High-Altitude Sickness
Context:
Every year, high-altitude regions in the Himalayas draw numerous adventurers and trekkers. However, these pristine but extreme environments also pose significant risks, including high-altitude sickness.
More on News:
- Recently, a trekker from Idukki, Kerala, tragically succumbed to respiratory failure while attempting to scale Garur Peak in Uttarakhand.
- Such incidents highlight the hidden dangers of high-altitude trekking.
What is High-Altitude Sickness?
- High-altitude sickness, or Acute Mountain Sickness (AMS), occurs when the body fails to acclimatise to elevations typically above 8,000 feet (2,400 metres).
- At higher altitudes, lower air pressure and reduced oxygen levels can lead to hypoxia—a lack of oxygen in the body’s tissues.
- Early symptoms of AMS include headaches, nausea, fatigue, and breathlessness. If left untreated, it can progress to life-threatening conditions such as:
- High-Altitude Pulmonary Edema (HAPE): Fluid accumulates in the lungs, making breathing difficult.
- High-Altitude Cerebral Edema (HACE): Fluid builds up in the brain, causing confusion, hallucinations, and, in severe cases, coma.
- Both HAPE and HACE require immediate medical attention, with descent to lower altitudes being the most effective treatment.
- At high altitudes, the body adapts by:
- Increasing the breathing rate, which can lead to hyperventilation.
- Producing more red blood cells to carry oxygen, which thickens the blood and strains the heart.
Challenges in Infrastructure:
- Despite the popularity of the Himalayas as a tourist destination, healthcare infrastructure in remote regions remains inadequate.
- Specialised facilities for altitude-related illnesses, like those in Leh, Ladakh, are exceptions.
- In many areas, even basic preventive measures, such as health screenings at entry points, are absent.
- Introducing protocols similar to the “Inner Line Permit” system could help.
- Tourists entering high-altitude zones like Kinnaur or Lahaul-Spiti could undergo health checks at base hospitals, potentially preventing fatalities.
Importance of a Registration System: A mandatory registration system for tourists visiting remote mountain regions could greatly enhance safety. A centralised database maintained by state governments would allow for:
- Tracking tourist movements.
- Swift emergency response.
- Research on high-altitude illnesses by analysing demographic data and risk factors.
The Need for Gradual Ascent: Rapid ascents without adequate acclimatisation are a leading cause of high-altitude sickness. To minimise risks, gradual ascent is essential. The Wilderness Medical Society recommends:
- Rest days every 3-4 days when ascending above 3,000 metres.
- Limiting daily sleeping elevation increases to no more than 500 metres.
- Preventive medications such as Acetazolamide (to improve oxygenation) and Dexamethasone (to reduce inflammation) can help, but consulting a doctor familiar with altitude-related risks is crucial, especially for those with pre-existing health conditions.
Treatment Strategies: The most effective treatment for high-altitude sickness is immediate descent by 300–1,000 metres. Additional measures include:
- Supplemental oxygen or portable hyperbaric chambers to alleviate symptoms.
- Medications like acetazolamide or dexamethasone for short-term relief.
Policy Recommendations: To mitigate risks and improve safety in high-altitude regions, the following measures are recommended:
- Establish advanced medical facilities in remote Himalayan areas.
- Create dedicated research centres for high-altitude illnesses.
- Equip Himalayan states with air-ambulance services for rapid evacuation.
- Provide comprehensive health and safety information online and at entry points for tourists.
- By addressing these challenges, authorities can enhance safety and ensure sustainable high-altitude tourism.
