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Rapid Responses: Rapid Responses published:
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Awareness and further research is needed in this population
- Matiram Pun (1 July 2009)
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Such tragedy could have been prevented
- Ghan Bahadur Thapa (7 July 2009)
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Simple measures
- Bibhuti Neupane (9 July 2009)
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Awareness Issues
- Ashish Lohani (9 July 2009)
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Matiram Pun, MDSC Grad Student, Mountain Medicine and High Altitude Physiology (MMHAP) University of Calgary, Calgary, Canada
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Dear Ma'm/Sir, Mr Yadav has rightly highlighted the recent death toll of Indian pilgrims who were visiting a sacred place called Kailash Mansarovar in the Himalayas. This is unfortunate indeed and it makes us pause and ponder that the participants were selected from the lottery and taken there rather than on the basis of fitness and strength to go there. It gives the impression that the trip was not aware of danger and didn't anticipate the perils of the mountains. First of all, these pilgrims are a different population from trekkers, who are fit and healthy, as decribed by the expert Dr Buddha Basnyat. Secondly, the pilgrimage is usually done by elderly people, who are likely to have some other comorbid conditions like diabetes, hypertension and others. On top of that, there is widespread belief and culture to do the pilgrimage to get rid of these comorbid conditions, which makes it even more dangerous and difficult for the trip. Finally, there are very few studies and explorations in this kind of population of pilgrims and in people with comorbid conditions who climb to higher in the elevations. So, we need a couple of things, first raise awareness among this population and, second, carry out more research on medical prevention, treatment and physiology among this different and complex population. Thanks! Best wishes, mati Competing interests: None declared |
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Ghan Bahadur Thapa, Medical student Institute of Medicine, Kathmandu, Nepal
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The death of the people going up to Kailash Mansarovar with a craving to conquer the bliss of lord Shiva and with a yearning to have a spiritual fulfilment is indeed a terible tragedy. The key point here lies in the lack of awareness and the ignorance about the high altitude sickness that occurs in an altitude above about 2500 meters. And had the locals and the pilgrims been aware of the grave consequences at high altitude and had they been well prepared, may be this tragedy could have been prevented. This news has put forward an important point to be focushed in future. with regards Ghan Bahadur Thapa(kamal) IOM, Nepal Competing interests: None declared |
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Bibhuti Neupane, Doctor Nepal
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Many pilgrims have been going to high altitudes like Kailash in Tibet or Gosainkunda in Nepal. Since vast number of these pilgrims are not so physically fit, they are prone to be sick or even die in the high altitude. It is indeed a great tragedy that people had to die to make others realise the gravity of things to come if they are unfit or not careful enough up there. These deaths could easily have been prevented by public awareness. A book entitled 'travel at high altitude' may be taken as an example. it is written for lay people, in the local languages so that porters and pilgrims can understand and benifit. And it can be downloaded for free from medex.org.uk (http://medex.org.uk//medex_book/about_book.php) This material or other of similar nature should be written in more languages. Simple measures like these can indeed save some lives and prevent sickness. Competing interests: None declared |
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Ashish Lohani, Medical Student Institute of Medicine, Kathmandu, Nepal
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Dear Ma'am/Sir, Mr. Yadav has rightly pointed out the facts which make these pilgrimage trips to high altitude so risky. Practically zero rescue facilities compound with the fact that the pilgrims have very little awareness of the conditions of high altitude. Mr Pun has suggested the need for further research and awareness especially for the pilgrim population as the trekkers and climbers are more youthful and know the gravity of the expedition they undertake. There has been very little research in the field of altitude medicine and when it comes to Ascent with Comorbid Conditions, we do not yet know how to properly manage the co-morbid conditions so often present in the pilgrims, as Prof. Basnyat has pointed out. The lack of awareness is due to the fact that there have been very few awareness articles and books for pilgrims, especially in native languages. And since most of the elderly population in this region cannot understand the English literature, there is a need for good and simple books about high altitude. I wish to point to one such book which has been written in English and translated to Nepalese language. It is a free e-book accesible in www.medex.org.uk produced and published by MEDEX Members and translated into Nepalese by the members of Mountain Medicine Society of Nepal. This book, in a simple language, describes the high altitude and the problems faced during ascent. If this book could be published in the native languages for use and awareness, many deaths can be prevented in the high altitude, where deaths occur many times not due to lack of medical expertise but simply due to the lack of knowledge of what to do when the pilgrims have problems. Along with it, I support Mr Pun's opinion of further research to broaden our knowledge pertaining Altitude Related Sicknesses. These will eventually make travel to High Altitude and Pilgrimage safe and maybe this is what Lord Shiva wants us to take care before we embark on a holy trip to the mountains. Competing interests: None declared |
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