4th Update in Altitude and Expedition Medicine

Festival of the Sun

CUSCO/SALCANTAY AND INCA TRAIL

JUNE 20 - JULY 1, 2011

Limited number of trail permits available -
Don't miss out.
Book soon!

In 2011 join MOTE for our 4th 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. We have decided to return to the Inca Trail for a 3rd time after a successful and oversubscribed trips in 2009 and 2010! As with the last two trips we anticipate this one will also fill up very quickly so an early booking is recommended.


2011 Inca Trail - Essential Information

4TH UPDATE IN ALTITUDE AND EXPEDITION MEDICINE 

CUSCO/SALCANTAY AND INCA TRAIL


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 throughout the 2009 trip. We also prefer the arrival schedule that they help us 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 5000 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. In 2009 the temperature on the first night on the trail reached -15.

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:There are two cost options. One incorporates 3 star hotels in Cusco whilst one utilises a 4 star hotel in Cusco ( which is also the conference venue although both hotels are only a 5 minute walk from each other)


OPTION1 including 3 star hotel in CUSCO  AUD$ $4895

OPTION 2 including 4 star hotel in CUSCO AUD$ $5555


There is no GST as the entire activity is conducted offshore. 

The price will include the following:

  • Accommodation and breakfast In Cusco 20/21/22/23/24 June and 30 June.
  • Accommodation and breakfast in AguascCalientes 29th June 
  • All trail entrance fees 
  • Private bus transportation Cusco to start of trek 
  • All guiding, porterage and cooking fees on trek 
  • All non personal equipment eg tents ( igloo tents will have 3 person capacity but be shared by 2 people for extra space), mess tents, tables and chairs, cooking equipment 
  • All meals whilst on trek 
  • Entrance fees to Machu Picchu Bus 
  • Transfers Machu Picchu to AguasCalientes 
  • Train Transfers AguasCalientes to Cusco 
  • Full time PuraAventura guides 
  • Attendance at all conference sessions both in Cusco and on the trek at the evening campsite sessions 
  • All conference materials including a full set of all slides used in the presentations 
  • MOTE Shirt
  • Our Hotel accommodation in Cusco will be in a charming and comfortable 3 star hotel. The hotel we will use is the Casa Andina San Blas. The 4 star hotel upgrade option will utilise the Novotel. Please note the Novotel is also the conference venue although walking distance between hotels is less than 5 minutes. In Aguas Calientes we will all stay at the El Mapi Hotel.  If all rooms are full by the time we receive your booking we will utilise equivalent rooms at alternative hotels.

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.

  • 3 star AUD $1133
  • 4 star AUD $1702


The following costs are not included:

  • Travel Insurance
  • Airport Taxes
  • Visa Costs
  • Personal equipment
  • Meals other than those listed above
  • Tips for porters and guides
  • International airfares from your home to Cusco


We will require a deposit of 25% at the time of booking and the balance by the 15th December 2010. 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 50. 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.

EXTRA NIGHTS:In 2010 many delegates chose to either arrive early or stay on after the meeting in Cusco. Please be aware that we do not hold any hotel reservations outside of the conference period. However, we are happy to put you in touch with our in-country agents who can help you in this regard.  Hotel prices do drop outside of our meeting dates as the meeting has been planned to occur over the Festival period. If you are staying extra nights it is also worth trying to source accommodation yourself. Most Cusco hotels are on the internet and easily accessible.

CME:In 2010 the meeting was accredited for MOPS points by the Australasian College for Emergency Medicine and CPD points by the Australian and New Zealand College of Anaesthetists. We will be applying for this again in 2011.

MORE INFORMATION:Contact us via phone or email if you want more information about this meeting.


REGISTRATION FORM 

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CONTACTS:  

Email – info@medicine-on-the-edge.com.au


Web -
www.mote.net.au 

Phone - Dr Geoff Ramin +61 0400 005 668

2011 Inca Trail - Conference Program

4th UPDATE IN ALTITUDE AND EXPEDITION MEDICINE

CUSCO/SALCANTAY AND INCA TRAIL


CONFERENCE PROGRAM: For a printable copy use the download PDF.  (PDF being designed and will be available shortly)



REGISTRATION FORM       

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20th June

Arrive Cusco.  Rest Day.  Introduction to the program.  Q&A session.

 21st June

11:00 – 12:00 Introduction to Altitude Medicine – a brief history of high altitude exploration. A brief history of high altitude medicine.

12:00 – 13:00 What is Mountaineering? – an introduction to the world of mountains and its own unique terminology

13:00 – 14:00 Lunch Break

14:00 – 15:00  Physiology of High Altitude Part 1 – Definitions. The physics you need to know.  Physiological changes at altitude. The importance of HVR and HCVR. How do we begin to acclimatise?

15:00 – 16:00 Physiology of High Altitude Part 2 – More physics. Effects of latitude. Chronic altitude exposure. Role of nitric oxide. Tissue and cellular adaptation. Latest research

16:00 – 17:00 Heat Related Illness – Heat syndromes including sunburn. Hypothermia. Frostbite. Field treatment vs Hospital treatment

17:00 – 18:00 – Lightning Strike – Physics of Lightning. Lightning injury. Prevention.

22nd June

11:00 – 12:00  Acclimatisation vs Adaptation – Physiological responses. How to make sense of the research.  High Altitude populations. The role of genetics. Why we all eventually deteriorate.

12:00 – 12:30 Avalanche – Avalanche mechanics. Avalanche safety. Avalanche related injury. Mechanism of death

12:30 – 13:15 Altitude Nutrition - Effects of altitude on metabolism. Optimising diet.


13:15 – 14:00 Lunch Break


14:00 – 15:00 High Altitude Syndromes Part 1 – Acute Mountain Sickness. Chronic Mountain Sickness.. High Altitude Cerebral Oedema.

16:00 – 17:00 High Altitude Syndromes Part 2 – High Altitude Pulmonary Oedema.. Miscellaneous syndromes

17:00 – 18:00 Latest Research – a summary of the significant research findings over the last 12 months

23rd June

10:00 – 12:00 Expeditions Part 1 – Preparing for expeditions. Planning. The role of the expedition doctor.  Insurance issues. Medical kits and equipment. Common problems.

12:00 – 13:00 Exercise at Altitude – Effects of altitude on performance. Role of VO2 max. Training for altitude. Training at altitude.

13:00 – 14:00: Lunch Break

14:00 – 15:30 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.

15:30 – 17:00 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.

17:00 – 18:00 Trek Briefing

24th June – Rest Day

25th June – Campsite Session

Improvisation of Medical Care in the Expedition Environment – How to do a lot with very little and why sometimes less is best.

26th June – Campsite Session

High Altitude Case Studies

27th June – Campsite Session

When Things Go Wrong – What happens when your expedition goes wrong? Why do some expeditions fail? Survival, search and rescue.

28th June - Campsite

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.

29th June Session

Arrive Machu Picchu

Debrief at Aguas Calientes in evening.

30th June Session

Free Day to explore Machu Picchu .  Return to Cusco

1st July

Departures



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