Understanding Altitude Effects
The Swahili phrase “Pole Pole”, often reiterated throughout Kilimanjaro treks, translates to “slowly slowly”. This is more than just a saying; it's a mantra emphasizing the importance of a gradual ascent on Kilimanjaro, facilitating better acclimatization. Every climber, regardless of their physical fitness or experience, can be affected by altitude sickness on Kilimanjaro in diverse ways. It's not uncommon for even the fittest athletes to be impacted as much as those less in shape. Given this unpredictability, some trekkers consider consulting with healthcare professionals familiar with high-altitude conditions.
As you progress to higher elevations, the air becomes notably thinner, leading to reduced oxygen pressure. At heights between 5500m – 6000m, the atmospheric pressure plunges to about 50% of what one would experience at sea level, effectively halving the available oxygen. While it might seem that breathing at double the pace is the solution, the challenges mount. The lung's capacity to extract and process oxygen deteriorates at a rate even faster than the decreasing oxygen pressure. Coupled with the physical and mental exertions of the trek, the body's demand for oxygen significantly escalates, underscoring the importance of understanding altitude effects.
Can oxygen become too low? There is no exact scientific evidence to determine exactly what percentage of atmospheric or internal body oxygen is too low. Each body reacts differently and some can adapt to the lower oxygen easier than others.
Identifying Altitude Sickness
Mild symptoms of altitude sickness on Kilimanjaro might include headaches, fatigue, loss of appetite, and dizziness. Many trekkers experience some of these symptoms, but with proper monitoring by our guides, most can still summit successfully. More severe symptoms, like hallucinations or fluid buildup in the lungs, are serious and require immediate attention.
Mild / Accute Altitude Sickness symptoms
- Headaches
- Fatigue
- Lost appetite and nausea
- Shortness of breath
- Dizziness
- Poor sleep
Most of our trekkers will experience some form or another of the above and it does not mean you cannot still successfully and safely summit with close monitoring from our guides.
Moderate Altitude Sickness symptoms
- Awful headaches that cannot be releived with medication
- Short or shortness of breath
- Strong feelings of nausea and muscle fatigue
- Ataxia (feeling of decreased coordination)
Some trekkers do experience the moderate symptoms and with monitoring and considering other factors (blood oxygen, overall condition) you may still be able to summit successfully or be advised to descend where unsafe.
Severe Altitude Sickness symptoms
- An inability to walk or stand
- Severe shortness of breath, even at rest
- Inability to think straight (poor cognitive ability)
- Fluid buildup in lung
- Hallucinations
Most do not reach the severe altitude sickness symptoms as they should have turned around before their onset. These symptoms can sometimes appear suddenly or overnight and immediate descent / evacuation is the best solution with emergency oxygen administered by guides if deemed necessary.
It is suggested that anyone who is exposed to below 80% blood oxygen for a prolonged period is at risk of organ failure however recent research also indicates that some humans can still adapt and survive at below this level. It is for this reason any clients who descend with symptoms above moderate are recommended to visit the hospital before returning to their post climb lodges or carrying on with their next tour.
Recognizing Severe Altitude Illness Conditions
There are two altitude sickness conditions that demand immediate attention:
High Altitude Cerebral Edema (HACE)
High Altitude Cerebral Edema (HACE) is a severe altitude sickness condition. It occurs when pressure build-up in the brain results in fluid breaching the capillary walls in the cranium. It is a rare condition on general treks, but much more common among mountaineers in high altitude mountain ranges such as the Himalayas.
Here are the typical symptoms for suffers of HACE: very bad migraines, loss of coordination, hallucination and disorientation, memory loss, and loss of consciousness (ultimately leading to lapsing into a como). Generally HACE tends to strike at night and the condition can worsen rapidly. Hence, time shouldn’t be lost in getting someone down to lower altitudes if they have suspected HACE. Do not wait for daylight. Descend immediately.
High Altitude Pulmonary Edema (HAPE)
High Altitude Pulmonary Edema (HAPE) is another fatal altitude illness condition. It occurs when fluid breaches the pulmonary capillaries and enters the lungs. Fluid in the lungs inhibits the effective exchange of oxygen to the blood.
Here are the signs that someone is suffering from HAPE: very tight chest and extreme shortness of breath (even while resting), the feeling of suffocating, particularly during sleep, coughing up white or mucus coloured frothy fluid, extreme fatigue, irrational behaviour and hallucinations.
Like HACE, descent is paramount, but caution should be taken not to exert the person suffering from HAPE as this can worsen the condition. Any available oxygen can and should be administered. The drug, Nifedipine, has also been shown to help ameliorate the condition, but descent is always required.
Regular monitoring with high-altitude pulse oximeters, understanding the implications of blood oxygen levels, and taking necessary precautions are crucial. Your blood oxygen levels will be monitored regularly on the trek for your safety.
Tips for Acclimatization
Successful acclimatization is key to avoiding altitude sickness. To avoid altitude sickness on Kilimanjaro, it's essential to:
- Ascend slowly, because it takes time to acclimatize
- Choose additional acclimatization days or longer itineraries on trek
- Take slow, steady, controlled deep breaths
- Drink plenty of water, recommended 3-5 liters per day
- Eat enough food especially a high calorie / carbohydrate diet for energy even if your appetite is low
- Do not over-exert yourself
- Sleep well and get enough rest
- Choose an itinerary that takes you to higher altitudes during the day, but overnights are spent at lower altitudes
- Avoid tobacco, alcohol and other depressant drugs including tranquilizers, sleeping pills and opiates. These will decrease the respiratory drive during sleep resulting in altitude sickness
- If symptoms of altitude sickness appear, inform your guide immediately
Non-Altitude Related Health Concerns
While altitude sickness is a primary concern, trekkers should also be vigilant about:
- Cold and coughs
- Dehydration
- Hypothermia
- Frostbite
- Sunburn
- Snow-blindness
- Foot blisters
- Sprains
- Fractures
- Knee problems
Awareness of both altitude and non-altitude related health issues ensures climbers are prepared for the varied challenges of Kilimanjaro.
