Too much cold is just as dangerous as too much heat, particularly if it leads to
hypothermia. If you are trekking at high altitudes or simply taking a long bus trip
over mountains, particularly at night, be prepared. In the Himalayas, you should always
be prepared for cold, wet or windy conditions even if you're just out walking or
Hypothermia occurs when the body loses heat faster than it can produce it and the
core temperature of the body falls. It is surprisingly easy to progress from very
cold to dangerously cold due to a combination of wind, wet clothing, fatigue and
hunger, even if the air temperature is above freezing. It is best to dress in
layers; silk, wool and some of the new artificial fibres are all good insulating
materials. A hat is important, as a lot of heat is lost through the head. A strong,
waterproof outer layer is essential, as keeping dry is vital. Carry basic supplies,
including food containing simple sugars to generate heat quickly, and lots of fluid
to drink. A space blanket is something all travellers in cold climates should carry.
Symptoms of hypothermia are exhaustion, numb skin (particularly toes and fingers),
shivering, slurred speech, irrational or violent behavior, lethargy, stumbling,
dizzy spells, muscle cramps and violent bursts of energy. Irrationality may take the
form of sufferers claiming they are warm and trying to take off their clothes.
To treat mild hypothermia, first get the person out of the wind and/or rain, remove
their clothing if it's wet and replace it with dry, warm clothing. Give them hot
liquids - not alcohol - and some high-kilojoule, easily digestible food. Do not rub
victims, instead allow them to slowly warm themselves. This should be enough to
treat the early stages of hypothermia. The early recognition and treatment of mild
hypothermia is the only way to prevent severe hypothermia, which is a critical
Lack of oxygen at high altitudes (over 2500m) affects most people to some extent.
The affect may be mild or severe and occurs because less oxygen reaches the muscles
and the brain at high altitude, requiring the heart and lungs to compensate by
working harder. Symptoms of Acute Mountain Sickness (AMS) usually develop during the
first 24 hours at altitude but may be delayed up to three weeks. Mild symptoms
include headache, lethargy, dizziness, difficulty sleeping and loss of appetite. AMS
may become more severe without warning and can be fatal. Severe symptoms include
breathlessness, a dry, irrelative cough (which may progress to the production of
pink, frothy sputum), severe headache, lack of coordination and balance, confusion,
irrational behavior, vomiting, drowsiness and unconsciousness. There is no
hard-and-fast rule as to what is too high: AMS has been fatal at 3000m, although
3500 to 4500m is the usual range.
Treat mild symptoms by resting at the same altitude until recovery, usually a day or
two. Paracetamol or aspirin can be taken for headaches. If symptoms persist or
become worse, however, immediate descent is necessary; even 500m can help. Drug
treatments should never be used to avoid descent or to enable further ascent. The
drugs acetazolamide (Diamox) and dexamethasone are recommended by some doctors for
the prevention of AMS, however their use is controversial. They can reduce the
symptoms, but they may also mask warning signs; severe and fatal AMS has occurred in
people taking these drugs. In general we do not recommend them for travellers.
A number of measures can be adopted to prevent acute mountain sickness:
Ascend slowly - have frequent rest days, spending two to three nights at each rise
of 1,000 meters. If you reach a high altitude by trekking, acclimatization takes
place gradually and you are less likely to be affected than if you fly directly to
It is always wise to sleep at a lower altitude than the greatest height reached
during the day if possible. Also, once above 3000 meters, care should be taken not
to increase the sleeping altitude by more than 300 meters per day.
Drink extra fluids. The mountain air is dry and cold and moisture is lost as you
breathe. Evaporation of sweat may occur unnoticed and result in dehydration.
Eat light, high-carbohydrate meals for more energy.
Avoid alcohol as it may increase the risk of dehydration.
In Himalayas, or at high altitudes you can get sunburnt surprisingly quickly, even
through cloud cover. Use a sunscreen , a hat and barrier cream for your nose and
lips. Calamine lotion is a good way to soothe mild sunburn. Protect your eyes with
good quality sunglasses, particularly if you will be near the sand, sun or snow.
Prickly heat is an itchy rash caused by excessive perspiration trapped under the
skin. It usually strikes people who have just arrived in a hot and moist climate
while trekking or climbing in Himalayas. Keeping cool but bathing often, using a
mild talcum powder or even resorting to air-conditioning may help until you
Dehydration and salt deficiency can cause heat exhaustion. Take time to acclimatize
to high temperatures and make sure you get sufficient liquids. Wear loose clothing
and a broad-brimmed hat. Do not do anything too physically demanding.
Salt deficiency is characterized by fatigue, lethargy, headaches, giddiness and
muscle cramps; salt tablets may help, but adding extra salt to your food is better.
Anhydrotic heat exhaustion, caused by an inability to sweat, is quite rare. Unlike
the other forms of heat exhaustion, it is likely to strike people who have been in a
hot climate for some time, rather than newcomers.
This serious, sometimes fatal, condition can occur if the body's heat-regulating
mechanism breaks down and the body temperature rises to dangerous levels. Long,
continuous periods of exposure to high temperatures can leave you vulnerable to heat
The symptoms are feeling unwell, not sweating very much or at all and a high body
temperature ( 102 to 106 degrees Fahrenheit). Where sweating has ceased the skin
becomes flushed and red. Severe, throbbing headaches and lack of coordination will
also occur, and the sufferer may be confused or aggressive. Eventually the victim
will become delirious or convulse.
Hospitalization is essential, but meanwhile get victims out of the sun, remove their
clothing, cover them with a wet sheet or towel and then fan continually. Give fluids
if they are conscious.
Fungal infections are occur more commonly in hot weather and are usually found on
the scalp, between the toes or fingers, in the groin and on the body (ringworm). You
get ringworm (which is a fungal infection, not a worm) from infected animals or by
walking on damp areas such as shower floors. To prevent fungal infections wear
loose, comfortable clothes, avoid artificial fibres, wash frequently and dry
carefully. If you do get an infection, wash the infected area daily with a
disinfectant or medicated soap and water, and rinse and dry well. Apply an
antifungal powder like tolnifate (Tinaderm). Try to expose the infected area to air
or sunlight as much as possible and wash all towels and underwear in hot water and
let them dry in the sun