Health & Safety

    Your guide to staying safe and healthy on Kilimanjaro

    Altitude Sickness

    As you climb higher, the air contains less oxygen. Your body needs time to adjust. Altitude sickness is the most common health concern on Kilimanjaro and understanding its forms is essential.

    Acclimatisation

    Proper acclimatisation is your single best defence against altitude sickness. Your body needs time to adapt to lower oxygen levels — rushing the ascent is the biggest risk factor.

    "Climb High, Sleep Low"

    This is the golden rule of acclimatisation. During the day, hike to a higher altitude to stress your body gently, then descend to a lower camp to sleep. This trains your body to function with less oxygen while recovering at a more comfortable altitude overnight. Most well-designed Kilimanjaro itineraries build this principle into the schedule.

    Key Tips

    • •Walk slowly. "Pole pole" (slowly, slowly in Swahili) is your mantra. There is no prize for arriving at camp first.
    • •Choose a longer route. Routes like Lemosho (7–8 days) or the Northern Circuit (9 days) offer significantly better acclimatisation profiles than shorter routes.
    • •Don't skip rest days. These aren't lazy days — they're when your body does the hard work of adapting.
    • •Avoid alcohol and sleeping pills. Both can mask symptoms and impair breathing during sleep.

    Diamox (Acetazolamide)

    Diamox is a prescription medication that can help prevent and reduce symptoms of altitude sickness. It works by acidifying the blood, which stimulates faster and deeper breathing, increasing the oxygen in your blood.

    ✓ Pros

    • Clinically proven to speed up acclimatisation
    • Reduces the severity and incidence of AMS symptoms
    • Improves sleep quality at altitude by preventing periodic breathing
    • Well-studied with decades of use in high-altitude medicine
    • Typically affordable and widely available

    ✗ Cons

    • Tingling or numbness in fingers, toes, and lips (very common)
    • Increased urination (acts as a mild diuretic)
    • Can make carbonated drinks taste flat or metallic
    • May cause nausea or drowsiness in some people
    • Not suitable for those with sulfa drug allergies
    • Can mask symptoms — some argue this gives false confidence

    Hydration

    At altitude, you lose moisture much faster through breathing and sweating. Dehydration worsens altitude sickness symptoms and reduces your body's ability to acclimatise.

    • •Aim for 3–4 litres of water per day while on the mountain.
    • •Monitor your urine colour — it should be clear to pale yellow. Dark urine is a sign of dehydration.
    • •Add electrolyte tablets or rehydration salts to replace minerals lost through sweat.
    • •Avoid excessive caffeine and alcohol — both are diuretics that accelerate fluid loss.
    • •Drink regularly throughout the day, not just when you feel thirsty — by the time you're thirsty, you're already dehydrated.

    Sun Protection at Altitude

    UV radiation increases by approximately 10–12% for every 1,000m of altitude gained. On Kilimanjaro's summit at 5,895m, UV exposure can be nearly 60% higher than at sea level. Snow and ice reflect additional UV rays, increasing the risk further.

    • •Use SPF 50+ broad-spectrum sunscreen and reapply every 2 hours.
    • •Don't forget your lips — use an SPF lip balm.
    • •Wear UV-blocking sunglasses (Category 3 or 4) to prevent snow blindness.
    • •Cover exposed skin with a wide-brimmed hat and lightweight long sleeves.

    Travel Insurance

    Comprehensive travel insurance is not optional — it's essential. Standard travel policies often exclude high-altitude trekking, so you must verify your cover explicitly.

    What to look for in your policy

    • •Altitude coverage up to 6,000m — Kilimanjaro's summit is 5,895m, so you need cover above this.
    • •Emergency helicopter evacuation — this is the most critical element. Evacuations from the mountain can cost $3,000–$5,000+.
    • •Medical treatment and hospitalisation in Tanzania and potential repatriation to your home country.
    • •Trip cancellation and curtailment — in case you need to cut the trip short for medical reasons.
    • •24-hour emergency assistance helpline — accessible from Tanzania.

    Emergency Evacuation

    While rare, emergencies do happen. Understanding the evacuation process can reduce anxiety and ensure a faster response if needed.

    What happens in an emergency

    1. Your guide assesses the situation — all reputable guides carry pulse oximeters and are trained in altitude-related first aid.
    2. Immediate descent begins — even a descent of 300–500m can produce dramatic improvement in symptoms.
    3. Supplemental oxygen is administered — all reputable operators carry emergency oxygen supplies.
    4. Stretcher or wheeled evacuation — if the climber cannot walk, porters will carry them down on a stretcher or evacuation wheel.
    5. Helicopter evacuation — in severe cases, a helicopter can be called. Landing is dependent on weather and usually occurs at lower elevations.
    6. Hospital transfer — the climber is taken to KCMC (Kilimanjaro Christian Medical Centre) in Moshi or another suitable medical facility.