Kilimanjaro is the highest mountain in Africa and the highest 'walkable' mountain in the world. The trek to the summit is magnificent and spectacular 5 to 9 night undertaking, to rank amongst the greatest outdoor challenges on the planet.
We are the leading provider of high quality treks on Kilimanjaro, with over 15,000 past customers, a summit success rate of 87% and an exemplary safety record.
We are also the only company able to provide ALTOX Personal Oxygen Systems, to greatly improve your chances of reaching the summit.
On route selection, our most popular shorter option is the five or six night Rongai route.
Those absolutely confident in their fitness and willing to spend longer on the mountain to increase the chances of summit success should start by taking a look at the seven night Shira route.
Whilst those looking for a really unusual longer trek may be interested in the eight night North route.
Our guidebook sections should contain everything you need to know about trekking Kilimanjaro.
We are the leading provider of high quality treks on Kilimanjaro, with over 15,000 past customers, a summit success rate of 87% and an exemplary safety record.
We are also the only company able to provide ALTOX Personal Oxygen Systems, to greatly improve your chances of reaching the summit.
On route selection, our most popular shorter option is the five or six night Rongai route.
Those absolutely confident in their fitness and willing to spend longer on the mountain to increase the chances of summit success should start by taking a look at the seven night Shira route.
Whilst those looking for a really unusual longer trek may be interested in the eight night North route.
Our guidebook sections should contain everything you need to know about trekking Kilimanjaro.
Kilimanjaro Altitude Sickness
Air at the summit of Kilimanjaro contains only about half the amount of oxygen that it does at sea level. Altitude sickness is caused by the failure of the body to adapt quickly enough to this reduced level of oxygen as one gains altitude. It is likely that you will experience some form of altitude sickness at some point whilst climbing Kilimanjaro.
A general mountain rule is that you should not generally ascend more than 300 metres per day and for each 1000 metres that you do ascend you should take a rest day. Although the main Kilimanjaro routes are designed to follow the same basic principles, ultimately they all fail to meet these criteria. This is what makes this mountain so difficult and potentially dangerous. It is therefore critically important that all trekkers read and understand the contents of this section.
In trekking terminology, mountain altitudes are divided into three zones ... high, very high and extreme. As you can see below, this trek involves extreme altitudes ...
High altitude : 2400m to 4200m : includes virtually all but the very start of the trek
Very high altitude : 4200m to 5400m : includes the night before summit attempt
Extreme altitude : above 5400m : includes much of the summit attempt with Uhuru Peak at 5895m
Unlike other extreme peaks such as those in the Himalaya, the summit of Kilimanjaro is approached in just a few days, leaving very little time for the body to adjust. This is what makes Kilimanjaro such a unique challenge.
A trekker reaches his limit on the approach to Kibo Summit
Different Types of Kilimanjaro Altitude Sickness
There are three different types of Kilimanjaro altitude sickness. The first is the most common and can often be managed without recourse to evacuation from the mountain. The other two are much more serious and tend to lead to immediate removal from the mountain ...
Altoxia
During a trek on Kilimanjaro it is likely that more than 75% of trekkers will experience at least some form of mild altitude sickness caused by a failure of the body to adapt quickly enough to the reduced level of oxygen in the air at an increased altitude.
This type of altitude sickness is known as Altoxia, a term which is used almost exclusively on Kilimanjaro, since this is the only commonly trekked mountain where these extreme altitudes are encountered so quickly.
Altoxia is most commonly experienced on the summit approach, but can also occur earlier in a trek, especially during day hikes to higher altitudes, in which case it should recede as the trek overnights at a lower altitude.
Altoxia can have many different symptoms, the most common being headaches, light headedness, nausea, loss of appetite, vomiting and a mild swelling of the face, ankles and fingers. These symptoms can be rather unpleasant, add a new dimension to the adversity faced by trekkers and can really take the shine off the experience. However, in this mild form, Altoxia does not generally have serious consequences and normally disappears within 48 hours.
The symptoms of Altoxia are commonly relieved or even eliminated by use of an ALTOXTM Personal Oxygen System or by taking Diamox, more on these methods below.
If the symptoms of Altoxia become persistent or severe, then there is a danger of acute mountain sickness developing. This is a much more severe form than Altoxia and must be treated by immediate removal to lower altitudes. There are two distinct forms of this sickness ...
HAPE : High Altitude Pulmonary Oedema : "water in the lungs"
High Altitude Pulmonary Oedema is characterized by breathlessness at rest, very high pulse, crackling sound in the chest and coughing of pink fluid (sputum). This condition is rapidly fatal unless the casualty experiences immediate descent. There are no drugs to cure and no possibility of re-ascent following an episode.
HACE : High Altitude Cerebral Oedema : "swelling in the brain"
High Altitude Cerebral Oedema is a combination of two or more of the following : Very severe headache, severe loss of balance, mental confusion and repeated vomiting. This condition is rapidly fatal unless the casualty experiences immediate descent. There are no drugs to cure and no possibility of re-ascent following an episode.
Trekkers should not be too scared by all this talk, but it is essential to understand that if you push on or stay at same altitude with AMS, HAPE or HACE then you will probably die. People do. The only correct resolution is immediate descent.
Our guides are all very experienced in dealing with the problems of altitude. It may be necessary for you to descend to a lower altitude until you recover or even to abandon the trek in the interests of safety. The decision of the guide in such situations is final.
Avoiding Kilimanjaro Altitude Sickness
There are seven main factors that affect the incidence and severity of Kilimanjaro altitude sickness ...
1. Rate of ascent
2. Altitude attained
3. Length of exposure
4. Level of exertion
5. Hydration and diet
6. Inherent physiological susceptibility
7. Use of oxygen systems or drugs
The following three techniques are commonly used to assist acclimatisation ...
High water intake : A fluid intake of 4 to 5 litres per day is recommended. Fluid intake improves circulation and most other bodily functions, but does not increase fluid leakage from the body. Thirst should not be an indicator of proper fluid intake, if your urine is clear then you are drinking enough.
Walk slow : Pace is a critical factor on all routes. Unless there is a very steep uphill section your breathing rate should be the same as if you were walking down a street. If you cannot hold a conversation you are walking too fast. Breathing through the nose for the first 2 days of the trek will limit the pace. Walk "softly" allowing your knees to gently cushion each pace. "Pole pole" ... slowly slowly ... is the phrase that will echo around your head as it is repeated to you by the Kilimanjaro guides.
Walk high sleep low : If you have enough energy and are not feeling the affects of altitude, then you might take an afternoon stroll further up the mountain before descending to sleep. All our routes already include these recommended acclimatisation walks whenever possible.
ALTOX Personal Oxygen Systems
An ALTOXTM Personal Oxygen System is a set of equipment which provides a low dosage oxygen supply to a trekker on the mountain.
The use of such a system considerably reduces the effects of Altoxia, improves your chances of summit success and should increase your enjoyment of the experience.
We had long since suspected that it may be possible to massively improve the safety, enjoyability and success of our treks by being able to provide some form of low dose oxygen supplement, but until recently we had been unable to find a system which did this without requiring enormous cylinders of oxygen to be hauled up the mountain. So when we happened across Neil at Summit Oxygen during 2009 we quickly recognised that he was onto something.
An ALTOXTM Personal Oxygen System works by supplying oxygen directly into the nostrils by means of a small plastic tube, or nasal canula, connected to a small oxygen cylinder carried in a backpack. The really clever part of the system is the controller, or pulse dose meter, which detects when the user is commencing an inward breath and delivers a small and precise dose of oxygen during the first part of the intake, ensuring that the valuable oxygen reaches the deepest parts of the lungs. This method of dosing makes it possible for each oxygen cylinder to last for 7 to 10 hours, rather than the usual 40 to 50 minutes.
Neil has an army background and first developed his system for military use. Although only properly introduced to the Kilimanjaro arena during 2010, this kit has been successfully deployed in other arenas since 2007, most notably with American, British and Norwegian armed services.
ALTOXTM Personal Oxygen Systems have been used on successful ascents of Mount Everest, by Chinook helicopter pilots and crews during high altitude special forces deployments, by extreme altitude sky divers and paragliders, by pilots of unpressurised light aircraft and by pilots of military aircraft in the event of pressurisation systems failure.
ALTOXTM Personal Oxygen Systems are serious bits of kit, with a proven track record in extreme environments.
ALTOXTM Personal Oxygen System in use on Everest
We quickly teamed up with Neil and between us embarked upon a very extensive programme of field testing on Kilimanjaro. The results were so overwhelmingly successful and we were so impressed by Neil's operation that we decided to help out with the significant investment needed to get sufficient equipment on the ground in Arusha.
As a result, ATR is now the only company able to offer ALTOXTM Personal Oxygen Systems on Kilimanjaro.
Because of this exclusivity, you may encounter some negative flack from other operators who do not have access to this type of equipment. We would like to assure you that it is a matter of fact that these systems both significantly increase summit success and significantly increase the enjoyability of a trek by limiting the affects of Altoxia.
If you do wish to book a trek with another agent but still use an ALTOXTM Personal Oxygen System, then you need to get them to book their trek through us. We are usually able to make that happen to everybody's satisfaction. If you wish to climb Kilimanjaro with another mountain operator, then you will unfortunately not be able to use the equipment.
Please note that ALTOXTM Personal Oxygen Systems are not the same as emergency oxygen systems, which are offered by other companies. See separate section below.
Each ALTOXTM Personal Oxygen System comprises ...
2 x lightweight oxygen cylinders
1 x regulator
1 x pulse dose meter
1 x inline flow indicator
1 x tubing with nasal canula
ALTOXTM Personal Oxygen System
The kit that we provide contains two oxygen cylinders, each weighing 3kg or 6.6lbs. The first cylinder is usually used partly during a practice session during the middle part of a trek and on the evening of the summit attempt. The second cylinder is usually then used for the summit attempt itself. If you are not acclimatizing well on the first few days of the trek you can also use some of the oxygen whilst resting at the lower camps to ease your acclimatization. The kits are carried by the porters on all days when they are being used.
>ALTOXTM Personal Oxygen System
Whereas drugs such as Diamox allow you to push your body harder in a high altitude environment, an ALTOXTM Personal Oxygen System serves to lower the effective altitude, causing your body to have to work less hard. It is therefore much safer and more predictable.
All trekkers using an ALTOXTM Personal Oxygen System should experience considerable relief from the symptoms of extreme altitude, have greater energy and experience less of the mental haziness than can impair the summit experience.
On the Rongai route the advantages of oxygen are particularly pronounced. Before we started to use ALTOXTM Personal Oxygen Systems our success rate to Gillman's Point on the crater rim was 86%, but only 68% went on to reach Uhuru Peak, 18% choosing to turn back. The use of ALTOXTM Personal Oxygen Systems has already increased the summit percentage to 80%, an improvement of 12%. We are certain that virtually all trekkers on these shorter routes are significantly advantaged by using an ALTOXTM Personal Oxygen System.
On longer Kilimanjaro routes such as Shira, Lemosho and North, which are generally used by a trekkers who are fitter and more experienced at high altitude trekking, and where the trekkers have more days to acclimatise to altitude, the benefits of an ALTOXTM Personal Oxygen System are slightly less pronounced, but are still significant.
It is very important to note that we cannot guarantee the availability of ALTOXTM Personal Oxygen Systems. In peak season we sometimes do not have enough systems to meet demand; the economics making it impossible for us to stock in sufficient numbers. It is therefore essential that you book as far in advance as possible in order to maximise your chances.
Comments from Rich :
We have been amazed at the success of these systems. Our initial thought was that trekkers may not consider them necessary, since people have been reaching the summit of Kilimanjaro for so many years without oxygen, so they would not be inclined to rent them in the first place. Fortunately the message of quite how difficult it is to reach the summit seems to be filtering out. Trekkers seem to be increasingly aware of the trials that lie ahead, of how low the summit success ratios are on some routes and with some operators. The take up of equipment has been remarkable. During the trial stages, when neither ATR or AFW were pushing the systems, over 30% of trekkers chose to go with oxygen, almost 50% on the Rongai route.
We worked closely with Neil at Summit Oxygen to figure out quite how best to deploy the gear on the mountain and I personally oversaw the initial trials on the mountain.
Whilst it is true that there can be an initial feeling on the part of trekkers that using an oxygen system might be a little over the top, once on the mountain and starting to suffer the first mild symptoms of Altoxia, these concerns quickly fade and the vast majority of trekkers are delighted that they have made the decision to go with oxygen.
On the summit attempt itself we had anticipated that trekkers from other groups may view those using oxygen rather disparagingly, but in reality the dynamic seems to be rather different. Everyone without oxygen suffers to such an extent on those night time summit pitches that they all want to know why on earth no one told them that they should be using oxygen. It strikes me that if we were able to have a little stall renting oxygen kits out at the high camps the take up rate would be even more extraordinary, almost irrespective of price!
We have had the odd trekker who has taken oxygen as back-up, choosing to attempt the summit without it. That is of course fine. And just having the oxygen along gives them massive reassurance in case they do have any problems towards the top.
The equipment has proved to be very reliable, relatively easy to use and the support services offered to us by Summit Oxygen in terms of supply and maintenance have been first class. Our mountain guides are now familiar with their correct usage and able to convey this suitably to trekkers.
I think that the positive effects that these oxygen systems have had on our summit success have already been noted. I would like to emphasise a couple of the other positive effects ...
Firstly, trekkers with oxygen kits seem to be much more confident and relaxed about the prospects of going to extreme altitude. During the pre-trek briefing things can get pretty scary and this has helped enormously. Although the converse effect is also true, when we have group treks where some do and some don't have oxygen, those without now seem to be rather more nervous than previously.
Secondly, once on the summit attempt and using the equipment, our head guides have reported a noticeable increase in vigour and energy levels amongst trekkers, much clearer heads and, for the fitter trekkers especially, much more ease and enjoyment. Without oxygen a lot of trekkers used to describe their summit experience as "a bit of a trip", an intense experience couched in a deep sense of unreality. This is the altitude talking. I am convinced that using oxygen in this way makes the summit experience more of a reality, making it an ultimately more intense and memorable event.
These days it is becoming increasingly unusual for us to not recommend the use of ALTOXTM Personal Oxygen Systems to a group of trekkers, it has been such a success story and we are proud to be playing our part."
As a final footnote to this section, we would like to emphasise that a around 35% of our trekkers do continue to head up Kilimanjaro without oxygen systems. A straw poll around our office still reveals that a similar proportion of us would still prefer to attempt the mountain without, although most of us would still take a kit along for back-up and emergency use. Of course the additional cost is a considerable factor for some trekkers. So if you chose not to take oxygen then we are more than happy to support you in that decision.
Diamox
The use of Diamox on our treks has been drastically reduced since the introduction of ALTOXTM Personal Oxygen Systems.
Diamox is a drug which can be taken to assist the body by improving the efficiency with which oxygen can be absorbed from the thin air. There is no disputing the efficacy of the drug. There is however a big debate as to whether and how Diamox should be used.
There are three ways to use Diamox when climbing Kilimanjaro ...
The first way is to use it as a preventive throughout the trip starting from the day before the climb. The conventional argument against doing this is that it conceals the symptoms of body underperformance, thus increasing the chances of a failure if one does occur being catastrophic.
The second way is to "listen to your body" until day 3 (6 day climbs) or day 4 (7 day climbs) and then, if you are not demonstrating any severe symptoms, to take Diamox as directed above to boost your performance at higher camps. The argument against is the same as previous.
The third way is to only use Diamox as a treatment for altitude illness. This is reasonable, but severe symptoms can only be treated by removal from altitude.
We carry enough Diamox in our medical boxes for the second and third options. This should not be taken as an indication of our advocating this course of action. The choice is yours and we suggest that you consult your doctor and do some background reading on the subject if you remain unsure.
We estimate that before the introduction of ALTOXTM Personal Oxygen Systems perhaps as high as 75% of American climbers took Diamox in some form during the climb. Of non-American climbers this number probably dropped to 25% or lower. Most of these people now use Personal Oxygen Systems and these percentages are greatly reduced.
Here are some notes from Rich on the subject of Diamox :
"Diamox has a proven medical dosage of 750mg. That is not to say that a lesser dosage will not work, but that for the manufacturers need this dosage to prove its efficacy 100%. In our experience 500mg seems to work. More importantly you don't need to pee ALL the time with this dosage, only most of the time. Quite a lot of clients are still recommended only 125mg or 250mg by their doctors."
"If, as the medical literature states, Diamox does not disguise serious symptoms of altitude sickness, then the consideration of whether or not to take it is more to do with the trekker's individual attitude towards taking drugs as preventatives. This is where a cultural difference comes into play, with Americans typically being much more inclined to take it than Europeans for example. Ultimately it is your choice and we will work around your decision. There is little doubt that taking Diamox will significantly increase your chances of summiting, but it may also marginally increase your chance of dying. "
"We do use Diamox as treatment if the trekker is going to descend and we may recommend it to trekkers who are still going up. If our guides suggest that you take Diamox, then you may well wish to take them up on it, but this is very much your decision."
"Last more general comment. Doctors in general practise back home may have very little idea about Diamox, therefore the advice that climbers gets varies enormously. If you really want to get the full information, then ask your doctor to refer you to a specialist."
Emergency oxygen
Emergency oxygen systems should not be confused with ALTOXTM Personal Oxygen Systems.
An ALTOXTM Personal Oxygen System is designed to provide oxygen at low dosage in order to assist a trekker to continue their Kilimanjaro climb. An emergency oxygen system provides full flow oxygen to a trekker suffering from acute symptoms as part of their evacuation from the mountain.
ALTOXTM Personal Oxygen Systems can be converted for use as emergency oxygen systems by bypassing the pulse dose meter. Emergency oxygen systems CANNOT be converted into ALTOXTM Personal Oxygen Systems.
Historically we have never carried emergency oxygen systems as part of our standard kit on the mountain, although we have been able to provide them as an optional paid extra. The main pressure to carry these systems comes from the fact that some of the large charity outfits have started to take them as standard, largely due to the fact that they have a much more mixed clientele, some of whom are not particularly well suited to the rigours of the mountain. Some of our competitors have followed suit and now offer emergency oxygen systems as standard.
We continue to NOT provide emergency oxygen systems as standard on all treks because ...
1. Ten years of experience on Kilimanjaro demonstrates that it is not a necessity for our clientele.
2. Trekkers who are keen to have this facility are better advised to take ALTOXTM Personal Oxygen Systems, which provide them with the dual functionality at a similar level of price.
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