Everest Clinic Tends Ills on High

April 4, 2003

The world's highest medical clinic opened on April 1 at Mount Everest Base Camp, just as climbers began to arrive to mark the 50th anniversary of the first ascent. Located at 17,500 feet (5,330 meters), the tent-based clinic will be run by a member of the Himalayan Rescue Association (HRA), Luanne Freer, and staffed by volunteer physicians who will treat visiting trekkers, climbers, and Base Camp staff for ailments such as high altitude sickness, frost bite, and snow blindness.

The mission of the HRA, which opened its first clinic in 1973 in the Khumbu village of Pheriche, Nepal, is to reduce casualties due to high-altitude sickness in the Himalaya and to provide low-cost medical care for the Nepali people. Funded by donations and fees generated from Western trekkers, the Everest Base Camp Medical Clinic is the HRA's most recent endeavor. The idea to start a central, organized clinic on Mount Everest originated when Freer, a 45-year-old emergency medical physician, visited Base Camp last year and saw the need for more medical care on the mountain. This year, the clinic will operate from April until climbing permits expire in May, with two board-certified physicians and medical students on site. Before Freer traveled to Nepal to prepare for the April 1 opening, we spoke with her about the state of health care at the top of the world.

How did you become interested in high-altitude medicine?

During medical school on the East Coast, I spent nearly every vacation in the Rockies. On one trip I saw hospital signs in Yellowstone—I couldn't believe you could work in a hospital in a national park. So in 1992, 12 hours after graduation, I literally drove out to Yellowstone to work.

Even at 8,000 feet [2,440 meters], 25 percent of my patients developed some form of altitude sickness, so I started doing an epidemiology study. The more I asked about the subject the more I wanted to know, and I've worked there every summer since. I'm now the park's director of medical care.

How did you become involved in the Himalayan Rescue Association?

I ended up making an impromptu decision to join a group of physicians trekking in Nepal in 1999. While there, I volunteered at a clinic where we treated about 650 Sherpas in five days. This was my first introduction to the needs of the area, and I couldn't wait to get back.

The mission of the HRA is to prevent serious altitude sickness and reduce casualties due to altitude sickness in the Himalaya. What upsets us most is that death from altitude sickness is almost always preventable, so we strive to offer education as well as medical care to visitors and locals.

Why did you want to start a clinic at Base Camp?

When I visited Base Camp last year, I met some expeditions who brought their own physicians, and others who didn't. A light bulb turned on when I discovered that the teams without doctors were trying to wing it and practice medicine without any training. Expedition leaders are basically well-versed with treatment of high-altitude sickness—they see it more often then most physicians—but they have trouble with common ailments like bronchitis and diarrhea. So I thought, Why not set up one clinic that has physicians with altitude training and experience with common local problems, and improve care and reduce expedition costs?

How will the clinic operate?

The staff are all volunteers [except our paid Nepali interpreter]. I will be on staff throughout the climbing season, and there will be two board-certified physicians present at all times. There will also be a resident in emergency medicine and a medical student conducting altitude research and helping out with clinical care. We'll be recruiting volunteers at lower altitude and putting them on medication designed to prevent altitude sickness. Our staff will maintain contact with them during the trek, monitoring their symptoms and the effects of the medication.

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