KILIMANJARO
TIPS AND GENERAL INFO

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. A stick/ski pole is very necessary - hire/buy up there or take with you.
7. Thin socks inside thick socks really helps.
8. Light shoes for around the camp relieve your feet.
9. A decent pile/fleece sweatshirt is invaluable (available for hire)
   
10. 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.
    
11. 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.

"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.