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Written by: Doctor Leo Mavis (Belgium)

Fitness and training:  Lack of personal fitness can cause major problems, turning back may be difficult and it could endanger the rest of your group, delays high up on mountains in bad weather can be dangerous. Overexertion is a risk factor for altitude illness. Kilimanjaro, Everest Base Camp and many other treks involve strenuous days. On Kilimanjaro, the summit day involves climbing 1200m and descending 2200m. In addition, these hard days are at altitude where there is a reduced oxygen level.
At Kala Pattar (Everest viewpoint) or the summit of Kilimanjaro, there is only 50% of the oxygen that is available at sea level.
The fitter you are, the more you will enjoy your trek. Training should start three to four months before your departure.


The Buddy System: You should arrange a 'buddy system' (pairing up to keep an eye on each other) this is a good way for early recognition of illness and problems of members in your group. Buddies should then voice their concerns to the leader or team doctor as soon as possible.

Signs of Someone Becoming Unwell ("Grumble, mumble, stumble, tumble") These signs and changes in behaviour are particularly important when they are 'out of character'. Loss of appetite, missing meals, tiredness, lethargy; coming to camp late and last, going to bed early, being last to get out of bed.
Personality changes: anxiety, irritability, excitability, anger, aggression, complaining, social withdrawal, depression, loss of concentration, talking more or less, clumsiness, staggering, falling over, dropping things, inability to tie shoelaces or pack own bag. Breathlessness, confusion and drowsiness

Sunburn and Blisters: You should walk with a wide brimmed hat and wear it to reduce the risk of sunburn and heat exhaustion. Sunburned noses, necks, ears, the backs of hands on walking poles, and backs of knees and calves are painful and can last the rest of the trip. Cover up or burn!
Stop and attend to blisters at the first 'hot patch' symptom of rubbing.

Painkillers and Medications at Altitude: If pain relief is needed at altitude, paracetamol is a safe option while ibuprofen is better at treating the headache of AMS. Neither drug will mask symptoms of altitude illness.
No other drugs should be taken at altitude without consulting the team doctor or team leader

Fluids: Dehydration is common at low altitude, where it can be hot and humid, causing much sweat loss; it occurs also at altitude, while exercising in cold dry air. Trekkers need to keep their fluid intake up in the form of soups, drinks and water. Discipline yourself to stop and drink at least every hour. The way to know you are keeping ahead of dehydration is if your urine is 'pale and plentiful'. Strong- smelling, yellow urine passed infrequently and in small amounts means you are dehydrated!

Diarrhoea and Food Poisoning: Diarrhoea in developing countries has a greater than 50% incidence for first-time travelers. Diarrhoea can vary from mild to severe; it can result in dehydration and loss of salts with resulting depletion of energy and fitness. Diarrhoea is a cause of failure to complete a trek or to summit.
Reduce the risk of diarrhea by frequently washing your hands and avoid hand-to-mouth contact.


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