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2ND
UPDATE IN ALTITUDE AND EXPEDITION MEDICINE - CUSCO/SALCANTAY AND INCA
TRAIL
In 2009 join MOTE for our 2nd
annual update in Altitude and Expedition Medicine, the academic content
of which will be reinforced by our participation in one of the world’s
greatest high altitude treks.
DATES: Ideally you will
arrive in CUSCO on the 22nd June where we will meet as a group and
remain together till the 2nd July. From the 2nd July you are then free
to return home or travel on to even more adventures.
PROGRAM OUTLINE:
For a printable copy use the download PDF. 
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22nd June:
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Arrive Cusco .
We will aim to arrive in Cusco today. This will give you the
opportunity to settle into your hotel for four nights and start
acclimatising to the rarefied air of this beautiful city (3,326m).
Get to meet the other delegates. You have the rest of the
afternoon free to relax after your long journey. In the evening
there will be a short introduction to the meeting and program.
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23rd June:
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Cusco - At
the conference
First full day
of the MOTE meeting (see course outline).
Today will be
classroom based with the educational program running from 09:00
– 17:00.
Our local
guide will also be on hand throughout your time in Cusco to
provide any help or advice you may need. He can also make
suggestions for any free time.
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24th June:
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Cusco -
Festival of the Sun
Second day of
the MOTE meeting (see course outline).
Today is also
IntiRaymi, “the festival of the sun”, which marks the winter
solstice. Daylong celebrations take place in Cusco and the streets
become strewn with flowers, music and dancing. At Sacsayhuaman,
just outside the city, crowds throng to a theatrical
representation of the original Incan ceremony, honouring the god
Inti. As the sun sets, celebrants dance around stacks of straw lit
in homage to Tawantinsuty, or the Empire of the Four Wind
Directions. A colourful procession then makes its way back to
Cusco where celebrations last long into the evening. Time will be
allocated today to allow delegates to fully experience this unique
event.
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25th June:
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Cusco - At
the conference
Third day of
the MOTE meeting (see course outline). Today will be
classroom based with the educational program running from 09:00
– 17:00.
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26th June:
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Start the
Salcantay/Inca Trail
Set off early
this morning to drive into the Sacred Valley of the Incas. The
road passes through the Pampa de Anta region, past the small town
of Mollepata, then up though eucalyptus groves up to Markokasa to
join the trail. Your start point here is higher than Cusco
(3,500m), so set off at a gentle pace as you continue
acclimatising. You
will be walking for around four to five hours today, climbing
gradually to your first campsite at 4,000m.
This evening
we will run a 2 hour educational session in our campsite (see course outline).
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27th June:
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Walk the
Salcantay Pass
A spectacular
day’s walking as you take the Salcantay pass close to the
glacier. The zigzag path leads steadily north. En route you pass
the terminal moraine, a large wall of scree left by the advancing
glacier. On your left you pass the glacier itself. Seeing
the bulky mass of the ice it’s rather incredible to think that
this is one of the origins of the Amazon. Begin the descent
through the Inca Canal valley towards Pampacahuana, your second
campsite on the trek.
This evening
we will run a 2 hour educational session in our campsite (see course outline
).
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28th June:
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Meet the
Inca Trail
A steady start
today as you walk along the Inca Canal, passing through a huddle
of farms and a local football pitch. As the path descends into the
relative warmth of the Cuischaca Valley the sparse mountain
vegetation mellows to rich scrub. Snapdragons and orchids
flourish. Arrive at Llulluchapampa, your first campsite on the
"official" Inca Trail.
This evening
we will run a 2 hour educational session in our campsite (see course outline).
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29th June:
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The
toughest day!
Today is the
hardest day of the trail as you cross over two high passes,
effectively hiking an ‘m’ shape. The 15km walk takes around
eight hours. From your campsite walk a steady and increasingly
steep path up to Dead Woman’s Pass at 4,215m, the highest point
of the trail. Standing at
Dead Woman’s Pass you find yourself beyond obvious signs of
human life and you begin to get a sense of how remote Machu Picchu
really is. You will also have stunning views of the surrounding
Andean peaks and should have a great sense of achievement by the
end of the day. Lunch is served in the dip between the two passes.
Once you hike over the
second high pass of the day (3,900m), then you should find the
going good. Your campsite tonight is at 3,600m on a bluff
overlooking beautiful mountain scenery.
This evening
we will run the last 2 hour educational session in our
campsite (see course outline).
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30th June:
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Arrive at
Machu Picchu
The final day
of the trail is the most beautiful, starting with what can be the
most stunning sunrise.
We will walk 11kms over about 6 hours. There are lots of steps as
you approach the satellite Inca site of Winaywayna.
The evidence of Inca masonry is everywhere as the trail leads you
through cloud forest rich with orchids and birds. This afternoon
your walk is longer than in the morning but at lower
altitude so it should be easier on the lungs. Lunch is served at
the ruins of Winaywayna before the final push up a steep stairway
to the Sun Gate and your first views of Machu Picchu. From the Sun
Gate it is another 3km to Machu Picchu itself. You should be here
at around 4pm when most people have gone for the day so take
time to just wander through the ruins in the quiet of the late
afternoon. Take time to soak up your achievement and, hopefully
watch the citadel bathed in the warm afternoon light. Catch
a shuttle bus down the hill into the river valley to spend tonight
in a fairly plain but comfortable hotel in the ramshackle village
of Aguas Calientes.
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1st July:
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Free day to
explore Machu Picchu
This morning
if you are feeling energetic, you can catch one of the first buses
up to Machu Picchu, heading slightly up the hill beyond the site
to catch sunrise over the mountains. Enjoy
a full-guided tour of the site this morning. Afterwards you can
continue to explore the extensive ruins on your own or climb the
emblematic peak of Huayna Picchu for a ‘condor’s-eye’ view
of the city. Return to Cusco by train this afternoon to arrive
some time after nightfall. Transfer to your hotel for your last
night in the town.
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2nd July:
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Cusco Goodbyes
After
breakfast we say goodbye. You can then depart for home or the next
leg of your journey.
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COURSE
OUTLINE For a printable copy use the download PDF.
Monday 22nd June
Arrive
Cusco
. Rest Day-
Introduction to the Program. Q&A session
Tuesday 23rd June
09:00
– 10:00 Introduction to Altitude Medicine
– a brief history of high altitude exploration. A brief history of
high altitude medicine.
10:00 – 10:30 What is Mountaineering? – an introduction to the world
of mountains and its own unique terminology
10:30
– 12:30 Physiology of High Altitude
– definitions. The physics you need to know.
Physiological changes at altitude. The importance of HVR and HCVR.
How do we begin to acclimatise?
12:30
– 13:30 Lunch Break
13:30
– 14:30 Acclimatisation – Physiological responses. How to make
sense of the research. Deterioration. Adaptation.
14:30
– 16:00 Heat Related Illness – Heat syndromes including sunburn.
Hypothermia. Frostbite. Field treatment vs Hospital treatment
16:00
– 17:00 – Lightning Strike and Avalanche
– Physics of Lightning. Lightning injury. Prevention. Avalanche
mechanics. Avalanche safety. Avalanche related injury.
Wednesday 24th June
07:00
– 09:00 – When Things Go Wrong
– What happens when your expedition goes wrong? Why do some
expeditions fail? Survival, search and rescue.
Rest Day
Thursday 25th June
09:00
– 11:00 High Altitude Syndromes
– Acute Mountain Sickness. Chronic Mountain Sickness. High Altitude
Pulmonary Oedema. High Altitude Cerebral Oedema. Miscellaneous syndromes
11:00
– 12:30: Expeditions
– Preparing for expeditions. Planning. The role of the expedition
doctor. Insurance issues.
Medical kits and equipment. Common problems.
12:30
– 13:30: Lunch Break
13:30
– 14:00 Altitude Nutrition
- Effects of altitude on metabolism. Optimising diet.
14:00
– 16:00 High Drugs
– Drugs for prophylaxis in altitude syndromes. Drugs for treatment.
Diamox. Steroids. Sildenafil. Nifedipine. Salmeterol. Recent research
into new drugs. Local remedies for altitude syndromes.
16:00
– 17:00 Exercise at Altitude
– Effects of altitude on performance. Role of VO2 max. Training for
altitude. Training at altitude.
Friday 26th June - Campsite
Session
16:00
– 18:00 – Improvisation of Medical Care in the Expedition
Environment
– How to do a lot with very little and why sometimes less is best.
Saturday 27th June - Campsite
Session
16:00
– 18:00 – Other Medical Problems and Fitness to Ascend
- How to determine if your
patient with CAL, IHD, Diabetes etc is fit to go to altitude or on an
expedition. What about the very young, the very old, the pregnant woman?
Other medical problems that can occur at altitude.
Sunday 28th June - Campsite
Session
16:00
– 18:00 – Case Histories
– a discussion of interesting case histories to reinforce the content
that has been discussed over the preceding days
Monday 29th June - Campsite
Session
16:00
– 18:00 - Q & A
Session
– an opportunity for delegates to ask questions on any aspect of
altitude and expedition medicine, to clarify any issues discussed over
the preceding days and to review the material presented.
Tuesday 30th June
Arrive
Machu Picchu
Debrief
at Aguas Calientes in evening.
Wednesday 1st July
Free
Day to explore
Machu Picchu
. Return to
Cusco
Thursday 2nd July
Departures
OVERVIEW - For a
printable copy of the following use the download PDF.
EDUCATIONAL PROGRAM:
Topics to be covered in the education program will include:–
• Introduction to the mountaineering environment
• Physiology of high altitude
• Acute Mountain Sickness
• HAPE and HACE
• Hypothermia and other heat related illness
• Trauma in the mountains
• Pharmacology in the mountains
• Fitness to climb
• Improvisation of medical care
• Rescue dynamics
• How to prepare for an expedition
ABOUT THE TRAIL:
The Inca Trail runs between the Sacred Valley of the Urumbamba River and
the abandoned city of Machu Picchu. It is one of the most famous treks
in the world. Although only 45km in length it manages to traverse a
stunning and diverse mix of terrain including the Andean plains, high
mountain passes and cloud forest. Along the way it passes many Inca
ruins and constructions before culminating in Machu Picchu, the lost
city of the Incas.
We are combining the
Inca Trail with the Salcantay Trail to offer an even greater adventure.
The Salcantay Trail is quieter, more rugged and more remote than the
Inca Trail. It traverses higher than the Inca Trail and, therefore,
affords some truly spectacular views of the big Andean mountains.
We have also allowed
for a full day at Machu Picchu on completion of the trek.
INCA
TRAIL PERMITS
The increasing popularity of the Inca Trail has resulted in restrictions
being placed on the number of trekkers. Each day the Peruvian Government
allows 500 people to start onto the trail. These numbers include all
guides and porters so equates to probably around 200 trekkers. Although
this seems like a large number the popularity of the trail means that
permits are sold out very quickly. Permits cannot be reserved in
advance. They are issued on a strictly first come first allocated basis.
Each permit must be issued to a designated named trekker for a given
start date. We can only obtain a permit for a confirmed booking.
Therefore, bookings will need to be made early to ensure a spot on this
program. To be certain of a spot we believe that bookings should be
finalized before December but clearly the permits for our trek dates
could sell out earlier or later depending on demand from other groups.
Once all permits are sold we will not be able to take any more
registrations.
OUR GUIDES
There are dozens of
licensed guide operators on the Inca Trail. Independent trekking is not
permitted on the Inca Trail although it is possible on the Salcantay
Trail. We have chosen to use PuraAventura as our preferred guides. We
have been impressed by their communication, professionalism and level of
service. We also prefer the arrival schedule that they operate
into Machu Picchu itself – see next section.
MACHU
PICCHU
The following is an extract from PuraAventura which explains the
philosophy behind their arrival schedule into Machu Picchu:
PERMIT SYSTEM
Each day the
Peruvian Government allows 500 people onto the trail. This includes
all guides and porters so actually equates to about 200 hikers each
day. If this sounds like a
lot, frankly it is but there are ways to avoid the crowds.
THEIR WAY
The vast majority
of those 200 walkers do the trail which aims to arrive at Machu Picchu
at sunrise. Once they arrive, they visit the site and catch that
afternoon’s train back to Cusco. Those
going at this pace on the Inca Trail suffer a couple of disadvantages.
Firstly, the campsites are very
busy, particularly the last night in Winaywayna which can have over
300 people spending the night. That equates to a lot of tents, a lot
of noise and some fairly unpleasant sanitary conditions. Secondly,
your first views of Machu Picchu can be rather compromised as people
jostle for a perch in a small viewing area at the Sun Gate. This
a quote from one, very good, operator “Almost every group wants to
be at the sun gate for sunrise. Sheer numbers require an early start
to make sure people are in place for the sunrise.” Lastly,
since Machu Picchu is in a cloud forest, sunrise happens probably
around 30% of the time. More normal is that the clouds gradually drift
clear later. If the
weather isn’t good, they will not get to see the site in all its
glory as they will be on a train back to Cusco that same afternoon.
OUR WAY
Meanwhile…PuraAventura
clients are half a day behind the main group of walkers on the Inca
Trail. Our guides work hard to make sure that you walk in the peaceful
conditions at any time of year. You enjoy a quiet, often empty, trail
ahead of you. The places we camp are very peaceful. You arrive in
Machu Picchu in the twilight when the site is at its prettiest and
quietest. That afternoon
you stroll down through the site to soak up the atmosphere before
spending a welcome night in a hotel nearby. The
following morning you come back up to the citadel - early enough to
catch sunrise if you like. You have your full guided tour before
returning to Cusco by train that afternoon. In
all you have about 24 hours at Machu Picchu spread over two days,
giving you the best possible opportunity to see the site at its best.
THE
PORTERS
The following is an extract from PuraAventura regarding their porters:
By the end of day one you are likely to really appreciate the work your
porters are doing for you. In the
mornings they are there to wake you for breakfast with a cup of tea and
warm water for a wash. As
you set off walking for the day, they pull up camp, overtaking you a
while later fully laden with all of the gear. A
couple of hours later you come across them again and they will have
prepared a three- course lunch for you on the side of the trail. After
this, you waddle onwards and upwards only to be overtaken again soon
afterwards. By the time you
get to the day’s stopping point, the team will have set up the
campsite, have supper on the go and greet you with a cup of tea! PuraAventura
adheres strictly to the Porter Protection Policies in place on the Inca
Trail. In fact our porters are from the community of Chacllanca, about
45km from Cusco. Generally they are subsistence farmers who supplement
their earnings by working on the Inca Trail. Our two head chefs,
Virgilio and Herlin are in charge of getting the teams together and are
therefore the bosses. Your
team of porters is usually therefore made up of friends, family and
neighbours who respect one another and work well together.
HOW
FIT TO YOU NEED TO BE?
Remember that Cusco
is located at 3400metres. Most people will arrive there from sea-level
and will immediately feel the effects of altitude. That is why we will
spend 4 nights in Cusco – this will allow for adequate time for acclimatisation
before the more strenuous trek commences. It is important to rest for
the first few days in Cusco, avoid significant exertion and maintain
adequate hydration.
The Salcantay and Inca Trails should be achievable by anybody with a
moderate degree of fitness who is used to hill walking. The terrain is
not technical but does involve significant ups and downs at high
altitude. The highest point of our trek will be 4215 metres.
The pace will be
relaxed and there will be plenty of time to complete each day’s walk.
Also there will be a team of porters to carry your main pack and to set
up tents and prepare meals.
WEATHER
April to November is the best time for the Inca Trail with predominantly
dry, sunny conditions during the day. Nights can be very cold at
altitude.
THE
FESTIVAL OF THE SUN
We have timed our meeting to coincide with the Festival of the Sun in
Cusco. This is South America’s 2nd biggest festival and is a week long
celebration. The festival’s origins were to honour the Sun God and pay
homage to his first born son the Inca. There is a week long series of
activities the highlight of which occurs on June 24th when a dramatic
recreation of traditional Inca ceremonial events occurs both in Cusco
and the ancient fortress of Sacsayhuaman.
COSTS:
The cost will be $3790.00 per person twin share. There is no GST as the
entire activity is conducted off shore.
The price includes the following:-
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Accommodation
and breakfast In Cusco 22/23/24/25 June and 1st July
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Accommodation
and breakfast in AguasCalientes 30th June
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All trail
entrance fees
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Private bus
transportation Cusco to start of trek
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All guiding,
porterage and cooking fees on trek
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All non personal
equipment eg tents ( igloo tents will have 4 person capacity but be
shared by 2 people for extra space), mess tents, tables and chairs,
cooking equipment
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All meals whilst
on trek
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Entrance fees to
Machu Picchu
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Bus Transfers
Machu Picchu to AguasCalientes
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Train Transfers
AguasCalientes to Cusco
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Full time
PuraAventura guides
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Attendance at
all conference sessions both in Cusco and on the trek at the evening
campsite sessions
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All conference
materials including a full set of all slides used in the
presentations
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MOTE Shirt
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Hotel
accommodation in Cusco will be in a charming and
comfortable 3 star hotel. This will be the Hotel Taypikala http://www.taypikala.com/cusco/ingl/ or equivalent if all rooms
are full at time of booking.
A 4 star hotel upgrade option
is available for $4520 per person twin share. This would utilise the
Novotel (http://www.novotel.com/novotel/fichehotel/gb/nov/3254/fiche_hotel.shtml
) in Cusco or equivalent if all rooms were full at the time of booking.
If you are travelling alone we will try and match you with another same
gender delegate to share accommodation. A single supplement will apply
if you prefer not to share – contact us for details.
The following costs are not included:-
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International
airfares from your home to Cusco
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Travel Insurance
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Peru Airport
taxes
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Visa costs
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Personal
equipment
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Meals other than
listed above
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Tips for porters
and guides
We will require a deposit of 25% at the time of booking and the balance
by the 15th December 2008. The early payment is required to ensure we
can hold all our reservations and permits for the Inca Trail. Permits
for the Inca Trail are booked out very early and once the quota has been
reached no exceptions are made. Please be aware that as there are many
logistical preparations and costs that we incur at an early stage the
deposit is non refundable if you choose to make a subsequent
cancellation and we cannot find a replacement to take your place. Good
travel insurance should cover you for such an eventuality and it is
worth checking with your provider. Of course if for any reason we were
forced to cancel the meeting all monies paid to us would be refunded in
full.
NUMBERS
Initially we intend
to restrict the numbers to 40. We believe it is unlikely we would secure
any more permits than that for the Inca Trail but will endeavour to do
so if there is greater interest.
MORE
INFORMATION
Contact us via phone
or email if you want more information about this meeting.
REGISTRATION
FORM
CONTACTS:
Email – info@medicine-on-the-edge.com.au
Web - www.medicine-on-the-edge.com.au
Phone - Dr Geoff Ramin 0400 005 668
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