24th April 2024 – How to Climb Kilimanjaro – Dr Alan Kershaw

Alan, a retired consultant anaesthetist at Barnsley Hospital, gave us another great talk on how a group of his friends and colleagues (Fig 1) successfully tackled Mount Kilimanjaro.

Ironically, the older you are, the more likely you are to succeed in reaching the summit. Between 30 and 75 per cent fail to reach it, depending on the particular route up the mountain. The eldest of Alan’s group was 73. It’s slowly, slowly as you go, ever upwards. It’s all about mental, rather than physical strength. To pre-empt any medical problems on the way, there was a urologist, a GP, Alan as the anaesthetist and, looking on the dark side, a pathologist too! An orthopaedic surgeon and a psychiatrist might have been useful.
Mount Kilimanjaro (Fig 2) lies in north-eastern Tanzania (Fig 3) close to the Kenyan border, and whose plains beyond are clearly visible from its peak. It’s the highest peak in Africa at 5895 metres. Climate change has resulted in a huge loss of ice in recent years. The climbing season is October to February, otherwise it’s damp and miserable.

This climb was all about endurance, mostly walking up the pink route (Fig 4) but with some hairy scrambling at midnight on Day 6 on frozen scree at -20ºC to reach the top. After crossing the summit at midday, it’s an even hairier descent down the scree slope after the ice has melted, moonwalking and slithering back to base camp, hoping the ankles don’t give. All in all, day 6 was 18 hours’ hard work!
Acclimatisation to prevent mountain sickness is all important with a very slow shuffling ascent (“Pole Pole”); the local guides are strict about slowing the pace. “Climb high, sleep low” means climbing for six hours, then returning down for a further couple of hours before bedtime. Further measures to counteract pulmonary and cerebral oedema are diuretics (acetazolamide) and a dose of prophylactic steroids before the final ascent. Even then, reaching the top isn’t guaranteed and the reason why some make it and others don’t, after taking the same precautions with identical acclimatisation, isn’t clear. Some get to the top but have no memory of it, just the photo!

Cerebral oedema (swelling of the brain within the confines of a rigid skull) is dangerous and potentially fatal. Failure to rationalise can lead to error of judgement, further aggravated by alcohol. Other symptoms are appetite loss, decreased urine output and disorientation and confusion. Immediate descent is of paramount importance. Awareness of the possibility of cerebral oedema by the whole group is vital. The guides have designed their own bicycle-like contraptions for an ultrafast descent in the event of pulmonary or cerebral oedema onset.
The group were accompanied by a large team of 47 local tribesmen who carried all the equipment; provisions, tents, water and food. One unfortunate porter, but possibly paid a fortune in tips, was responsible for carrying the group’s Porta-potty. No privacy on the way up! (Fig 5), although there are some very basic toilets on the way to base camp. A visit first thing while the air’s still frozen was a very wise move(ment). It was important to load up with calories to counteract energy consumption, despite suppressed appetites. Factor 50 sun cream was essential.

Gaiters stopped the dust getting in the boots and were valued additions to the porters’ tips of US $50 from each guest. It was surprising that such an exotic trip cost only £1,800, but it was nine years ago, so maybe £2,500 plus tips nowadays. In case any Probus members are thinking of it, climbs need to be booked two years ahead and places are limited so the Tanzanian National Park authorities know exactly who’s there. It’s a race against time.
By the way, telephones don’t work there either.