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Avoiding the dangers of altitude sickness when climbing Kilimanjaro

Climbing Kilimanjaro is the adventure of a lifetime. This iconic mountain has captured the imagination of adventurers for decades.

It’s easy to see why it is so popular. It is the tallest mountain in Africa and at 5,895 metres, its height has earned its place on the seven summits – which are comprised of the highest mountains on each of the 7 continents.

Kilimanjaro is accessible in that anyone in reasonably good health can climb it because it is not a technically difficult mountain to climb. However, it has a summit success rate of 60% and one of the main factors that affect this is altitude sickness caused by the high elevation.

At 5,895 metres Kilimanjaro is in the extreme altitude zone and almost everyone who climbs it will be affected by altitude sickness, in some way.

Altitude sickness can cause shortness of breath, dizziness, nausea and headaches. Climbers may feel the effects of this altitude from as low as 1,500 metres (4,921 feet).

However, with advance preparation and planning, it is possible to mitigate the effects of altitude sickness and prevent it from becoming more severe.

It is worth noting that the route you choose to climb Kilimanjaro can determine how well you acclimatize to the high altitude.

The longer the route, the more your body has a chance to adjust to it. In general, the 7-8 day routes help you to adjust much better to the altitude.

Although it is possible to climb Kilimanjaro in as little as 5 days, this is only recommended for experienced mountaineers who are accustomed to high altitude climbing. For most climbers, the longer routes are recommended.

Mount Kilimanjaro is a relatively safe mountain to climb and the risks are very low compared to other mountains, especially with advance preparation.

In this blog, we will discuss how you can prepare for your Kilimanjaro climb and mitigate the impact of altitude sickness.

What is altitude sickness?

climbing kilimanjaro, Avoiding the dangers of altitude sickness when climbing Kilimanjaro

A common question that many new climbers ask is 'what is altitude sickness?'

Altitude sickness is the side effect caused by exposure to high altitudes. As a person reaches higher altitudes, the air contains less oxygen which begins to negatively affect the human body.

Symptoms usually develop from around 2,500 meters of altitude.

First signs of altitude sickness include headache, nausea or shortness of breath. More severe symptoms include dry cough, fever, vomiting or retinal haemorrhage.

Extreme cases can include fluid build up in the brain characterized by loss of coordination, confusion, inability to walk and even coma. If left untreated, AMS can be lethal.

If such symptoms arise, immediate descent assisted by your guide is imperative to avoid more serious and lasting consequences.

How dangerous is altitude sickness on Kilimanjaro?

climbing kilimanjaro, Avoiding the dangers of altitude sickness when climbing Kilimanjaro

Altitude sickness is a serious and potentially dangerous risk when climbing Kilimanjaro.

If ignored and left untreated, it may become severe and, in extreme cases, lethal.

It is the most common cause of tourist deaths on Mount Kilimanjaro and needs to be taken seriously by the climber. It is important to climb with a well-trained and experienced guide who can monitor your individual altitude acclimatization, watch out for symptoms of altitude sickness, and – if required – insist on and assist with your descent.

There is currently no public information about the number of people who suffer from severe altitude sickness when climbing Kilimanjaro. We expect that it may be significantly higher than common estimates.

So this leads us on to another question: why do incidents not get reported?

Kilimanjaro is a major source of tourist revenue and income for Tanzania. The local government naturally has an incentive to keep a clean safety record in order to attract more climbers. Therefore, local tour operators are encouraged by the government to keep safety incidents on Kilimanjaro confidential.

Moreover, no tour operator would voluntarily want to disclose their own records. Because even if they are much better than any competitor, it would create the perception that they don't have good Kilimanjaro safety practices if they are the only ones disclosing those incidents.

 

However, there are ways that you can mitigate the impact of altitude sickness when climbing Kilimanjaro. We discuss these in more detail below.

How to prevent altitude sickness

Almost everyone who climbs Kilimanjaro will be affected by the high altitude to some extent. However, you can take steps to prevent altitude sickness from becoming more severe. One of the ways you can do this is by following the 3 golden rules of acclimatization.

The so-called 3 golden rules of altitude acclimatization will help you acclimatize naturally in order to reduce the discomforts and risks associated with altitude sickness. The golden rules are:

  1. Take your time: Choose a route that allows you to ascend slowly over multiple days, and walk slowly during the day.
  2. Stay hydrated: Drink at least 2-3 liters of water every day, or more if in combination with dehydrating substances such as diamox or caffeine.
  3. Walk high, sleep low: Sleep at a lower altitude at night than you've climbed during the day. Some routes offers such a beneficial altitude profile.

This means that the best way to prevent severe altitude sickness in advance is by choosing a longer route with a good altitude profile.

Importance of choosing the right route

climbing kilimanjaro, Avoiding the dangers of altitude sickness when climbing Kilimanjaro

A common people ask is how long does it take to climb Kilimanjaro? Budget and time permitting, we recommend that you climb for at least 7 and ideally 8 days.

Taking your time helps you to acclimatize naturally to the high altitude and therefore reduces discomforts and the risks of altitude sickness. The better you acclimatize, the more likely you will reach the summit (and safely so).

There is statistical evidence that 7 days leads to a higher summit success rate than 5 or 6 days. Route permitting, you may even want to consider 8 days or more. However, please note that we do not (yet) see sufficient evidence that your summit success chance significantly further improves beyond 7 or 8 climbing days.

Shorter routes that last just 5-6 days are only suitable for experienced climbers who are accustomed to high-altitude climbs.

Importance of choosing the right operator

climbing kilimanjaro, Avoiding the dangers of altitude sickness when climbing Kilimanjaro

Choosing the right operator means you will have better trained and experienced guides that can help you should anything go wrong, for example, if you have severe altitude sickness.

One way to stay safe on Kilimanjaro is to book a tour with a KPAP Partner company. KPAP is an abbreviation for the Kilimanjaro Porters Assistance Project and is an independent organization that monitors porter treatment practices locally.

Although KPAP does not measure safety criteria, we believe that companies who have demonstrated a commitment to treating their porters fairly are also more likely to be committed to your safety, compared to the industry average. On the other hand, some budget operators use guides and companies who are not even duly licensed.

You should also choose a company that is very transparent about the safety standards/equipment included in each tour. If possible, spend a little more on a premium tour that includes a Wilderness First Responder certified guide and emergency oxygen; plus a hyperbaric chamber for overnight stays at Crater Camp.

At Fair Voyage, we offer good safety standards for an affordable price on our premium tours and we also offer luxury packages.

Symptoms of moderate altitude sickness

climbing kilimanjaro, Avoiding the dangers of altitude sickness when climbing Kilimanjaro

Moderate altitude sickness is a little more intense than mild short-term altitude sickness. Fatigue, weakness, and shortness of breath gets worse instead of improving over time.

Climbers may start to experience a loss of coordination and although the person may still be able to walk on their own, it will become more difficult for them to do so. Normal activities will also become more difficult.

This may be accompanied by symptoms of nausea, vomiting, tightness, congestion in the chest and severe headaches that are not relieved by pain medication.

If a person is showing signs of moderate altitude sickness, immediate descent is necessary.

Symptoms of severe altitude sickness

climbing kilimanjaro, Avoiding the dangers of altitude sickness when climbing Kilimanjaro

Although all Kilimanjaro climbers may experience mild altitude sickness to some degree, in extreme cases, it can develop into more severe forms, which include HAPE (high altitude pulmonary oedema) and HACE (high-altitude cerebral oedema).

HAPE is excess fluid on the lungs, and if altitude sickness has progressed to this stage, a person may experience shortness of breath while they are resting, coupled with fever and coughing.

Another severe form of altitude sickness is HACE, which is fluid on the brain. Symptoms of HACE include clumsiness, confusion and stumbling.

Sometimes a person with severe altitude sickness may have both HAPE and HACE.

A person suffering from severe altitude sickness may also have a bluish, grey or pale skin tone. In this case, immediate descent is imperative.

What is the best action when experiencing symptoms of moderate altitude sickness?

If you are experiencing moderate symptoms of altitude sickness, then in the interests of your own safety, we recommend immediate descent. If symptoms do not improve with descent, then hospital treatment is necessary.

Some guides may encourage climbers to keep going even if they are suffering from altitude sickness.

This is not recommended. If you notice that your symptoms are getting worse, then you should insist on descending.

What is the best action when experiencing symptoms of severe altitude sickness?

If you are experiencing symptoms of severe altitude sickness then immediate descent is mandatory. You should also seek emergency hospital treatment even if your symptoms improve.

What else can you do for your own safety when experiencing symptoms of altitude sickness?

The key thing here is to remember that altitude sickness can be lethal. Therefore, it is important to be honest with your guide and never try to hide the fact that you are feeling ill.

Although some guides may try to persuade you to keep going even when you are feeling very unwell, coming down safely is mandatory.

Summiting is optional but you should remember that there is no shame in making the difficult decision to descend. Instead, your number one priority is your health and wellbeing and you should be proud of your achievement.

By taking the decision to climb Kilimanjaro, you have already achieved far more than most people. So by prioritizing your life and knowing when to call it a day, you will not only stay safe, you will also be setting a good example for other climbers.

What can you do for the safety of your group members?

When you observe moderate or severe symptoms of altitude sickness in any of your group members, this is when you should force an open discussion. You should make the climber and your guide aware of what you're observing.

Understand that there are different dynamics at play and remember that the affected climber may not always be in a position to act in their own best interests and your guide may be reluctant to insist on descent.

If this is the case, then try to keep calm and have a factual discussion. Make sure the climber understands that you're concerned about their safety and you should understand that the final decision will rest with the guide.

How many guides will there be for my group when climbing Kilimanjaro?

climbing kilimanjaro, Avoiding the dangers of altitude sickness when climbing Kilimanjaro

When climbing Kilimanjaro, you must have at most 2 climbers per guide, and at least 2 guides for groups of 2 climbers or more.

This ensures that there will always be enough guides to assist climbers who require descent, while at the same time allowing all other climbers to continue their summit ascent safely.

The minimum guide-to-climber ratios are stipulated by Kilimanjaro National Park regulations and they apply to all climbs booked via Fair Voyage. So for every group, there will always be one lead guide, and we have classified all other guides as assistant guides.

Please beware that guides and companies operating illegally on Kilimanjaro may not adhere to these minimum ratios, which can lead to dangerous, life-threatening situations. While it may be tempting to save costs by booking with a low-budget operator, your financial savings may come at the cost of your own safety.

Minimum ratio of Kilimanjaro climbers per guide for all climbs booked via Fair Voyage:
ClimbersGuides
1 climber1 guide
2 climbers2 guides
3 climbers2 guides
4 climbers2 guides
5 climbers3 guides
6 climbers3 guides
7 climbers4 guides
8 climbers4 guides
9 climbers5 guides
10 climbers5 guides
11 climbers6 guides
12 climbers6 guides

How to find the best Kilimanjaro guide

climbing kilimanjaro, Avoiding the dangers of altitude sickness when climbing Kilimanjaro

Currently, there are no objective certifications or ratings which can help you to find the best Kilimanjaro guides. We are hoping to change that eventually and create an industry standard. However, there are ways that you can increase your chances of finding a good guide.

Firstly, you should book with a responsible tour operator. They tend to have the best guides, because they are better paid, trained properly and given the resources they need to navigate the mountain.

The two things you want to look for are Wilderness First Responder (WFR) training and CPR first aid training, should you fall ill on the mountain.

Who certifies Kilimanjaro guides for Wilderness First Responder (WFR)?

Kilimanjaro guides have to undergo many hours of practical and theoretical training to obtain their Wilderness First Responder (WFR) certification.

The cost of doing this is often paid by the tour operator. Most tour operators who employ WFR certified guides train their guides at Wilderness Medical Associates International (the only institute that conducts training in Tanzania). WFR certificates are valid for three years.

Our most luxurious tour operator partners send their guides overseas to train at the Sentinel Outdoor Institute, which is based in the US.

What motivates guides?

climbing kilimanjaro, Avoiding the dangers of altitude sickness when climbing Kilimanjaro

Although many Kilimanjaro guides choose their profession out of passion, remember that guides are human beings that have the same pressures as other people. They usually have a family that relies on their income, including children and elders.

In a country without social security and where people are still working to move up to a higher income level, pay is an important motivator.

Therefore, tipping is a major component of pay for all guides, particularly for those that are employed by operators who do not treat their staff fairly. With many of these budget operators, guides rely solely on a tip. The highest tips are usually paid by happy climbers after they've reached the summit.

Ask yourself: Would you be willing to give your guide a big tip if he forced you to descend before reaching the summit? As long as you have doubts whether that decision was really necessary and whether you could still have reached the summit, you will be unlikely to reward your guide for keeping you from reaching your dream.

Unfortunately, those hard decisions to force climbers to stop often have to be made by guides under uncertain conditions. You might have made it and stayed safe, or you might have suffered severely – perhaps even with your life – if you had continued to push.

This is why it is important for you to understand that guides have a natural incentive to get you to the summit, even if it is risky. However, this is less likely to happen with an ethical company that pays their porters and guides fairly.

Final thoughts

climbing kilimanjaro, Avoiding the dangers of altitude sickness when climbing Kilimanjaro

The important thing to remember when climbing Kilimanjaro is that preparation is essential when it comes to mitigating the effects of altitude sickness.

Part of that preparation includes choosing a longer route that lasts between 7-8 days, which allows you to acclimatize to the high altitude.

You should also book your trip with an ethical tour company, which pays their staff properly. This helps to ensure you get well-trained guides that have the resources to help you navigate the mountain safely.

Typically, a responsible tour operator will have guides trained in Wilderness First Responder (WFR) and CPR first aid training.

However, the key thing to remember while you are on the mountain is that if you do fall ill and you are experiencing moderate to severe altitude sickness, then immediate descent is necessary.

You must also seek emergency treatment, particularly if descending does not alleviate your symptoms.

Communication is also essential. The old adage that there is safety in numbers applies here, so be open with your guides and other members of the group. Be sure to speak up if you are unwell or you are concerned about another climber.

By following these basic steps, you will help to ensure that your Kilimanjaro climb is a safe one.

Need more information about climbing Kilimanjaro?

For more information on climbing Kilimanjaro, or to book a climb, please visit our Climbing Kilimanjaro Experience page, which contains more tips, itineraries and booking information.

You can also request a quote and get a free copy of our Climb Kilimanjaro eBook.

About the author

Janine is a travel content writer and blogger, with a background in marketing and journalism. She loves travelling and uses her writing to share her passion for responsible travel with others.
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