Tanzania Rewilded

Arusha · Tanzania
Est. 2015
Chapter I
A decade in the bush
Founded in 2015 by guides who grew up tracking leopards on foot. Built for travellers who know the difference.
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Chapter II
Summit on foot
Africa's highest peak, summited with our most experienced climbing guides. No shortcuts, full preparation.
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Chapter III
Authored for you
Every journey custom-built. Browse the most-requested shapes or begin with a blank page.
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Chapter IV
Every season, every region
From Serengeti plains to Zanzibar reefs — we work only in regions we know by foot, by season, by name.
Explore Tanzania
Chapter V
The practical book
Seasons, visas, vaccinations, weather, tipping. Nothing glossed over. Written by people who live here.
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Kilimanjaro · Altitude
Above 2,500m · Where AMS beginsMedically reviewed protocols

Respect theAltitude.

Altitude sickness is the biggest reason climbers don't summit — not fitness, not weather. What it is, how to recognize it, how to prevent it, and when to turn back.

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5,895m
Uhuru Peak
Summit altitude
~75%
experience symptoms
At least mild AMS
~2%
serious cases
HACE or HAPE annually
Zero
deaths on our climbs
With proper protocols
The three conditions

AMS, HACE, HAPE

Three altitude-related illnesses. AMS is common and manageable. HACE and HAPE are medical emergencies. Knowing the difference saves lives.
AMS

Acute Mountain Sickness

Common, manageable

The body's initial response to altitude. Almost everyone experiences some form above 3,000m. Think of it as altitude jet-lag.

Symptoms
  • Headache (universal)
  • Nausea or loss of appetite
  • Fatigue beyond normal
  • Difficulty sleeping
  • Dizziness or light-headedness
Action: Rest at current altitude. Hydrate aggressively. Ibuprofen or paracetamol for headache. If symptoms worsen, descend.
HACE

High Altitude Cerebral Edema

Emergency

Brain swelling from prolonged altitude exposure. Starts as worsening AMS but becomes neurological. Life-threatening if ignored.

Symptoms
  • Severe headache not responding to painkillers
  • Confusion or disorientation
  • Ataxia (unable to walk a straight line)
  • Extreme drowsiness or lethargy
  • Hallucinations
  • Loss of consciousness (late stage)
Action: Immediate descent. Every hour matters. Guides will evacuate immediately — no decision-making by the patient.
HAPE

High Altitude Pulmonary Edema

Emergency

Fluid in the lungs. Can develop rapidly, often without prior warning signs. Also life-threatening.

Symptoms
  • Shortness of breath at rest
  • Cough (sometimes blood-tinged)
  • Frothy sputum (advanced)
  • Rapid heart rate
  • Chest tightness
  • Blue tint to lips or fingernails
Action: Immediate descent. Supplemental oxygen if available. AMREF evacuation. Cannot be treated at altitude — only descent or evacuation.
Practical defense

Six Prevention Protocols

Altitude sickness is dramatically reduced by good protocol. These six behaviors, followed consistently, are the best protection.
01

Choose a long route

7-8 days minimum. Lemosho and Northern Circuit give your body time to adjust. Rushed 5-6 day routes show dramatically lower success and higher AMS rates.

02

Climb high, sleep low

When route allows, day-hike to a higher point, then descend to a lower altitude to sleep. Best acclimatization pattern. Our guides build this in where possible.

03

Hydrate relentlessly

4-5 liters of water daily minimum. Dehydration mimics and worsens AMS. Your urine should be clear. Electrolyte tablets help.

04

Pole pole

'Slowly slowly' in Swahili. Walk so slowly you feel embarrassed. Racing the first few days costs you on summit day.

05

Diamox (prescription)

Acetazolamide speeds acclimatization. Not a replacement for good protocol but reduces AMS severity. Discuss with your travel doctor 4 weeks out. Trial it at home first.

06

Eat even without appetite

Carbohydrates are fuel. Loss of appetite is a symptom you push through — force small regular portions. Soup, rice, bananas, energy bars.

What your guide is watching for

Stages & Responses

Your guide is trained to recognize altitude illness in you before you do. This is what they're assessing at each daily check-in.
Stage
When
Signs
Action
Early
Day 2-3 at altitude
Headache, mild nausea, fatigue
Monitor. Continue carefully with extra rest. Adequate hydration usually resolves.
Moderate
Any day
Headache not responding to painkillers, persistent nausea, poor sleep after 2 days
Pause ascent. Rest day at current altitude. If not better in 24 hours — descend.
Severe
Emergency
Ataxia, confusion, chest tightness, severe breathlessness at rest
Immediate descent with assistance. AMREF alert. No delay for decision-making.
Post-summit
After descent
Often resolves within hours
Most climbers feel dramatically better within 2-3 hours of descending to 3,000m. If symptoms persist — medical evaluation in Moshi.
The Diamox question

About Acetazolamide

The most-asked medication. What it does, whether to take it, and the honest trade-offs.

What is Diamox?

Brand name for acetazolamide — a mild diuretic that causes your kidneys to excrete bicarbonate, which triggers deeper breathing. This raises blood oxygen, effectively accelerating acclimatization.

Should I take it?

Most of our climbers do. It's not a replacement for proper protocol, but it meaningfully reduces AMS severity at the cost of minor side effects. Discuss with your travel doctor. Some people prefer climbing without — it's a personal choice.

What's the standard dose?

125mg twice daily, starting 24 hours before reaching 3,000m, continuing through summit day. Your doctor will prescribe based on your health profile. Do not exceed — more isn't better.

Side effects?

Tingling in fingers/toes (common), frequent urination (expected — it's a diuretic), altered taste of carbonated drinks (harmless), occasionally fatigue. Most resolve after stopping.

Who shouldn't take it?

Anyone with sulfa allergies, severe kidney disease, or some liver conditions. Always get a doctor's clearance and trial it at home before your trip — reactions can happen.

Safety first, always

Summit safely, or not at all.

Every climb is led by certified mountain guides trained in altitude medicine, with pulse oximetry and emergency oxygen at every camp. AMREF Flying Doctors coverage is included. Your safety is non-negotiable.

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