How to avoid altitude sickness on Kilimanjaro

Celebrating at the top of Meru

The EAC realize that the short distances and high per diem cost of climbing Kilimanjaro make this lengthy itinerary impractical. So instead they recommend a pre-trek acclimatization walk on Mount Meru or Mount Kenya (4895m to Point Lenana).

This is an excellent idea if you have the time and are feeling fit. But you also need to do either of these walks immediately before you climb Kili. Only then will they be beneficial. (What’s more, the views towards Kilimanjaro from Meru are delightful too!)

Take rest days

But what if you don’t have the time or money to do these other climbs? The answer is to plan your walk on Kilimanjaro as carefully as possible. If you have enough money for a ‘rest day’ or two, take them.

These ‘rest days’ are not actually days of rest at all. On the Marangu trail, for example, guides usually lead their trekkers up from Horombo Huts to the Mawenzi Hut (4600m ASL) before returning that same afternoon. But they do provide trekkers with the chance to experience a higher altitude before returning to below 3000-4000m again. As a result, they obey that old mountaineers’ maxim about the need to ‘climb high, sleep low’ to avoid mountain sickness.

Choose a ’slow’ route up

The route you take is also important. Some of the routes naturally obey the mountaineers’ maxim on the third or fourth days. The Machame, Lemosho and Shira trails via the Barafu Huts, for example. On each of these the trail climbs above 4500m ASL at Lava Tower, before plunging down to 3985m at Barranco Camp ASL where you spend the night.

Some of the shorter trails, however, do not. For example, it is possible for a trekker walking at an average pace on the Marangu or Rongai trails to reach the Kibo Huts in just three days. In other words, they can attempt an assault on the summit on that third night! This sort of schedule is entirely too rapid, allowing insufficient time for trekkers to adapt to the new conditions prevalent at the higher altitude.

This is why it is imperative, on certain trails, that you take a ‘rest day’ on the way up. That way, you give your body more time to acclimatize.

Walk as slowly as possible — go ‘pole pole’ if you don’t want to feel ‘poorly poorly’

Taking a rest on the Lemosho Route

How you approach the walk is important too. Statistically, men are more likely to suffer from AMS than women. Surprisingly, perhaps, young men are the most vulnerable of all. But the reason is obvious. The competitive streak in most young men causes them to walk faster than the group. That, and the mistaken belief that greater fitness and strength (which most men, mistakenly or otherwise, believe they have) will protect them against AMS. But AMS is no respecter of fitness or health.

Indeed, many experienced mountaineers believe the reverse is true. The less fit you are, the slower you will want to walk, and thus the greater chance you have of acclimatizing properly.

The best advice, then, is to go as slowly as possible. Let your guide be the pacemaker. Do not be tempted to hare off ahead of him, but stick with him. That way you can keep a sensible pace. What’s more, it also means you can ask him any questions about the mountain that occur to you on the way.

The most frequently heard phrase on Kilimanjaro is ‘Pole pole’. It means ’slowly slowly’, and it should be your mantra for your trek.

Take Diamox

In addition to being a cure for altitude sickness, Diamox can also act as a prophylactic – ie, it can prevent the onset of altitude sickness happening in the first place. There seems to be no hard-and-fast rule about how much you should take each day, and when you should start, but most companies seem to advise taking 125mg twice a day, starting on the first day of the trek.

Other tips to help you acclimatise on Kilimanjaro

There are other things you can do that may or may not reduce the chance of getting AMS. One is to eat well: fatigue is said to be a major contributor to AMS, so try to keep energy levels up by eating as much as you can.

Dehydration can exacerbate AMS too, so it is vital that you drink every few minutes when walking; for this reason, one of the new platypus-style water bags which allow you to drink hands-free without breaking stride are invaluable. Wearing warm clothes is very important too, allowing you to conserve energy that would otherwise be spent on maintaining a reasonable body temperature.

Although there hasn’t been a serious study on this subject, many people swear that carrying your own rucksack increases your chance of succumbing to AMS. Certainly, in my experience, this is true, so, finally, hire a porter to carry your baggage (the agencies will assume you want this anyway unless you specify otherwise).

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