Africa Safari FAQ

Travel is one of those things that naturally gives rise to queries, concerns and doubts, so we’re here to put your mind at ease. Which trip is right for me? What do I do about visas? How much do I tip? Should I have banned or photo for lunch? For questions frequently and otherwise, this is the spot.

Which style of trip is right for me?

Our three styles of travel – Basic, Original and Comfort – cover a whole gamut of travel experiences. To find out which one has ‘You’ written all over it, visit our trip styles page.

Are trips physically demanding?

Want to lie in a hammock and not move until cocktail hour? We’ve got a trip for that. Want to power up the side of mountain at high altitude? We’ve also got a trip for that. To determine what type of trip suits you best, each of our trips comes with a Physical Rating to let you know how physically demanding it is… or isn’t. Find out more about ratings.
Moonlight Tours Expedition offers a wide range of Family Adventures around our Africa Destination. The minimum age (for Family trips) varies depending on destination, and Moonlight Tours Expedition has set minimum ages to ensure that the included activities suit each age range. Additionally, you’ll notice that some of the more adventurous destinations have a higher minimum age. Please click here full details and FAQs associated with our Family Adventures.

Who are Moonlight Tours Expedition travellers?

Each Moonlight Tours Expedition adventure has a physical and cultural grading to help you decide if the trip is right for you. No special skills are required for most adventures, just a sense of adventure and a curiosity about the world. Even on our camping adventures no previous experience is required; our tents are easy to set up, even for first-time campers.

How many people will be on my trip?

Good things come in small packages, which is why we keep our group sizes down. This means we’re small enough to remain flexible as we thread our way through communities without intimidating the locals. On most of our trips you’ll be part of an intimate group of 10-100 people, though our group sizes are on average. Our Overland trips are in purpose-built vehicles that can carry up to 7 travellers. Group sizes are displayed on each trip’s overview page on our website.

Are there age restrictions on your trips?

For the majority of our trips the minimum age is 15. An adult must accompany all children under the age of 18. Our Overland Adventures have a minimum age of 18. Younger children can join us on our Family trips and Short Break Adventures, but check each trip for its minimum age, which is located on the trip’s overview page on the website. Most of our trips don’t have a maximum age limit, but a Self-Assessment Form is required for all passengers 70 years and over.

Who will be my group leader?

While we can’t tell you who your leader is prior to departure, we can tell you they will be awesome. Our leaders are experts in their regions, some because they’ve been travelling there for years, others because they’re local to the region and can’t wait to show you around. On longer journeys, or ones that travel through more than one country, you may change leaders part way through – but this just means double the awesomeness.

Can I just do part of the trip?

Although you won’t be reimbursed for any portion of the trip unused, you can opt to sign off the trip if you need to leave a day or so earlier. If you let us know before travel that you’ll be arriving late or need to leave before the trips ends, we will notify our team on the ground to best accommodate your requirements.

Can I make any changes to the itinerary of my group trip, either before or during the trip?

Please make sure you are happy with your group trip itinerary before booking because we are unable to change them for individual travellers. However, if you and a group of friends, colleagues or even your school would like your own personally designed itinerary, get in contact with our very talented Private Groups; they can tailor an itinerary just for you.

Can I add an extra night on the beginning or end of my group trip, either before or during the trip?

You sure can. Just ask your travel specialist at the time of booking.

I’m travelling alone – is that OK?

This is the beauty of the Moonlight Tours Expedition style of travel: many of our travellers join because they are travelling solo and want to meet and share experiences with like-minded people. Find out more If I am travelling solo, will I be charged a single supplement? As a solo traveller, you will be paired up with another passenger of the same gender as per your passport information. If you’re not comfortable sharing a room with someone of the same gender, you also have the choice to pay for a single supplement (available on the majority of our trips). If you don’t identify with the gender assigned on your passport, please let us know at time of booking and we’ll arrange the rooming configuration accordingly. Find out more

Are Moonlight Tours Expedition trips suitable for LGBTQI travellers?

Everyone should feel comfortable when they travel with Moonlight Tours Expedition and we know that many of our travellers are part of the LGBTQI community. It’s important for our travellers to be aware of the local laws and customs in the destinations we visit as some countries have laws that discriminate against LGBTQI people. We recommend you visit Equaldex and/or Smartraveller before you choose your trip for up-to-date advice and information about LGBTQI-related laws. If you are a solo traveller booking on a twin share basis you will be paired with another passenger of the same gender as per your passport information. If you have concerns with this arrangement please let us know at the time of booking.

I have a disability – can I join Moonlight Tours Expedition trip?

Moonlight Tours Expedition is committed to making travel widely accessible, regardless of ability or disability. We ask that you carefully consider whether you are physically and mentally able to complete the itinerary you have chosen, recognizing that on many trips you will be required to carry your own bags and use public transport. Where can we make reasonable adjustments to the operation of our trips to facilitate the requirements of disabled travellers – such as booking ground floor accommodation, or having our leaders communicate important directions in writing as well as verbally. Many travellers with disabilities have been able to enjoy our trips by travelling with a friend or companion who can assist with specific needs. If joining a group trip is not practical we may be able to provide you with a private departure. Please contact our sales team for further information on any of our itineraries.

Trip Notes

How do I obtain Trip Notes/itinerary for full details of my trip?

Make sure you bring these with you. Every trip has a set of trip notes, accessible on our website, that gives you in-depth information about all aspects of your trip. To access your Trip Notes, please visit your trip’s specific facts page on our website. The Trip Notes are accessible at the top of this page or Emails Us:

Do I need travel insurance?

Travel insurance is compulsory for all Moonlight Tours Expedition travellers and should be taken out at the time of booking. You must provide proof of your travel insurance on the first day of your trip; you will not be able to join the trip without it.

What does my policy need to cover?

At a minimum, your travel insurance should be 'comprehensive', providing cover against personal accident, death, medical expenses, emergency repatriation and personal liability, with a minimum coverage of US$200,000. We also strongly recommend it covers cancellation, curtailment and loss of luggage and personal effects.

How do I find out about the visa requirements for the trip I am interested in?

While we do include information in our Trip Notes about visa requirements, we always recommend that passengers check with their local embassy as visa rules can change without warning. Embassy websites in your home country will always have information about requirements, visa costs and will provide the required forms. If you are uncomfortable with the visa process, you can visit a travel agent who can arrange these for you at a cost.

How do I organise my Visa?

Please contact the relevant local embassy, or visit a travel agent, to organise your visa,likewise clontact us we can also help you:

Do you help with Visas?

Moonlight Tours Expedition can’t assist in the actual application of visas, but you can do this through the embassy or with the support of a travel agent.

I am concerned about the political stability of the country through which my trip will travel.

The safety of our passengers, leaders and operators is a major priority for Moonlight Tours Expedition. With this in mind, we monitor world events very closely and Moonlight Tours Expedition makes operational decisions based on informed advice from a number of sources.If this advisory is at Level 4 'Do Not Travel' then Moonlight Tours Expedition will either cancel the Moonlight Tours Expedition Travel operated trip or reroute the itinerary to avoid the areas concerned.

How safe are my belongings whilst on the trip?

While we take all the precautions we make sure your belongings are safe, we are travelling to some exciting destinations that are sometimes home to some pretty skilled thieves. Travel insurance is a must and a lockable bag or money belt will always help too.

What is the best way to carry money?

We recommend having access to money from a variety of sources – cash, cards and travel money cards are all commonly used.

Will refrigeration be available for medicines? eg. Insulin

Availability of refrigeration cannot be guaranteed. As a general rule, many of our city hotels provide access to small fridges; however, outside of this, especially when trekking or in homestay environments, you cannot rely on access to refrigeration. Please be sure to advise Moonlight Tours Expedition if you are travelling with medication that requires refrigeration.

What are the medical and vaccination requirements?

Medical and vaccination requirements differ between nations and as we are not medical practitioners, we unfortunately cannot advise on this issue. Please see your local GP or travel doctor for details and advice about current vaccination requirements.

What if I get ill or injured on the trip and unable to continue?

Our leaders are trained to deal with these situations and we will endeavour to get you help as quickly as possible. If you must leave the trip early due to illness, our local offices will help you find appropriate medical care and ensure someone at home is aware of the situation. We will do whatever we can to get you home or on your onward journey. Your travel insurance, which is compulsory on all our trips, should cover any costs incurred if illness occurs.

What is the currency in my destination? How much should I take in credit cards/cash? Can I use my credit card during my trip?

Our Trip Notes include a section on ‘Spending money’. Please refer to this for an idea on budgets. Travellers’ cheques are not common practice anymore so it is a good idea to travel with a credit card and ATM card, or a bank issued ‘cash card’ specifically for travel. Having a couple of options will assure that you are covered if one doesn’t work. In certain countries it comes down to potluck if you can withdraw money. One day it’ll work, the next it won’t, but it will work for your friend… Go figure! Visa cards are more widely accepted than Mastercard.

What type of luggage do you recommend I take?

On most Moonlight Tours Expedition trips you will be required to carry your own luggage, sometimes up stairs and on and off transport. We therefore recommend you travel with a backpack. For a full list of what to take on your adventure see our Safari and Climber’s packing list.

Can I store excess luggage at the starting point hotel?

Most starting point hotels can store your excess luggage for you; however, this is at your own risk. Often a nominal fee is charged for this service. Of course, this is only an advantage if your trip is circular (i.e. returning to the same starting point).

Do I need to bring a sleeping bag?

We only have a handful of itineraries where sleeping bags are required and these are generally trips that involve camping. When we use homestays, blankets are provided but some travellers feel more comfortable with their own sleeping bag or sleep sheet. This decision is a personal preference. Refer to your Trip Notes if you are unsure whether a sleeping bag is required.

What clothes and footwear should I take on treks?

On a more physical trip, hiking boots are definitely recommended. If the physical rating is under 3, hiking boots or sneakers/runners will be adequate. Many Moonlight Tours Expedition treks will be hiking in near freezing environments so please be sure to research the climate and weather conditions at the time of year you will be trekking and pack accordingly. There is also a packing 'checklist' in our website.

What essential documents do I need to take?

It’s important that you always travel with your current passport, visas, travel insurance and Moonlight Tours Expedition documentation.

What time can I check in at my arrival hotel?

Check-in times can vary from hotel to hotel and region to region. Generally, they are between midday and 2pm. If you do arrive earlier, you’ll be able to store your luggage with the hotel and head out to explore for a couple of hours.

Can I request an early check-in?

We can’t confirm an early check-in, but our sales team can assist in booking you a night of pre accommodation at the same hotel. If you don’t wish to pay for the extra night, you can try your luck locally (they may let you in early if the room is free) or you can store your luggage. Are airport transfers included in the trip price? If not, how much will a taxi cost from the airport? If not, how do I get to and from airports? Generally airport transfers are not included in your trip price unless you're travelling on a Comfort or Independent Journey style trip where an arrival transfer is included. You can normally add an arrival and/or departure transfer to most of our trips when you are booking your trip (or by contacting us if you have already booked). For more information on your arrival, refer to the ‘Joining Point instructions’ in your Trip Notes. Here, we often indicate the price you can expect to pay for a taxi from the airport to the hotel. The cost of the transfer will inevitably be more expensive than a taxi, but it is important to remember that you are paying for a private service and a trusted driver who will offer the security travellers often desire when they arrive into a foreign country.

What is the name of the hotel where my trips starts?

This information can be found in your Trip Notes under ‘joining point hotel’.

Is tipping commonplace in other parts of the world?

Yes, in most places tipping is expected. At your welcome meeting, ask your leader about the local custom and advice on how much is recommended at restaurants or with local guides. At the end of your trip, if you're happy with the service you received, providing a tip for the leader - though not compulsory - is appropriate. While it may not be customary to you, it's of great significance to the people who will take care of you during your travels, inspires excellent service, and is an entrenched feature of the tourism industry across many Moonlight Tours Expedition destinations.

What communication facilities will be available?

Communication facilities are always improving globally. Many hotels and public places have Wi-Fi so it’s usually possible to keep in touch with home every couple of days, if you so desire. In remote places (think Mali, Serengeti) or on treks or homestays, you will not be able to communicate as readily. Your leader will usually give you the heads up before you leave a place so you can send a quick email or two. Phone cards are easy to get your hands on; just make sure your phone is unlocked before you travel. Or in many countries, the cheapest way to make a phone call is at an internet cafe.

How can friends and family contact you?

If family and friends are unable to contact you in an emergency through email or phone, they can contact Moonlight Tours Expedition directly. Emergency contact details (for your destination) are listed in your Trip Notes, or they can contact one of our Global Sales offices, who can pass on a message if required.

Will my mobile work?

We can never guarantee your phone will work as desired, as many of our destinations are out of the way and you may have limited coverage. Chat to your phone provider before you leave about global roaming and the costs involved, and get their advice on the coverage you’ll receive in the places you’re travelling in. Alternatively, you can usually pick up a local sim card on the cheap (just make sure you phone is unlocked!).

Will I get internet coverage?

Some places have Wi-Fi hot spots everywhere and other places will have no coverage at all. If you stumble into the latter, take the rare chance to just sit back and get to know your fellow travellers the old-fashioned way.

Will I be able to charge my electrical appliances?

In most places you’ll be able to recharge your appliances at the hotel. We recommend you bring a travel adapter with you. On our Overland trips, most vehicles come with their own power supply and you should be able to recharge onboard. Be sure to bring an extra camera battery just in case.

Accommodation Transport & Activities

Moonlight Tours Expedition adventures are for travellers with a yearning to get off the beaten track. Whether you're travelling solo, with a group of friends, or are aged 18 or 70, there is Moonlight Tours Expedition adventure to suit your interests and comfort level

Can you provide me a list of places we are staying at?

We are only able to provide information on your joining and finish point accommodation, the details of which are listed in your Trip Notes. As Moonlight Tours Expedition likes to support numerous local businesses, we often have a few places in each city that we can alternate our groups between. For this reason, we can’t give you a full list before you travel. At the welcome meeting on Day 1, your leader may be able to provide you with this so you can email friends and family back home with the details.

What standard of accommodation should I expect?

The standard of accommodation depends on the Trip Style you have chosen.

Is accommodation air-conditioned/ heated?

We want our passengers to be as comfortable as possible so when you are headed to a hot climate, it is likely that you will either have a fan or air-con. Of course, if you are staying in remote areas or at homestays, you will need to expect the facilities to be a little more basic.

I have special dietary requirements – will they be catered for?

We will try our very hardest to accommodate all dietary requirements but in some out-of-the-way places it can be very difficult to guarantee. We will let you know if there are places on your itinerary where this is the case. Please let us know at the time of booking of any food requirements or allergies and we’ll pass the information onto your leader. It is also a great idea to bring a card with your dietary requirements written in the local language for those times you are eating away from the group.

What will the food be like on my trip?

Food is one of the most exciting parts of travel. There may be some familiar fare but often you’ll be confronted with the new, interesting and downright weird of the culinary world but we like to think of it as an adventure for all the senses. In addition to this, our flexible itineraries often allow you to eat with the group or branch out on your own - this means you can eat to suit any budget or desire.

Can I drink the water in the countries I visit?

In some destinations it may not be wise to drink the local water. For more details, you can find country-specific information in our fantastic Destination Pages, which can be found in the red menu bar at the top of our home page, or by going to the belo and then choosing the destination you are travelling to.

Can we book a triple room?

Depending on the trip style you choose, our trips are organized on a twin, triple or multishare basis. As our bookings are made well in advance, individual room requests can’t be guaranteed.

Can I book a single room?

You can book pre and post accommodation on a single basis; however, throughout your Moonlight Tours Expedition trip, rooming is organized on a twin-share basis. Some trips do have a single supplement available – check a trip’s overview page on our website, or their Trip Notes, to see whether a single supplement is offered. If so, please request this at the time of booking.

Are there western toilets available?

Some trips have regular access to western toilets while others don't – it just depends on the areas you’re travelling in. As a general rule, the more remote the place the less likely you are to find western bathroom facilities.

Will I be able to do any laundry?

Along the way there are usually chances to do laundry, either through your hotel or using local services. Your leader will be able to let you know once you are on the trip.

What type of ground transportation is used?

If it moves there’s a good chance you’ll be riding on it. The type of transport used depends on your trip style. Find out more or see your Trip Notes for the specific type of transportation used on your journey.

Mount Kilimanjaro FAQ

We always strive to inspire and assist our Clients, and we get inspired by them. It's a miracle how sometimes one sentence can change the World or the whole perception of something. How one sentence can influence you and guide you through. How few words can answer all your questions?

The average temperature at the foot of the mountain is 25° to 30° C. On the summit, it can range from -12° to 10° C but is usually below freezing. At 3000m (above the tree line), the day temperatures range from 5° to 15° C and then cool off significantly at night. As you work your way up the mountain, you will traverse through many different climates that vary in temperature and precipitation. Light rain is fairly consistent in the lower rainforest section while the upper parts of the mountain often experience passing snowstorms.
If you’re looking to break the record, the smallest age to reach the summit of mountain Kilimanjaro was 9 years old, and the oldest person who reached the summit of Kilimanjaro was 87 years old!
Swahili is widely spoken in Tanzania as well in Kenya, Uganda, Eastern Zaire and Rwanda. Your guide will speak excellent English as well Swahili and usually also a native language. Some porters know English while others may have just picked up a few words here and there.
Absolutely. East Africa has some of the world’s most wonderful safaris to offer. You can very easily do a multi-day safari before or after your climb.
The number of hours you hike each day varies from 3 hours (minimum) to 7 hours (maximum), depending on the intensity of the slope and difficulty of the climb.
Kilimanjaro may be climbed at any time throughout a year, in the bimodal regime the March-May rains are referred as the long rains, whereas the October-December rains are generally known as short rains. January to May is very good with mild temperature.
Kilimanjaro is easily accessible. However you should not underestimate this mountain. There is no technical mountaineering skills required, but only general fitness. If necessary you can do some physical exercises prior to the trek (optional).
This is common concern; there is no need to worry about. By walking slowly, your body will acclimatize itself to the high altitude. The guide will permanently remind you about this (“pole pole’-which means “slowly slowly’).
You will carry your own daypack, you do not need to carry your personal backpack/duffel pack” It will be carried by a porter. During a day you need to carry some water, snacks, camera, waterproof layers, hat and basic First Aid Kit. These will depend on your priorities.
On Marangu route you will sleep in the hut. All other routes you will sleep in the tent-two people each and single supplement. The tent is set-up, broken down and carried by our porters. Water for bathing is provided for each person every morning if possible (no showers).
Your Kilimanjaro price includes park entry fees, camping fees, rescue fees, transport to/from the park entry gate, head guide, assistant guides, cook, porters and tents. 3 meals every day (breakfast, lunch and dinner). All of our guides cook and porters are paid a proper salary in accordance to the Porters Association requirements.
Additional costs include tipping to your guides, porters & cooks and hiring of clothing equipment if you do not have.This is split between everyone climbing. Upon booking we provide an equipment hire list. This covers things like clothing, walking poles, sleeping bags etc. This list includes hiring prices therefore anything you choose not to bring from home can be hired once you arrive.
To enter Tanzania territory you must have a tourist Visa.The best Ideal is to obtain a Visa from the Tanzanian Embassy in your country. To avoid potential loss of passports in the mail or delays in visa processing, Moonlight Tours Expedition recommends that US citizens obtain their visas upon arrival, at Kilimanjaro International Airport. It is an easy and simple process. The cost of a Tanzanian visa IS $50 but for US citizens is $100.
There are post offices, you can buy and send postcards, Internet cafe is a hit and price is cheap, Telecommunication is good, you can send International fax, and use your standard GSM mobile phone in Tanzania.
The passport is to be presented to the Immigration Control Officer at any entry point: border station, airport, and harbor. The passport must be presented along with one of the following: • A valid visa Resident permit • A passport • A visitor must also present an onward or return ticket together with proof that the visitor has sufficient funds to support himself or herself while in Tanzania. All foreigners from non-Commonwealth countries are required to have a valid visa unless their countries have agreements with Tanzania under which the visa requirement is waived. Exemptions: Citizens of Commonwealth countries are not required to obtain visas unless they are citizens of the United Kingdom, Canada, Nigeria, or India. The visa is permission granted to a foreigner who intends to travel to Tanzania on business, for a holiday, to study or conduct research, or for other approved activities. When entering Tanzania, the visitor with a visa may then obtain from the immigration control officer, a pass or any other authority to enter the country.
Our safari vehicles are traditional safari Toyota Land Cruisers. The removable roof allows you to stand up and take photos and enjoy the serenity and wildlife of Africa. They are fitted with radios therefore allowing the driver to communicate with other vehicles and therefore giving you the best opportunity to find animals. The vehicles are extremely comfortable.
This section covers what gear you need to bring, physical training, Tanzania entry requirements (passport & visa), immunizations and vaccinations, and travel insurance. Please read carefully equipment page and make sure you have gathered everything before you depart on your trip.
Climbing Mount Kilimanjaro is a physical undertaking, so you should prepare yourself accordingly with a Kilimanjaro training program. Being in good shape is important in many respects. Obviously, strong, conditioned legs make it easier to walk uphill and downhill for sustained periods of time. General aerobic fitness allows the body to function efficiently with less oxygen. And a fit body is more likely to withstand the stress of consecutive days of hiking and camping. Finally, a positive mental attitude can work wonders for you when fatigue and doubts arise.
All climbers should have a medical check prior to attempting the mountain. Ask your doctor if high altitude trekking is permissible for your age, fitness level and health condition. Ask if you have any preexisting medical conditions that can cause problems on the climb. Ask if any of your medications can affect altitude acclimatization. Ask whether Diamox can be taken with your existing prescription medicines.
Our climbs originate in Moshi, is a short drive from the Kilimanjaro International Airport (airport code: JRO). If you fly into Kilimanjaro International Airport, you should communicate your flight information to us, and we can arrange for transport from the airport to the hotel for a small fare.

Altitude Sickness FAQ

Our team is experienced in managing the risks of altitude sickness and we will continuously monitor your health throughout your trek. To help us ensure you have a safe and enjoyable trek, we would appreciate if you read the information in this Page. Please! carefully and keen,Read our helpful ALTITUDE SICKNESS FAQ .Symptoms associated with altitude sickness result from the body’s inability to adjust to lower levels of oxygen in the blood. It is the pathological effect of high altitude (commonly above 2,400 m or 8,000 ft) on humans caused by exposure to low partial pressure of oxygen at high altitude!

Altitude sickness is a collection of nonspecific symptoms acquired at high altitude. It covers a spectrum of illnesses from acute mountain sickness that resembles a bad case of the “flu” or a “hangover,” swelling of the brain (high altitude cerebral edema) or accumulation of fluid in the lungs (high altitude pulmonary edema). It is hard to determine who will be affected by altitude sickness, as there are no specific factors that correlate with a person’s susceptibility to altitude illness. However the rate of ascent, altitude attained and degree of physical activity are all contributing factors to the onset and severity of the illness.
Symptoms associated with altitude sickness result from the body’s inability to adjust to lower levels of oxygen in the blood. It is the pathological effect of high altitude (commonly above 2,400 m or 8,000 ft) on humans caused by exposure to low partial pressure of oxygen at high altitude. The percentage of oxygen in air remains at altitude, but the density or number of oxygen molecules in each breath decreases as altitude increases. At 3,650 m (12,000 ft) there are roughly 40% fewer oxygen molecules per breath.
The main cause of altitude sickness is going too high too fast. Over time your body will adapt to the lower oxygen levels at a specific altitude. This adaptation is called acclimatization and generally takes one to three days at any given altitude. In order to increase oxygen levels in the blood, you body responds by increased the frequency and depth of your breathing. It is possible to prevent altitude sickness by ascending slowly and allowing your body to adjust as you go. Watching for early signs and symptoms of high altitude illness and responding quickly by descending to a lower altitude can usually avoid serious complications of high altitude disease.
Acute Mountain Sickness (AMS) is common at high altitudes and occurs in over 50% of individuals who live at a low altitude and sleep at altitudes about 3,000 m (10,000 ft). The severity of AMS is variable. Symptoms usually begin within 6 to 12 hours of arrival at altitudes above 2,400 m (8,000 ft), but may begin as soon as one hour or as long as 24 hours after arriving. Symptoms generally begin to decrease in severity by the third
The symptoms of AMS are similar to a hangover and include: headache, fatigue, lightheadedness, lack of appetite, difficulty sleeping (because of waking frequently from Cheyne-Stokes breathing), nausea with occasional vomiting and decreased co-ordination. Symptoms may be mild or severe and are often the worst after the first night at altitude and improve within a day if you do not ascend to a higher altitude. However symptoms may return as you travel higher. As long as symptoms are mild, climbers can usually continue to climb at a moderate rate. As symptoms become more severe, you should NOT climb higher until your symptoms have resolved (usually within 24 hours) and you should consider descent to reverse the symptoms. Even a descent of 300 m (1,000 ft) will significantly improve symptoms. You should rest and avoid drinking alcohol and taking sedatives or sleeping pills as you recover. This may mean that you, as well as your fellow climbers, will be delayed or unable to climb as high or as far as you had hoped. However, climbing higher while you have symptoms of AMS can lead to serious complications. All symptoms of AMS should be communicated to the head guide who will make a decision about whether or not to evacuate the climber suffering from AMS.
HACE is a life-threatening illness and is a severe form of AMS. It is caused by leaky blood vessels in the brain leading to swelling of brain tissue. HACE usually occurs within a few days after climbing above 3,000 to 3,500 m (9,800 to 11,500 ft). Symptoms may include: headache; exhaustion with severe weakness, drowsiness, loss of co-ordination and difficulty walking in a straight line Severe illness can lead to death if not treated quickly and immediate descent is a necessary life-saving measure. Follow-up care must be sought at a medical facility.
HAPE is a potentially fatal condition in which lung capillaries leak and fluid accumulates in the lungs preventing effective oxygen exchange. Symptoms may include: cough shortness of breath even at rest, fatigue, grunting or gurgling sounds when breathing, persistent cough with white or pink-tinged frothy fluid, feeling of impending suffocation or drowning, confusion and irrational behavior. In cases of HAPE, immediate descent is necessary. Patients should be evacuated to a medical facility for follow-up treatment.
Ascending slowly to achieve proper acclimatization is the best way to avoid AMS. Another method is to consider taking a preventative medicine (see below) prescribed by a physician familiar with high-altitude medicine. We always advise our climbers to go “pole pole” (slow) and drink plenty of water to prevent dehydration. Urine should be clear in color. Ideally you want to climb high during the day and sleep at lower elevations. Don’t over-exert yourself at altitude. Light activity during the day is better than sleeping because respiration decreases during sleep that can further worsen symptoms. Also avoid tobacco, alcohol and other depressant drugs including barbiturates, tranquilizers, and sleeping pills because they also decrease respiration leading to an exacerbation of symptoms. If you drink caffeine (eg. coffee, tea, soda) regularly, do not stop drinking it before or during your trip. Caffeine is safe at high altitudes and stopping it suddenly can cause withdrawal symptoms similar to AMS. It is important to tell your guide if you begin to show symptoms of AMS so he can determine the best course of action.
Diamox is a drug that allows you to breathe faster so you metabolize more oxygen and minimize or prevent symptoms of AMS. It is advisable to start taking it 24 hours before you go to altitude in order for it to have an effect and continue for at least five days or until you reach the highest point of your trip. It can temporarily cause carbonated drinks to taste unpleasant. Other possible side effects include: tingling of the lips, hands or feet, nausea or blurred vision. Diamox is a sulfa medicine and people with sulfa allergies should not take it. It is also not recommended in pregnancy. Contact your physician for a prescription.
Dexamethasone is a steroid that may be recommended as a preventive treatment if you are allergic to Diamox. Euphoria and mental disorientation are complications feared by some, yet a number of studies have failed to demonstrate these symptoms. However, dexamethasone should not be taken for more than seven days in order to avoid side effect due to ‘long-term’ steroid use such as high glucose blood levels, high levels of calcium in the urine, protein catabolism, immune suppression and psychiatric effects. Contact your physician for further information.
A number of over the counter anti-inflammatories such as ibuprofen and aspirin can help prevent the headache that occurs with AMS. If you plan a rapid ascent, you can start taking the medication before you ascent. Otherwise you should only take it if you develop a headache.