There are silent heroes on Mount Everest who are often forgotten. Like the Icefall Doctors, responsible for the route through the dangerous Khumbu Glacier. The rope-fixing team of Nepalese climbers who secure the route to the summit. The numerous Climbing Sherpas, without whose help most of the clients of the commercial expeditions would never reach the highest point at 8,849 meters. And then there are the rescue teams: the helicopter pilots who fly up to altitudes of 7,000 meters to bring climbers down to the valley on a long rescue line.
And the medical staff in the Everest ER at the base camp. ER stands for Emergency Room. An emergency room at 5,364 meters, where sick or injured mountaineers have been treated during the spring season since 2003. The infirmary at Everest Base Camp is organized and financed by the Himalayan Rescue Organization Nepal, a non-governmental organization founded more than 50 years ago.
The intensive care physician and anaesthetist Ashish Lohani is one of three doctors – alongside his Nepalese compatriot Suraz Shrestha and the South African Roy Harris, who lives in Scotland – who have been working in the Everest ER this spring season. All three are proven experts in high-altitude medicine. Since the beginning of April, Lohani and Co. have already treated more than 550 patients in their arched tent.
Many cases of Khumbu cough
“We have mainly seen viral upper respiratory tract infections and associated cough in the beginning of the season,” Ashish writes to me. “Now we are seeing more of the Khumbu Cough when climbers and Sherpas have gone to higher camps for rotation (to acclimatize).”
The 39-year-old is very familiar with the “Khumbu cough”, which is triggered by the cold and dry air at high altitudes. From 2010 to 2012, he treated patients during three spring seasons at Everest Base Camp. He also conducted a study to test whether a certain mix of medications helped against high-altitude cough. Lohani completed his doctorate with this study at the medical faculty of the University of Munich in 2014.
A dozen evacuations by helicopter so far
On average, four out of five people seeking help in the Everest ER have been Nepalese, reports the doctor. The patients from abroad have almost exclusively been mountaineers; only a few trekking tourists have presented to the doctors. The work has not been too stressful so far, says Ashish: “The job has its moments, most of the times it is a practice of general medicine, we see a lot of common complaints. Once in a while it gets challenging, when we get seriously ill clients (of commercial teams) or Sherpas, we do feel challenged.”
According to Lohani, twelve patients have had to be flown out by helicopter so far – “for different reasons – most commonly HAPE”, he says. HAPE is the abbreviation for high altitude pulmonary edema. This form of high altitude sickness is fatal in every second case if it is not treated.
Emergency medication by drone
Ashish is enthusiastic about the possibilities that the use of drones has opened up on Everest since this season. All the ropes and ladders for the Icefall Doctors have been transported by drone, and the flight devices have also been used to search for the best route through the Khumbu Icefall, says the doctor. “We have not seen any deaths in the icefall so far – I hope that remains the case till the end of the season.” In emergencies, medicines, other medical supplies or bottled oxygen can also be delivered by drone to the icefall or to Camp 1 (6,100 meters) above, says Lohani. This has been agreed with the people responsible for deploying the drones. These drones, which cost around 70,000 dollars each, can carry a load of up to 30 kilograms to a height of around 6,000 meters.
When the first big summit wave rolls in shortly, things will also get hectic in the Everest ER. “We think that it will for sure be busier,” expects Ashish Lohani. The hot phase of the spring season on the highest mountain on earth will then also begin for the doctors.
