Travelling at altitude in South America

My South American escapades began in 2000 and I've been lucky to travel to some of the most breathtaking high-altitude wonders. From the iconic heights of Cusco, the gateway to Machu Picchu, the awe-inspiring vastness of Bolivia's Salar de Uyuni and the otherworldly landscapes of Chile's Atacama Desert and altiplano, my travels have been a combination of stunning destinations.

During my extensive trips, I've encountered altitude sickness on numerous occasions, gaining insights into how my body adapts and discovering remedies. If this condition is unfamiliar to you, below I will detail some of the basics to consider for your upcoming adventure.

Don't be deterred by daunting tales; our local guides, seasoned and perceptive, can identify signs of altitude sickness, possibly even before you notice them! Should the unexpected happen, take comfort in the excellence of local hospital facilities, where skilled medical staff are adept at treating altitude-related issues. A crucial companion on any journey is travel insurance, offering reassurance against unforeseen challenges. Let my information and experience guide you, ensuring that altitude doesn't overshadow the thrill of exploring these incredible destinations in South America.

Note – While not medically trained, I've lived in Cusco at an altitude of 3400m for over two years and successfully trekked to altitudes exceeding 5000m in both South America and SE Asia.

Let’s start with the basics and some science

Why do you get altitude sickness?

Atmospheric pressure, also known as barometric pressure, is the force exerted by the air surrounding us. As you ascend to higher altitudes, this pressure diminishes, resulting in a reduced availability of oxygen and ‘thin’ air. People residing at moderate elevations adapt to the air pressure, but those accustomed to sea level may experience an adjustment period when venturing to higher altitudes. Altitude sickness becomes noticeable at approximately 2500m, a level comparable to the altitude encountered during air travel. Whilst at 4000m, it is estimated that every lungful of air only has 60% of the oxygen molecules compared to sea level.

Travel altitudes for reference:

• Cusco, Peru – 3399m / Lake Titicaca, Peru - 3800m

• La Paz & Salar de Uyuni, Bolivia – 3650m

• Atacama Desert, Chile – 2500m, however excursions are up to 4320m

• Quito, Ecuador – 2800m

Will I get altitude sickness?

Altitude sickness is a potential concern for anyone, irrespective of their fitness level, age, or overall health, including athletes. In fact, engaging in physical activity at elevated altitudes can increase the likelihood of experiencing altitude sickness. Several key factors contribute to the risk, including the speed of ascent, the altitude reached, and the sleeping conditions.

Our tailor-made South America trips at Far & Wild meticulously consider altitude, incorporating recommendations into the planning process. Clients residing at sea level are more prone to feeling the effects of altitude, and adequate acclimatisation is recommended, particularly for children. Prior altitude exposure provides insight into individual adaptability, and while pre-existing illnesses like diabetes or lung disease don't inherently heighten the risk, we do recommend a consultation with a doctor before planning a trip.

Upon reaching higher elevations, the body initiates acclimatisation, producing more red blood cells to aid oxygen transportation. Indigenous populations in these high-altitude areas, like the Quechua in Peru and Aymara in Bolivia, showcase adaptive biological traits, such as larger blood cells and lung volumes, developed over generations. These people will generally never experience the effects of altitude.

If you weren't born into altitude, however, our comprehensive approach ensures a balanced understanding of these variables, enhancing the safety and enjoyment of your high-altitude adventure.

What are the symptoms?

Altitude sickness symptoms typically manifest 6 - 10 hours after reaching high elevations, easing within a day or two as the body adjusts. Acute mountain sickness (AMS), the mildest form, is widespread, and typically feature a headache, loss of appetite, nausea/vomiting, fatigue, shortness of breath, dizziness, and difficulty sleeping.

In more moderate cases, symptoms intensify and may not respond to over-the-counter medications, leading to a worsening condition. High-altitude pulmonary edema (HAPE), a severe complication, involves dangerous fluid accumulation in the lungs and is a primary cause of altitude sickness-related fatalities. Timely intervention at the AMS stage is crucial, and effective acclimatisation methods can be pivotal in preventing things from building to this stage. Understanding the best ways to acclimatise becomes imperative for mitigating altitude-related challenges and ensuring a safer, more enjoyable high-altitude experience.

So, what is the best way to acclimatise?

Upon reaching higher altitudes, it's crucial to allocate sufficient time for your body to acclimatise to the altered air pressure. This holds particular significance for high-altitude endeavours like the Inca Trail to Machu Picchu.

Rest assured, we prioritise your well-being, carefully planning the trek at a leisurely pace with the highest pass (4215m) on day 3, ensuring a gradual ascent. For further details, read more HERE.

Some of my advice and tips:

• Ensure a daily water intake of at least 2 litres, ideally 3 litres. Electrolytes, found in sugary sports drinks like 'Gatorade,' or Oral Rehydration Salts, can be beneficial. Eating and drinking carbohydrates are useful for your acclimatisation.
• Refrain from vigorous exercise during the initial 48 hours and skip the gym!
• Steer clear or minimise the consumption of tobacco, alcohol, and sleeping tablets
• In Peru and Bolivia, indulge in the local coca or muña tea, known for its digestive benefits. Additionally, consider chewing coca leaves as a traditional remedy.
• Explore the option of using Diamox (acetazolamide) to help acclimatisation with a medical professional. Alternatively, there are local remedies such as 'Alti Vital,' a natural blend of coca, muña, and guarana, offered by pharmacies in Cusco.
• The thin air at higher altitudes tends to be dry. Don't forget to carry moisturiser, eye drops, and high SPF sun screen and lip balm to combat the dryness and protect your skin from the effects of elevated sun exposure.
• Acclimatisation treks are effective. Adopt the "trek high, sleep low" approach for optimal altitude adjustment.
• Adopt a slow and steady walking pace. Moving at a leisurely speed facilitates deeper breaths, aiding your lungs in accessing more air. This approach also enables your red blood cells to efficiently transport oxygen throughout your body.

Hotels such as the Palacio del Inka in Cusco provide oxygen, either in tanks for a 30-45 minute session or through in-room facilities, aiding in improved sleep. If discomfort persists, our local partners can facilitate a move to a lower elevation. Notably, Machu Picchu sits at a moderate altitude of 2430m, allowing for lower-altitude accommodation at 2300m, with the return to the higher altitude of Cusco only for departure flights.

And, finally, what are the medical facilities like?

In the event that rest, oxygen, and medication prove insufficient, the medical facilities are generally of exceptional quality, particularly in highly frequented tourist areas like Cusco. Prominent private clinics, such as Cima and Clinica Suiza, are well-versed in treating tourists and proficient in English. These facilities offer hyperbaric chambers, providing oxygen treatment in sealed chambers if necessary. In dire situations, evacuation to sea level is an option, achievable through commercial flights to Lima or privately scheduled flights, although the latter may exceed $20k, emphasising the importance of comprehensive travel insurance coverage.

Conclusion

The human body exhibits remarkable adaptability to diverse environments, yet effective preparation, thoughtful planning, and helpful suggestions enhance this natural capability. Just as you wouldn't embark on a 5km run without prior training, expecting the body to perform seamlessly at lower oxygen levels requires gradual acclimatisation and adaptation. While essential to consider when travelling in high-altitude regions, it should not be a deterrent from experiencing the magic of these extraordinary places.