HOW DO I PREPARE TO CLIMB KILIMANJARO?
This section covers what gear you need to bring, physical training, Tanzania entry requirements (passport & visa), immunizations and vaccinations, and travel insurance.
Please read this carefully and make sure you have gathered everything before you depart on your trip.
WHAT GEAR DO I NEED TO BRING?
You are responsible for bringing personal gear and equipment while communal equipment (tents, food, cooking items, etc.) is provided. Below is a gear list of required, recommended and optional items to bring on your climb.
TECHNICAL CLOTHING
1 – Waterproof Jacket, breathable with hood
1 – Insulated Jacket, synthetic or down, warm
1 – Soft Jacket, fleece or soft-shell
3 – Long Sleeve Shirt, light-weight, moisture-wicking fabric
1 – Short Sleeve Shirt, light-weight, moisture-wicking fabric
1 – Waterproof Pants, breathable (side zipper recommended)
2 – Hiking Pants
1 – Fleece Pants
1 – Shorts (optional)
1 – Long Underwear, moisture-wicking fabric
4 – Underwear, moisture-wicking fabric recommended
3 – Sport Bra (women)
Headwear
1 – Brimmed Hat, for sun protection
1 – Knit Hat, for warmth
1 – Balaclava or Buff (recommended)
Handwear
1 – Gloves, warm (waterproof recommended)
1 – Gloves, light
Footwear
1 – Hiking Boots or Shoes, warm, waterproof
4 – Socks, wool or synthetic
1 – Gaiters, waterproof (optional)
Accessories
1 – Sunglasses Sunglasses or Goggles
1 – Backpack Cover, waterproof (optional)
1 – Water Bottle (Nalgene, 32 oz.)
1 – Water Bladder (Camelbak type, 3 liters)
1 – Towel, lightweight, quick-dry (optional)
1 – Pee Bottle, to avoid leaving tent at night (recommended)
Stuff Sacks, Dry Bags or “Ziploc”-Type Plastic Bags, to keep gear dry and separate. Note that there is a general ban on plastic bags in Tanzania, however, Ziploc-type bags for toiletries are permitted for tourists.
Equipment
1 – Sleeping Bag, warm, four seasons*
1 – Camp Pillow, inflatable (optional)
1 – Trekking Poles, collapsable (highly recommended)*
1 – Head Lamp, with extra batteries
1 – Duffel Bag, 70L-90L capacity, for porters to carry your equipment
1 – Daypack, 30-35L capacity, for you to carry your personal gear
*maybe rented on location
Other
Toiletries
Prescriptions
Sunscreen
Lip Balm
Insect Repellent, containing DEET
First Aid Kit
Face Mask (REQUIRED)
Hand Sanitizer (REQUIRED)
Toilet Paper
Wet Wipes (recommended)
Snacks, light-weight, high calorie, high energy (optional)
Electrolytes, powder or tablets (optional)
Camera, with extra batteries (optional)
Paperwork
Trip Receipt
Passport
Visa (available at JRO)
Immunization Papers
Insurance Documents
See What Should I Wear to Climb Kilimanjaro?
The most common mistake that climbers make is that they over pack and bring way too much gear.
Be selective in what you take with you. Please note that our porters are limited to carrying 33 lbs (15 kgs) of your personal belongings. Everything the porters will carry for you between campsites should be placed into the duffel bag, including the sleeping bag, but it is OK to pack the sleeping bag separately if necessary. If you rent a sleeping bag from us, note that the bag weighs 5 lbs 6 oz. and this weight does count against the 33 lb limit.
Our porters will place your duffel bag and sleeping bag into a large, sturdy, waterproof bag with a roll-top closure.
If you have excess weight, you will be required to hire an additional porter. It is rare to require an extra porter and should happen only in special cases, such as for carrying extensive photography equipment. You are expected to bring everything you need, though we do rent warm sleeping bags and trekking poles on location. All extra luggage, items you will not use on your climb, such safari clothing, gear and equipment, can also be safely stored at the hotel.
Plastic, recyclable water bottles are not allowed in the park, due to past problems with litter. So water should be carried in Nalgene bottles, water bladders, or similar devices. You should be able to carry 3-4 liters of water with you at all times. Please do not bring alcohol. It is illegal to have alcohol in the park. Our staff will not carry it for you. Besides, drinking and high altitude do not mix well.
Checked luggage on airplanes can get lost or delayed on the way to Tanzania. You should prepare for this possibility by wearing or carrying on the items that are essential to your Kilimanjaro climb. While most clothing, gear and equipment can be replaced in Tanzania prior to your climb, there are some things that you should not replace.
Praygod Africa Safaris recommends that you wear one complete hiking outfit on the plane, including a long sleeve shirt, hiking pants, underwear, socks, and hiking boots. In your carry on baggage, you should bring your backpack, waterproof jacket and pants, insulated jacket, fleece pants, snacks, toiletries, medications, camera and all paperwork. Airline regulations do not allow you to carry trekking poles on the plane. Make sure you do wear/carry your hiking boots; wearing a different pair of boots on your climb will likely cause blistering.
If your baggage is lost or delayed, please notify us immediately upon your arrival so we can assist you in assembling the necessary gear. We will take you to local, independently owned rental gear shops in Moshi. Note that these shops generally carry second-hand items that may not be up to Western standards. Praygod Africa Safaris cannot guarantee the fit, quality or functionality of items found in local shops. Therefore, we strongly encourage you to carry on the most important pieces of gear as noted above. We will make reasonable attempts to deliver delayed luggage to you on the mountain. All additional expenses that are incurred by us while resolving lost or delayed luggage problems must be reimbursed locally.
How do I Train to Climb Kilimanjaro?
Climbing Mount Kilimanjaro is a physical undertaking, so you should prepare yourself accordingly with a Kilimanjaro training program. Being in good shape is important in many respects. Obviously, strong, conditioned legs make it easier to walk uphill and downhill for sustained periods of time. General aerobic fitness allows the body to function efficiently with less oxygen. And a fit body is more likely to withstand the stress of consecutive days of hiking and camping. Finally, a positive mental attitude can work wonders for you when fatigue and doubts arise.
How hard is it to climb Kilimanjaro? That’s a difficult question to answer because some people don’t train much and fare very well, while others engage in a disciplined training program and succumb to the altitude in a few days. We’ve heard marathon runners tell us that climbing Kilimanjaro is the hardest thing they’ve ever done. The best advice we can give is to train adequately, as described below, and get yourself in the best possible hiking shape. The mountain is a big unknown, and you won’t know with certainty how you will react until you are there. In a survey we administered, on a scale of 1 (easy) to 10 (difficult), respondents rated their climb with an average difficulty of 7 (see Can an Unfit Person Climb Mount Kilimanjaro?).
The best exercise that you can do to prepare for Mount Kilimanjaro is hiking.
There are training regimens on other operator’s sites that entail strict, extensive, cross-training programs, featuring hiking, running, biking, swimming, weight training, etc. Do not be alarmed by this. Those programs are excessive and unnecessary. To sufficiently prepare for climbing Kilimanjaro, the best and perhaps only exercise you need to do is to hike – period. After all, that is what you will be doing on the mountain. Ideally, you should try to hike as much as possible on hills or mountains to simulate climbing Mount Kilimanjaro. Doing day hikes is superb training. For those who do not have access to trails, the next best option is to train on stairs. You can also train very productively on a stair master machine. As a last resort, walk as much as you can, with extended walks on the weekends.
You should start training for climbing Kilimanjaro at least two months prior to your departure.
If you’ve never hiked before, you should start with shorter time intervals, a slower pace, and no weight (in your day pack), and then gradually increase all of the above as your fitness level improves. Remember that on Mount Kilimanjaro, you will walk slowly for prolonged periods, and carry probably no more than 20 lbs in your day pack. Therefore, in your training, it is better to increase the time interval/distance and keep a slow pace than to shorten the time interval/distance and increase the pace. Try to train three times a week, for at least one hour per session, at a minimum. If you can do day hikes for four to six hours, with moderate elevation changes (~1,000 ft/305 m) while carrying a 20 lb pack, or if you can climb stairs or use a StairMaster for 1-2 hours, at 30 steps per minute while carrying a 20 lb pack, then you’re probably ready for the real thing.
Your longest/hardest workouts should be performed two to four weeks before your departure. For the last two weeks, you should taper off your training and in the final days, rest so that your body has time to recover before your actual climb. In addition to walking/hiking, you can also supplement your training with exercises such as running or cycling, which will increase your aerobic capacity.
It is imperative that during Kilimanjaro training, you wear the boots that you intend to climb with so that they are sufficiently broken-in (to prevent blisters). Additionally, you should wear the day pack you intend to carry so you’re your shoulders/back/hips get used to the points of contact and weight (to minimize chafing and soreness).
Lastly, physical training is just one part of getting in shape. If you have an unhealthy lifestyle, use the climb as your motivation to change. Eat more fruits and vegetables. Reduce your red meat consumption. Don’t drink or smoke. Get eight hours of sleep per night. Don’t worry. Be happy.
How Can I Prepare for High Altitude?
Getting your body in great shape through physical training certainly helps prepare you for altitude. However, the ability to adjust quickly to the changing oxygen content is largely genetic. As the Kilimanjaro climbing success rates show, some people can climb Kilimanjaro in as little as 5 days (not recommended), while some still fail with 8 days. It is impossible to tell how well a prospective climber may fare in an oxygen-deprived atmosphere until he or she is actually in it.
High altitude training systems enable climbers to pre-acclimatize at home, drastically improving the success rate, safety, and enjoyment of the climb.
Altitude training systems simulate high altitudes to induce beneficial biological adaptations in the body. Besides going to (and staying in) high altitude places, using a high altitude training system is the only way to pre-acclimatize to high altitude before your trip (see Pre-Acclimatization).
Should I Get a Medical Check-Up?
All climbers should have a medical check prior to attempting the mountain. Ask your doctor if high-altitude trekking is permissible for your age, fitness level, and health condition. Ask if you have any preexisting medical conditions that can cause problems on the climb. Ask if any of your medications can affect altitude acclimatization. Ask whether Diamox can be taken with your existing prescription medicines.
If you have any medical issues that can be make climbing Kilimanjaro more dangerous for you than the average person, we need to be informed of this before you book.
Such medical issues include but are not limited to: spine problems; circulation problems; internal problems such as diabetes, hypoglycemia, intestinal or kidney problems; respiratory issues such as asthma; high or low blood pressure; head trauma or injury; heart conditions; blood disease; hearing or vision impairment; cancer; seizure disorders; joint dislocations; sprains; hernia.
The minimum age for climbing Mount Kilimanjaro is 10 years old. There is no maximum age. However, the climb is strenuous and presents health risks, especially to people in high-risk categories. Serious consideration should be given to anyone under the age of 18 and over the age of 60. The climbers on the extreme ends of the age spectrum should definitely consult their doctor.
Our minimum fitness requirements are that each climber must have a resting heart rate of under 100 beats per minute. We will check your resting heart rate before your climb. If your resting heart rate is above 100, you will be required to see a local doctor prior to the climb to get approval. The average resting heart rate is 60-80 beats per minute.
What Are the Entry Requirements for Tanzania?
Foreigners seeking to enter the United Republic of Tanzania should be in possession of a valid passport, at least six months prior to expiration. The passport is to be presented to the Immigration Control Officer at any entry point: border station, airport, harbor. The passport must be presented along with one of the following:
- A valid visa
- Resident permit
- A pass
A visitor must also present an onward or return ticket together with proof that the visitor has sufficient funds to support himself or herself while in Tanzania.
All foreigners from non-Commonwealth countries are required to have a valid visa unless their countries have agreements with Tanzania under which the visa requirement is waived. Exemptions: Citizens of Commonwealth countries are not required to obtain visas unless they are citizens of the United Kingdom, Canada, Nigeria, or India. The visa is permission granted to a foreigner who intends to travel to Tanzania on business, for a holiday, to study or conduct research, or for other approved activities. When entering Tanzania, the visitor with a visa may then obtain from the immigration control officer, a pass, or any other authority to enter the country.
Visas are issued by the following:
The office of the Director of Immigration Services, Dar es Salaam, and the office of the Principal Immigration Officer, Zanzibar.
Tanzanian representatives abroad: Visas can be obtained at Tanzanian Embassies and High Commissions, such as the Tanzanian Embassy of the United States.
Entry points to the United Republic of Tanzania: principally Namanga, Tunduma, Sirari, Horohoro, Kigoma port, Dar es Salaam International Airport, Kilimanjaro International Airport, Zanzibar Harbour, and Zanzibar Airport.
Any other gazetted entry point.
At Kilimanjaro Airport, passengers disembark their flights outside on the tarmac. You may be required to show your boarding pass to staff outside the airport for verification that you got off the plane at the correct destination, so keep your boarding pass handy.
Upon entering the airport (which would be from the left side of the photo), there are several lines for visitors who have their visas and lines for visitors who need to purchase their visas. Pay attention to all open booths as the airport staff are not very helpful in directing the crowd to open lines.
You should have received a declaration form to fill out from the airline staff. If not, there are forms available inside the building. The declaration card is shown below and can be downloaded here. You will need to submit this form to immigration.
Pray god Africa Safaris recommends that clients obtain their visas prior to arrival in order to expedite the immigration process at Kilimanjaro International Airport.
The cost of a Tanzanian visa upon arrival for US citizens is $100, payable in US dollars. Canadian, Australian, British and most European passport holders can also obtain visas upon arrival at the airport. The cost of a Tanzanian visa is $50, payable in US dollars. Confirm with your embassy.
What Vaccinations, Immunizations, and Medications Do I Need?
The following information was obtained from the Center for Disease Control and Prevention, Tanzania.
Recommended Vaccinations and Preventive Medications
The following vaccines may be recommended for your travel to East Africa. Discuss your travel plans and personal health with a healthcare provider to determine which vaccines you will need.
Hepatitis A or immune globulin (IG). Transmission of hepatitis A virus can occur through direct person-to-person contact; through exposure to contaminated water, ice, or shellfish harvested in contaminated water; or from fruits, vegetables, or other foods that are eaten uncooked and that were contaminated during harvesting or subsequent handling.
Hepatitis B, especially if you might be exposed to blood or body fluids (for example, health-care workers), have sexual contact with the local population, or be exposed through medical treatment. Hepatitis B vaccine is now recommended for all infants and for children ages 11-12 years who did not receive the series as infants.
Malaria: your risk of malaria may be high in all countries in East Africa, including cities. See your health care provider for a prescription antimalarial drug.
Meningococcal (meningitis) if you plan to visit countries in this region that experience epidemics of meningococcal disease during December through June.
Rabies, pre-exposure vaccination, if you might have extensive unprotected outdoor exposure in rural areas, such as might occur during camping, hiking, or bicycling, or engaging in certain occupational activities.
Typhoid vaccine. Typhoid fever can be contracted through contaminated drinking water or food, or by eating food or drinking beverages that have been handled by a person who is infected. Large outbreaks are most often related to fecal contamination of water supplies or foods sold by street vendors
Yellow fever, a viral disease that occurs primarily in sub-Saharan Africa and tropical South America, is transmitted to humans through the bite of infected mosquitoes. The virus is also present in Panama and Trinidad and Tobago. Yellow fever vaccination is recommended for travelers to endemic areas and may be required to cross certain international borders (For country-specific requirements, see Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, by Country.). Vaccination should be given 10 days before travel and at 10-year intervals if there is ongoing risk.
As needed, booster doses for tetanus-diphtheria, measles, and a one-time dose of polio vaccine for adults.
Malaria
Malaria is always a serious disease and may be a deadly illness. Humans get malaria from the bite of a mosquito infected with the parasite. Your risk of malaria may be high in all countries in East Africa, including cities. All travelers to East Africa, including infants, children, and former residents of East Africa, may be at risk for malaria. Prevent this serious disease by seeing your health care provider for a prescription antimalarial drug and by protecting yourself against mosquito bites.
All travelers should take one of the following drugs:
atovaquone/proguanil,
doxycycline,
mefloquine, or
primaquine (in special circumstances).
Yellow Fever
A certificate of yellow fever vaccination is required for entry into Tanzania when arriving from countries where yellow fever is present.
Food and Waterborne Diseases
Make sure your food and drinking water are safe. Food and waterborne diseases are the primary cause of illness in travelers. Travelers’ diarrhea can be caused by viruses, bacteria, or parasites, which are found throughout East Africa and can contaminate food or water. Infections may cause diarrhea and vomiting (E. coli, Salmonella, cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage (hepatitis).
To stay healthy, do…
Wash your hands often with soap and water or, if hands are not visibly soiled, use a waterless, alcohol-based hand rub to remove potentially infectious materials from your skin and help prevent disease transmission.
In developing countries, drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, learn how to make water safer to drink.
Take your malaria prevention medication before, during, and after travel, as directed. (See your health care provider for a prescription.)
To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot, even on beaches.
Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.
Protect yourself from mosquito insect bites:
Wear long-sleeved shirts, long pants, and hats when outdoors.
Use insect repellents that contain DEET (N, N-diethyl methyl toluamide).
If no screening or air conditioning is available: use a pyrethroid-containing spray in living and sleeping areas during evening and night-time hours; sleep under bed nets, preferably insecticide-treated ones.
Do not…
Do not eat food purchased from street vendors or food that is not well cooked to reduce the risk of infection (i.e., hepatitis A and typhoid fever).
Do not drink beverages with ice.
Avoid dairy products, unless you know they have been pasteurized.
Do not swim in freshwater to avoid exposure to certain water-borne diseases such as schistosomiasis.
Do not handle animals, especially monkeys, dogs, and cats, to avoid bites and serious diseases (including rabies and plague). Consider pre-exposure rabies vaccination if you might have extensive unprotected outdoor exposure in rural areas.
Do not share needles for tattoos, body piercing or injections to prevent infections such as HIV and hepatitis B.
Avoid poultry farms, bird markets, and other places where live poultry is raised or kept.
Do I Need Travel Insurance?
Travel insurance is required to participate on this trip.
Trip deposits are non-refundable and balance payments are only partially refundable. Therefore, it is prudent for you to protect your investment against trip cancellation, interruption, delays and unforeseeable expenses. Standard travel insurance provides coverage for:
Trip cancellation
Trip interruption
Missed connection
Travel delay
Baggage delay and personal items lost
Hurricane and weather
Employment layoff
Pre-existing medical conditions
Emergency medical
Medical evacuation and repatriation
Financial default
Terrorism
At a minimum, the insurance should protect you against trip cancellation and trip interruption, should you need to cancel your trip due to circumstances such as training injuries or sickness or emergencies.
Your travel insurance must cover high altitude trekking up to 6,000 meters to be eligible for rescue by Kilimanjaro Search and Rescue (SAR) – a private company which provides medical support and helicopter evacuation. Without a client’s verified travel insurance with this specific coverage, Kilimanjaro SAR will not initiate a rescue operation on the mountain. This is not to be confused with coverage for “mountaineering” or “mountain climbing,” which most insurance will not cover.
For our customers residing in the USA, we recommend that you obtain Travel Guard’s Deluxe, Preferred or Essential plans, which provide coverage for high altitude trekking, trip cancellation, interruption and delay; lost, stolen and damaged baggage; medical expenses and emergency medical evacuation; and luggage delay, for a low cost. You can compare the Deluxe, Preferred or Essential plans and purchase online through Travel Guard.
For our international customers, we recommend that you obtain travel insurance through World Nomads.
Climbers are strongly advised to obtain travel insurance immediately after booking their trip. Travel Guard insurance covers trip cancellation due to pre-existing conditions only when insurance is purchased within 15 days of booking. Clients must be able to provide proof of insurance to staff upon request. Clients who fail to obtain travel insurance will not be allowed to climb.
Where Do the Kilimanjaro Climbs Begin?
Our climbs originate in Moshi /Arusha a coffee-producing gateway town to Mount Kilimanjaro. Arusha /Moshi is located at the base of the mountain to its south, at approximately 3,000 feet. Moshi is a short 47mile drive from Kilimanjaro International Airport (airport code: JRO). If you fly into Kilimanjaro International Airport, we can arrange for transport from the airport to the hotel.
Transfers are available at any time, including early morning or late evening, and take about 40 minutes (see What is Kilimanjaro Airport Like?).
KLM flies from the USA and UK to Kilimanjaro International Airport regularly. KLM flights typically arrival at Kilimanjaro International Airport in the evenings.
Most people choose not to take a rest day, and will begin climbing the following morning. But it is a good idea to take a rest day to recover from a long flight, to adapt to the new environment, and to get your things ready for the trek. Flights from the USA to JRO typically range from $1,500 to $3,500, depending on the season.
Vayama is a good source for domestic Tanzanian flights if you want to extend your vacation to other parts of Tanzania or East Africa, such as Zanzibar, Kenya or Uganda.
We do not recommend flying into Jomo Kenyatta International Airport (airport code: NBO) in Nairobi, Kenya or Dar es Salaam International Airport (airport code: DAR) in Dar es Salaam, Tanzania. Although flights are cheaper than flying into Kilimanjaro International Airport, getting to Moshi from Nairobi requires an overnight stay in Nairobi, the purchase of a Kenyan visa, and a 7 to 8 hour bus ride (Riverside Shuttle) with a border crossing. Getting to Moshi from Dar es Salaam also typically requires an overnight stay and an 8 hour bus ride (Dar Express).
Arusha is about 50 miles west of Moshi. We can arrange a private vehicle for pick up and drop off in Arusha if needed. However, taxis and shuttles are readily available between Moshi and Arusha. It is a 90-minute drive.
Is Climbing Kilimanjaro Safe?
If you only read one page on our site, this should be it.
Climbing Kilimanjaro is probably one of the most dangerous things you will ever do. Every year, approximately 1,000 people are evacuated from the mountain, and approximately 10 deaths are reported. The actual number of deaths is believed to be two to three times higher. The main cause of death is altitude sickness. Everyone climbing Mount Kilimanjaro should be familiar with the symptoms of altitude sickness. And everyone climbing Kilimanjaro should choose an operator like Ultimate Kilimanjaro® that has the proper safety systems in place.
Praygod Africa Safaris@ Safety Precautions:
Our staff abides by the Standard Operating Procedures to prevent clients from exposure to novel coronavirus (COVID-19) while in the country.
Our guides are highly experienced in preventing, detecting, and treating altitude sickness because they handle over 1,000 climbers per year.
Our guides conduct twice-daily health checks using a pulse oximeter to monitor your oxygen saturation and pulse rate.
Our guides administer the Lake Louise Scoring System (LLSS) to help determine whether you have symptoms of altitude sickness and their severity.
Our guides are certified Wilderness First Responders (WFR). They have the tools to make critical medical and evacuation decisions on location.
Our staff carries bottled oxygen on all climbs and can administer it to quickly treat climbers with moderate and serious altitude sickness.
Our staff carries a portable stretcher on northern routes to evacuate climbers who need to descend but are unable to walk on their own. Wheeled stretchers provided by the park are available on other routes.
Our staff has the ability to initiate helicopter evacuation through Kilimanjaro Search and Rescue (SAR), a helicopter rescue operation.
Our staff carries a first aid kit to treat minor scrapes, cuts, and blisters.
The abovelisted measures ensure that Ultimate Kilimanjaro® guides and staff are prepared to keep our climbers safe and have the ability to treat climbers who become ill or injured. Your health and well-being is our first priority.
WHY ARE SAFETY PRECAUTIONS IMPORTANT? OUR CLIENT EXPLAINS.
“Read this before booking a Kilimanjaro climb. It might seriously save your life!”
“This review is designed for anyone who has made the decision to climb Kilimanjaro but has not yet chosen a guide company.
Let me start off by saying you should definitely find out if your guide company carries bottled oxygen on the climbs and if the guides perform daily health checks on you during the climb. Think that stuff doesn’t matter? Think you would never need any medical assistance on the mountain? Think again.
I recently went on a 9-day climb of Kilimanjaro with Ultimate Kilimanjaro and found out the hard way that altitude sickness truly can strike anyone at any time regardless of fitness level or previous experience at altitude. I had read that prior to my trip but I honestly didn’t think it could happen to me.
A brief background on me, I am a 31-year-old male who regularly hikes 7-10 mile trails that feature large changes in elevation in rocky terrain and I go to the gym 4 days per week for at least one hour each session. I have climbed three 14ers in Colorado and have been above 10,000 feet while hiking and snowboarding at least 50 times in my life. I had never felt any symptoms of altitude sickness during any of those previous trips to altitude.
Starting on day 4, the guides had been watching me very closely because I started to score poorly on my daily health checks. However, something severe hit me on day 5 of my Kili climb that required the guides to give me bottled oxygen and take me down the mountain. I am still not sure exactly what happened to me but I am certain without the quick diagnosis and response from my Ultimate Kilimanjaro guides that I very well could have gone into a coma or worse.
So please stop and ask yourself, if altitude sickness hits you on Kili, do you really want to be with a guide company that hasn’t been monitoring your health and doesn’t have bottled oxygen? A few hours can mean the difference between living and dying.”
WARNING: Most Kilimanjaro operators do not have safety measures in place. They are simply not prepared for emergencies. While it is true that most operators employ guides with many years of experience on Mount Kilimanjaro, that does not necessarily mean they actually know how to handle serious altitude sickness cases. Consider the following excerpt from the Journal of Travel Medicine:
Acute Mountain Sickness (AMS)
The percentage of oxygen in the atmosphere at sea level is about 21%. As altitude increases, the percentage remains the same but the number of oxygen molecules per breath is reduced. At 12,000 feet (3,600 m) there are roughly 40% fewer oxygen molecules per breath so the body must adjust to having less oxygen. Altitude sickness, known as AMS, is caused by the failure of the body to adapt quickly enough to the reduced oxygen at increased altitudes. Altitude sickness can occur in some people as low as 8,000 feet, but serious symptoms do not usually occur until over 12,000 feet.
Mountain medicine recognizes three altitude categories:
High altitude: 4,900 to 11,500 ft (1,500 to 3,500 m)
Very high altitude: 11,500 to 18,000 ft (3,500 to 5,500 m)
Extreme altitude: 18,000 ft and above (5,500 m and above)
In the first category, high altitude, AMS and decreased performance is common. In the second category, very high altitude, AMS and decreased performance are expected. And in extreme altitudes, humans can function only for short periods of time, with acclimatization. Mount Kilimanjaro’s summit stands at 19,340 feet – in extreme altitude.
At over 10,000 feet (3,000 m), more than 75% of climbers will experience at least some form of mild AMS.
There are four factors related to AMS:
High Altitude
Fast Rate of Ascent
High Degree of Extertion
Dehydration
The main cause of altitude sickness is going too high (altitude) too quickly (rate of ascent). Given enough time, your body will adapt to the decrease in oxygen at a specific altitude. This process is known as acclimatization and generally takes one to three days at any given altitude. Several changes take place in the body which enable it to cope with decreased oxygen:
The depth of respiration increases
The body produces more red blood cells to carry oxygen
Pressure in pulmonary capillaries is increased, “forcing” blood into parts of the lung that are not normally used when breathing at sea level
The body produces more of a particular enzyme that causes the release of oxygen from hemoglobin to the body tissues
Again, AMS is very common at high altitudes. It is difficult to determine who may be affected by altitude sickness since there are no specific factors such as age, sex, or physical condition that correlate with susceptibility. Many people will experience mild AMS during the acclimatization process. The symptoms usually start 12 to 24 hours after arrival at altitude and will normally disappear within 48 hours. The symptoms of Mild AMS include:
Headache
Nausea & Dizziness
Loss of appetite
Fatigue
Shortness of breath
Disturbed sleep
The general feeling of malaise
Symptoms tend to be worse at night and when respiratory drive is decreased. Mild AMS does not interfere with normal activity and symptoms generally subside as the body acclimatizes. As long as symptoms are mild, and only a nuisance, ascent can continue at a moderate rate.
While hiking, it is essential that you communicate any symptoms of illness immediately to others on your trip.
The signs and symptoms of Moderate AMS include:
Severe headache that is not relieved by medication
Nausea and vomiting, increasing weakness and fatigue
Shortness of breath
Decreased coordination (ataxia)
Normal activity is difficult, although the person may still be able to walk on their own. At this stage, only advanced medications or descent can reverse the problem. It is important to get the person to descend before the ataxia reaches the point where they cannot walk on their own (which would necessitate a stretcher evacuation). Descending only 1,000 feet (300 m) will result in some improvement, and 24 hours at the lower altitude will result in a significant improvement.
Continuing on to higher altitude while experiencing moderate AMS can lead to death.
Severe AMS results in an increase in the severity of the aforementioned symptoms including:
Shortness of breath at rest
Inability to walk
Decreasing mental status
Fluid build-up in the lungs
Severe AMS requires immediate descent of around 2,000 feet (600 m) to a lower altitude. There are two serious conditions associated with severe altitude sickness; High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE). Both of these happen less frequently, especially to those who are properly acclimatized. But, when they do occur, it is usually in people going too high too fast or going very high and staying there. In both cases the lack of oxygen results in leakage of fluid through the capillary walls into either the lungs or the brain.
High Altitude Pulmonary Edema (HAPE)
HAPE results from fluid buildup in the lungs. This fluid prevents effective oxygen exchange. As the condition becomes more severe, the level of oxygen in the bloodstream decreases, which leads to cyanosis, impaired cerebral function, and death. Symptoms of HAPE include:
Shortness of breath at rest
Tightness in the chest
Persistent cough bringing up white, watery, or frothy fluid
Marked fatigue and weakness
A feeling of impending suffocation at night
Confusion, and irrational behavior
Confusion and irrational behavior are signs that insufficient oxygen is reaching the brain. In cases of HAPE, immediate descent of around 2,000 feet (600 m) is a necessary life-saving measure. Anyone suffering from HAPE must be evacuated to a medical facility for proper follow-up treatment.
High Altitude Cerebral Edema (HACE)
HACE is the result of the swelling of brain tissue from fluid leakage. Symptoms of HACE include:
Headache
Weakness
Disorientation
Loss of co-ordination
Decreasing levels of consciousness
Loss of memory
Hallucinations & Psychotic behavior
Coma
This condition is rapidly fatal unless the afflicted person experiences immediate descent. Anyone suffering from HACE must be evacuated to a medical facility for follow-up treatment.
Daily Health Checks
Our guides are all experienced in identifying altitude sickness and dealing with the problems it causes with climbers. They will constantly monitor your well-being on the climb by watching you and speaking with you. Twice daily, in the morning and evening, our guides will conduct health checks.
Pulse Oximeter
A pulse oximeter measures oxygen saturation – the oxygen level in your blood – and your pulse rate. The oximeter is placed on a climber’s fingertip. The oximeter uses two beams of light that shine into small blood vessels and capillaries in your finger. The sensor reflects the amount of oxygen in the blood.
Oxygen saturation is a measurement of how much oxygen your blood is carrying as a percentage of the maximum it could carry. Normal blood oxygen levels at sea level are 95-100%.
As altitude increases, oxygen saturations decrease. Proper acclimatization generally brings oxygen saturations higher, which is why these figures typically rise when oxygen saturations are tested after resting overnight. On Kilimanjaro, oxygen saturations percentages are regularly in the 80’s. There are no definitive saturation levels where a client can be declared absolutely safe or at risk. However, when oxygen saturation drops below 80%, we monitor that climber very closely.
Mountain Rescue
Bottled Oxygen
We carry bottled oxygen on all of our climbs as a precaution and additional safety measure. The oxygen cannister is for use only in emergency situations. It is NOT used to assist clients who have not adequately acclimatized on their own to climb higher. The most immediate treatment for moderate and serious altitude sickness is descent. With Kilimanjaro’s routes, it is always possible to descend, and descend quickly. Therefore, oxygen is used strictly to treat a stricken climber, when necessary, in conjunction with descent, to treat those with moderate and severe altitude sickness.
We are aware that some operators market the use of supplementary personal oxygen systems as a means to eliminate the symptoms of AMS. To administer oxygen in this manner and for this purpose is dangerous because it is a temporary treatment of altitude sickness. Upon the cessation of the use of oxygen, the client will be at an even higher altitude without proper acclimatization.
99% of the companies on Kilimanjaro do NOT offer supplementary oxygen – because it is potentially dangerous, wholly unnecessary and against the spirit of climbing Kilimanjaro. The challenge of the mountain lies within the fact that the summit is at a high elevation, where climbers must adapt to lower oxygen levels at altitude. Using supplementary oxygen is akin to putting the mountain at sea level, where nearly everyone can summit.
Portable Stretcher
Large, one-wheeled rescue stretchers are found on Mount Kilimanjaro but they are only available on certain routes of the park. That means that if a climber is unable to walk due to severe altitude sickness or a leg injury that compromises mobility, getting that climber down the mountain could pose difficult challenges for Kilimanjaro operators when these stretchers aren’t nearby. Usually it means assisting the injured climber by carrying him or her on one’s back.
At Praygod Africa Safaris we carry a portable stretcher on northern routes in case of emergencies when a climber is unable to walk on their own and the trekking party is some distance away from the park’s stretchers.
Our portable stretchers are compact, strong and lightweight. The device can be used to evacuate an injured climber quickly off the mountain. To use, the subject is secured to the stretcher using straps. Then porters hold on to the hand grips to usher the climber to safety.
Gamow Bag
The Gamow Bag is portable hyperbaric chamber used to treat AMS. The inflatable bag simulates descent to lower altitude. The patient is placed inside the bag and it is inflated with air to increase the concentration of oxygen. A Gamow bag weighs about 12 lbs. Inflated, the bag is about 7 feet long and 2 feet in diameter.
At 9,800 feet (3,000 m), the Gamow Bag can simulate a descent of 4,800 feet (1,500 m). After two hours in the bag, the person’s body chemistry will have “reset” to the lower altitude. This acclimatization lasts for up to 12 hours outside of the bag which should be enough time to get them down to a lower altitude and allow for further acclimatization.
Our staff does not carry Gamow bags. Use of a Gamow bag on Mount Kilimanjaro is impractical because descent is the most immediate, accessible treatment.
Kilimanjaro search and rescue
We are partnered with Kilimanjaro Search and Rescue (SAR), a helicopter rescue operation that conducts modern, efficient rescue services on Kilimanjaro. Airbus AS 350 B3 helicopters waits nearby at Moshi Airport. Once a distress call is received, rescue procedures are activated within five minutes. Expert pilots, highly trained rescue doctors, and emergency flight technicians are exceptionally qualified and prepared for all emergencies on the mountain.
Kilimanjaro SAR manages a medical clinic that focuses on high altitude-related illnesses, mountain medicine, and trauma. It is staffed 24 hours a day by physicians, nurses, and assistants offering the best possible treatment. This group is advised by a unique Clinical Advisory Team made up of top-level medical and high-altitude professionals.
Note that this service is only available to clients who have the required travel insurance. Special travel insurance is mandatory to participate in our trips. Clients must be covered to trek at high altitudes up to 6,000 meters to qualify for Kilimanjaro SAR rescue. Your travel insurance will be verified by our staff before the trek.
