Medevac from Shira Cauldera

Morning of Day 3 -- 12 Feb 11 Medevac from Shira Cauldera

One of our group began having medical problems yesterday afternoon which was making the climb difficult. A heart condition, hereto unknown, combined with what turned out to be an upper respiratory infection with lots of coughing, has convinced everyone that a return to the flatlands is the better part of valor.

While it might still be possible to continue, the guides, while not flat out saying no, were not very encouraging. Can I make it? Maybe. Should I do it? Mmmm... You have to respect their experience, so the decision was made for a return to the hotel.

The remaining 5, all bundled up in the cold (35F) morning, began their uphill track, and the sick one headed down hill with two porters.

When preparing for the climb, most everyone reads about what should be done in preparation, but it all distills pretty much into layer up for tropical to arctic conditions, pack light, and keep putting one foot in front of another. One doesn't really give much thought to injury or sickness, and in reading, you don't come across much about the issue.

The down hill trip, "medevac" is really too strong a word, brought up some interesting insights.

Fortunately our injured was merely sick and in "walking wounded" condition, and was able to walk to the evac zone. Though the walk was mostly downhill, there was some climbing, and the walk took a fair amount of effort to complete.

About 1/2 hour into the hike, and roughly half way to the evac point, one of the porters remembered a slight administrative detail -- we had not logged out. Off he runs (literally) back to the Shira camp, and returns in 20 minutes (???) with the sick log book. Fill in and sign the log, and off runs the porter back to Shira, returning in another 20 minutes.

Looking at the log, there was at least one evac from the Shira location every 2 out of 3 days. The age breakdown was most were in their 20's and out of about 50 logs, only 2 were 60 or older. In that log group, the only "injury" was altitude sickness (present company excepted), there were no physical injuries noted.

The climb is difficult only in its duration and elevation changes. For the most part the trails are well used, easy to walk and have only a few spots that require climbing. That climbing is more like enhanced, oversized steps rather than wall climbing.

With care, a broken bone should be rare, but possible, a twisted, sprained ankle is more likely, but again, with care, probably rare given the type of person who would attempt the climb in the first place. Given the frequency of rain, snow and ice, care must definitely be taken.

The Shira area is for now the only evac point -- other than 1st day problems, all other locations are effectively a 2 day walk out.

What happens if the injury is debilitating and the injured is unable to walk? There is the unicycle ambulance, a bone jarring vehicle which is really the only way out. There is a helipad at Shira, and another at the end of the evac road, but both are at the reasonable altitude limit for all but the most specialized of helicopters, and once you reach the helipads, the ambulance (a toyota land cruiser with red crosses painted on it) can take you down.

Availability of air transport is really the big question. In the Kilimanjaro area, where it’s hard to find a vehicle with shocks that work -- where can one expect find what is one of the most sophisticated pieces of hardware in the world and costs more to operate for an hour than much of the local population earn in a year?

After waiting for an hour for the amublance, it took over 3 hours to return to Moshi with a stop at the Londorosi gate to do another medvac log in. The ride itself is interesting, a long, long dusty ride in the dryest of outback Africa. Got to see a lot of the local lifestyle, but strangely no animals other than a few cows and goats.