Showing posts with label first aid. Show all posts
Showing posts with label first aid. Show all posts

Saturday, 6 October 2018

3rd of October - Morocco - Jebel Toubkal

We slept surprisingly well the night before the summit part of our expedition. I guess that the 10 km walk and 1400 meter ascent the before contributed a bit.
The summit day started early. I got up just before 6 AM in order to prepare the last part of my day pack and to decide what to wear. Most of us had done as much as possible the evening before. We had expected pitch blackness in the morning, but luckily the generator at the refuge was turned on in the morning so head torches were not needed. also we had expected to need them when leaving the refuge, but the sky shifted quite early from dark to fresh, morning blue.

Breakfast was bread with cheese, marmalade, hot water for our porridge portions and finally I got to try out my coffee bags. The refuge only had Nescafe which I cannot stand, and the Peter Larsen coffee I had with me was just perfect for this morning. I also found that the coffee bag could be reused. It is strong enough.

We were ready to head off just after 7 AM. Our group started the trek first of all, but we were soon passed by another group as we scrambled up a slope of scree. We tried maintaining a very calm and gentle pace, as we were planning on keeping it up for about 4 hours. Somewhere along the way our group name changed from pit vipers to apples!! Whyyy?? We went from super cool to ... apples... well... what to do, what to do...

Our ascent began at an altitude of 3200 m and the goal was 4167 m.  At the beginning of the trek we were quite uncertain as to weather or not the full ascent was doable. It had been snowing during the night also, which further lowered our expectations. Nigel, our group leader, had made it crystal clear that if the path became too dangerous and our safety was compromised, he would turn us back. WMT Barry didn't go to the summit, but stayed behind at the refuge and looked after our things. He later told us that he almost expected us to return by noon, due to the weather.

Before reaching the midpoint of our trek we crossed the ice line which soon turned into the snow line and our pace got very slow. Some passages were a bit tricky and slippery. Nigel, was really keen on keeping everybody safe and naturally, having decades of experience, he was extremely professional about it. Along the way he would give us comments and insights into the way of thinking a leader has to have, mixed with anecdotes from he's life and experiences.

At one point I realized the tempo was so slow that I couldn't keep my temperature up. My toes were getting colder and actually beginning to turn a bit painful. I was wearing all my layers so the only solution would've been a higher pace. That was not possible, however, since not all in the group could keep up. Some were in no way used to snow (at least not like a northerner who has spent half a lifetime rolling in snowpacks, digging holes, falling over, sliding, gliding, skiing,  and just reveling in it). To my great surprise I found that I had a sliver of frustration in the back of my head. Frustration due to the pace and having to stand still in the snow with increasingly aching feet. Well, at least I had the time to take loads of pictures.
I'm usually a very patient person, infuriatingly so, but not right now, not in that situation. So, I find that I learn new things about myself during this trip. Knowing that I actually get frustrated by having to slow down and wait is a great insight and will be easier to work with now that I know.
To keep the group together and to adapt to the slowest person is a key aspect of being a leader.

https://drive.google.com/open?id=1p3SZ5hHsQfF1kHSf6JNFlqL2YN1QJmkW

https://drive.google.com/open?id=1G9XGzFp7BGYX46McFNjXJPKPBCsLIXAy

As we reached the crest of the slope it finally started to look like we would actually reach the top. The snow was fresh and soft as powder goose down and thus easy to walk in. There were no icy, slippery bits higher up. At the crest we had a fabulous view back the way we had come. It was cloudy on the other side of the crest, but apparently you can see the Sahara desert on clear days.
We had another 20-30 minutes to go in order to reach the summit. As we got closer our group gathered and we had our most tired member lead, so that all of us would reach the summit together.
When we finally reached our goal the view was breathtaking.

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We had a kind of a victory milling about, taking pictures, laughing and smiling and having something to eat.
The scenery was absolutely fantastic, snow capped mountains around us, lowlands visible in a brown haze below, brilliant sunshine reflecting off the snow. We had covered us up with loads of sunscreen. Nigel of course had an anecdote with sunscreen and snow. During an ascent and breathing heavily in the hypoxic air, facing the snow, he had once burned his tongue on the slopes of Everest. The snow reflects so much of the sunlight! Well, I burned my lips, even though I kept putting on more and more sunscreen...

I was surprised to feel so strong throughout the ascent. If you've read my pre-Morocco posts you know I did a lot of step training the month before the trip. I can tell you, it really works. I felt GREAT! And just generally happy and content.

What goes up, must come down. At one point we had to turn back in order to make it back to the refuge in good time.

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The descent was very messy. People were falling over, sliding in the snow, not trusting the snow and not daring to walk briskly. Running down a snowy slope is actually very much fun, especially since you are more or less incapable of getting hurt, whatever you do. There is always a soft cover to dampen your tumble, no matter how you attempt to somersault your way down. Anyhow, we ended up spending as much time heading down as going up and my frustration bubbled up even more.  Even so, we kept our group together, just as we were supposed to. Nigel was extra cautions going down, as the groups who had gone before us had walked and tumbled the path very slippery. We ended up going down the untouched slopes beside the path at many places, instead of risking the icier areas on the path.

At one point a member of the group had the symptom of some unfortunate food intake present itself. If you gotta go, you gotta go. Well, we all knew this could happen. Just a bit unlucky spot, though. To me it seemed as Nigel had experienced this before (what has he not seen or heard of already? I mean seriously...) so no worries, we waited patiently again for a very long while and just as Nigel started taking small steps up the slope again our final member showed up. Still alive then.

Luckily the rest of the way down went more or less smoothly for us all, including our member who had gotten ill, which did worry me a tad (and probably all the other doctors as well - D&V can really be a bitch).

When we fiiinally arrived back at the refuge the sun was high overhead and we were welcomed with warm sweet tea. I felt I needed to wash up and attempted to shower, but I failed horribly. I swear the shower spewed out icicles. Even attempting to wet my hair gave me brain freeze and nearly a stroke. After some feeble splashing about with small droplets of ice I had to give up washing my hair and keep on having it feel as fresh as a rats fur in a sewer.

Later we had some lessons and discussions on female health during expeditions, which was quite interesting. I have never really thought about it as a "thing" as its kind of private, but of course it should be seen as a "thing". I learned some interesting facts such as birth weight decreasing by 100 grams per km higher altitude of living. I think I'll write some more about this topic at a later time.


Next we had a fabulous dinner (everything is tasty after a mountain summit above 4km). I got a super tasty chicken tajine, the others couscous with chicken. I sat next to Chris and Peichii. Peichii and I had a discussion on religion (even though we weren't drunk at all - no alcohol at the refuge ;) ). Chris told me about his interest in Caucasia, a place that I must admit, I know nearly nothing (read absolutely nothing) about. I told him a bit of life on the Faroe Islands (I've lived there for a year) and my silly attempt of driving over the mountains in a snowstorm with a pocket size Suzuki Alto without winter wheels. Silly, as in really stupid. Chris has a knack for story telling and relayed a story of a trip to Armenia and a visit to a family's home. It was a single mother and grandmother and the English speaking son, if I remember correctly. He and his travel buddy had noticed a painting on the wall in a different style than all other artwork in the house. It depicted a man being attacked by a mountain lion, I think, and a woman protecting the man with an axe. It turns out it was a true story. The grandmother in the family had actually done that, and it was her in the painting, killing a lion. Fascinating.

The final lesson came after our dinner. This time the topic was heuristic bias, such as your own experiences affecting your judgement and what decisions you make when assessing risk for example. Another one is the kind of lemming-effect, you see someone do something and because they do it successfully you believe you can too and assume that the conditions are staying the same. The next topic was mountain leader education programs. Only UK based of course. I would have loved to know more of international educational programs.


The night ended with a quiz about all we had been taught - A competition ! YAY! - and my group ended next to last haha. We got 23 out of 25 correct answers and the questions were such as what is the prophylactic dosage of Diamox for mountain sickness, or at what temperature does live tissue freeze, the steps of frost bite, when not to do CPR in a hypothermic person and such. It was fun :-)
We all won some chocolate. I was completely wrung out and had a pounding headache as I went to bed at 22 PM. Some of the others still had energy enough for socializing, which I would've liked doing, but I simply could not at that point.

Friday, 5 October 2018

2nd of October - Morocco - Heading to the refuge

Tuesday began early. This day we were bound for our refuge in the mountains, Refuge Mouflon. Luckily this was a fabulous day with shining sun from a cloud free sky, but with cooling breaths of mountain air. The ascent for this day was about 1400 meters over a stretch of 10 km, so not too steep at all. Our group named itself the pit vipers on a whim. So off the vipers went. It took us about 6 hours to get to our destination. We kept a very calm speed so as not to over exert any of us in the group as we were quite a mixed bundle. We had many breaks for hydration and more or less about half way we stopped at Sidi Chamharouch for something to drink. video



Some went for freshly made orange juice, some for coffee, but most of us went for mint tea and some of our own snacks (nuts and figs).
At this point I had almost all the names in my group memorized. I can be soo extremely bad with names. The pit vipers consisted of Mike, Sarah, Gary, Sophie, Peichii, Jemma, Mat, Chris (the last name I etched into my head while sitting there basking in the sun) and me.
After a rest and toilet break we continued up the mountain side for a bit more before deciding we needed lunch - the one we had bought the day before. Bread with cheese, chili sausage with a suspiciously pink color, eggs, bananas and apples. And a whole lot of water, of course.
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On the path upward we passed and were passed by numerous mules of which most were heading downward with large packs. Many trekkers were going downward too. It seemed like some of the mules were carrying luggage. Cheats ;)
Two of the trekkers told us that there is ice on the top of Toubkal and that crampons are necessary in order to reach the summit. That said, it seems as the ice and snow will be hard pressed to melt enough for us to reach all the way to the top. So we may not reach it at all ! Oh well, this is how expeditions go - uncertainty, sudden changes of plan... Adapting to the situation...


When we finally neared the refuge temperature dropped somewhat. It must've been about 10 degrees Celsius.We got our sweaters and jackets out and as we got to the refuge, even the staff were wearing jackets.

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Les Mouflons has its name from a mountain deer (mouflon https://en.wikipedia.org/wiki/Mouflon ) that lives in the Atlas mountains among other places. The refuge is located at 3207 m elevation and is quite large, 600 m² . The dormitories have up to 24 beds. Our room had bunk beds with 8 people sleeping side by side and double bunk bends. Quite funny actually.

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On arrival we were offered warm mint tea, which at that point was quite appreciated. It took us quite some time to get the body warmth up again. The refuge was quite dark inside. No electricity until nightfall and then only for a short while. We sat huddled together in the main hall wearing winter clothing and fiddling with oxymeters. I tried Sarah's phone oxymeter (with my frozen fingers - saturation is often falsely low with cold fingers) and had a SAT of 89%. At sea level with warm fingers I would expect it to be 97-100%.

The soup that arrived shortly after was evened with flour, but luckily I wasn't very hungry. What I did notice was the lack of water, however. I had only had one liter of water on the ascent. I tried out, or at least attempted to try out the mini Sawyer that I borrowed from Ben (my brother), but I couldn't attach it to my bottle. After a while I was forced to seek other solutions - thus I bought a 1,5 L water bottle. I tried the mini Sawyer on that bottle as well, but it didn't fit. Just to be sure i tried a third time, on my other bottle, that I had brought with me from home and NOW it actually fit the mouth of the bottle! it turns out the mini Sawyer only works with slim bottle mouths and by chance I had brought two different bottles with me, a Kildevæld - wide one, and an Egekilde, slim one. I hadn't even noticed. They look the same.

After the soup I tried to have a nap as others were enjoying a card play, yoga and just mingling. While lying there, doing my best to relax my attention went to my breathing. I was actually hyperventilating. It came totally naturally. Well, at least my body was attempting to normalize its oxygen level.

That evening we had a lesson on primary care and medical kits, which was very interesting. We had a brain storming exercise on what to bring for an expedition such as ours. They also talked about different things that are important to keep in mind before an expedition concerning the previous medical history of attendees and what might go wrong with travelers medication due to factors such as jet lag, dehydration, lack of food, stress and differences in time zone. Simple but important stuff.

Dinner was unfortunately spaghetti, so once again I went for bread. I had a can of tuna with me so no worries. My appetite wasn't great either, so surviving on toast worked out fine.

Tomorrow we will be getting to an early start at 6 o'clock and try to leave the refuge at 7 sharp wearing head lamps and winter clothing. Exciting!





























1st of October - Morocco - Acclimatization trip around Imlil

Our day started a tad earlier today than yesterday. The plan was to be finished with breakfast and have our day-packs packed at 0830, in order to be on our way early for a short acclimatization trek. So, prepared for anything after yesterday's rain and cold, we packed for a strenuous day in the mountains. I was wearing a t-shirt, merino wool sweater and had a fleece sweater, gloves and several buffs in my backpack. Oh, and the rain set of course. The Kasbah made lunch packs for us containing fruit, a boiled egg, a can of tuna and a piece of bread. I brought my own bread of course. Aside from that I grabbed some dried fruit with me from the breakfast buffet.

It was quite chilly in the shade, but as soon as we entered sunlight the cold dissipated. The sun was quite sharp and burning. Actually I found my grade 4 sun glasses quite comfortable in that bright sunlight. Usually I find them to be way too dark.

We walked in the two groups into which we had been divided earlier and practiced navigating with a map and reading the landscape around us - orienteering. We walked along mule paths and talked about navigation, flexible solutions in case of accidents and injuries, how to transport an injured person in the simplest way possible using trekking poles or backpacks and how to create simple slings and bandages for broken limbs.
I totally love this kind of simple pre-hospital way of thinking, and some day I wish to be the teacher, strolling along a path in a forest or on a mountain, giving others tips and tricks for easy fixes.

We had our lunch packs sitting on a slope of scree, in between fields of thistle and low, gnarly, very green conifers.

We were out for about 4-5 hours this day and our walk circled around the side of the north facing mountain, heading west, crossing a few rivulets and then crossing over to the south facing mountain side back down in the village of Imlil.

Imlil is by the way a little town at 1800 m altitude. It has more or less been created by the increasing mountain tourism. The area has several old communities, though that still exist. The area used to be known for its walnuts, apples and cherries, but now the tourism is a leading source of income.

On arrival in Imlil we were divided into three groups, each receiving 300 Dirhams, just about 30 EUR. The plan was to buy lunch for 2 days for each of us and our group leader, Nigel. This is part of the expedition thinking, how to get food that works with everyone with a limited budget.

The groups hit the streets of the village and we started bargaining for good prices. We ended up buying local bread for 2 days (I have my own of course), cheese and 800 grams of almonds, 11 eggs, 3 turkey sausages to share, two bags of apples, a whole lot of bananas, dried figs and a few cookies. So more than enough for a couple of lunches for our group. A bit too much actually.
So, first test passed with flying colours, everybody got more or less what they wanted.

The day carried on with some lessons. Barry started with an introduction to the use of a GPS. I don't use GPS a lot, not even on my smartphone, but it is quite handy. You just need to remember to get to an open space, preferably high up, so as to have as many satellites as possible in range of the GPS.
We had another lesson on simple temporary orthopaedic fixes, such as femur fractures, ankle sprains and fractures, wrist and forearm fractures.

We had a quite intensive session on frost injuries, hypothermia and heat related injuries with Duncan. After that we finally got something to eat. The main course this evening was lamb tajine. Really nicely prepared with prunes and almonds. The dessert was fresh fruit served at our evening session which started with Charlotte sharing her experiences on how she became an expedition medic through just showing interest and having some free time from her education in order to go on trips and expeditions.

Last of all Barry chose to share his experiences and activities throughout the years with us. He told us the story of climbing mount Everest in 2004. After that he shared what had happened to him last year while paragliding. I have met him before, in 2015 in Chamonix and I thought he was a bit different since last time. A bit thinner, with some scares and uneven areas in his face. It turns out he crashed last fall while paragliding at 4 km altitude. The fall was about 50 meters as he was crossing the crest. He smashed his face, chest and hurt his knees. Somehow he managed to activate his emergency GPS and the first person to find him stayed with him until the helicopter could come the next day as it had gotten too dark for a rescue. They slept under a bush until evacuation.

It's fantastic to meet someone who has come so far after such a serious incident and to see the will to continue.
After his talk it became very still and I think all of us had some reflecting to do. I would've asked him some questions as I feel his experience has so much to teach, especially as I sometimes meet people who are very hurt... Didn't feel like the right moment though.
Anyhow, we went to bed after this and I think my reflections kept going on all night... I can't remember what I dreamed of, just that my mind was mulling things over.
















Thursday, 4 October 2018

30th of September - Morocco - Polar, altitude and a walk



This day had an interesting beginning. After a nice breakfast with loads of coffee, fresh orange juice and some yogurt we finally got on to some WMT stuff. The main organizer, Barry, held an introduction and started with just getting some of the admin out of the way.

The first talk of the day was actually done by the British ambassador in Morocco, Thomas Reilly. Turns out he's wife has been on the course some time back just previous to their moving to Morocco. He gave us some background information to why Morocco is so much more successful than the neighboring north African countries. When many of the others had revolutions happening that overthrew the governments, Morocco had demonstrations as well. More than 4 million people were out calling for change. The leader of the country, the king, recognized that he would be losing he's position unless he changed something, so he did. He moved some of he's power to a counsel and gave the people what they wanted, more influence. The result - he is still in power, although not absolute. The counsel has some power and works with a sort of democracy. People are content. Morocco more or less thrives.

I must admit, my Africa knowledge has huuuuge gaps.

Next we heard about some arctic expeditions with teenagers, mostly to show us what these experiences can be used for. How to plan, what can go wrong, what to pack, how to screen and when to deny attendance. One example would be someone who will not eat the food that is available when in remote places. What is brought with is what you have. If you don't eat you will slow the whole group down, potentially creating dangerous situations.






The more interesting lecture was about altitude sickness. I find this to be very intriguing. It can hit anyone at around 2 km altitude. You don't know who might get affected before it hits. It's something about the body's response to hypoxia. Some people don't respond strongly enough - don't start hyperventilating enough, or something of the like. The percentage of affected people increases with altitude and speed of ascent. An ascent up Kilimanjaro (about 5,5 km) will cause altitude illness in 70% of people if the speed of ascent is 4 days, but 10-15% if its done in 8 days. Acclimatization is key. If someone gets affected they need to stop and do a rest day until symptoms dissipate alternatively descend if it gets serious.



We had lunch on the roof terrace of the Kasbah. Lunch was couscous, but I asked and they made a special for me. Totally unexpected. I thought they'd just pick some chicken off the couscous and offer me that.
Very kind of them to prepare something for me.



After lunch we had a walk with daypacks and a bit of training outside. We got a little lesson on navigation and map reading, basic trauma assessment and the simplest sort of belaying with a rope, carabiner and sling with only two knots, a regular and an Italian hitch. I enjoyed this part most of all. Rope and knots are fun.

It got a bit chilly and rainy while we were out. We actually had to change the planned hiking route due to lightning (not wise to be the highest point on a bare mountain). I ended up wearing all my layers - t-shirt, merino wool sweater, fleece sweater, shell jacket, two buffs and gloves. Luckily the rain didn't get very bad so there was no need to start pulling on my rain pants.




The weather in the mountains is quite shifty and by the time we were heading back the sun was shining and it was getting quite warm. So layers off again and we enjoyed ourselves. I had a nice chat with two of the girls, Elinor and Naomi. I realized that my mind is not quick enough for the fast English they kept sprouting. Wow! Having English as my third language really doesn't help, hahaha! I had to ask them to repeat several times, because I simply couldn't catch what they were saying ;)

The last session of the day was quite fascinating. It was one of the leaders telling us of all kinds of expeditions and experiences he has had during he's career. Himalayas, Kilimanjaro, Arctic, Antarctic, Australia, Alaska, Iraq war and so on and so on.
So exciting to listen to, but oh my, so much activity. It felt quite distant from what any of us would be able to achieve in our lifetimes.

Dinner was three courses again and by that time we were all exhausted.

Tomorrow our day will start with a long hike. Our day-packs are already packed. Time to hit the sack.