Below a very shocking description of a porter dying of high altitude sickness.
I tried to accurately describe the events including our grief and disbelieve but realize this may clouded by a reduces sense of reality, also due to the high altitude of 5500 m. I apologize if a reader feels their is sensationalism in the story.
I hope that publishing an account of this accident will help in preventing similar ones in the future. I still have the feeling it could have been avoided.
Baruntze (7300 m; left), Little Baruntze (6700 m; far middle) and West Col Pass (6100 m; right). Baruntse Base Camp right side on top of hill. Photo provided by Gert Esselink, taken in December a few years ago.
At 2.45 Am I was called by Lokendra Raj, one of our mountain guides. "Sir, I am so sorry, porter dying, please bring medicine".
I quickly put on my clothes in the freezing temperatures and took my personal medicine box expecting Diamox and painkillers would be sufficient.
I entered the kitchen tent where some 15 kitchen staff and porters were sleeping. In the middle, one of the older Sherpa porters, Passang Sherpa, 32 years old, had a gurgling breath, his mouth covered in yellow foamy phlegm, a classical case of acute HAPE, high altitude pulmonary edema, or water-filled lungs.
Last night two porters were sick but there was no indication they needed a strong medicine. They were exempted from carrying their 30 kg load yesterday across the 6100 m East Col (Sherpani Col) and 6135 m West Col.
This was the trickiest part of our trek, one of the highest crossings from Makalu Base Camp at 4900 m in the Arun Valley region, going West to Baruntse Base Camp at 5450 m in the Everest Region, a 4 day crossing. We decided to acclimatize at 5750 m before the passes using a two-day rest and during the day of crossing it would take 8-10 hours for the specially selected high altitude porters and help of the climbing Sherpas to cross the two steep passes with two multi-pitch rappels (abseils) of 100-200 m each.
Jacco and myself reached Baruntse Base Camp after 7-7.5 hours walking on mostly glacier, arriving at 2.30 PM, going almost non-stop with a light rucksack.
Baruntse Base Camp in October 2004: (1) View NE Baruntse; (2) View NW, Ambu Labtse; (3) View SW,
The porters all made it to base camp but the other 13 members stayed at the 6100 m advanced base camp, some involuntarily as it would take them 4 hours to go down and they did not arrive at the advanced base camp until 4 or 5 PM due to long delays during the rappels and walking at 6100 m is slow. Most of the mountain guides also stayed there.
Passang only had a bowl of soup and some hot water last night but said he was fine. He showed no indication that he was already very sick for days, since Makalu Base Camp 5 days ago. Last night I saw him together with 4 other Sherpa porters lying on a few mattresses sharing their sleeping bags and blankets for warmth. I did not notice anything unusual, always watching for signs of high altitude sickness. The remedy is normally very simple, 3 tablets of Diamox, to drain excess water in the brains and lungs as the cells leak fluids in the brains and lungs at high altitude.
Around 1 or 2 AM, the gurgling go of Passang was so loud it alarmed the other sleepers. Lokendra, who slept in one of the mountain guide tents, was called for help. After some hesitation but with a panic feeling increasing as the situation was highly unusual, he called me for help.
The situation could not have been worse. I felt I could have helped him easily last night by given him Diamox if he had reported being very sick with spitting yellow phlegm to Lokendra. Whenever porters spit even a little bit of yellow phlegm above 5000 m I give them Diamox to be on the save side. He had some medicine yesterday morning before going up. No doubt he was already spitting yellow phlegm last night but must have concealed it. Porters often hide being sick as they feel it makes them less marketable.
His hands were cold and the Gamow Bag to increase oxygen pressure was stored in the advanced base camp, 6 hours to pick up for our second mountain guide in the Camp, Nima Sherpa. After Nima pointed out we had two cylinders of medical oxygen in one of the drums, he quickly left to pick up the Gamow bag, Nifedipine, a strong medicine against lung edema that widens the lung blood veins, and a Porto phone to be able to communicate with the satellite phone in advanced base camp. We were very lucky we thought to have the two bottles of medical oxygen.
We applied the oxygen at 3.15 AM and Passang reacted immediately, within minutes his hands were warm again and his pulse went up, first to 60 and it finally stabilized at 120. The foamy phlegm reduced and his breathing was less heavy. We regularly cleaned the oxygen mouthpiece, checked the oxygen flow, and measured his pulse. His eyes were open know, being conscious and he seemed to see us, fighting for his life. We thought we had him stabilized, being conscious with a steady, strong pulse and with at least 4 hours of oxygen to go. The Gammon Bag would come down in 6 hours.
At 4.30 AM his breathing suddenly slowed down and his pulse was too weak to measure. He now coughed a lot of phlegm and his lungs seemed to be drowning in liquid. "Not good, Sir", Lokendra said with an emotional voice. We checked the oxygen flow but this was fine.
Within a minute the breathing slowly stopped. He was dead, his open eyes that showed signs of life until a few minutes ago, now staring into infinity. The tent was dead silent, nobody moved for the next few minutes.
When we finally recovered in disbelieve, we covered the Passang's body in his sleeping bag and a blue tarp, and laid him outside at a distance of the tents towards the lake in the quiet, freezing night lighted with the bright stars and a thin layer of fresh snow.
Lokendra said: "First time in Iceland Trekking".
Lokendra and one of the high altitude porters left for advanced base camp to pass on the sad news and call off the rush for the Gammon Bag.
It was too late. Passang had acute HAPE, only 8 hours between feeling sick and developing water filled lungs that killed him. The oxygen extended his life by perhaps 1 hour but we applied it to late.
I went back to my tent and crawled in the warm sleeping bag. My mind were empty. It was now 5 AM, the camp would not get up until 8 AM as we had a day off tomorrow to recover from the heavy day of crossing yesterday. In the turmoil I forgot to tell Jacco in the next tent that a porter died but must have noticed the unusual activity. First time for me in 30 years but not acceptable.
The next day I spoke to Dawa, our lead climbing Sherpa who knew Passang’s brother and the rest of his family very well. He suggested that possibly Passang's recent (past few years) inexperience above 4000 m as a porter by staying too long down in Katmandu and possibly earlier lung damage accelerated his very rapid development of HAPE. This rapid development was very unusual. Still, Dawa did not know what to say, felt very uncomfortable, as he would soon be confronted with Passang's family.
Already at the 4200 m Shipton La (Kong La), 2 days before Makalu Base Camp at 4900 m, Passang had severe headaches and should have gone back. He should at least haver returned back together with most of the other porters down from Makalu Base Camp at 4900 m. He hid his sickness, unfortunately.
Dawa appreciated that Lokendra and I did try the very best we could have done by applying medical oxygen. Unfortunately, it did not work.
The porters did not want to carry the body to Lukla, a 4-day trip, despite being offered a high bonus. They tried but left it up the hill, not only being afraid of Passang's ghost but also as on carrying the body, it was spreading a foul smell.
We decided to evacuate out Passang's body by a special high altitude rescue helicopter of the Nepalese Army flown by one of their best pilots who also flies the highest government officials. His family would then be able to give him a proper ceremonial burning in Katmandu. It would still take 7 days before a helicopter would pick up Passang’s body due to poor weather.
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