When I interviewed local mountaineers Martin and Esther Kafer for the 2012 annual fundraising hike up Mount Kilimanjaro for the Alzheimer Society of B.C., I did not question their years of experience in the mountains. For their engagement, they gifted each other a climbing rope. On their honeymoon in the Swiss Alps, Esther used the rope to save Martin's life when he lost his footing and fell over a ledge. Esther dug in and held on to the other end of the rope, stopping his fall. They've climbed and travelled all over the world including New Zealand, Turkey, India, Burma, Kenya, Chile, Peru and Ecuador. Sixty years later, they are still climbing together and have made over 30 first ascents of the British Columbia mountains.
However, I did question the risk of having Martin and Esther on the team. After all, Martin is 85 years old and Esther is 84. Although Kilimanjaro is a non-technical hike that is accessible to many people of varying age and ability, at 5,895 metres, the summit is considered extreme altitude. People die there every year.
Each person wishing to join the Kilimanjaro Ascent For Alzheimer's fundraising team is interviewed. Successful candidates must be able to raise a minimum of $10,000 for the Alzheimer Society of BC, pay their own trip expenses of about $6,000, commit to a training schedule of three 90-minute workouts a week plus hikes on the weekend, and be a positive member of the team. Finally, they must get medical clearance from their physician.
In addition to the standard medical clearance, I requested the Kafers test their maximum achievable heart rate and their vital lung capacity as both decline with age and are important factors in dealing with lack of oxygen at altitude. Acute mountain sickness is less likely to occur the older one is. However, there is not sufficient research of people of advanced age going to very high or to extreme altitude. Apparently, not many octogenarians venture into thin air. Martin and Esther passed all medical tests. They were on the team, along with nine others.
Since 1998, I have guided more than 100 people, ages 16 to 70, to the summit of Kilimanjaro for the Ascent For Alzheimer's. The common ingredient of those people who participate is their story. Alzheimer's has touched almost all of them. Cathie, an occupational therapist, will hike for her mother and her grandmother. Katherine, an ophthalmologist, and Barbara, a lawyer, will hike for their fathers. Martin and Esther will hike for Martin's sister, a retired genetics professor.
For months the 2012 team trains, hiking on the North Shore and near Whistler. Esther and Martin are slower than others on the flat but faster than some going uphill and downhill. Esther, standing at no more than five feet tall, with hands on her hips, confides in her strong Swiss accent (even after living in Canada for 58 years), "people are always asking us how old we are and saying how inspirational we are. We're used to it. But you know, we're just hiking and we've been hiking all of our lives. It's no big deal! And I am so lucky that I have never had a serious illness."
Martin adds, raising his bushy white eyebrows: "We're just two old fools trying to be young."
We have done what we can to prepare. The team has everything on the equipment list, has trained hard over varied terrain, and has surpassed their fundraising goal. I have my worries as usual. Acute Mountain Sickness is a risk. One person has nerve damage in her feet. Another is afraid of heights. One team member is unsure on rocky terrain. Martin has two prosthetic hips. And Martin and Esther may die of old age at any time.
Given the added risk to the participants, why does the Alzheimer Society continue to support the fundraiser year after year? "The event raises incredible awareness for Alzheimer's," says the Society's CEO Jean Blake. "The hike to altitude symbolizes the journey that Alzheimer patients and their caregivers take." The team members will venture into the unknown and possibly experience symptoms of Acute Mountain Sickness similar to Alzheimer's.
After 18 hours of flying, we step out into the warm, decomposing smells of Tanzania, where we are transferred by mini bus to the Marangu Hotel, the guiding outfit I have worked with for 15 years, in the foothills of Kilimanjaro. We are disoriented and wait for our souls to catch up from the long journey. Some sleep well under the mosquito netting that night. Others fight jetlag, listening to the 300 species of birds on the grounds long before sunrise.
The next morning, our team gathers in the U-shaped, hard dirt courtyard next to spiked Aloe plants, blood-red lacey bougainvillea flowers and the 38 Tanzanians who will carry everyone's gear for seven days on the mountain. I have worked with most of these men the 14 times I have been to the summit. They have been to the summit hundreds of times.
We migrate to the parking lot and settle onto the bench seats of the overland Mercedes truck that will take us the 90 minutes to the trailhead. Esther and Martin bump along and I feel badly for Martin's hips. Broad, dust-covered leaves hang over the edges of the paved road that undulates with the ridges and rivers of the foothills. Women wrapped in flowing, bright, orange, blue, yellow and green kangas crane their necks under their loads to get a look at us. Children holding hands wave when we yell out, "Jambo."
Towns of wooden shacks with tin roofs and colourful misspelled signs advertising "Beuty salon", "Coca-Cola," and "Safari" beer dot the way. We circle the mountain, on the border between Tanzania and Kenya. A dishevelled-looking shantytown of odd pieces of wood appears out of the dust. Nalemuru — the jumping off point to the Rongai route on the northeast side of the mountain.
We walk a few steps to the official trailhead where a tall wooden sign warns of the dangers of going to altitude. After a team photo, a trip to the outhouse and lathering on sunscreen, I lead the team up the dusty trail and look over my shoulder frequently as they take their first steps on the mountain. Pole, Pole. Slowly, slowly. I can feel the energy of the person behind me, almost stepping on my heels, willing me to go faster. Martin grins, "You know if Esther and I were hiking on our own, we would be going much faster." They must get used to this pace or they will be more susceptible to altitude sickness higher up. People get symptoms of altitude sickness as low as 2,500 metres. We will be higher than that at our first camp tonight. In fact, we will be 500 metres higher than the peak of Whistler Mountain.
Joseph walks with us and carries two cylinders of oxygen, only to be used on descent in the event of an emergency. Descent is the optimum treatment for Acute Mountain Sickness. Fortunately, the terrain on Kilimanjaro allows for a quick retreat and we have 38 people to help us. Winneford is Martin and Esther's personal guide. He will alternate carrying their daypacks so they get a chance to rest. Three and a half hours later, seven kilometres farther and 638 metres higher, as the sun threatens to disappear behind the massive mountain, we arrive at Simba camp, meaning Lion, almost hidden by giant heather trees. Kilimanjaro represents eight climatic zones ranging from desert to alpine. Today the pine tree forest where we started our hike has morphed into these heather trees that reach up to 30 metres tall.
In the dining tent, while feasting on chicken, a heap of roast potatoes and other carbs that are good for acclimatization, I coach the team about how to stay warm at night. Eat well. Get into your sleeping bag warm. Keep a toque on. Keep an extra layer handy to put on. If you have to go to the bathroom, don't procrastinate because it takes a lot of energy to keep the urine warm in your body. Esther and Martin negotiate the tent guy lines in the dark to get to the outhouse. Most chores take longer for them to do.
The next morning we see the summit cone of Kilimanjaro in all its splendor. Mount Kilimanjaro is the highest mountain in Africa and the highest freestanding mountain in the world, exploding from the muted plains of Tanzania like an exquisite blemish. Vast volcanic craters, Shira and Mawenzi, flank the main massif, Kibo. Sparkling glaciers tumble from this broad cone Hemingway described as "wide as all the world, great, high and unbelievably white." The magic of ice and snow in a crackly brown land mesmerizes.
Today we hike for almost ten hours to an elevation that is much higher than Mount Baker. Esther and Martin walk together, help each other to get snacks and water at rest stops and keenly tell stories of their past adventures to their teammates. It is 7 p.m. and dark when we reach our second camp, Kikelewa Cave, at 3,675 metres, where chunky black volcanic rocks are strewn everywhere and water is scarce. At this altitude, about 35 per cent of people experience altitude symptoms. At dinner, several people eat much smaller portions, a sign of the altitude sickness. Esther says, "There's too much food. I don't eat this much. I don't want to get fat." Before they head to their tents, I warn them about periodic breathing. When asleep at altitude, a person can have very irregular breathing and then actually stop breathing for several seconds. This is not abnormal above 3,000 metres.
After our second night on the mountain, Esther and Martin stand dutifully in front of the video camera. "My name is Esther Kafer and I feel great. The porters are very helpful and call me Bibi because that means Grandma and they call Martin Babu because that means Grandpa."
"My name is Martin Kafer and I had a lousy sleep but I'm going on anyway." The team has agreed to video and photograph Esther and Martin at each camp and to document the trip in a specific logbook because Esther and Martin have applied to the Guinness Book Of World Records to be the oldest man and woman to summit Mount Kilimanjaro.
In five hours, we gain a ridge and descend slightly to Mawenzi Tarn at 4,302 metres, the only "lake" on the mountain. Mount Mawenzi towers above at 5,200 metres and fingers the sky with its jagged black rock. Martin falls back and steadies his digital SLR camera with his long, bony fingers to take several shots. His breath comes in short puffs from the exertion of taking photos. "Beautiful," he says. I wait for him so that he does not go too quickly to catch up to the group. Over exertion is a good way to get altitude sickness. The body is not getting enough oxygen as it is. The air pressure at this altitude is approximately 60 per cent of that of sea level meaning that the body is breathing in less air and less oxygen. With time, the body adapts by breathing faster and by producing more red blood cells.
Many tours of Kilimanjaro are five or six days long. Our overall hike is seven days including an acclimatization day at Mawenzi Tarn where we spend two nights at the same altitude. A slow, steady ascent is the best.
During the acclimatization day, we luxuriate in not having to pack up, have tea in bed, as usual, and hike pole pole up the North Corrie to a ridge of lava extending thousands of metres to the plains of Kenya. We are higher than Mount Rainier. I stop at a plateau covered with papery everlasting flowers overlooking the tents below. In 1999, I sprinkled some of my first husband's ashes at this viewpoint above the clouds, surrounded by colour and black rock. Jim led the first Ascent For Alzheimer's in 1998 and I went as his assistant guide. The next spring, he was killed in an avalanche in Alaska, a few months before we were scheduled to guide the 1999 Ascent. The Alzheimer Society asked me if I would guide the group anyway. I did — for the next 14 years. Remembering the past has allowed me to embrace the present and to envision a future. I wonder what it is like when you can't remember?
That afternoon, the team does a summit dress rehearsal. Burdened by layers of synthetic clothing, down and Gore-tex, they sweat in the sun and amble around the dusty basin like sumo wrestlers. On their chests, underneath several layers, bulge camelbacks of water rigged to stay in place so they won't freeze on the cold and dark summit night. I adjust some systems. Esther is dubious about the camelback.
"I don't drink very much. When we first began climbing in Switzerland, we weren't allowed to drink until we got to the top, so my body got used to it. And I prefer to drink from a water bottle." She makes a face at the camelback. I tell her that everyone I've taken to the summit has not had the energy to take out a water bottle and drink from it. The water must be easy to access and insulated so it doesn't freeze.
Martin appears in puffy down. He has had frostbite on his hands and feet before so I am careful to check his gear for the third time. I comment on their long down jackets with ample hoods made of a telltale rust-coloured nylon used in outdoor gear in the '60s.
"Esther made these," says Martin. "We got very cold once, on an expedition. We had to bivy. When we got home, she made these down jackets and our sleeping bags." He smiles at his wife.
"How long ago was that?" I sense the answer.
"1965." Martin's memory kicks in immediately.
"No way! They're older than me!" We all have a chuckle at their 47-year-old gear, but it seems in good shape apart from a few patches.
The group wants to know what summit night will be like. It will take 13 hours to go to the summit and back to high camp. We begin to hike at night so that we will be on the summit close to sunrise. Otherwise the clouds rise up quickly from the plains and obscure the view. It has also been said that if you could see the way, you might not go. It could be anywhere between minus 4 and minus 30 Celsius. It could be windy or it could be calm. It could snow. If the sky is clear we could see a full moon. The forecast changes quickly. Kilimanjaro is so big and so alone that it makes its own weather. How hard will it be? I don't know. It varies from person to person.
They have done everything right. They have trained, they have the proper equipment, they have ascended at a slow and steady rate without overexerting in order to acclimatize, they have taken Diamox (a diuretic that speeds acclimatization), they have eaten a diet high in carbs, they have kept hydrated. But there is no guarantee that they will make the summit.
And you can do everything right to prevent Alzheimer's and still get it.
The next day we cross the barren saddle in six and a half hours and arrive at our high camp, Kibo Hut, at 4,714 metres, nestled at the base of the grey volcanic cone, which is Kibo. I point out the scree path that zigzags its way up the side of the mountain, getting steeper as it gets higher, until it reaches the crater rim. At 11 p.m. we will begin our push to the summit.
We spend the late afternoon packing daypacks for the summit. I circulate to answer questions. "Don't forget your sunglasses and sunscreen. They'll be the last thing on your mind at 11 tonight." Memory lapses can affect emotions and cause anxiety. The air is thin and the pressure of making the summit nears. Tolerance wanes and fear slips in. "You are the worst tent-mate I've ever had!" One spouse says to another. "You're good at your job at home but you are useless here." The couples vent their anxieties. When you love someone you have to learn to forgive because they will hurt you. Facing the adversity together ultimately makes their relationship stronger. But what would happen if the mood changes were constant and permanent and abusive? What if your partner was getting Alzheimer's? What if your partner forgot who you were?
At 10 p.m., my alarm rings. The team is due in the dining tent at 10:30 p.m. for tea. There are the usual delays. "I can't find my gloves." "My zipper is stuck." "I need to go to the bathroom." I find Esther and Martin in their tent trying to get on all of their layers. "It takes so long and we don't want to keep people waiting," Martin worries. Esther helps him to put his gloves on and I put on their water systems and zip up their jackets. Finally, standing bunched together in the tent like overstuffed Michelin men, pregnant with camelbacks, wrapped up in down, fleece and Gore-tex, I give my parting words.
"You have all done well preparing for tonight. But remember that altitude sickness plays no favourites. Try to take each step as it comes. Your job tonight is to ask for help when you need it. Offer help when you can. And try your best. I will look out for you, as will the boys. And finally, a wise mountaineer once said, 'the summit is optional, descent is not.' Let's have a great hike."
It is 11:30 p.m. when we trudge single file out of the rocky camp, headlights bobbing. The African crew spreads out along the line and chatters in Swahili to each other but our team is quiet. People concentrate on the pair of boots in front of them. A full moon has elbowed its way through the dense cloud and I turn off my headlamp. I am grateful that there is no wind. The temperature is tolerable at minus 10. We are lucky.
The night becomes a blur, the air gets colder and thinner. I watch the team to see who sways when we stop to rest. Martin has not slept well for several nights. After three and a half hours of plodding, we huddle in Hans Meyer Cave at 5,259 metres, half way to the crater rim. I make the rounds, shining my lamp indirectly at each person to see if their eyes are clear and focused on me. I ask them questions to hear how they articulate. I make sure their breathing recovers within a few minutes of stopping. I offer them water, hard candies and dried ginger. Some take Ibuprofen or Tylenol for a headache. Others take Gravol or ginger for nausea. Some slump against each other on the frozen rocky ground like exhausted rag dolls. Some wear an expression of despair and helplessness. What must it be like, in the late stages of Alzheimer's, to lose the ability to speak, move, eat and use the bathroom independently? Martin says of his sister, "she is reduced to incoherent words, carefully tending to her doll. A life reduced to a pitiful minimum." Everyone is coherent and able to walk on his own, albeit in a zombie-like trance. We continue.
The trail gets steeper.
Martin lags and sits down to rest, head hung low and cheeks sunken. "I am so tired." The boys begin to chant in deep melodic voices, "Babu, Babu, Babu." We help him to his feet and he continues. A bit further on Esther stops. I crunch over close to her and ask how she is doing.
"Not very well," she says. "I'm losing my balance."
"Are you dizzy?" I ask
"Yes, a bit."
Dizziness can be a symptom of acute mountain sickness. It's important to watch for these symptoms because mountain sickness progresses in stages, just like Alzheimer's, and if you don't heed the early warning signs, it may be too late. Esther is coherent and still walking steadily. She takes 125 mg of Diamox.
"Let's reassess in 20 minutes." I tell her and continue at a slower pace, although it hardly seems possible. She does not falter again.
Our line labours on connected by an invisible cord. The energy is heavy like a chain gang. I hear Cathie's words in my head. "We are all connected by a disease that equalizes us and does not discriminate."
"The sun will be up soon, we can do it." I call into the night. This is when I feel teary. I look at these people, hunched over, plodding, suffering for a common good. And then it happens. A yellowy glow rises behind us slowly lighting up the entire horizon. "Look guys, the sun is coming. Feel its energy. Draw it inside of you. We can do this." Joseph gives us the gift of his tenor voice and sings the Tanzanian version of "Hallelujah." We are so high that we can see the curvature of the Earth. People do not pick up the pace, but they do raise their heads. The snow crystals on the rocks shine. At 6:45 a.m., after more than seven hours of hiking, we top out onto the crater rim, Gillman's Point, a rocky ledge that holds a dozen people and drops off a hundred feet to the inside of the crater which is 2.5 kilometres wide, with ice 40-metres thick in places.
I hug everyone and say, "Congratulations."
When I get to Esther, she says, "I didn't do very well."
"What do you mean?"
"I was so slow."
All I can do is laugh. "OK everyone, remember this is not the top. We'll have a quick drink, put on sunglasses and sunscreen and then keep going to the top." We are at 5,719 metres and I point around the crater rim to antlike objects, people at Uhuru Peak, the summit. It is only 176 metres higher and a few kilometres but will take us over two hours. We are at extreme altitude.
The views of Mawenzi, the four jumbled glaciers of the crater, the sun illuminating a blanket of cloud below us are spiritual. We are in the heavens.
"I don't think I can take another step. I have to rest." Martin is exhausted from the walking, the lack of sleep and the altitude. But he keeps going. Later, I ask Martin and Esther how they kept going.
"You always get to a point in the mountains when you are tired and don't think you can go on, but from experience you know your body can do it."
At 9:30 a.m., the whole 2012 Ascent team stands together in front of the green sign that says, "Congratulations! You are now at Uhuru Peak." There are hugs and tears. Our moment of triumph. The similarities with Alzheimer's stop here. There is no cure for the disease. There is no moment of triumph. And we are able to go down into thicker air.
Esther and Martin sit side by side in front of the sign and perform their most important monologue in front of the video camera.
"My name is Esther Kafer and I am so happy that I made it to the top of Africa."
"My name is Martin Kafer and I am happy to have done the same as my dear wife, to whom I have been married for 59-and-a-half years and this is one of our peak experiences together." He smiles and then I help him up.
We descend and, incredibly, after 12 hours of hiking at altitude, Martin and Esther run down the scree. Martin doesn't think it is so surprising. "Our bodies, having done thousands of steps in the mountains, remember how to do it."
For the next two days, we descend on the most popular Marangu route, a well-worn road surrounded by lush palm tree-like groundsel, giant lobelia, golden grasses and heather trees. Groups pass by us going the other way, on their way up the mountain. When they ask Esther and Martin if they made it to the summit, Esther says proudly with a smile, "Yes, I did and I'm 84."
"And I did too and I am 85," beams Martin.
"Are you happy you did it?" I ask.
"Oh yes. It had a very special purpose and we met so many great people." Esther smiles.
"Yes, and engaging in a cause gives you that extra bit of satisfaction that makes it more than just climbing another mountain." Martin's blue eyes shine.
"Would you do it again?"
"No!" they say in unison.
"Esther wants to go rafting in the Northwest Territories or Alaska. So that will be our next adventure," says Martin.
Sue Oakey-Baker is a guide, teacher, painter and writer and lives with her husband and son in Whistler. Her first book "Finding Jim" will be published in September 2013 by Rocky Mountain Books.
Dementia
Dementia is the umbrella term of which Alzheimer's is the most common form. Alzheimer's disease is a progressive and always fatal disease that destroys cell-to-cell connections in the brain. In late stages, a person with Alzheimer's is no longer physically or mentally capable of caring for themselves. Although there is no cure, you can lower your risk by leading a healthy lifestyle. It is not just an old person's disease. In the past few years, the first baby boomers turned 65, which has increased the demand on our resources by about 34 per cent. And now we're seeing people under 65 getting dementia. In British Columbia, 70,000 people have Alzheimer's and 10,000 of those are under the age of 65. The median age of Whistler is rising and now one-fifth of the permanent population is between the ages of 45 and 64. If you think you have symptoms of Alzheimer's disease, see your doctor immediately. The contact for Alzheimer's BC in Whistler is [email protected], 1-866-964-8348
The Kilimanjaro Ascent For Alzheimer's fundraiser happens each September.
We have an over 90 per cent success rate of reaching the summit and all money raised goes to the Alzheimer Society of BC. If you are interested in donating or participating in this event, or the hike up the Grouse Grind that happens concurrently, please visit www.ascentbc.org or e-mail [email protected]
