By
Lynn Martel
On
her first night at the Everest Base Camp Medical Clinic, where she had
volunteered to treat patients for the two-month spring climbing season, Dr. Ola
Dunin-Bell discovered her tent sat next to a major yak route.
Very
quickly she realized how challenging life at the clinic — consisting of a small
two-man tent as her private sleeping quarters, a large tube-shaped tent housing
the clinic and a kitchen/dining building with stacked rock walls and a blue
tarp roof — would be.
Though
most of April and May, Dr. Dunin-Bell, a part-time Whistler resident since the
mid 1990s, who, when not enjoying the Coast Mountains, lives half the year in
Oakville, Ontario, was the first Canadian physician to work at the clinic.
The
experience, she said, presented an avalanche of challenges.
During
their stay, Dr. Dunin-Bell and her colleague, Dr. Suzanne Boyle, an
anaesthesiologist from Edinburgh, Scotland, moved their sleeping tents four
times, while the kitchen walls repeatedly collapsed.
“We
were right on the glacier, the mixed ice and rock flowing stream of the Khumbu
Icefall,” Dr. Dunin-Bell said. “At night, we heard avalanches or rockfall every
hour. I learned to sleep through it. The ground underneath really crackles and
pops, everything is constantly shifting and expanding. In the daytime, if I heard
the start of an avalanche, I stopped sticking my head out to look.”
The
latrine consisted of blue barrels lined with plastic bags for solid waste only,
since the charge for barrel removal is based on weight.
Asthmatic,
Dr. Dunin-Bell returned to Canada with bronchitis and pneumonia.
“We
were constantly dealing with weather and discomfort,” she said. “The month of
April was, in a word, cold. We lived in down jackets practically the whole
time. It was so much physically tougher than I would have thought.”
No
newcomer to challenges, in 2003, after two decades as a general surgeon at
Mississauga’s Credit Valley Hospital, Dr. Dunin-Bell left to teach at McMaster
University and to work with Canadian Global Air Ambulance, flying international
air evacuations of critically ill.
A
Wilderness Medicine Society member, she knew about clinics operated by the
non-profit Himalayan Rescue Association in Pheriche, which opened in 1973, and
Manang, launched in 1981.
One
day’s walk south of Everest Base Camp, Pheriche is the last substantial village
before heading up the 11-kilometre long Khumbu Valley.
The
village of Manang, situated west of Everest in the Annapurna-Dhaulagiri Region
of Nepal, sits on the northern edge of the popular 300-kilometre Annapurna
Circuit trek, which circles a collection of mountains anchored by Annapurna 1.
The
HRA opened its third clinic, at Everest base camp, in 2003, on the 50th
anniversary of the first ascent of Everest. It is intended to serve trekkers,
climbers and locals. Fees collected from treating Westerners finance care for
Nepali and Sherpa patients.
In
2004, Dr. Dunin-Bell volunteered at the Manang clinic for over three months,
living at 3,500 metres and treating trekkers for HACE (High Altitude Cerebral
Oedema), HAPE (High Altitude Pulmonary Oedema), Acute Mountain Sickness and
numerous blisters and foot problems.
This
spring, two days after arriving in Kathmandu, Dr. Dunin-Bell began the trek to
Everest. The journey took 11 days, one more than usual because the British
Caudwell Everest Xtreme research team had hired every yak in Pheriche to ferry
their mountain of equipment, forcing the HRA clinic staff to wait to have their
own gear transported to base camp. Everest Extreme was studying over 200
climbers and trekkers for physical reactions to altitude, and ultimately aimed
to conduct blood oxygen measurements on Everest’s 8,848-metre summit.
With
about 250 climbing permits issued for Everest’s south side (plus more on the
north), base camp this spring swelled to 1,000 people, including Sherpas,
cooks, support staff, climbers and trekkers. Over the following six weeks, the
clinic treated more than 200 Nepali and Western patients for altitude related
illnesses, including frostbite, HACE, Khumbu cough, and snow blindness.
Relying
on basic equipment, the clinic was furnished with two lawn chairs with foam
mattresses, and a desk built of rocks. Their camp also accommodated a Sherpa
translator/helper, cooks, five climbers, a psychology research student,
visiting trekkers and four BBC film crewmembers.
While
the large commercial expeditions often get a bad rap, Dr. Dunin-Bell said, they
were very well organized and managed their waste well.
“There’s
a lot of negative things said about the big commercial teams, but one thing
they have is a plan,” Dr. Dunin-Bell said. “They have a back up plan, and a
back up plan for their back up plan. They know what they’re doing.”
Some
smaller, poorly organized teams were another story. One team from Nepal’s
lowlands trekked to Base Camp in five days. Determined to make a political
statement, the poorly prepared group included a woman, Usha Bista, who made
international headlines after western climbers saved her life. The day before
she started climbing, Dr. Boyle treated her for dehydration, nausea and
diarrhoea.
“She
was too sick to climb,” Dr. Dunin-Bell said. “But she did not return for her
follow up.”
A
BBC member reported seeing her vomit as she left camp.
While
descending from her own successful summit, Canadian Meagan McGrath discovered
Bista alone and barely conscious at 8,300 metres. Bista’s oxygen had run out,
so McGrath shared hers.
Veteran
American Everest guide Dave Hahn, also descending from the summit, executed an
11-hour rescue with two fellow guides. The rescuers packaged Bista in a
sleeping bag strapped to a sled, and lowered her down steep, difficult terrain
until they reached Camp III, where one of the Everest Xtreme doctors provided
advanced care, including an I.V.
The
following day, several Westerners helped Bista down the mountain from Camp III
to Camp II, where she remained for two nights under the care of another Everest
Xtreme physician. Unable to unclip from the fixed ropes due to her frostbitten
hands, and with help from her own teammates not forthcoming, Western climbers
helped her down to base camp.
“I
have nothing but admiration for Dave Hahn,” Dr. Dunin-Bell said. “Somebody like
(Bista) puts everybody else on the mountain at risk. I really did not expect
people to be so laissez faire and casual that they expected others to pick up
after them. I think with so many tents, so many Westerners, it’s easy to forget
the fact Everest is extremely dangerous. They think they can just snap their
fingers and get rescued.”
At
base camp, the doctors dressed Bista’s frostbite and administered medications.
Everest Xtreme had arranged for a helicopter to evacuate one of their doctors
the next morning, and offered to transport Bista as well — very tricky
business.
“You
need a clear, cold morning to get enough lift,” Dr, Dunin-Bell explained. “The
helicopter drops down the valley before it can gain enough lift to properly
fly. That can’t be taken casually. When you hit 5,400 metres, the air is so
much thinner it changes everything.”
A
recreational climber with experience in the Coast Mountains and the Canadian
Rockies, Dr. Dunin-Bell said the array of people aiming to climb Everest amazed
her, including some who had never worn crampons and couldn’t tie a basic figure
eight knot.
“There’s
such a variety of reasons people had,” she said. “One woman said she needed it
to pump up her resume as a motivational speaker. Another had dreamed of it
since he was a teenager. He was willing to do whatever it took.”
That
climber reached the summit in the dark at 3 a.m.
“But
for him it was wonderful,” Dr. Dunin-Bell said. “It seemed those who had
climbed before had respect for the mountain itself. Those who were just
checking off a tick list had not as much soul in their reason for doing it.”
Capitalizing
on a nine-day window of virtually windless weather, 514 climbers had summitted
Everest by May 28 during the spring 2007 climbing season.
Dr.
Dunin-Bell, however, stated no such interest.
“I
have no desire to ever summit Everest, particularly after seeing the masses of
people going up,” she said.
“But
I met the challenge of living there for two months, and the boredom that can
ensue if you are not climbing. I learned about physical and physiologic
responses at that altitude and enjoyed making a difference in the health of the
climbers.
“I met some amazing people. And I think I have a better perspective on commercial climbing — Everest really is the ultimate. But from what I’ve seen, it takes three things to climb Everest: a body that is tolerant of altitude, sufficient motivation to put up with discomfort and trudging, and luck.”