It is of course impossible to predict exact weather conditions, and mountains are notorious for creating their own, localised conditions. The highland areas of East Africa, including Northern Tanzania where Kilimanjaro and the parks of Ngorongoro, Tarangire and Lake Manyara are located, have a pleasant, temperate climate throughout the year. There is a long rainy season in April/May and a second, shorter rainy period in November/early December. Temperatures vary greatly with altitude. At the foot of Kilimanjaro it’s usually approximately 25- 28⁰C, dropping to 15⁰C at night. At 3000m, daytime temperatures can be around 15⁰C. Above 4000m, the night-time temperatures will fall below freezing and it is usually no more than 10⁰C in the day. For more information we recommend visiting www.worldweather.org.
The unit of currency is the Tanzanian Shilling (TSZ or TSH) although US dollars are widely accepted in hotels and tourist areas. We recommend that you change money at the airport. Credit cards are accepted in large hotels and some souvenir shops, but may be subject to commission.
In order for non-residents to enter Tanzania for a short-term (classified as up to 3 months) the Tanzanian government requires ta tourist visa. The tourist visa can be obtained in your home country OR very easily at the airport/border in Tanzania for approximately $50 (single entry) or $100 (US passport holders multiple entry). If you do apply for this in your home country bear in mind that the date of issue is the date the visa will start.
Mt. Kilimanjaro – also known as the “Roof of Africa” – stands 5,895 m above sea level and hence forms the highest freestanding mountain in the world. With a variety of landscapes at different altitudes, climbing the mountain is a truly exciting and unforgettable experience. Nevertheless, one should not overlook the fact that being exposed to high altitudes puts you at risk. Acute Mountain Sickness (AMS) or more commonly known as altitude sickness is one of the biggest threats when climbing Kilimanjaro.
AMS is the result of a lack of air pressure on higher altitudes (and not as often said a lack of oxygen; the oxygen content in the air throughout the troposphere is always 20%). The air pressure decreases at about 10% with a gain of altitude of about 1000 m. Therefore, the air pressure on top of Kilimanjaro is only 40% compared to the air pressure at sea level. Consequently, every breath you take on your way up the mountain still contains 20% of oxygen but the air volume inhaled decreases because the atmosphere pushes less air and thus less oxygen into the lungs. A deficiency of oxygen can cause different malfunctions which in the end lead to AMS. Luckily, the human body can adapt to the changing oxygen level. This process is called acclimatisation and is the key to success on Kilimanjaro. While ascending you will automatically breathe deeper and faster. Moreover, your blood will thicken due to a higher production of red blood cells which ‘carry’ the oxygen all over your body. But these changes take time. Given the fact that most itineraries for climbing Kilimanjaro are construed as 5 to 7-day expeditions your body might not be given enough time to adjust to the lack of air pressure and the lower oxygen level. The consequence: AMS!
Symptoms of mild AMS include headaches, nausea, sleeping problems and are often comparable to having a hangover. Pain killers should bring redemption. Suffering from a mild AMS does not mean that the trekker has to descend immediately. Nonetheless the trekker should rest at the current altitude and not ascend any further until the symptoms disappeared and a complete recovery can be assumed.
Moderate AMS is accompanied by vomiting, headache (pain killers at this stage won’t bring any relief) and a permanent feeling of being out of breath even while resting. The trekker can only continue the climb after an extended period of rest and a complete recovery from the symptoms.
Most common when suffering from a severe AMS is a lack of coordination and balance (a condition known as ataxia) and mental confusion. Ataxia can easily be diagnosed. Draw a straight line on the ground, and have the trekker walk along the line, placing one foot immediately in front of the other, so that the heel of the forward foot is right in front of the toes behind. Try this yourself. You should be able to do it without difficulty. If they struggle to stay on the line (the high-wire balancing act), can't stay on it, fall down or can't even stand up without assistance, they fail the test and should be assumed to suffer from severe AMS. An immediate descent should undoubtedly be the consequence.
High Altitude Cerebral Edema – HACE
HACE is a life-threatening and thus very severe form of AMS and is a condition in which the liquid around the brain is built up. This build-up causes a persistent headache, vomiting, ataxia, changes in mentation and behaviour, lethargy or in severe cases even unconsciousness. Immediate descent is the best treatment for HACE. This is of the utmost urgency and cannot wait until morning (unfortunately, HACE often strikes at night). Delay may be fatal. The moment HACE is recognised is the moment to start organising flashlights, helpers, porters, whatever is necessary to get this person down. Descent should be to the last elevation at which the sufferer woke up feeling well. Bearing in mind that most cases of HACE occur in persons who ascend with symptoms of AMS, this is likely to be the elevation at which the person slept two nights previously. If you are uncertain, a 500 to 1000 m descent is a good starting point. People with HACE usually survive if they descend soon enough and far enough and usually recover completely. The staggering gait may
persist for days after descent.
High Altitude Pulmonary Edema – HAPE
Another form of a severe and serious AMS is HAPE, the accumulation of fluid around the lungs causing excessive pressure on the lung arteries. A gurgling, liquid sound in the lungs, a persistent watery cough and pink phlegm or even blood are the consequences. Exertion and cold exposure can also raise the pulmonary blood pressure and may contribute to either the onset or worsening of HAPE. HAPE can be confused with many other respiratory conditions. High Altitude Cough and Bronchitis are both characterised by a persistent
cough with or without sputum production. But there is no shortness of breath at rest, no severe fatigue and normal oxygen saturations (for the altitude) will be measured if a pulse oximeter is available. Pneumonia can be difficult to distinguish from HAPE. The diagnostic test and treatment is descent - HAPE will improve rapidly with lower altitude. If the patient does not improve with descent a treatment with antibiotics should be considered. HAPE is much more common and unfortunately more dangerous at altitude than pneumonia.
Many climbers have died of HAPE when they were mistakenly treated for pneumonia. Asthma might also be confused with HAPE. Fortunately, asthmatics seem to do better at altitude than at sea level. In a tentative diagnosis of asthma, the corresponding asthma medication should be given. But if the person does not improve quickly, HAPE should be assumed and treated accordingly. Immediate descent is once again the treatment of choice for HAPE. Unless oxygen is available delay may be fatal. Descend to the last elevation
where the sufferer felt well upon awakening. Moreover, for severe cases of HAPE there are different medications available which lower the pulmonary hypertensive response to the lack of oxygen. It is common for persons with severe HAPE to also develop HACE, presumably due to the extremely low levels of oxygen in their blood (equivalent to a continued rapid ascent). HAPE usually resolves rapidly with descent and one or two days of rest at a lower elevation may be adequate for complete recovery.
In severe cases of AMS, HAPE or HACE descent might not be sufficient for a recovery. Additional treatment must be considered. These treatments include oxygen, hyperbaric bag, Acetazolamide (Diamox®) and Dexamethasone (Decadron®).
Symptoms of severe AMS disappear when giving additional oxygen from a bottle or canister over an appropriate period. Although, in combination with an immediate descent, considered as the most effective treatment, oxygen is reserved for more serious cases of HACE and HAPE.
The hyperbaric bag is a man-sized bag which is, once the victim is enclosed, inflated. This will then simulate an increasing air pressure as felt at lower elevations and therefore enables the sufferer to inhale more oxygen. To be effective, the bag has to be kept at a constant pressure.
Acetazolamide supports/accelerates acclimatisation and reduces the symptoms of mountain sickness but the cure of AMS is not immediate. Acetazolamide is a diuretic. It forces the body to excrete excessive liquids which occur when suffering from HACE and HAPE.
There is a lot of mythology about acetazolamide:
MYTH: acetazolamide will prevent AMS during rapid ascent
This is not a myth, but rather a misused partial truth. Acetazolamide does lessen the risk of AMS. Even on acetazolamide, it is still possible to ascend so rapidly that when AMS strikes, it may be sudden, severe and possibly fatal.
MYTH: acetazolamide hides symptoms
Acetazolamide accelerates acclimatisation. As acclimatisation occurs, symptoms resolve, directly reflecting improving health. Acetazolamide does not cover up anything - if you are still sick, you will still have symptoms. If you feel well, you are well.
MYTH: acetazolamide will prevent AMS from worsening during ascent
Acetazolamide DOES NOT PROTECT AGAINST WORSENING AMS WITH CONTINUED ASCENT. Plenty of people have developed HAPE and HACE who believed this myth.
MYTH: If acetazolamide is stopped, symptoms will worsen There is no rebound effect. If acetazolamide is stopped, acclimatisation slows down to the body’s own intrinsic rate. If AMS is still present, it will take somewhat longer to resolve.
Dexamethasone (Decadron®) is a potent steroid used to treat brain edema. Whereas acetazolamide treats the problem (by accelerating acclimatization), dexamethasone treats the symptoms (the distress caused by hypoxia). Dexamethasone can completely remove the symptoms of AMS in a few hours but it does not accelerate or support acclimatisation. If dexamethasone is used to treat AMS you should not ascend any higher until the next day to ensure the medication has worn off and is not hiding a lack of acclimatisation.
The Golden Rules
GOLDEN RULE I: If you feel unwell at altitude it is altitude illness until proven otherwise.
GOLDEN RULE II: Never ascend with severe symptoms of AMS.
GOLDEN RULE III: If you are getting worse (or have HACE or HAPE) descend at once.
If possible, it is recommended to take a pre-acclimatisation climb on for example Mount Meru shortly before conquering Kilimanjaro. This is indeed a question of time and money but it is beneficial regarding a successful Kilimanjaro climbing expedition. In the case a pre-acclimatisation climb is not possible it is highly recommended to take rest days on the way up to the summit of Kilimanjaro. The rest days are not days on which the trekker rests but rather days on which the trekker ascends further and returns to the same altitude where he/she slept the night before. The ‘climb high, sleep low’ –method has a positive influence on a trekker’s body to adapt to higher elevations and therefore can decrease the risk of suffering from altitude sickness. Choosing the most suitable route is also important to lower the risk of getting sick. Some routes follow the above mentioned ‘climb high, sleep low’ –mantra. Both, the Machame and the Lemosho route include hikes to a higher altitude before descending again to the camp where trekkers spend the night at a lower elevation.
The Marangu route on the other hand is designed to a daily gain of altitude of about 1000 m. When choosing routes like Marangu it is highly recommended to add an additional rest day to lower the risk of AMS. Not only which you route someone climbs but also how the trekker approaches the walk is important. The slower one walks the greater the chance to acclimatise. Thus, the best advice is to walk as slowly as possible. 'Pole, pole’ is therefore probably the most frequent heard sentence on the way up the mountain. Once again,
the body needs time to adjust to the changing conditions of higher elevation. Respiratory depression (the slowing down of breathing) can be caused by various medications and may be a problem at altitude. The following should therefore never be used by someone who shows symptoms of altitude sickness (these may be safe in persons who are not sick, although this remains controversial)
- Sleeping pills (acetazolamide is the sleeping tablet of choice at altitude)
- Narcotic pain medications in more than modest doses
And last but certainly not least eating well and drinking enough water is a key to success on Kilimanjaro. A diet consisting of a high share of carbohydrates and fibre and which is low in complex proteins at the same time is ideal to keep the energy levels up and provide the body with all necessary nutrients needed when facing a physical and mental challenge like that. As dehydration can exacerbate AMS, drinking enough water BEFORE, DURING AND AFTER doing anything is vital. Not only that it supports the ability to acclimatise and to deal with altitude but it also helps the trekker to avoid all sorts of health problems such as hypothermia, frostbites,
constipation and diarrhea. Moreover, it can alter the performance of a trekker completely. A minimum intake of 3 litre of water per day at rest and additional liquid for exertion or losses due to vomiting or diarrhea (up to 8 litre) is recommended. To check the hydration level, the urine is an adequate indicator. Deep yellow/amber coloured urine indicates a lack of fluids, a clear and straw urine on the other hand is a sign for a sufficient hydration.
To prevent severe AMS there is one simple rule to be followed:
NEVER ASCEND HIGHER IF YOU HAVE SYMPTOMS OF AMS!
Ascending with AMS will worsen the sickness which might lead to death. This is extremely important - even a day hike to a higher elevation is a great risk. In many cases of HACE, this rule was violated. Stay at the same altitude (or descend) until your symptoms completely go away. Once your symptoms are completely gone, you have acclimatised and then it is OK to continue ascending. It is always OK to descend, you will get better faster.
Colds and coughs are very common when climbing Kilimanjaro. A cough that produces mucus can have different causes. Most likely are the common cold or irritation of the bronchi due to cold air which produces symptoms that are like flu. It could, however, point to altitude sickness. A cough that produces thick green and yellow mucus could indicate a bronchitis. If it occurs together with chest pain (most severe when the patient breathes out), a high fever and blood-stained mucus, any of these could indicate pneumonia which requires a course of antibiotics.
Exposure, also known as hypothermia, can be caused by a combination of exhaustion, high altitude, dehydration, lack of food and not wearing enough warm clothes against the cold. Note that it does not need to be very cold for exposure to occur. Symptoms of exposure include a low body temperature, poor coordination, exhaustion and shivering. As the condition deteriorates the shivering ceases, coordination gets worse making walking difficult and the patient may start hallucinating. The pulse then slows and unconsciousness or even death follow shortly. Treatment involves thoroughly warming the patient quickly by using sleeping bags, warm/hot water in a bottle and the bodily warmth of a second person.
Frostnips, the first stage of frostbites, may occur if not kitted out properly with thick socks, boots, gloves and hats. However, severe frostbites which lead to the loss of fingers and toes rarely happen to trekkers on Kilimanjaro. In the case of fingers or toes getting cold and painful and then numb and white the application of warmth is the first treatment.
A twisted ankle, swollen knee or a septic blister on your foot can ruin a Kilimanjaro trek. Therefore, it is important to take care to avoid these. Comfortable boots with good ankle support, not carrying too heavy a load, washing feet and changing socks regularly, treating/covering blisters as soon as possible is recommended. In case of a sprained ankle, cooling and bandaging afterwards is the first-choice treatment in combination with Aspirin to reduce the pain and swelling. In order to avoid knee problems which occur especially while descending smaller steps should be made and hiking sticks should be used.
Milestone Safaris & Mountaineering ensures that all clients are properly equipped to comfortably reach the top of Mt. Kilimanjaro. Prior to the arrival all clients receive a list of required equipment. During the in-depth pre-climb briefing the clients’ gear will be inspected by our guides to ensure it is suitable. In case of any missing or unsuitable items, Milestone Safaris & Mountaineering works closely with local rental companies that will provide climbing equipment very quickly. Milestone Safaris & Mountaineering provides all necessary cooking and eating equipment as well as the camping gear for those clients who choose a camping route.
Required Mountaineering Equipment (non-exhaustive list)
In addition, the clients’ day pack should contain the following items:
In some cities and towns in Tanzania, expensive-looking clothing, jewellery and electronics could put you at an unnecessary risk for robbery or worse. Individuals with electronic equipment such as laptops, cameras, and music players are asked to use them discreetly.
It is recommended that you do not photograph Tanzanians without their express permission. However, you will find that many people enjoy having their pictures taken especially if they can see the instant results of a digital image. If individuals do refuse to be photographed, please respect this decision.
Tipping is not a common practice in Tanzania, with exception of the tourism industry. It is customary for visitors climbing Kilimanjaro or going on Safari to tip the guides and crew. This is discretionary and should depend on the level of service you received and be a mirror of your satisfaction of the professionalism of the team.
We strongly feel this should not depend on whether or not you reached the top. Whilst discretionary, many of our guests ask us for a guideline so we suggest the following percentages:
Kilimanjaro Expeditions: 10-15% of total sum shared across the crew
Safaris: 5-7% of total sum shared across the crew
Local Excursions: 10% of total sum shared across the crew
Though Tanzania is a rather tolerant country, people tend to dress rather conservatively and it is a sign of respect that you dress the same. Women should never dress in what the local people might interpret as a provocative fashion. We recommend that skirts or shorts at or below the knees or long pants should be worn at all times. Spaghetti strap tops, halter tops, or tank tops are not worn by local women very often, but are definitely seen more now than they used to be. Tight fitting or revealing clothing should be avoided – mainly to avoid stares from local men rather than any other reason.
Men can wear shorts or trousers, although you will find the local men rarely wear shorts. It is also advisable that men avoid wearing sleeveless shirts. It can be rainy between November – April, so we’d suggest bringing a raincoat and a sweatshirt. At other times of the year, light cotton clothing is best for the heat, though you should be prepared and pack a light sweater just in case.
We recommend that you make 3 photocopies of each of the below documents; you should scan them and email them to yourself as well.
Passport (valid for at least 6 months after your intended return date)
We recommend that you make 3 photocopies of each of the above documents; you should scan them and email them to yourself as well. On your journey to Africa, you should keep one copy in your backpack, one in your day-bag and give one set to your parents or a friend back home (in case you need to contact them in case of an emergency). To be extra safe you should also bring with you photocopies of the following:
It is strongly recommended you secure travellers insurance for your upcoming trip and if climbing Kilimanjaro with us, be sure to include this additional coverage. The nearest hospitals of western standards for severe and life threatening emergencies are located in Nairobi. For a minimal fee we can arrange Emergency Air Evacuation coverage to be transferred via helicopter to accredited facilities. Medical evacuations often cost tens of thousands of US Dollars.
There are many options for this, including AMREF Flying Doctors, Air Med, Medjet Assistance, International SOS, Patriot Travel Medical Insurance and Foreignsure. Before your trip, we recommend that you consult with an insurance provider about these and other options to decide what is best for you.
As a developing country, health care costs are considered fairly low for local and basic services, and International travellers usually have to pay cash for any required medical care during travel. Few places will bill your home health insurance direction. And many health insurance plans do not cover medical care outside of your home country.
Please enquire for our most up to date prices.