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Altitude in the Himalaya: Part Two

Altitude is a silent killer; if you’re unprepared for the height of your lofty alpine objectives it can knock you down in the most horrible and brutal way. Climbing in the high Himalaya isn’t all about alpine skill or even fitness - it’s about your body’s ability to adjust to and survive altitude.

Ama Dablam stands at the head of the Khumbu valley Ama Dablam stands at the head of the Khumbu valley

We were standing outside our tents at 4,300m with the incredible breadth of Mt Ama Dablam was standing before us, its huge shoulders reaching out around the basin, the peak soaring above us up to 6,895m. Below the summit sits the Dablam; a hanging glacier above a 1,500m cliff that cascades down to where our tents were pitched. It’s exciting but daunting; this is a formidable mountain.

Ama Dablam stands at the head of the Khumbu valley Ama Dablam stands at the head of the Khumbu valley

Neither my grandfather or father made it to the top — although we were doing a more sensible route that my dad’s audacious attempt up the West Face in ‘79. It was exciting to be stepping forward and continuing my family’s history with this mountain alongside my brother George. However, in basecamp I really had more important things to think about. I had an increasingly painful infection on my abdomen that was threatening to be quite a problem. After a few days the swollen abscess was so sore I couldn’t sit or stand without discomfort; I needed a doctor. And this, naturally, had to happen before ascending to the remote camps at altitude, where the chances of a swift recovery are nil. At extreme heights the body breaks down, and where I was going a small cut would take weeks to heal.

The day before we began our ascent I made a lightning fast trip around the valley to the Pheriche clinic; one of the many clinics that are now in the Khumbu region. I waited with people suffering from altitude sickness — the most common ailment amongst foreigners in these high remote valleys. I met with a Canadian doctor who promptly had at me with a scalpel, poking and prodding away. I soon sped back to basecamp with a course of antibiotics and an uneasy feeling in my abdomen. Over the next two weeks the wound slowly healed, but changing the bandages as we climbed left me very concerned — it wasn’t pretty. The swelling and weeping of the wound made the difficult and active rock climbing on Ama Dablam even more of a challenge.

My brother and I have both been affected by altitude sickness in one form or another, but over time you learn to interpret the signs of your body’s acclimatisation. My first experience of altitude sickness was below the summit on Kilimanjaro, where a crippling headache, wobbly legs and tunnel vision made it one of the hardest ascents of my life… at the age of 17!

Back on Ama Dablam the long circuitous walk up to Camp 1 travels over moraine ridges to eventually form the mountains south-west ridge. Arriving at this camp marks a significant altitude milestone; 5600m. Breathing gets significantly harder when climbing — you have to literally suck air into your lungs in order to move over the broken rocky terrain. But this night also marked the begining of our difficulties with sleeping; it’s not just because the site is anything but flat, but also because your breathing changes as you sleep.

Camp 1 among the messy choss of the South-West ridge at 5600m Camp 1 among the messy choss of the South-West ridge at 5600m

At height, the amount of carbon dioxide in the blood can drop to very low levels and this can literally switch off your drive to breathe. It’s only when your body senses the resulting further drop in oxygen that you start to breath again. This deadly cycle of breathing is called cheyne stoke breathing. At sea level this type of breathing is a sign that someone very ill is in their final hours of life. Up at 5600m on Ama Dablam, it’s completely normal.

Camp 1 among the messy choss of the South-West ridge at 5600m Camp 1 among the messy choss of the South-West ridge at 5600m
Ama Dablam Camp 2 with Kangtega and Tamserku in the background — Emiliano Fernandez
The views up high are immediate, sweeping and extreme. The views up high are immediate, sweeping and extreme.

Camp 1 meant that we had ascended the broad shoulder of Ama Dablam, but ahead of us lay increasingly steep and treacherous terrain. The summit and it’s Dablam icecliff soared upwards, heavy above us.

The views up high are immediate, sweeping and extreme. The views up high are immediate, sweeping and extreme.

I’ve dubbed Camp 2 the Pillar of Hell — and that’s coming from the person who’s lifelong alpine goal has been Ama Dablam since I saw it at age 13. To call it the Pillar of Hell really isn’t far from the truth; it sits upon the yellow tower which violently juts up from the rest of the ridge to provide the only (questionably) flat platforms in the area, nearly all of which aren’t large enough for our tents. It’s an iconic Himalayan camp.

On one side the rock pillar plummets down over a 1000 metres to a rolling moraine slope that leads toward Basecamp. On the other side it’s much the same. It’s a highly improbable campsite, but there is literally nowhere else to sleep.

The unfortunate reality of this spectacular campsite is that it is essentially an alpine dustbin and toilet. Its geography is so extreme that there is barely enough room to pitch a tent, let alone to seperate toilet use from living space. Ama Dablam itself is clean and majestic, but its camps are plagued with diseased dust and waste as no one removes it, so there it stays perched atop the pillar where no rain will ever wash it away. Camp 2’s mess is not a matter of laziness; at such an altitude every action and chore is an exhausting struggle, which unfortunately means that many people just go to the toilet outside their tent. In such a situation, with immune systems already exhasted by altitude, many people fall ill. For a few nights at Camp 2 I found myself leaning out of my tent door and vomiting into the 1000 metre abyss below. I couldn’t wait to leave that hellish but beautiful camp.

The easy becomes hard the higher you go, and the more your motivation wanes The easy becomes hard the higher you go, and the more your motivation wanes

Climbing further up the mountain was exciting as the summit drew nearer. Camp 2.7 at 6,500m was our next goal. It’s called 2.7 due to its position between Camps 2 and 3 on the mountain. The risk of avalanche at the traditional Camp 3 is so high that it hasn’t been used for years, so our camp was tucked against a huge bergschrund that was lined with tiers of menacing icicles.

The easy becomes hard the higher you go, and the more your motivation wanes The easy becomes hard the higher you go, and the more your motivation wanes

Despite being high on Ama Dablam, we were only around 1,400m higher than Everest basecamp which speaks volumes to the incredible scale of Everest. If you were to trek rapidly (or even instantaneously) up to Everest basecamp at 5,360m you would unquestionably get mountain sickness and be in serious danger of some of it’s worst symptoms, that can lead to a coma or even death.

George, Tendi and I were feeling strong — over a month high in the Himalayas does that to you. Although the climbing was hard we slept well enough to keep our spirits high and our bodies strong. However this wasn’t the case for everyone else on Ama Dablam that day...

When things go bad at altitude, they often go very bad. It’s the nature of the sport; being wildly out on a limb. Mountaineering is about finding a balance between risk and safety, and walking that line of wonder, adrenaline and self-exploration.

On Ama Dablam that day an older couple ignored the signs of altitude sickness and denied the pleas their bodies made to stop. We caught up with them below the summit after a late start and found them stumbling and falling over each other, both being physically lowered by their Sherpa guides down the steep flutings of the summit. When we met one of them, he was tangled in rope, completely oblivious with his eyes rolling into his head and saliva drooling from his mouth. I was terrified to see someone so incapacitated in such an unforgiving place. I wasn’t sure that they would make it down.

The incredible long-line rescue from Camp 2.7 at 6,500m on Ama Dablam The incredible long-line rescue from Camp 2.7 at 6,500m on Ama Dablam

The couple took hours and hours to descend to Camp 2.7 with the help of their Sherpa guides. The next morning we watched as they were rescued by a helicopter from the camp, spinning in circles on a long-line below the Heli.

The incredible long-line rescue from Camp 2.7 at 6,500m on Ama Dablam The incredible long-line rescue from Camp 2.7 at 6,500m on Ama Dablam

Mountain sickness manifests as headaches, nausea and loss of coordination, which in turn can lead to pulmonary or cerebral oedema. These are a mountaineer’s worst nightmare. These oedemas occur when fluid accumulates in the lungs and brain, rendering many climbers unconscious in a terrifyingly short amount of time. Ascending to the top of the Himalayas requires both experience and an acute understanding of how one’s body responds to altitude.

When climbing, you have to ascend step by step, methodically and progressively, so that your body, your physiology, has a chance to adjust to the rarefied atmosphere of high altitude. Even some of the fittest people from all around the world cannot cope with altitude — you must go slowly to gain your acclimatisation.

Ama Dablam taught me a huge amount about the difficulties of high altitude; it was the closest I’d ever been to 7,000m. But it was also an experience that showed me the importance of rising and adapting to challenges as they occur. Mountaineering is a game of adversity versus resilience; self-motivation is everything.

In early 2020 we are returning to the Nepalese Himalaya for our next big objective. We’re back for Everest.

Alexander Hillary

Photography by Alexander Hillary


Edmund Hillary