Is Climbing Kilimanjaro Safe?

View from trail heading to Barranco Camp from Lava Tower on Kilimanjaro

Like any outdoor activity, climbing Kilimanjaro can certainly be dangerous. Basic injuries like a twisted ankle or a fall can occur. However, Kilimanjaro’s main danger is its high altitude, which also makes it somewhat difficult to climb. However, the mountain guide you select can tremendously affect your level of safety as you will see.

First, let’s put things into perspective. Approximately 35,000 people attempt to summit Kilimanjaro every year. About 1,000 people are evacuated from the mountain for safety reasons and there is an estimated 10 fatalities on the mountain per year. So the chance of death is about .03%. Comparatively, your chances of dying in a car crash is about 1 in 103 (almost 1%). So you are almost 100 times more likely to die in a car accident than on Kilimanjaro!

However, just like you take safety precautions in your car (buckle your seat belt, drive the speed limit, avoid driving while tired), you and your guide should be taking safety precautions while on Kilimanjaro. And choosing the right guide can literally be a life-saving decision.

Be sure you are healthy when you arrive

Look, we are not all super athletes. Many of us have desk jobs or simply don’t get as much exercise as we should. And, even more unfortunately, many of us haven’t gone to the doctor for a wellness checkup in far too long. One of the most important things to do before you book your trip to Kilimanjaro is to ensure you are healthy enough for the journey.

Most likely, you will need to get several immunizations before coming to Tanzania . So, you will probably be going to your doctor for your immunizations, why not get a checkup while you are there? Be sure to tell your doctor that you would like to climb Kilimanjaro and get her/his perspective. You should really do this even before your start your exercise regime .

Now is the time to identify any issues with your heart health (don’t wait until you are on the mountain)! High blood pressure has been called the “silent killer” because you don’t have any symptoms. Over time, high blood pressure causes many issues in your organs and can eventually lead to dangers such as heart attacks or stroke. This risk is greatly multiplied at high altitudes like Kilimanjaro. Indeed, many deaths that occur on Kilimanjaro are actually caused by a heart problem that the climber did not even know about. So get your doctor’s advice before getting on that plane to Africa!

Safety precautions on the mountain

It is important to know that everyone is susceptible to altitude sickness. There is no avoiding it by assuming “it won’t happen to me”. That being said, a great guide that has been trained on safety techniques can significantly help climbers reduce the affects of altitude sickness and reduce the chance of it being fatal essentially to zero.

First, your guide will do “health checks” two times a day. The health check entails each guest answering a set of questions such as:

  • Do you have any headaches? How bad is it?
  • Are you eating well?
  • Are you feeling sick?
  • Are you tired? How tired?
  • Are you feeling dizzy? How dizzy?
  • Did you sleep poorly? How poorly?

In addition to asking and recording your responses to these questions, they will also take two important measurements: Resting heart rate (e.g. “pulse”) and oxygen saturation. Collecting these measurements in addition to the responses to the questions will give great insights as to how each guest’s body is handling the increase in elevation. Perhaps more importantly, these readouts are recorded and written down so that the trend is clear. It is easy to see if the guest’s health is improving or degrading.

Handwritten document showing daily health check of a climber on Kilimanjaro
While each health check is important, it is even more important to see the climber's health trend over time.

A great guide will likely have a good “feel” for how well their guests are doing even before doing the health checks. They subtly notice who is eating well and encourage those not eating to try and eat some more. They notice if guests start to move slower than previous days and monitor their progress. But the health check record is definitely an important document for the guide to keep.

Safety decisions

By monitoring each guest’s health, guides will then need to make decisions about guests whose health seems to be diminishing. Their plan may include moving more slowly up the hill, or perhaps treating some of their symptoms with ibuprofen or a similar medication. In more extreme cases they may give supplemental oxygen (which every good guide should be carrying).

In many cases, the symptoms of altitude sickness are mild. And oftentimes they will improve as the guest’s body gets used to being at higher altitudes (“acclimatizes”). The health check will show this. Oftentimes, guests will start feeling poorly at approximately 12,000-14,000 feet (3600 m – 4200 m). But after a day or two will start feeling better (oftentimes just in time for summit day!)

However, if the guest’s health continues to decline, they may have to make the difficult decision to have the guest discontinue their journey and go back down the mountain. This is obviously a difficult decision. However, most guides that we have spoken with say there is rarely a big disagreement between the guide and the guest. Generally, when the guide makes the call that the guest must go back down, the guest understands why and is anxious to start feeling better. And going back to lower elevations quickly alleviates nearly all cases of altitude sickness.

Emergency evacuation

Your guide will have several options available to get you down the mountain if you do not feel well enough to continue (or they make a decision based on your declining health). This may include simply walking you down or using special emergency cart that you lay on and they can wheel you down.

Emergeny cart with single wheel held by Kilimanjaro guide
While it seems primitive, this cart is very effective in getting injured climbers down to a road for rescue. It requires 6 guides/porters to assist in the rescue.

In either case, they will generally take you down a non-standard route (allowing more rapid descent of the mountain). The goal will be to get you to one of a handful of roads that are used purely for emergency purposes. They will radio ahead and have the ambulance pick you up at a road.

Emergency road on Mount Kilimanjaro with clouds in background
The Kilimanjaro National Park maintains a well groomed road that is only used for emergency evaculations.

More often than not, the guests will rapidly improve being at a lower elevation and can simply head back to their hotel and rest. In more extreme cases, you may be taken to a hospital if it is deemed necessary.

In very extreme cases, guests may be helicoptered out. There is a helicopter search and rescue service on Kilimanjaro that runs out of the town of Moshi called Kilimanjaro SAR. There are limits to helicopter rescue (for example they will not fly at night or in poor weather), but this can be a very effective rescue in more extreme cases.

Helicopter pad for emergency evaculation on flat ground with rocks making a circle
While not often needed, there are many helicopter pads on Kilimanjaro that may be used for emergency evacuation if medically necessary.