
• Consult a doctor about Diamox: This medication can help speed up acclimatization by increasing the body’s ability to adapt to the altitude.

Preventing Altitude Sickness

• Hike Slowly: Slow and steady is key to allowing your body to adjust to the increasing altitude.
• Stay Hydrated and Well-Fed: Eating regularly and drinking fluids will help prevent dehydration and fatigue.
• Avoid Alcohol and Stimulants: These substances can interfere with acclimatization and worsen symptoms of altitude sickness.
• Rest and Recover: If you feel symptoms of altitude sickness, rest and descend to a lower elevation if necessary.

Does Altitude Training Help?

Pre-acclimatization can be beneficial for some climbers. While some athletes use altitude training methods, like sleeping in hypoxic tents or training in altitude chambers, the best way to prepare is to spend time at high altitudes before your Kilimanjaro climb. If this isn’t possible, a gradual ascent on the mountain itself will provide the necessary time for acclimatization.

Effects of Altitude on Existing Conditions

People with heart, lung, or neurological conditions must get medical clearance before climbing Kilimanjaro. Many individuals with well-managed pre-existing conditions can successfully summit, but it’s crucial to consult a doctor to ensure their medications and condition are suitable for the altitude.

Other Health Considerations

• Hypothermia: Always carry proper layers of clothing to prevent hypothermia. Wet clothes, either from rain or sweat, can quickly lead to a dangerous drop in body temperature.
• Sun Protection: The higher you go, the stronger the sun’s rays become. Use sunscreen, wear protective clothing, and sunglasses with 100% UV protection to prevent sunburn and snow blindness.
• Gastrointestinal Issues: Always use hand sanitizer and avoid unpeeled fruits or tap water. At Kili2sere Adventure, we ensure safe water and food hygiene throughout the climb.

Kilimanjaro Safety Procedures

Our experienced guides will carefully monitor your condition throughout the trek. We use pulse oximeters daily, monitor your symptoms, and listen for unusual lung sounds. Early detection of altitude sickness is key to preventing more serious issues.

In the event of an emergency, Kili2sere Adventure is equipped with:

• Emergency oxygen for immediate relief
• Portable stretchers provided by the National Park
• Helicopter evacuation in case of severe altitude sickness or injury

Our commitment to safety ensures that every climber is closely monitored and supported. If you feel unwell at any time, please inform your guide immediately so they can take appropriate action.

Conclusion

Climbing Kilimanjaro is a remarkable achievement, but it comes with its risks. By taking precautions, acclimatizing properly, and maintaining clear communication with your guide, you can significantly reduce the chances of altitude sickness and other health issues. Your safety is our top priority, and we’re here to support you every step of the way to the summit.