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Monday, April 02, 2007

How trekkers risk reaching a fatal high (The Guardian)

How trekkers risk reaching a fatal high on Africa's biggest peak
Altitude illnesses strike as charity groups accused of rushing to 5,895m summit
Ed Douglas
Saturday March 31, 2007The Guardian

"Climbing Kilimanjaro," Marcel Bujold said as he prepared to travel to Tanzania, "is one of my oldest dreams." Even better, he and his wife would be reaching the summit at 5,895m (19,340ft) to raise money for CARE Canada, the international relief and development agency.
Mr Bujold, a 65-year-old grandfather of four from Carelton, Quebec, had been working as a CARE volunteer for more than 10 years. But he fell ill last week as he trekked up Africa's highest mountain and, despite prompt medical attention and evacuation, he died.

Climbing Kilimanjaro to raise money has become a lucrative source of revenue for many charities. The 31 trekkers on Marcel Bujold's expedition had committed to raising at least £2,200 each. British charity trek agents claim a typical expedition with 20 trekkers can raise anywhere from £30,000 to £40,000.

But high-altitude medical experts say they are alarmed about how quickly some expeditions reach the summit where there is less than half the oxygen found at sea level. They say that many charity trekkers, who do not have previous experience of high altitude, are being asked to take unnecessary risks.

David Hillebrandt, medical adviser to the British Mountaineering Council, said: "We're not suggesting that people shouldn't raise money in this way. Far from it. We just want trekkers to understand that there are risks associated with being at high altitude and they would be well advised to take a bit longer over their trip so their bodies can acclimatise naturally."

According to Dr Hillebrandt, acclimatising to high altitude is a complex business. Each individual responds differently to altitude, and fitness does not prevent trekkers from falling ill. Standard high-altitude medical advice says trekkers should not sleep more than 300m above their previous night's altitude above 3,500m. Dr Hillebrandt says that many with experience of altitude ascend more quickly than that. "But you'd be foolish to plan to do Kilimanjaro in less than five nights as a novice trekker," he said.

More than 30,000 people climbed Kilimanjaro in 2005, up from 20,000 five years ago, and trekking agencies say there are around 10 to 15 fatalities each year. Western trekkers who die are required to have an autopsy under Tanzanian law. Local porters, hired to carry supplies and equipment, are buried without one. Studies show that more than half of trekking deaths are caused by high-altitude illnesses.

Although the risk of death is quite small, the number of trekkers requiring medical treatment and evacuation is around 3%, or a thousand cases a year. Most of those involve acute mountain sickness (AMS), which can be avoided with proper acclimatisation. Symptoms include vomiting, dizziness, headaches and insomnia. AMS can develop into potentially fatal conditions including pulmonary or cerebral oedema.

Trekkers rush to the summit partly because the Tanzanian authorities charge a fee of more than $100 ($50) a day to enter Kilimanjaro National Park.

But Dr Hillebrandt said: "Would you choose to go on a holiday with an 80% chance of becoming sick with an illness that in some cases can, within hours, progress to becoming a life-threatening condition?"

CARE Canada's president John Watson would not speculate on the cause of Marcel Bujold's death but acknowledged Kilimanjaro's high altitude was at least partly responsible.

But CARE Canada's tour agents, Tusker Travel, did take time to ascend slowly. "CARE works with Tusker because of their high standard of safety and security," Mr Watson said.

Other companies are not so cautious. In a recent study of 20 British charity treks to Kilimanjaro, only one, organised on behalf of Childline by adventure company Charity Challenge, exceeded Dr Hillebrandt's recommended minimum, while 75% spent just four nights or less before attempting to reach the summit.

Discover Adventure organises Kilimanjaro charity treks for charities including Scope and Macmillan Cancer Support. Its trekkers take four nights to climb Kilimanjaro, and the company says this is a sufficient safety margin. It takes UK doctors on its trips, and most are specialists in high-altitude medicine.

"We're very aware of safety," said spokeswoman Hannah Kelsall-Joel. "We have to be in this industry. We've worked with charities for over 10 years, and we know that they are much more familiar household names than we are. If something goes wrong on a trip it's very bad press for them."

But Ms Kelsall-Joel is also anxious about safety standards on the mountain. "Fundraising challenges have now been around for a long time and attract people who aren't experienced and don't fully appreciate what they're getting into.

"You get people applying who don't really understand the risks and it's down to us as companies to make sure they do understand them. There are companies out there whose standards aren't as high as ours."

Staff at CARE Canada are still in shock at the death of a valued supporter. "When something like this happens," John Watson said, "you have to go back and look at the fundamentals of what you're doing. I know we will want to review this particular fundraising event and we'll make a decision on whether it should be continued in coming years."

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