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Altitude sickness is a serious health problem experienced by some climbers on Kilimanjaro. If you have a good guide team to manage the climb, it can be avoided.
Altitude sickness is by far the dominant health issue on the mountain and really the only thing that makes climbing Kilimanjaro so difficult. Kilimanjaro is seriously high. No amount of training and no amount of other trekking below 4000m altitude can prepare you fully for this. Almost all people who climb Kilimanjaro suffer some form of mild to medium symptoms of altitude sickness.
Some trekkers suffer symptoms severe enough to warrant their immediate removal to lower altitudes. Up to 1% of trekkers require emergency evacuation. Altitude sickness does need to be respected. Following the advice below should minimise the chances of inconvenience and catastrophe to acceptable levels.
Unlike other extreme peaks such as those in the Himalayas, the summit of Kilimanjaro is approached in just a few days, leaving very little time for the body to adjust. This is what makes Kilimanjaro such a unique, difficult and potentially dangerous challenge. A general rule on really big mountains like this is that you should climb high and sleep at low altitudes whilst ascending up Kilimanjaro.
Altitude Sickness on Mount Kilimanjaro FAQs
This zone covers the majority of all treks on Kilimanjaro, except the first half day on some of the lower starting routes. Here you can expect to be seriously impacted by the effects of altitude in terms of workload and stamina and you may start to feel the symptoms of sickness such as headaches and nausea.
VERY HIGH ALTITUDE: 4200m - 5400mThis zone covers the night before summit attempt on all routes and, on better routes, one or two acclimatisation hikes on earlier days. Here the effects of altitude are starting to become more acute, walking at anything other than a snail's pace is quickly tiring. Most people will now be experiencing adverse symptoms unless they are taking supplementary oxygen. Some people cannot handle this altitude at all and will need to be removed from the mountain.
EXTREME ALTITUDE: ABOVE 5400mThis zone covers much of the summit attempt, with Uhuru Peak at 5895m. At these altitudes your body is simply deteriorating, if you stay up here too long without oxygen you will die. Unless you have supplementary oxygen you are basically making a run for the summit in order to get down before you succumb to the adverse effects. If you have oxygen then you can take your time and will be more likely to clearly appreciate what is going on.
For many years we did not carry Emergency Oxygen Systems as part of our standard kit on the mountain, although we have always been able to provide them as an optional paid extra.The main pressure to carry these systems comes from the fact that some of the large charity outfits have started to take them as standard, largely due to the fact that they have a much more mixed clientele, some of whom are not particularly well suited to the rigours of the mountain. Some of our competitors have followed suit and now offer emergency oxygen systems as standard. But we continue to advocate that Emergency Oxygen Systems are not essential. Since our climb partners, African Walking Company started Kilimanjaro operations in 1999 they have never encountered a situation where it was needed.
A fluid intake of 4 to 5 litres per day is recommended. Fluid intake improves circulation and most other bodily functions, but does not increase fluid leakage from the body. Thirst should not be an indicator of proper fluid intake, if your urine is clear then you are drinking enough.
WALK SLOWLYPace is a critical factor on all routes. Unless there is a very steep uphill section your breathing rate should be the same as if you were walking down a street. If you cannot hold a conversation you are walking too fast. Breathing through the nose for the first 2 days of the trek will limit the pace. Walk "softly" allowing your knees to gently cushion each pace. "Pole pole" ... slowly slowly ... is the phrase that will echo around your head as it is repeated to you by the Kilimanjaro guides.
WALK HIGH, SLEEP LOWIf you have enough energy and are not feeling the effects of altitude, then you might take an afternoon stroll further up the mountain before descending to sleep. All our routes already include these recommended acclimatisation walks whenever possible.
DIAMOXDiamox is a drug which can be taken to assist the body by improving the efficiency with which oxygen can be absorbed from the thin air. There is no disputing the efficacy of the drug. There is however a big debate as to whether and how Diamox should be used.
SIMULATED ALTITUDE TRAININGThere are also certain centres around the world which are able to provide training facilities which simulate the effects of altitude. It is very rare for trekkers to use such a facility, but if you happen to have one close by, why not?
There are three different types of altitude sickness. The first is the most common and can often be managed without recourse to evacuation from the mountain. The other two are much more serious and tend to lead to immediate removal from the mountain.
ALTOXIADuring a trek on Kilimanjaro it is likely that more than 75% of trekkers will experience at least some form of mild altitude sickness caused by a failure of the body to adapt quickly enough to the reduced level of oxygen in the air at an increased altitude.This type of altitude sickness is known as Altoxia, a term which is used almost exclusively on Kilimanjaro since this is the only commonly trekked mountain where these extreme altitudes are encountered so quickly.Altoxia is most commonly experienced on the summit approach, but can also occur earlier in a trek, especially during day hikes to higher altitudes, in which case it should recede as the trek overnights at a lower altitude.
Altoxia can have many different symptoms, the most common being headaches, lightheadedness, nausea, loss of appetite, vomiting and mild swelling of the face, ankles and fingers. These symptoms can be rather unpleasant, add a new dimension to the adversity faced by trekkers and can really take the shine off the experience. However, in this mild form, Altoxia does not generally have serious consequences and normally disappears within 48 hours.
The symptoms of Altoxia are commonly relieved or even eliminated by use of an ALTOX Personal Oxygen System or by taking Diamox. If the symptoms of Altoxia become persistent or severe, then there is a danger of acute mountain sickness developing. This is a much more severe form than Altoxia and must be treated by immediate removal to lower altitudes. There are two distinct forms of this sickness
HAPE: HIGH ALTITUDE PULMONARY OEDEMATranslated for the layman = Water in the lungs! High Altitude Pulmonary Oedema is characterized by breathlessness at rest, very high pulse, crackling sound in the chest and coughing of pink fluid (sputum). This condition is rapidly fatal unless the casualty experiences immediate descent. There are no drugs to cure and no possibility of re-ascent following an episode.
HACE: HIGH ALTITUDE CEREBRAL OEDEMATranslated for the layman = Swelling of the brain.High Altitude Cerebral Oedema is a combination of two or more of the following: Very severe headache, severe loss of balance, mental confusion and repeated vomiting. This condition is rapidly fatal unless the casualty experiences immediate descent. There are no drugs to cure and no possibility of re-ascent following an episode.
Trekkers should not be too scared by all this talk, but it is essential to understand that if you push on or stay at the same altitude with AMS, HAPE or HACE then you will probably die. People do. The only correct resolution is immediate descent. Our guides are all very experienced in dealing with the problems of altitude. It may be necessary for you to descend to a lower altitude until you recover or even to abandon the trek in the interests of safety. The decision of the guide in such situations is final.
