Altitude Sickness on Rwenzori: Symptoms and Management

A Rwenzori trekking adventure is a challenging and rewarding experience, but the high altitudes of the “Mountains of the Moon” introduce a significant risk of altitude sickness. Unlike a simple hike, a full Rwenzori Mountains hiking expedition can take you to elevations over 5,000 meters, well into the zone where altitude-related illnesses are a serious concern. Recognizing the symptoms and knowing how to manage them is crucial for a safe and successful climb.

Understanding Altitude Sickness

Altitude sickness, also known as Acute Mountain Sickness (AMS), occurs when your body doesn’t have enough time to adapt to the lower oxygen levels and reduced air pressure at high altitudes. While some people may be more susceptible, it can affect anyone, regardless of age, fitness level, or previous experience. Symptoms typically appear within 6 to 24 hours of ascending to a high altitude and can range from mild to life-threatening.

Symptoms of Altitude Sickness

Altitude sickness can be a spectrum, with three main classifications: mild, moderate, and severe. It’s important to recognize the early signs to prevent the condition from worsening.

Mild Symptoms (Acute Mountain Sickness – AMS)

Mild AMS often feels like a hangover and is the most common form of altitude sickness. You should not ascend any higher if you experience these symptoms.

• Headache: This is the most common symptom. It can be mild to moderate and is often unresponsive to over-the-counter painkillers.
• Nausea and Vomiting: A feeling of being unwell in the stomach, which can lead to vomiting.
• Fatigue or Weakness: Feeling unusually tired, even after a good night’s rest.
• Dizziness or Lightheadedness: A sense of unsteadiness or vertigo.
• Loss of Appetite: A lack of desire to eat.
• Insomnia: Difficulty sleeping, which is a common occurrence at high altitudes but can be a sign of AMS.

Severe Symptoms (Medical Emergencies)

If mild symptoms are ignored and a person continues to ascend, it can lead to two life-threatening conditions: High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE). Both require immediate descent and medical attention.

• High Altitude Pulmonary Edema (HAPE): This is a dangerous condition where fluid builds up in the lungs, making it difficult to breathe.
  • Symptoms: Shortness of breath even when resting, a persistent cough that may produce a white or pink frothy sputum, a tight chest, and a rapid heartbeat.
• High Altitude Cerebral Edema (HACE): This is when fluid builds up in the brain, causing swelling. It is the most severe form of altitude sickness.
  • Symptoms: A severe, persistent headache, loss of coordination (ataxia), confusion, slurred speech, irrational behavior, and in later stages, loss of consciousness.

Prevention of Altitude Sickness on Rwenzori

The best way to manage altitude sickness is to prevent it in the first place. The rugged and wet terrain of the Rwenzoris, combined with their multiple peaks and valleys, makes proper acclimatization absolutely vital.

• Ascend Slowly (Proper Acclimatization): This is the single most important rule. A longer trekking itinerary allows your body to gradually adjust to the changing altitude. Most experts recommend limiting your daily elevation gain to no more than 300-500 meters once you are above 2,500 meters. The “climb high, sleep low” principle is a good strategy, where you trek to a higher altitude during the day but return to a lower camp to sleep. The Rwenzori routes, with their multiple camps at varying altitudes, lend themselves well to this.
• Stay Hydrated: Drink plenty of water throughout the day. Dehydration can worsen the symptoms of altitude sickness. Avoid alcohol and caffeine, as they are diuretics and can contribute to fluid loss.
• Eat a High-Carbohydrate Diet: Your body burns more calories at high altitudes, and carbohydrates are an excellent source of energy.
• Consider Preventive Medication: Consult a doctor about preventive medications like Acetazolamide (Diamox). This medication helps your body acclimatize faster by increasing your breathing rate. It should not be used as a substitute for a slow ascent.
• Train in Advance: While fitness does not prevent altitude sickness, being physically prepared will make the demanding Rwenzori trekking easier and allow your body to focus on acclimatization rather than exhaustion.

Management and Treatment

If you or a fellow trekker begins to show symptoms of altitude sickness, swift action is essential.

1. Stop and Rest: At the first sign of mild symptoms (AMS), stop ascending immediately. Rest at your current altitude until symptoms subside. Do not go any higher.
2. Descend: If symptoms worsen or if a person shows signs of HACE or HAPE, immediate descent is the only cure. No amount of rest or medication can substitute for a rapid drop in altitude. Your local guides are trained to recognize these symptoms and will not hesitate to initiate a descent.
3. Administer Medication: In severe cases, your guides may have emergency medication like dexamethasone to temporarily manage symptoms and facilitate a descent. A portable oxygen tank or hyperbaric chamber can also be used as a short-term solution to stabilize a person before evacuation.
4. Do Not Ascend Again: Once you have descended, do not attempt to re-ascend the mountain. Your health and safety are paramount.

By understanding the risks and adhering to these principles of prevention and management, your Rwenzori Mountains hiking experience can be a safe and rewarding journey to the heart of this majestic range.