In Cambridge, the Department of Community Medicine provides a valuable service for university-approved expeditions. Lorraine Perril, the Occupational Health Nurse, organised the medical kit after an interview with Jim. Most of the drugs were obtained free or at a discount from the drug companies through the scheme. They also provided a booklet for diagnosing and treating common medical problems on expeditions. Finally they organised a question and answer session with a doctor at the department. All of this was extremely useful and saved the expedition a considerable amount of money.
The department recommended the following inoculations :-
|Japanese B Encephalitis||Tetanus|
The Rabies vaccine is expensive: two shots are needed at £25 each. It is much cheaper if you can arrange for six people to have it at once as the vaccine is sold in doses of six, so it costs the same as for one. We only took the first Rabies inoculation, but this still provided some protection. The Japanese B Encephalitis inoculation is also expensive. The disease is transmitted by mosquito bites and is not common. As the period of our exposure was so short - transit time from Delhi to base-camp - we decided to miss this one out as well. There is risk of malaria in Northern India. Paludrine, two once a day, and Chloroquine, two once a week, were taken for prophylaxis.
We also took the book Mountaineering Medicine, which provided amusing reading, in its explanations of how to perform appendectomies and other operations. Most of us felt that we would rather take our chances than risk medical treatment from any of the other expedition members. Data sheets were also ordered from the 'Mountain Medicine Centre' on acclimatisation and frostbite. Unfortunately, these did not arrive in time.
Lorraine Perril recommended that Diamox (Acetazolamide) be taken to aid acclimatisation. Everyone took two tablets a day for five days starting in Gangotri. Diamox helps to prevent cerebral and pulmonary oedema by acting as a diuretic. It also inhibits the excretion of carbon dioxide, making one breathe more, and so preventing cyanosis. A side effect of the last property is tingling in the extremities. Some of us found this so acute that they stopped taking the drug.
Everyone acclimatised fairly well on the walk-in except Richard. He felt extremely weak and was very slow. For most of the time at base-camp he coughed up blood and had little appetite. He did not have any other identifiable symptoms. Every time he tried to go above base-camp he felt nauseous and dizzy and coughed a lot. Towards the end of our stay, he stopped coughing up blood, and he fully recovered in the valley. Everyone developed dry coughs to some extent, but these were not a problem.
The L.O. suffered very badly with diarrhoea and vomiting on the walk-in. On the second day, he was moving extremely slowly and was requiring frequent rests. He stayed with two porters at Kedar Kharak for several days to recover. He was treated with a course of Flucloxacillin (Floxapen).
All of us, except John, suffered from diarrhoea to a lesser extent on the journey to base-camp, despite precautions (only bottled water was drunk, no street food was eaten, etc...). John escaped, we reasoned, as he lives in Yorkshire and was used to bad hygiene and strange bugs. All of the Rehidrat sachets were used, and other similarly-sized expeditions should take at least twice as many. A little of the Imodium and Codeine Phosphate was also used.
At the end of the trip some of the drugs were given to the Indian expedition and the others burnt. None of us had any medical problems in the UK subsequent to the expedition.
|Malarial||Paludrine 700 X 100mg|
|Chloroquine 100 X 150mg||Quinine Sulphate 30 X 300mg|
|Antibiotics||Ampicillin 40 X 500mg|
|Tetracycline 50 X 250mg||Augmentin 30|
|Flucloxacillin 20 X 250mg||Fasigyn 20 X 50mg|
|Norfloxacin 14 X 400mg||Trimethoprim 30 X 200mg|
|Ciprofloxacin 40 X 250mg||Erythroped 56 X 500mg|
|Diarrhoea||Codeine Phosphate 50 X 30mg|
|Imodium 30 X 2mg||Rehidrat 30 sachets|
|Altitude||Acetazolamide 40 X 250mg|
|Analgesics||Paracetamol 100 X 500mg|
|Dihydrocodeine 10 X 30mg||Antihistamine|
|Triludan 30||Eye ointments|
|Chloromycetin 1 X 4g||Brolene 1 X 5g|
|Miscellaneous drugs||Hydrocortisone cream 1 X 30g|
|Algipan 1 X 40g||Betadine 1 X 8ml|
|Insect repellant 2 X 35g||Dressings|
|10 X eye pads||2 X triangular bandages|
|1 X varicrepe bandage||1 X 8cm bandage|
|1 X medium sterile wound dressing||1m sterile absorbent gauze|
|12 X non-adherent absorbent dressings||10 X sofra-tulle dressings|
|1 X sterile pad||5 X hypoallergenic skin closures|
|1 X roll elastoplast||11 X coverlet adhesive dressing|
|40 X assorted plasters||2 X 500cm micropore tape.|
|Miscellaneous||6 X Medi-Swab|
|15 X cleansing towelettes||3 X 5ml syringes|
|2 X 10ml syringes||3 X no. 14 needles|
|3 X no. 2 needles||1 X I.V. Cannula (1.2mm)|