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Climbing Mt. Kilimanjaro and Altitude Sickness

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Altitude Sickness


Mt. Kilimanjaro

In 2012, I was lucky enough to get to climb Tanzania’s Mount Kilimanjaro.  Though the “climb” is really not more than an occasionally steep hike, it is still challenging because of the endurance needed at high altitude and, oddly, for the stamina in takes for the hike down.

More than 1/3 of the people that attempt “Kili” don’t make the summit – mostly because of altitude sickness.  Some people take no precautions and summit successfully and others, who do everything possible to prevent altitude sickness, still succumb.   Though I made it to the top, and took every precaution, the last 2000 feet in elevation gain were agonizing and my stay at the top very brief.

There are many good web sites that explain to some degree or another, about how to prepare for the Kili climb.  Before we left on our trip (there were four of us, and yes, I was the only one that got altitude sickness), we put together an amalgamation of everything we could find on what to pack and how to be successful.

Over 19,000 ft!

As every website will tell you, the best way to prevent altitude sickness is to ascend slowly.  A good guide will help you maintain a slow pace with the constant reminder of “pole pole” (Kiswahili for slowly).  But ascending slowly is more than just how much altitude you gain in a day; it is even how quickly you gain that altitude during the day.  There is no need to hurry from campsite to campsite (Our guides said energetic young men are the worst at proving their fitness by ascending quickly and they are also some of the most common to get altitude sickness).  In fact, if you hurry, you will miss a big part of Kilimanjaro.  Some of the most unique plants, animals, and views in the world can be seen along the way and missing them is missing out on what should be one of your main reasons for your climb.  Most days are less than 5 miles of walking and there is no hurry to get from one site to the next.  Your guides will have dealt with almost every imaginable scenario and taking your time will not bother them at all.  Enjoy the spectacular, see all you can!

Hydration is another key to success.  Once you breach the rainforest and enter the heath zone, the humidity level drops dramatically and the sun can be relentless (even though you won’t notice it because of the low temperature – don’t forget good sunglasses!).  It is important to drink at least 2 or 3 liters of water a day.  Drink as much as you can while in camp in the morning and evening, and take a liter or two with you on the days hike (more on this in a future article about packing for the climb).  The downside is you will urinate a lot (you do anyway at these altitudes), but the inconvenience of the occasional stop behind a bush is much better than a pounding headache, dizziness, nausea, and not completing your (expensive) goal.

Aerial View

Many people take Diamox (Acetazolamide) as a preventative (and treatment for) altitude sickness.  Our entire party took it, and no one suffered any ill effects – well, except me near the top.  To help prevent altitude sickness, start taking acetazolamide 1 to 2 days before you start to climb. Continue taking it while you are climbing and for at least 48 hours after you have reached your final altitude. You may need to continue taking this medication while staying at the high altitude to control your symptoms.  I have taken Diamox one other time when I was at high altitudes and, while others around me were throwing up and using oxygen masks, I felt fine and continued on my hike.  Unfortunately, Diamox is also a diuretic.  This means that constant hydration is even more important if you choose to take it – and I would every time I plan to spend much time over 10,000 feet.

The other highly recommended thing to do before your climb is to get in shape!  Climbing Mt. Kilimanjaro is strenuous and you will be walking 4-7 hours a day at high altitude – the better condition you are in, the less chance that the strain you cause on your heart and lungs will result in altitude sickness.  Regardless of which route you ascend, summit day will be the toughest with most people walking for between 14 – 18 hours and covering about 12 miles.  Oddly, the descent was maybe even harder than the climb up.  It is hell on your knees and a pair of hiking poles helps relieve some of the strain.

The bottom line is, do whatever you can do to increase you odds of success.  Climbing Kilimanjaro will be one of the greatest and most exciting adventures of your life, and reaching the summit….beyond words.

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