Tag Archives: helicopter evacuation

Getting High in the Himalayas – Nepal – Chapter 10

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Namche Bazaar (3440m) – Phortse Tenga (3680m) – Dhole (4200m) – Macchermo (4470m) – Gokyo (4790m)

 Date = 19 – 22 March

P1020627 (2)A crumbling path rises vertically behind Namche Bazaar.  Angtu groans loudly at intervals, grinning widely, as they climb 400 metres in under an hour, overtaking a steady stream of panting, less acclimatised trekkers.

Angtu:  Not easy!

D:  It’s not a race.

L:  Of course it’s a race.

They reach the top and stand there gasping.

D:  Are you alright?

L:  No.  I can’t breathe.

D:  Is it the altitude?

L:  No.  It’s the views.

Ahead in the distance rise the iconic black pyramid of Everest, the twin peaks of Lhotse and the sublimely gorgeous cone of Ama Dablam.   D&L stumble on across an undulating grassy plateau, muttering like lunatics.

D:  Awesome.

L:  Ridiculous.

D:  Epic.

L:  Extraordinary.

D:  Stupendous.

L:  Amazing.

D:  Where’s Phurba?

Angtu:  He took the low path.  He’s seen it all before.

A helicopter is parked outside the €300/night Everest View Hotel.  They pick a table on the terrace and order probably the world’s most justifiably expensive hot chocolate.

P1020642 (2)All day they walk towards Ama Dablam pointing haughtily skywards, a backdrop to stupas, prayer-flags and picturesque yaks.  It photo-bombs their pictures.  It demands to be admired.  It’s the most beautiful peak they’ve ever seen.

At the top of a long flight of ancient stone steps clinging to the steep mountainside, is the village of Mong, balanced on a ridge just shy of 4,000 metres.   Here they find Phurba, sitting on a wall, smiling and fiddling with his phone.  Stopping here for lunch, they observe a pair of British guides gathering their group of gap-yars.  The guides bark orders, treating their charges like children, not to forget their belongings, not to be late.  They outline the itinerary for the afternoon and following days, which is far more ambitious than D&L’s.  Angtu makes a face.

Angtu:  Too high, too quick.  They could get sick.   Could need an Everest taxi.

L:  What d’you mean a taxi?  We haven’t seen a road for two weeks.

Angtu:  A heli.  There are many helicopters working every day here.

L:  How many?

Angtu:  Maybe 7 companies – 25 helis in all.

D:  For millionaire sightseeing?

Angtu:  And deliveries.  And medical evacuation – every day there’s rescues for people who get sick.

Trekker travel insurance in Nepal demands a USD $750 excess to be paid if a helicopter evacuation is required.  It’s to act as a deterrent.  Tour operators routinely walk their groups on a tight schedule, designed to allow most people to acclimatise – most, but not all.  Those needing more time are left behind, or struggle on, taking serious – potentially fatal – risks to their health.  As many trekkers in Nepal are on a “once in a lifetime experience”, they become determined to reach their goal whatever the consequences.   Once altitude sickness sets in, the only remedy is to head downhill – fast.  In a region with no roads, this means a “heli”.

P1030436 (2)Often, pushing trekkers too high too fast is simply down to a battle by tour companies to offer competitive prices and so a tightly timed itinerary.  Sometimes though, the reasons are a lot more sinister.   There are scams where companies deliberately cause their clients to become ill, with altitude sickness or food poisoning, and then call in a helicopter which delivers the trekker to a private hospital.  There are plenty of winners – kickbacks for all – the trekking company and guide, the helicopter company and pilot, and the private hospital.  There is also one big loser.  The trekker gets a curtailed holiday, a life-threatening illness, a helicopter ride, a stint in hospital, and a gigantic bill.

The group set off ahead of them, setting a fast pace as they have further to go.  D&L work their way slowly down a steep path.  A wave of Hindi pop music rises up from below, getting ever louder and closer until it crashes over them.  The source is an elderly porter, his straw doko empty on his back, his face blank, dance music blaring deafeningly from his pocket.  L&D greet him, shouting “namaste” over the noise.  Angtu and Phurba ignore him.

L:  Have you noticed that Nepali interaction is the opposite to British?

D:  In what way?

L:  Nepalis are really friendly, but they don’t talk unnecessarily.  If we’re passing other people walking, and there’s nothing to say, they say nothing at all, not even a greeting.  But if there is something to say, they launch right in – they don’t bother saying hello.   There’s no formalities.  And when talking they seem immediately comfortable, laughing and joking and smiling readily.

D:  You’re right.  Whereas us Brits are tremendously good at the formalities, with lots of hellos and excuse mes and thank yous and sorrys, but pretty hopeless at genuine conversation!

***

The following morning, the sky dawns blue.  Their room is cosy, but cold.  L snuggles deeper into her sleeping bag.

L:  Bruh!  What’s the temperature?

D:  4°C

P1020729 (2)Birch and rhododendron woods line the path, moss hanging from tree branches and the river is occasionally visible far far below.  Frozen waterfalls and torrents of snow and ice stripe the cliffs overhead and cross the trail, incongruous in the strong sunshine and soft woodland.

The forest dwindles out at around 4000m.  This is the treeline.  They’ll see no more vegetation much over knee-height for almost a fortnight.   The little there is, mostly the juniper shrub, is under serious threat, having been gathered for firewood for decades.  Without the juniper’s soil-binding roots, hillsides become eroded and barren.  Juniper grows very slowly, and in these harsh high altitude conditions it’s cold and windy and dry with only a 3 month growing season.  It’s not enough time to recover the damage – up here it takes 100 years for a juniper bush to grow a mere 4cm diameter trunk.

Dhole spreads comfortably on a two-tier open shelf, with mountains rising behind, and the ground ahead dropping sharply into the river ravine.  One of the region’s three kerosene depots is in this village, ensuring that expedition groups don’t use shrub-wood for fuel.

Despite arriving at 10.30am, they are now at 4,200m and have gained enough altitude today.   They sit in the sun, sipping hot tea.

Angtu:  How are you feeling?  All good?  No headache?

D:  We’re good.

L:  What actually is it?  Altitude sickness, I mean.  AMS.

D:  Acute Mountain Sickness.  Two things.  The higher you go, the less oxygen there is in the air, and so in your blood.  Which is what makes you breathless and tired.

L:  Makes sense.  And the other thing?

D:  The higher you go, the lower the air pressure, which means that liquid in your body sort of oozes out into your lungs, or your brain – a pulmonary or cerebral edema – either of which could kill you.

L:  Nice.  But by not going too high too fast, our bodies adjust as we go along, right?  If we give them time to?

D:  Yes – but it’s not an exact science.  Ideally we shouldn’t sleep more than 300 metres higher than we slept the night before.  If one goes way over this, take a rest day to acclimatise.  Walk high but sleep low.  Drink lots of water – dehydration doesn’t help and the air gets drier the higher you go.

P1020742 (2)L:  And what are the symptoms?  Apart from feeling tired and breathless.

D:  OK.  Headaches.  Dizziness.  Feeling sick.  Not being hungry.  Not sleeping.  Grumpiness.

L:  And how do I know if I’ve got an edema?

D:  If it’s in your lungs, you’ll cough a lot and spit pink.  If it’s in your brain, you’ve probably got a splitting headache and you act drunk – malcoordinated, confused, irrational.

L:  What about taking drugs – like Diamox?

D:  Diamox isn’t a cure for AMS.  It just makes you breathe better, but if you’ve got other symptoms it won’t hide them or make them go away.

L:  So what are your symptoms now?

D:  None.  I’m happy and hungry.  You?

L:  I’m happy and hungry too.

They rinse trail dust from their clothes in a bucket.  In a sauna-warm tin hut with transparent corrugated plastic roof they find a smart shower tray and a hosepipe dispensing tepid water.  As the afternoon cloud builds over the peaks, the temperature drops.  At 5pm, the yak-dung stove is lit in the centre of the dining room and chairs are pulled close around it.  Angtu is happy, having spent the afternoon with friends, other guides passing through the village, drinking home-made wine.  L&D play cards and listen to melodious Nepali chat and laughter drift over them.

***

L:  So?

D checks the temperature.   Despite her thick sleeping bag and the heavy duvet, L has slept in all her clothes including her woollen hat.

D:  Minus 1.

L:  Minus 1?

D:  Minus 1.  Happy Birthday.

L:  Oh.

L sits up in bed.  D has bought gifts in Namche Bazaar and has stuffed them into a sock – a donkey bell, a bangle, a pendant and some prayer flags.  L is delighted.

Later D lights a candle, hands around Snickers bars and with Angtu and Phurba sings Happy Birthday – all of them looking acutely uncomfortable.  It’s a sweet gesture.

Their walk to Macchermo only takes a couple of hours, but they’ve gained another 270m, so they stop to acclimatise.  It’s not enough activity for D who heads off for a walk alone towards the bowl at the head of the valley. P1020769 (3)

L:  I was so worried!  Where on earth have you been?

D: For a walk.  I said so.

L:  You were gone for ever!

D:  For just over an hour.

L:  But it’s dangerous!  There are yetis!

D:  I think you mean yaks.

L:  No, I mean yetis!  A woman and three yaks were killed.  By a yeti!  Right here!  The police said so!

D:  What?!  When?  Today?  While I was out?

L:  No.  In 1998.

***

It’s minus 1°C again in their bedroom this morning.  D&L are developing new skills: how to get dressed in a sleeping bag; how to clean their teeth in bed with a swig of water and a spit-mug pilfered from the dining room the night before.

They follow a broad scar of pebbles and boulders and water and ice snaking down from the pass ahead.  The turf beneath their feet is dissolving into sand as they gain altitude.   Beyond the pass, the horizon ends at the great white wall of Cho Oyu, at 8,188m the world’s 6th highest mountain, an impassable barrier between Nepal and Tibet.

P1020780 (2)At a lonely teahouse skirted by stone-walled yak paddocks, they stop for tea.  The sun gleams off the blue tin roof, the pristine whitewash and the silver dish of a solar kettle.

L:  It’s beautiful.

Angtu:  13 people died.

L:  Here?

Angtu:  Yes.  In 1995.  An avalanche came down and buried the lodge – not this one, there was another, at the foot of the slope.  A group of Japanese trekkers were staying there.

D:  How terrible.

Angtu:  There was so much snow.  I was stuck in Gokyo, 2 hours from here, for 11 days.  Many people needed rescuing.  I was helping as cook, feeding stranded trekkers and helicopter rescue teams.  There were no phones, no wifi.  It was more difficult back then.

L:  Were your family worried about you?

Angtu grins cheerfully.

Angtu:  They thought I was dead!  They’d heard all the stories, of the snow and the avalanches, and they knew I was here.  Every day I didn’t come home.  When I got back to my village, they were all so surprised.  They said “What are you doing here?  You’re supposed to be dead!”

A man skips towards them, moving at a trot down the trail, talking on his mobile.  He stops to greet Angtu, finishes his call and whoops with joy.  They chat, laugh, shake hands and move on.  Angtu explains.

Angtu:  He’s very happy!  He’s just been told he has 3 months work as an Everest expedition porter.  He can earn a lot of money – enough for a year.  He said to me that he sent his son away to work in the Gulf so he could send money home to the family, but he never sends any money – there’s always some excuse.  Now he can tell his good-for-nothing son to come home and look after the yaks while he earns the money instead!

P1020811 (2)At the top of the pass they enter a long valley strewn with boulders.  They pass the first of Gokyo’s sacred lakes on which a pair of orange Brahminy ducks glide and preen on the metal-grey water.  Further on they reach the second sacred lake.  It’s fringed with decorative cairns, placed there by Hindus and Buddhists for whom these lakes have religious significance, or by trekkers taking selfies.

L:  It’s frozen!

D:  I can see that.  It’s awesome.

L:  But it’s supposed to be blue.  In the pictures it’s blue!  An amazing turquoise blue.

D:  Not today it isn’t.

L:  But it’s on the cover of the guidebook!  Looking blue!

D:  I don’t think shouting’s going to change it.

Angtu:  The photo must be summer.  It always freezes in the winter.

L:  Oh.

P1020817 (4)A train of yaks lumbers by, calmly picking their way across the rocky ground, and swinging their big gentle lethal-weapon heads from side to side.  Some have untidy white face markings on otherwise black woolly coats, as though they have been apple-dunking in a trough of whitewash.

As they continue up the valley, the sun goes in, the frigid air nips their skin, and the landscape turns shades of white and grey.  Over a small rise fly tattered prayer flags, and beyond lies the village of Gokyo, on the shores of the third sacred lake.  The surface of the water is a solid crust of ice and snow, and the village is cloaked in sombre shade.  In sharp contrast, at the head of the valley, Cho Oyu dazzles whitely under a clear blue sky.

At 4780m Gokyo seems impossibly chilly and isolated, set amongst an unforgiving landscape of rock and ice.  Behind the village a high ridge of glacial moraine threatens to break surf-like over the buildings, and in front, the lake, ringed by spectacular mountains, breathes icily over the huddle of lodges.  To one side there is a gentler sight, its scale deceptive, seeming almost a hill, a soft dome of parched brown grass.  This is Gokyo Ri.

P1020833 (2)In this remotest of backwaters is a cluster of trekking lodges.  Their bedroom has a carpet, a lake view and clean linen on the twin beds.  The internet works and there is a plug for charging phones.  A skylight lets the sun heat the space in the day.  They look in wonder at the en-suite bathroom with Western loo, a basin and a shower tray.

L:  It’s fantastic.

Hotel:  Yes.  Only one small problem.  Last winter our caretaker forgot to drain the pipes, so they all froze.  And then they split.  So everything is broken.

D:  Oh.

Hotel:  But we’ll bring you a bucket!

D:  That sounds great.

After a walk around the lake, they get into bed.  It’s mid-afternoon.

L:  I  have to say – I didn’t expect to spend quite this much time in bed.  It’s brilliant of course – I love being in bed.  But I sort of imagined us wandering about and exploring more.

D:  And just sitting.

L:  It’s a bit chilly for sitting.  Or wandering.  Or exploring.

D:  We’ve become too used to central heating everywhere, all the time.  It’s much better for the planet to do it this way – just heat one communal room for a couple of hours in the evening.  And wear more clothes.

L:  I’m already wearing all my clothes.

D:  And you’ve got your hot-water-bottle.  At 3 dollars a fill.

L:  That’s 3 dollars of happiness.  Worth every cent.

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A Dangerous Gamble with AMS (Acute Mountain Sickness) – Nepal – Chapter 14

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Italian Pyramid (4970m) – Gorak Shep (5160m)

28 March

 Angtu:  Everest Base Camp!

D&L have been walking, under an intense blue sky, across high meadow plateaus with open views.  Now they stop and follow Angtu’s gaze to where the distant rubble river of glacier becomes an immense strip of blue-white ice.  This is the Khumbu Icefall, and at its edge are the infinitesimally tiny yellow flecks of tents at Everest Base Camp.  From this viewpoint they have the world at their feet, and all to themselves.  100 metres or so below them is the busy main trekking trail, a rocky ribbon of dust on the valley floor pinched between the foot of the hill and a wall of glacial moraine.  But up here there is no-one – just sunshine, solitude and stupendous Himalayan peaks.  It is soul-singing stuff.

P1030237 (2)The bliss ends abruptly as their route converges with the main path at a junction of two glaciers.  The meeting point is a monumental mess of rubble and rocks and boulders.  It’s less than a kilometre across the glacier to Gorak Shep on the far side, but it takes them an hour.  The dusty, stony trail weaves and undulates through the maze.  Every step is uneven, the ground loose, and dust rises to coat their faces.  New paths are forged as old ones fall away, crushed by slabs of dirty grey ice and dragged underground by slow-moving debris.

Finally, the blue tin roofs of Gorak Shep appear below them, on the shore of a dry sand lake on which yaks lie resting like clumps of driftwood.  At 5,160m, Gorak Shep provides the highest altitude accommodation on earth.  Most trekkers spend one night only here, warned by guide books that they are unlikely to sleep soundly due to the altitude and the cold.  D&L are in no rush and are well acclimatized – they are here for two nights.   The settlement is scruffy and has the tough frontier feel of a place with purpose but no community.  No-one lives here year-round.

Angtu has set them some homework.

Angtu:  We are really high now.  Over 5000 metres.  You may get sick.  Not sleep well.  This afternoon, you must walk at least 100m higher than here, to help you acclimatise.

They promise to do their homework and Angtu heads off to find Phurba who has been banished to the village Porters’ Lodge, despite L&D’s protestations.

Angtu:  All the porters have to sleep there.  The lodges aren’t allowed to give them a room.

D&L cross the sand-lake desert.  A man is galloping to and fro on a palomino pony.  It feels more wild-west than ever.  On the far side, at the foot of a steep slope, people are gathering water trickling slowly from a spring.  Up here clean water is a hard earned resource not to be taken for granted.

P1030252 (2)They climb the hill, checking their altimeter, breathing heavily but otherwise comfortable, and stop once they’ve reached 100m.  From here they can see the Porters’ Lodge.  It is set apart from the other buildings – a long low corrugated-iron barn with no windows, but skylights in the roof.  It looks a lot like a cow shed.

Later they ask Angtu if Phurba is OK in the Porters’ Lodge.

Angtu:  He’s happy.  He says it’s not so full so there’s plenty of blankets for everyone.  And the kitchen is warm.  He’s found friends.  He’s been playing cards.

***

Back at their lodge, a woman reels into the dining room, looking confused and breathless.  After hovering in the centre of the room, she sits down at a table.

L:  Are you OK?

The woman speaks little English but says that her breathing is bad.  A Nepali man joins her.   He tells D&L he is the assistant guide of a group who left Lobuche this morning, heading for Everest Base Camp.  They had lunch here and left him behind with one member not feeling so well.  She needs to lose altitude – returning downhill is the simple remedy.  He suggests to her that they should walk back to Lobuche.  She refuses – she’ll be fine to get to Base Camp tomorrow.  The lodge owner appears with a bottle of oxygen.

Owner:  Would you like some?

Woman:  What is the cost?

Owner:  One hundred dollars an hour.

Woman:  Maybe 15 minutes.

She lies down on a bench.  Hours later she’s still on oxygen, her breathing now audible and laboured.  The assistant guide begs her to return to Lobuche.  She refuses.  The rest of her group get back from Base Camp.  The head guide informs her she needs to lose altitude.  He talks about a horse back to Lobuche.  She refuses – tomorrow she will get to Base Camp.  Her husband implores her.  The guide calls his boss in Kathmandu.  He insists that she leaves, for her own safety.  She refuses.  It gets dark.

In the evening she rallies, walks around, eats a little.  L smiles at her.

L:  How are you?

Woman.  Fine.  A little better.  Thank you.

She returns to her bench, lies down, coughs a lot, cries a little and goes back onto the oxygen.

After supper, D&L’s room is bitterly cold.  They pile three quilts on top of their sleeping bags.  Outside it is snowing and they fall asleep to the jingle of yak bells.

***

They are woken at 5am by noises from a nearby room.  There is a rapid and constant wheezing and rasping and moaning, interspersed by bouts of wracked coughing.  It is the woman and it sounds as though she now has full-blown pulmonary edema.  Her breathing is shallow.  Her lungs are filling with fluid.  If she’s not treated soon she could die.  She needs to lose a lot of altitude.  Now.   They lie there feeling helpless, and fretting.

L:  Should I go and sit with her?  Hold her hand?

D:  I can hear voices.  She’s with people.  She’s not alone.

For the last 12 hours she has been trapped by the darkness.  The helicopters fly by sight, and it’s now way too serious to potter back down to Lobuche on a horse.  She needs to be in hospital.  Urgently.  D&L twitch the curtain from time to time, listening to her terrible, laboured, painful breathing and waiting for the sky to lighten.  As soon as it does, a helicopter will come.  They lie and wait.  She pants and moans and coughs.  They wait and twitch the curtain.  She rasps and wheezes and coughs.   D checks the window.

D:  It’s getting light.

L:  Thank goodness.  The helicopter will come.  She’ll be rescued any minute.

D:  No.  She won’t.

L:  Why not?  Why would you say that?

D:  We’re in the cloud.  And it’s snowing.

L:  Oh no.

At breakfast, L frets and they watch the sky.  Angtu tells them the assistant guide sat with the woman all night, administering oxygen.  She’s in good hands.  She’s with her husband.  They are waiting for the heli.  There’s nothing more to do.

Angtu:  Some clients tell me they’d be happy to die in the Himalayas.

D:  But not before their time!

At this altitude, during the busy season there are medical evacuations almost daily.  There is a question of whether trekking itineraries are too fast to allow all members of a group to acclimatise.  With a medical evacuation there is money to be made by helicopter companies, private hospitals and tour operators.   However, putting all that aside, Nepali guides and tour operators tread a tricky line.  They have wealthy, demanding clients with high expectations who have paid a lot of money for an experience.  Culturally many of these clients will be much more comfortable with confrontation than the gentle courteous Nepalis, who are reluctant to deny their client the experience, or to argue with them.  The Nepalis may be the experts in their environment but a paying customer gets what a paying customer wants – right?  But the paying customer doesn’t necessarily know best – they’ve probably never had AMS before, and one of the symptoms is confusion – their judgement may well be impaired.   In this case, no-one benefits here from letting the client get their way, least of all the client themselves.  A client determined to ignore advice and their own physical symptoms, and subsequently becoming life-threateningly unwell, both puts themselves at risk and places a huge burden of responsibility on trekking companies, local guides and others with little or no medical expertise, such as a lodge owner who provides oxygen or a herder with a horse.  Not to mention the trauma and disruption inflicted on the rest of the trekking group.  Where to draw the line?  Who draws it?  And how to ensure it’s adhered to?   There are no easy answers.

It’s another three long hours before the sky lightens and the clouds lift reluctantly.  Eventually, D&L hear, and then see, a helicopter land at the edge of the village.  Finally the woman will be rescued.   They hope it’s not too late.

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