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In September, a trekker from Idukki, Kerala, died in Uttarakhand while attempting to scale Garur Peak due to respiratory failure. Every year, numerous tourists like this succumb to the effects of high-altitude sickness in the pristine but challenging inner Himalayas. These regions present hidden dangers due to their extreme altitudes, where thinner air and reduced oxygen can lead to potentially fatal conditions.

What is High-Altitude Sickness?

• Acute Mountain Sickness (AMS) occurs when the body struggles to acclimatize to high altitudes, typically above 8,000 feet (2,400 meters), where oxygen levels are lower.
• As altitude increases, oxygen levels decrease, leading to hypoxia (lack of oxygen). Early symptoms include:Headache, Nausea, Fatigue&Shortness of breath
• If untreated, AMS can develop into:
  • High-altitude pulmonary edema (HAPE): Fluid accumulation in the lungs, leading to severe breathing problems.
  • High-altitude cerebral edema (HACE): Fluid in the brain causing confusion, hallucinations, or coma.
• Both conditions are life-threatening and require immediate descent to lower altitudes.

Infrastructural Issues

• Many Himalayan regions lack adequate healthcare facilities beyond major towns like Shimla.
• Leh is an exception, with specialized facilities for high-altitude ailments, but most areas lack preventive health measures.
• Implementing health screenings at entry points to high-altitude zones (like Kinnaur or Lahaul-Spiti) could significantly improve prevention and response to AMS.

Mandatory Registration System for Tourists

• Tourist Registration: A system where tourists must register before entering remote mountain areas would allow authorities to monitor movements and provide timely medical assistance.
• Benefits:
  • Quick emergency responses by having data on tourists' locations.
  • Research support: Tracking demographic patterns and risk factors to better understand how altitude impacts different populations.

Early Intervention for High-Altitude Sickness

• Gradual Ascent: To allow the body to acclimatize, gradual ascent is crucial. Every 3-4 days, take a rest day and avoid increasing sleeping altitude by more than 500 meters/day.
• Medications: Doctors recommend:
  • Acetazolamide to promote better oxygenation.
  • Dexamethasone for reducing inflammation in severe cases.
  • For those with a history of HAPE, Nifedipine may be used preventively.
• However, no medication guarantees immunity from AMS. Travelers with pre-existing conditions should consult a doctor before traveling.

Treatment Strategies

• Descent: The best treatment for AMS is to descend to lower altitudes (300-1,000 meters), where symptoms improve rapidly.
• Additional Measures: If available, supplemental oxygen or a portable hyperbaric chamber can help in emergencies.
• Medications like acetazolamide and dexamethasone can provide short-term relief but are not substitutes for descent.

Policy Recommendations

• Medical Infrastructure: Establish state-of-the-art medical facilities in high-altitude regions of the Himalayas.
• Research: Set up research centers to study high-altitude illnesses.
• Air-ambulance Services: Equip states with air-ambulance services for rapid medical evacuation in emergencies.
• Health and Safety Information: Provide accessible information on government websites and at check-in points to educate tourists on preventing and managing AMS.

Preventive Measures Before Scaling the Himalayas

• Acclimatization: Gradual ascent is essential for preventing AMS.
• Health Checks: Get a medical check-up to assess risk factors before travel.
• Medications: Consult a doctor for potential preventive medications.
• Hydration and Rest: Stay hydrated and take ample rest during the ascent.
• Monitor Symptoms: Be aware of early symptoms like headaches or nausea and stop ascending if they occur.

By addressing these measures, the risks associated with high-altitude sickness can be mitigated, improving safety for tourists and trekkers in the Himalayas.