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Kilimanjaro Health Precautions

Fortunately, the ailments you’re likely to encounter in East Africa are easily treated and rarely life-threatening. The most common ailment is simply an upset stomach, and most of the time this is the result of your body adapting to the bacteria of East African cuisine and water.

African medical facilities have a terrible reputation because of the prevalence of AIDS and other serious diseases. However, for the more common ailments you’re likely to encounter, diagnosis and treatment can be accomplished with­out ever drawing blood or cutting into the body.

There are many great websites with info on high-altitude mountaineering that offer much more information—including the High Altitude Medicine Guide (www.high-altitude-medicine.com), the British Mountaineering Council (www.thebmc.co.uk), and others—so make sure your trip is preceded by a dose of web reading. Also, check out the more mainstream health websites—like the World Health Organization (www.who.int/en) and the Centers for Disease Control and Prevention (www.cdc.gov)—for diseases not related to climbing / trekking.

Immunizations/Vaccinations
There are several immunizations that you should get before leaving North America or Europe for East Africa. At the bare minimum, include vaccinations for yellow fever, cholera, hepatitis A, tetanus, polio, typhoid, and meningococcal meningitis. Although medical professionals the world over agree that cholera shots are generally unnecessary, many governments—including those of East Africa—require the cholera stamp on your health documents. (Health docu­ments are simply records of the immunizations you have received. Every public or private medical facility that administers immunizations should provide you with these documents at no cost.)

Also, if you are planning to get the above-mentioned shots, plan early. Some of them require several courses spread over weeks, even months, and some can’t be taken with other medicines.

Malaria
Many Westerners—acutely aware of the well-publicized effect of AIDS on Afri­cans—seem to forget about malaria, but malaria is still one of the biggest killers in East Africa. According to the World Health Organization (WHO), “there are at least 300 million acute cases of malaria each year globally, resulting in more than a million deaths. Around 90 percent of these deaths occur in Africa, mostly in young children.”

Malaria tablets are easy to get both in East Africa and at home, before you leave (nearly all courses require starting several weeks before you travel). There are several brands available (you can buy them at chemists’ shops and many hotels, restaurants, and bars in East Africa), and some even sell for pennies per tablet. However, according to some medical professionals, some brands of malaria medicine are not effective.

Larium is reportedly the best antimalarial; however, it is not readily available in East Africa. It is also remarkably expensive, costing around US$150–200 for the typi­cal course (“generic” Larium is about half that). Ask your doctor before you go.

The best way to combat malaria, however, is to cover up and prevent mos­quito bites in the first place.

Dengue Fever
Dengue fever (there are several forms of it) has become something of a world issue in recent years, and an estimated 2.5 billion people worldwide are at risk of contracting it, according to the WHO, which also estimates that “there may be 50 million cases of dengue infection worldwide every year.” The fever mani­fests itself as a severe, flulike illness that affects people of all ages, but rarely causes death. There is no cure for dengue fever. Like malaria, it is transmitted by mosquitoes, so the best defense is to cover up against the insects and use repellent when covering up is not possible.

Trypanosomiasis (Sleeping Sickness)
Trypanosomiasis is spread by tsetse flies, and this disease has two distinct phases: early and neurological. The early phase includes fever, headache, itch­ing, and pain in the joints. The neurological phase occurs when the parasite that causes trypanosomiasis leaves the blood and enters the central nervous system. When this happens, the victim can experience confusion, a lack of balance, and reduced sensory skills. This is also when the parasite wrecks the sleep cycle, hence the name.

If the disease is not treated, it is fatal. Worse, if treatment does not occur before the start of the neurological phase, neurological damage can be irreversible. Treated early on—the treatment consists of two sets of drugs, each combating the parasite in the two phases—the chance of recovery is high. If you think you have contracted trypanosomiasis, seek professional medical help immediately.

Dysentery
Perhaps the most common ailment besides diarrhea is dysentery (and, obvi­ously, diarrhea occurs with dysentery). There are several kinds, but they all can be identified by severe stomach cramps and confirmed by a simple stool test, which can be done at any dispensary (pharmacy).

Water
Tap water is generally regarded as questionable to drink in East Africa. If you ask whether the water has been chlorinated, as some guidebooks suggest, you will either get an emphatic yes, regardless of whether it has been chlorinated or not, or no answer at all, as many local people are not sure what chlorination is. These days, most travelers, including climbers, rely on bottled mineral water, which is readily available throughout the region.

High on Kilimanjaro, the water is extremely clean, except for those few places where it has been contaminated by human waste. The lower you are, elevation-wise, and the closer you are to campsites and popular trekking routes, the more likely it is not. Wherever you are, it’s a good idea to boil or treat your water at all times.

Water is readily available at most camps and huts. At worst, such as Barafu Huts on Kilimanjaro, it’s a half hour’s easy hiking away.

VACCINATION TABLE
Type Vaccination Duration Comments
Cholera   No longer recommended. Only necessary if travelling from infected countries.
Diptheria & Tetanus 10 year booster Recommended. Tetanus vaccinations last for ten years and are absolutely vital for visitors to Tanzania. The vaccination is usually given in combination with one for diphtheria. Once you’ve had five injections, you’re covered for life.
Hepatitis A Up to 10 years Recommended. This debilitating disease of the liver is spread by contaminated water, or even by using cutlery that has been washed in this water. The latest inoculation involves two injections; the first will protect you for three years, the second, taken six to twelve months later, will cover you for ten years.
Hepatitis B   For extended travel or high risk
Polio 10 year booster Recommended. The polio vaccine used to be administered by sugar-lump, making it one of the more pleasant inoculations, though these days it’s more commonly injected.
Typhoid Up to 10 years Recommended. This disease is caught from contaminated food and water.
Meningitis A & C 3 years Long stay visitors, rural. This disease of the brain is often fatal, though the vaccination is safe, effective and lasts for three to five years.
Rabies   Long stay visitors, rural travel. If you’re spending some time with animals or in the wilderness, it’s also worth considering having a course of rabies injections, though it isn’t pleasant.
Yellow Fever Up to 10 years Recommended. Yellow fever is a viral illness that has caused large epidemics in Africa and the Americas and which is spread by the bite of a mosquito.

Malaria

Malaria is endemic to the region, especially on the coast. It is transmitted by infected mosquitoes. Remember that mosquitoes are most active during the evening and night.
If infection is suspected medical advice should be sought immediately. Malaria is detectable with a simple blood screen, but the sample is best taken during a high cycle of the fever, when the infection is at its most active.

Mefloquine one 250mg tablet weekly. OR Doxycycline one 100mg capsule daily. OR Malarone one tablet daily.

Mefloquine (Lariam) Start two and a half weeks before travel, throughout your stay in an endemic area and continue for four weeks after return.
Doxycycline Start two days before travel, throughout your stay in an endemic area and continue for four weeks after return.
Malarone Start two days before travel, throughout your stay in an endemic area and continue for one week after return.