Tips and General Info - Special Interest Kilimanjaro
- Go slowly, very slowly.
There is nothing to do at the huts/camps, so why rush to get there? It is important
to go extremely slowly on the first two days, even if you feel well.
- For those doing the Marangu
route, suggest to your guide that you go the longer route along the river en
route to Mandara Hut - much more scenic, birds, etc.
- There are no shower facilities
at any of the huts/camps - your porters will supply you with warm water if required.
A portbale ‘plastic bag’ type shower is great for washing hair, etc and is worth
taking along. If not, a bucket bath will have to suffice. No washing water at
Kibo/Arrow camp. ‘Wet Wipes’ are quite useful.
- There are no opening windows
in the huts (except Kibo) - to get air during the night you must leave the door
open or you’ll suffer from lack of air / sleeplessness, etc. If your hut partners
object, move huts - you’ll increase your chances of getting to the top by getting
good air and sleep.
- Walk high, sleep low -
at both Horombo and Kibo (and on the camping route this is also recommended),
try to do a short stroll to a higher altitude (perhaps 500 feet higher) and then
descend to sleep at the huts. This appears to help you acclimatise.
- A stick/ski pole is very
necessary - hire/buy up there or take with you.
- Thin socks inside thick
socks really helps.
- Light shoes for around
the camp relieve your feet.
- A decent pile/fleece sweatshirt
is invaluable (available for hire)
- Keep an eye on your waterbottles
when ascending Kibo - take at least 2 liters and wrap up to keep warm - they may
freeze solid in your bag.
- Medication:
- "Diamox" 250
mg - altitude sickness. Max 3 per day from 12 000 feet. Good supply.
- "Imodium" / "Buscopan"
- stomach disorders. Good supply.
- "Motilium" 10
mg - nausea. Good supply
- "Besenol" - headaches
- Basic antibiotic cream
for cuts / blisters
- Supply of Elastoplast,
etc. / small scissors for blisters.
- Zinc oxide cream - lip
cream for sun
- "rehidrant" salts
- Support bandage / anti-inflammatory
- for aching joints especially on descent.
- "Vitamist" natural
spray products: ‘Calmag’ - to avoid cramping. ‘Vitamin E’ - to assist in the oxygenation
process. ‘Extend’ - for muscle strength and stamina. ‘B12' - for energy.
- "Diamox" 250
"Decadron" (steroid)
and sleeping pills - these both help, but you must check with a doctor before
using. All of the above are suggestions only - you MUST consult a good physician
before using any of these - some may effect you at high altitude. We also suggest
consulting the British Airways Travel Clinic (27 11 807 3132) for advice and prescriptions.
ALTITUDE SICKNESS
ETC - INFO FOR CLIMBERS
Because visitors ascend
Kilimanjaro at a much slower rate, and start walking from a much lower altitude
than those climbing Mt Kenya, the serious problems associated with high altitude
acclimatization are less frequently encountered. Specifically, the number of cases
of Pulmonary and Cerebral Oedema (HAPE & HACE), as a percentage of
climbers ascending the mountain, are considerably less than on Mt Kenya. In part
this is due to a longer acclimatization period, but also to the fact that if the
walker is feeling ill at the 4000m point, he may be unwilling to push on for a
further 2 days, getting worse the whole time. Thus he goes on down. On Mt Kenya
he may "go for it" as the summit is only a couple of hours away and
he feels that he will be back in civilization in a further half a day. Because
of the higher altitude of Kilimanjaro, Acute Mountain Sickness, (AMS) is
more common. The incidence of appetite loss, headache, nausea and vomiting are
higher, affecting to a greater or lesser extent, 80% or more of the visitors to
the Kibo Hut area (4,800m) and above.
Information and recommendation
contained in the section below should be regarded as a guide only. More detailed
medical information can be obtained from such specialist publications as "Medicine
for Mountaineering" published by The Mountaineers of Seattle, USA; or, "Mountain
Medicine and Physiology" published by the Alpine Club in London.
Specific high altitude
problems: Caused through the inability of the human body to adjust to a rapid
gain in altitude, problems range from mild cases of AMS, experienced to some extent
by most climbers, through its various forms to the often fatal Pulmonary and
Cerebral Oedema’s.
The latter being less common.
Oddly enough, young fit males seem to be the most badly affected by altitude.
Symptoms of AMS include,
(in the order usually experienced), headache, nausea, vomiting, anorexia, exhaustion,
lassitude, muscle weakness, a rapid pulse even at rest (+ 120/min), insomnia,
swelling of the hands and feet and a reduced urine output. Climbers with severe
symptoms MUST stop ascending and seriously consider descending to a lower
altitude. Often a drop of as little as 500m and a stay of a couple of days at
that altitude will allow proper acclimatization to take place. Use of the drug
Diamox can help prevent or reduce the severity of AMS.
With Pulmonary Oedema,
additional symptoms may be noticed - shortness of breath, even at rest, gurgling
bubbly sounds in the chest and sometimes a watery blood-tinged sputum. Skin may
be cold and clammy, finger nails and lips bluish. With Cerebral Oedema,
severe headache, hallucination and lack of co-ordination are additional symptoms.
Treatment must be immediate. DESCEND!!! Even if it means walking down at
night. The speed with which these two conditions kill is often as little as 12
hours from when the symptoms first become apparent. If bottled oxygen is available,
it should be used.
Precautions that the visitor
can take to help minimize the severity of mountain sickness include; staying a
night at 3000m and an extra night at 3,800m (Horombo). Maintain a slow steady
pace whilst walking up. There is little point in trying to out distance every
one else, for even at a slow pace, the time between huts is seldom in excess of
6 hours. Drink at least 3 liters of fluids each day. Dehydration, even mild, leads
to a thickening of the blood with increased possibility of pulmonary embolism
or a thrombosis. Urine colour should be pale and the output copious.
Exposure: Or more
correctly, hypothermia, is the lowering of the body’s core temperature. Prevention
is the best course of action. Use appropriate equipment. Do not allow oneself
or ones clothing to become wet either from rain or perspiration. When at rest,
keep out of the wind. Treatment is simple and needs to be carried out as quickly
as possible. If a hut or natural shelter is not close by, a tent, bivi bag or
similar protection should be arranged to keep the victim dry. REMOVE wet
clothing and place the victim in a sleeping bag (or two or three), if possible,
another person should be placed in the bag as well, direct skin to skin contact
is the best. Once the victim is conscious, hot drinks will go a long way to boost
morale.
Frostbite, though
unlikely to kill, can result in later loss, through amputation, of the body’s
extremities such as fingers and toes. Equipment in the form of good woolen mittens,
good footwear and keeping dry is 90% of the way to preventing the problem. Warning
signs are severe pain in the affected area followed by a complete loss of feeling
there. Colour of the affected area will be almost white.
Sun related injuries:
As about 50% of the earth’s protective atmosphere is below an altitude of
5000m, far less of the harmful low frequency ultra violet light is filtered out,
and the suns rays are much more powerful. This can result in very rapid burning
of exposed skin. A preparation of 5% PABA in zinc oxide cream, or factor 25+ sun
cream is recommended protection.
Dark glasses with side panels,
‘wraparounds’, or proper snow goggles, are best warn at all times above 4000m
especially when the sun is out, and are essential when crossing snow or ice, even
in cloudy conditions. Snow blindness is a very painful experience. Eye
drops may help through the only real cure is to keep the eyes bandaged up to 24
hrs or more.
Feet problems: Blisters
are usually a result of poor fitting, new or little used boots. As soon as a ‘hot
spot’ is felt, stop, remove the boot and cover the area with zinc oxide tape,
mole skin or gel tape. If boots are even slightly to small, the will hit against
the front of the boots and be badly bruised, particularly when descending. Toe
nails should be kept as short as possible.
Cuts and abrasions: Stop
bleeding with direct pressure to the wound. If an artery has been cut, a tourniquet
should, if direct pressure is ineffective, be applied above the cut. Note that
the tourniquet should not be so tight as to cut off circulation to the Clean wounds
and the surrounding area with water and soap, preferably antibacterial. Usually
it is best not to cover abrasions and small cuts, but rather let them dry out.
Trauma: usually results
from a broken limb or other major injury. See section on mountain rescue. Medication
should not be given unless pain is extreme, for the victims ability to co-operate
or make decisions is reduced, further more there is the risk that it may contribute
to depressing the vital functions. In all instances, if drugs are given, record
the brand name, amount and the time it was administered.
Fitness: Any walker
who suffers from pulmonary or cardiac problem should be particularly cautious
about going on the mountain. If there is any doubt, consult a doctor. Normal preparation
should include several long walks before hand, with, if possible, some steep uphill
sections. If possible use the same footwear one intends to use on the mountain
and carry a light pack as well.
Above taken from: Kilimanjaro
1: 50 000 Map and Guide. By Mark Savage 1997.
MOUNTAIN SICKNESS RATINGS
The below chart of fairly
common symptoms will allow you an idea of how badly the mountain sickness is affecting
you, and suggest treatment. This is a personal guide only ...... your mountain
guide and your own feelings will determine the rest. Take note of the symptoms
of HAPE and HACE above.
SYMPTOM SCORE
Headache 1
Nausea and appetite
loss 1
Insomnia 1
Giddiness / Dizziness
1
Headache that remains
after aspirin 2
Vomiting 2
Difficult breathing
at rest 3
Abnormal or intense
fatigue 3
Decreased urination
3
Symptoms may disappear /
lessen as day progresses.... e.g. you may feel ill after lunch, but fine after
a rest and cup of tea on arriving in camp mid afternoon etc. Symptoms that last
for a while are what you must take notice of. In the final analysis YOU know how
YOU are feeling.
Add up your score and then
determine your condition and treatment as below
1-3 ----- Light Mountain
Sickness ----- Aspirin
4-6 ----- Mild Mountain
Sickness ----- Aspirin + Rest + Stop Ascending
6+ ----- Acute Mountain
Sickness ---- DESCENT !!!!!!!!!!!
Source; Himalayan
Kingdom Expeditions Trip Dossier 1998.
