Wednesday, April 29, 2009

Way to go Mamas!


Pictured in the dining tent on the mountain are Dorathea, Karen, Secunda, Agnes and Anna, the Mamas, the HIV+ women who climbed Mount Kilimanjaro and the woman who gave them the opportunity. A big thank you to Karen for her go for it nothing can stop me living life to the fullest maximizing every moment in life attitude!

To read more about the clinic and working in Tanzania, visit Karen's blog and Jenn's blog of the trip and more:

www.sunoverkili.blogspot.com

www.carpenter-chardsintanzania.blogspot.com


Dr. Karen Yeates, who founded the clinic in Moshi, is working with an American Foundation to start a dialysis program in Moshi. Currently, there are no established programs of dialysis in Tanzania. There may be a hemodialysis program starting in Dar es salaam for patients who can pay the high amount required. Otherwise, patients will try to travel to Kenya or abroad to seek care. Most cannot afford it. Karen is working in partnership with the hospital in Moshi to help start the program at the consultant hospital and will provide temporary peritoneal dialysis for women and children. This will meet the needs of women who suffer from acute kidney failure as a result of post partum hemorrhage and children who get kidney failure from diarrheal disease; both conditions patients can usually recover their kidney function in time, if they receive supportive care with temporary dialysis. Patients will need to pay for this treatment but they are working to make the program affordable and sustainable from the outset so that it is more likely to survive and be successful.

Karen is a kidney specialist who had a big interest in public health and women's issues before she went to medical school. After she finished her medical training she did Nephrology as her subspecialty (after Internal Med) and then still had a burning desire to get public health training so she went to Harvard and did an MPH (masters in public health) and spent a few years developing her academic career at Queen's University mostly in research in health disparities and access to care. She studies access to kidney transplantation for Aboriginal People as a model for how minorities access technologically advanced health services. She felt a nice connection with working in Africa as much of what goes on here is about access to care. Karen first came to Tanzania in October 2006 as a vacation/logistical trip with her husband. She and her husband had signed on with CACHA as volunteers and were planning to spend six months in Tanzania with their family and they were going to work on various HIV projects for CACHA while here. Soon she was introduced to Mama Minde and they discussed her vision of starting a shelter for those women who access legal aid through her organization KWIECO (in Karen's blog). Karen and Mama Minde rented a building while in Moshi and eventually the Women's center was born! Karen's biggest drive after that was to establish some improved free health care and women centered health education for Pamoja Tunaweza clients and other women in the region. CACHA had already done 4 health caravans around the villages in the area and so Karen utilized their ideas and focussed it on women with CACHA's full support.

The first women's only caravan was April 2008 and you can read about that in www.sunoverkili.blogspot.com A small women's clinic is now open in the center and as it grows, the women residents will likely be shifted to a new location that is less public. An outreach business/microloan support program is run from the center now too and other outreach initiatives are being established.

In terms of health care access in Tanzania, the poverty is grinding and for poor women and their children it can be impossible to get adequate care and medicine let alone education about their bodies. HIV care is now free for those who access it. Some other pediatric programs are also covered. Many still end up paying for medicine that are supposed to be free and women must make a choice to eat or buy medicine, but that is slowly changing.

Supporting programs like this directly helps the local people. Giving millions of dollars to governments in Africa can be like throwing money away (hey why not just buy them their own private plane and build them a palace). Grass roots efforts at change work and donors who support grass roots efforts can be sure their money is going straight to the people who need it.

"To the Top" - Summit Day & Night Climbing to the Roof of Africa - Days5 & 6










Sunday & Monday, January 25 & 26, 2009

Arguably these days and nights prove to be the best and most challenging days of my life. I said I'd never do it again, but I've since forgotten. Kilimanjaro anyone?

As I transcribe this from my journal I can see signs of altitude issues in my entries, some of which are not making much sense. Our porters packed up camp at 3rd Cave and we all head to Kibo Hut for what will be the longest most challenging day yet.

Sandy, Jen, Tanya and I went up last and slowly, with the exception of Mama Minde who can be seen in the photo at 3rd Cave Camp climbing up. Tanya is not feeling well, but she made it to Kibo Hut to have her photo taken before being sent down the mountain with no hesitation while Alfred our head guide shouted to her guide “Pamoja! Pamoja! Pamoja! (Stay Together!)” This shook some of us up a bit, but we were reassured she was in good hands so we continued on with our day. I felt confident at this time that if we have Acute Mountain Sickness or worse, we would be taken down and taken care of. However, this was extremely scary for Tanya.

Tanya's Story - Opiates or Alcohol:

By opiates, I am referring to religion, the opiate of the masses. I must say I felt more comfortable being guided up the mountain by the bible quoting guides than I did by the guides that smelled of alcohol and were retching on the way up to the summit. Come to think of it I did not see them at the summit. The guides who prayed were a comfort during our most fearful moments on the mountain. Tanya was comforted by her guide who held her tight and prayed with her the whole way down the mountain when she didn’t know if she would survive a scary case of cerebral edema. The way down the mountain is not straight down, there are a few up hills along the way. Each time Tanya had to go uphill she could feel the pressure increase inside her head which is when she and her guide did the most praying and went as quickly as possible. When she arrived at Horombo Hut (the 13,000 foot camp) she had to sign a book to let them know why she was going down the mountain. In the far right column of the book she was to fill in her ‘status’. Just above her status was the status of the previous climber spelled out in big red letters . . . DIED! She asked the administrator at the hut if she was going to die as well and he responded back to her with a blank stare. Fortunately her guide was a man of prayer and that was comforting to her as the pressure went up in her head at the same time as they ran as quickly as possible (to minimize her increasing symptoms) up the small hills that are part of the descent. Tanya made it down the entire mountain in 6 hours. It took our group 12 hours of rapid walking. Happily Tanya made it back home to her family (2young children) safe and sound and is recovering well from her traumatic experience on the mountain. She is grateful to be alive.

We sat to have some well-earned hot drinks after 5 hours of walking at high altitude. Many of us have achy heads and nausea. Dinner is at 4 p.m. after which we will sleep until 10:30 p.m., have some tea and biscuits and begin our ascent to the summit.

Our confidence is tested when a dead body of a Japanese climber is brought through camp in a sleeping bag. Rumor has it he was asked to turn around and go down, but he proceeded to the summit and died on the descent while coughing up blood (sounds like pulmonary edema). The porters and guides usually wear big smiles, but they are looking somber and some of them are holding hands.

At this time I wish I’d taken my massage therapist up on her offer of bringing some sage to burn. It could be a comfort to cleanse the mountain of death and fear before we go up. Prayers were being said by the Mamas in their tents who decided to err on the side of caution and not attempt the summit and the porters were also praying.

I said my nightly prayer of gratitude once again, for all of us and tried to remember the serenity prayer in my fuzzy brain state:

God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
Living one day at a time;
Enjoying one moment at a time;
Accepting hardships as the pathway to peace;
Taking, as He did, this sinful world
as it is, not as I would have it;
Trusting that He will make all things right
if I surrender to His Will;
That I may be reasonably happy in this life
and supremely happy with Him
Forever in the next.
Amen.
--Reinhold Niebuhr


After tea it began to lightly snow. The Gods of weather were with us the whole way up the mountain and continued to be as the snow creasted a light dust of white that made the climb that much more majestic as it sparkled by the light of our headlamps. Jill and I decided to get up at 10:30 p.m. for tea prepared to summit. Jill has some mild symptoms of altitude sickness (tinnitus) and was taking benadryl for an allergic reaction to what we think is something she is eating. She made a wise decision to err on the side of caution and chose to turn around and go back to camp. Rich, one of the porters who was given an opportunity to work as an assistant guide for the night, took her back to our tent. I continued on with no symptoms of altitude sickness, just fear of death, but I planted my poles firmly into the ground and told myself it was not much different than being at the top of Whistler and put one foot in front of the other. It was pitch black with plenty of stars in the sky, but no moon to light the way, only our headlamps.

Jen is Karen's right hand person and she had been bringing up the rear making sure Tanya was taken down safely and now she did the same thing for Gary as he turned around and went back to his tent. She had a feeling she needed to check on him and sure enough he was experiencing AMS and was taken down to Horombo Hut at 13,000 feet in the night to improve his condition.

We walked slowly up steep rocky switchbacks throughout the night. As I was bringing up the rear with a few other women I found Zoe sitting by herself on a rock crying by the edge of the trail. She reassured me she was feeling well, but needed water and didn’t know where her pack was and she has become separated from her guide and Kashini. A guide, who was helping me out and smelled of alcohol and was retching on the way up wanted to continue upwards, but I asked him to wait while we found Kashini, Zoe’s pack and another guide to bring up the rear. While we waited we found Melissa and Hillary. I put the retching alcohol smelling guide in front, us girls in between and another guide behind us and we tried to stick together. “Pamoja! Pamoja! Pamoja! We need to stick together” I told the guides. At this point I had run out of water since I was sharing my water supply with the guides who had no water. Kash & Melissa were both too nauseous to drink anything, so I gratefully took their water bottles and continued to share with the guides. I felt it was the only thing keeping me for developing altitude sickness and it was keeping a headache at bay.

Zoe only told me later that she was hallucinating – she was seeing hands by the side of the trail and poking her poles in them only to find they were not real. I think I would have sent her down if she told me that on the mountain. She seemed to have her wits about her though as she asked when the sun would be coming up. I checked my watch at that time and it was about 5:30 a.m. The sun began to rise in the distance and the sky was starting to brighten. Shortly after we were at Gilman’s Point on the crater ridge. From there we could see inside the crater and the ridge all around it. We were up above the clouds standing on the roof of Africa. It was unbelievably challenging to get to this point and Penina and Steve, who were there, chose to go down. Hillary and I were also talking about going down from here when along came Alfred, our head guide, with his usual chattering at a rapid clip telling us to get going up to the summit quickly quickly. No more time for pictures, time to get going. He reassured us it was not far, but once we got on the trail and saw the light in the distance and met others returning back from the summit we realized it was yet another 2 hours of slow gradual uphill walking. Two more hours seemed almost impossible, but Alfred kept us going with his seemingly endless amount of energy (did he have an oxygen tank in his pocket?). Nothing was alive except the humans on the crater rim and it was -22 C. It was colder with the wind and oxygen levels were 40% of normal. We could all feel it. Kash was stoically pushing forward and not looking back , focused only on making it to the summit no matter what.

At the summit we fumbled around for our cameras and Rich appeared with a Canadian flag for photos. I am amazed he got back up after taking Jill down. He had no gloves with him so I gave him my fleece gloves that I was wearing inside my down mittens. I was grateful for Alfred’s presence to help everyone get down. I made my way with Rich along the crater rim to Gilman’s point and was completely astonished at the number of steep switchbacks ahead of us that we had only come up a few hours before in the dark. I asked if there was a faster way down, but no, we had to go slowly through the switchbacks. Later, we came to some scree and I happily sat back on my heels, leaned into the mountain and slid down the scree. I came down from the summit in 1.5 hours and it took 8 hours to go up!

Rich offered to give me back my fleece gloves, but I told him to keep them and was inspired at that point to give all of my gear away since the porters seemed poorly outfitted for the climb, some of them wearing sweatshirts for warmth and flip flops on their feet. Luckily I waited ‘til we got to the bottom of the mountain since it was cold and wet on our way down. Once we got down I gave all my gear to Abbas to give to the porter’s association. I also gave Rich my water bottle (since he didn’t have one) with $20.00 US stuffed in the lid. I also stuffed a $20.00 bill in the porter’s pocket who carried my back pack + another 20 kg. on his head up the mountain in flip flops. I also gave my poles to a guide when he put his hands on them and asked for them and gave another porter a deck of cards with $20.00 stuffed into them. When we got down to the base of the mountain we went to a hotel with the guides and porters to celebrate. The porters stayed on one side of the room while we were on the other and we were discouraged from interacting with them. We could all sense the desperation in the room while Karen carefully counted out $6000.00 worth of tips for the porters and handed all the money out individually with a thank you and a hug to ensure that they all received their fare share. It seems few are above corruption and this is the only way to ensure fair pay.

When we arrived at the back at Kibo Hut after the summit, I decided I would never do anything like that again. It was extremely grueling and I’d rather give birth to 3 children in a row than do that again, however, I have since forgotten and I’d be game for another climb!

14 of us did not make it to the summit for a variety of reasons, but 19 of us did. They say fully 60% of people who attempt Kili do not summit so our stats beat the average.

Mama Minde made it to Kibo Hut. Her guide brought her down to Horombo Hut at 13,000 feet, but the rest of the trail is so bumpy that a group of porters decided to carry her down in a stretcher the rest of the way.

The first person to summit was Nini, our 62 year old retired nurse volunteer from Ottawa! She is pictured with Kash and Zoe on our descent with Kili in the background.

All of the HIV+ women made it to Kibo Hut which is a grueling climb in and of itself – congratulations to them all. They are role models for all of the women in Tanzania, particularly those who find themselves testing positive for HIV. This shows that an HIV positive test is not a death sentence, but it can even open doors to new opportunities. I don’t think any of the women ever dreamed they would be climbing Kilimanjaro and have their stories told on film.

In total 130 of us were on the mountain for 7 days.

Climbing to the Roof of Africa - Day 4



Saturday, January 24th, 2009, Acclimatization Day

We are a large group of about 90 people which is one of the reasons Dr. Karen Yeates has chosen the Rongai Route for us. The other routes are busier, but on this route we only see three other small climbing parties and there is enough space for us to set up camp for all of us and all of the porters. It seems appropriate that we are taking the road less travelled since how many groups bring four HIV+ women from Tanzania with them on the mountain. Abbas is the overseer of our whole trip. Karen has hired him to coordinate our travels. He is one of the most calm, compassionate peaceful men I have ever met. The night I taught yoga he began to demonstrate his mastery of yoga, easily pressing up into a handstand and more. Alfred was our head guide who kept us organized and on ‘German time’ as he called it. I tell Abbas he has the patience of an elephant. It is not easy keeping 30 women organized and heading in one direction at the same time on a mountain.

Seeing the dry riverbeds as we climbed today is more than a little disturbing. One can’t help but think this used to be drinking water for people at the base of the mountain. If you have ever seen a wide fast flowing glacier fed river as I have seen in British Columbia and Alberta, picture those river beds dry. It is a sad sight. Climate change has caused most of the glaciers on Kilimanjaro to melt and the permanent snow cover on the mountain is only at the very top now. I can’t help but wonder if there will be enough drinking water for the people that live around the mountain in the years to come. Water is sustenance and that is very apparent to us as we are told to drink at least 2 liters of water a day on the mountain. It is very dry up here and water helps us to acclimatize and keep altitude sickness at bay. Once nausea sets in (a symptom of mild altitude sickness) it is difficult to stay hydrated and the spiral of altitude sickness easily continues.

The center of one of the round-a-bouts that leads into the town of Moshi has several water fountains where people in Moshi and the surrounding towns can fill containers of water. In the center of the fountains is a statue presiding over the water, protecting the supply. It is a stature of a soldier with a rifle and in large letters underneath him is written "WATER FOR LIFE".

As I climb I hear Jacob Dylan’s words singing in my head . . ‘Got my window open wide . . . cause I know something good this way comes.”

We are all experiencing varying degrees of altitude sickness, mostly mild and some worse than others. Many of us are taking Diamox to help us acclimatize to the altitude and it leaves are fingers and toes vibrating from the inside out.
Training on the stadium steps has really paid off for Jill and I as our legs feel strong and I like to think the ‘breath holding’ Sandy and I were practicing prior to the trip may also be paying off.

Today we climbed to the Outward Bound hut which is the equivalent elevation of Kibo Hut. It stresses our bodies to produce more red blood cells before our actual climb to the summit tomorrow. Kibo Hut is the camp from which we will attempt the summit on Day 5 if we are not experiencing signs of altitude sickness. When Mama Minde was in her 20’s she climbed to the Outward Bound hut with a group of classmates during a 3 week long Outward Bound course. She really doesn’t remember much of it except that it was a lot of fun. She seems to be doing well – her strong spirit will get her to Kibo Hut tomorrow.

We set out on a 6 hour journey up to the Outward Bound hut which was set up by people in Munich, Germany. School groups are led up to the hut to build strength, endurance, confidence and teamwork and to test their limits. Mama Minde walked up for 1.5 hours today to help with acclimatization.

Dorothea and Secunda made it all the way to the hut and back down before many of us. Agnes and Anna did not make it all the way to the hut, but they are feeling strong and are happy to attempt Kibo Hut tomorrow.

Each of us has issues that we need to deal with and set aside for the summit tomorrow, some are real physical signs of altitude sickness and much of it is fear of what might be. Most of us are feeling strong and feel that we can do it together since we have so much support - Pamoja!

Climbing to the Roof of Africa - Day 3



Friday, January 23, 2009

This is the first day we climb above the tree line and we will really begin to feel the altitude and the lack of oxygen that comes with it.

I began the climb at the back of the pack of 30 of us, walking with the mamas, the last group to leave camp with the exception of the porters. We quickly caught up to Mama Minde whose legs and back were aching. She missed yoga yesterday, arriving at camp after dusk again after walking for 11 hours, so Melissa and I stopped on the mountain to give her legs and back a massage with Sandy’s homeopathic cream for aches and pains. Pole pole (slow) walking gets us to the top and she is practicing that. Her spirit will get her to the top.This whole climb is reminding me of the story of the tortoise and the hare – slow and steady wins the race. We were climbing with Abbas and whenever we experienced shortness of breath he suggested we stop and catch our breath, returning our breathing to normal before continuing to ascend.
We continued on past Mama Minde and attempted some meditative silent walking, but we are a chatty group of women and we could not go for any more than 10 minutes without talking. The meditative walking will come at higher altitudes when, with less oxygen, talking while walking will become impossible.

There has been a lot going on since the first day we arrived in Moshi – each day and night being different and not knowing what is going on which can be a challenge for those of us that lead very predictable lives. I am finding the predictable routine on the mountain and being cared for by the men (our guides and porters) very comforting.

All the Tanzanians have a strong sense of where they are from, they can tell you which village and tribe they are from and the name of their chief. A porter asked me one day how many tribes we have in Canada – two I suppose french and English!

This morning Agnes Mtambo, who is Chagga, from Kenya, tripped on her bootlace and broke her wrist. It could have been much worse. But, her inner strength which is attributed to her Chagga heritage has her persevering through the discomfort and inconvenience and continuing to attempt to push to the summit. The equipment and clothing seem elaborate and complicated for all of us to deal with, but I can only begin to imagine what it much be like if you have lived in a warm climate all your life and never really had to wear shoes or a jacket. Fortunately for Agnes she is surrounded by no less than 7 female doctors all of whom have checked out her wrist and decided it is mostly like broken. It is nicely wrapped and her guides can assist her with packing and climbing while she rests the wrist and takes some mild pain killers. Agnes has faced bigger challenges in her life than a broken wrist on Mount Kilimanjaro.

Originally the climb up Rongai was to be female only and we would meet the men at the top, but who are we kidding, in Africa mountain guiding is men’s work and we are surrounded my men, so we have embraced the two men from Canada, Jason and Gary, who have been working with us at the clinic and they are climbing with us up the Rongai Route.
Most of us have decided to take Diamox for prevention of altitude sickness. It makes our fingers and toes tingle. Tanya is also experiencing tingling and numbness of her lips and over the next couple of days it spreads to the rest of her face. We did not realize at the time that she was experiencing early symptoms of cerebral edema.

Our bodies are already working to make more red blood cells to provide much needed oxygen to our tissues as we climb.

Dorothea, Penina and Secunda are pictured on the mountain with the Kibo peak in the background.

Agnes, Dorothea, Anna and Secunda are all HIV+ and doing will on ARVs. Secunda has a 12 year old son who is HIV + and nearing the end of his life, he may only live for another year. Secunda was diagnosed with HIV when she gave birth to him. The women are from a village in Moshi called Rau and they are having fun speaking their native tongue with Alfred.

Secunda is an HIV counsellor at Pamoja Tunaweza. She has been through the HIV counselling training program and counsels all the patients that come in for an HIV test before and after. Precounselling involves telling people that if they are negative they need to come back for another test in 3 months since the test measures antibodies and it takes time for the antibodies to appear after exposure so the initial test can be negative with a positive three months later. If the patients are HIV positive they go to CTC for more testing and to the Mawenzi Government Hospital for ARV meds. Patients line up for three or four hours to receive their medicine. The HIV+ women are doing well, but they are anxious. Most of us have never been on a mountain before, let alone a mountain at high altitude. My own experience on the mountain helps me keep me calm as I experience the sensations of breathing less oxygen. I use my climbing poles to press into the mountain and imagine I’m climbing or skiing on a mountain in B.C.

As I write this is it is 1 p.m. and the porters are putting our delicious lunch together. We can hear the busy shouting of their voices.

We are at 3rd cave tonight. We are at 3800 meters (12,000 feet). We have about 7000 feet or 2000 meters to climb to get to the top. We will sleep at this camp for two nights and spend tomorrow climbing up to about 5000 meters and back down to camp to stress our bodies and tell our bodies to make more red blood cells. This is our acclimatization camp.

Again I taught another yoga class. Many people are feeling anxious as our bodies produce hormones that help with the altitude and make us anxious. I once again taught a very spiritual class that helped us ground into the power of the mountain, take our fear away and open our chests and shoulders to open the door of our hearts to let the spirit that is all around us on the mountain fill us. We also practiced the universal breath connection. “As you breathe in imagine the universe is exhaling and as you breathe out imagine the universe is inhaling and share in that which connects us, our breathe, our life force, our universal energetic connection”.
We also ended the class with a rule from Karen’s book of RULES FOR LIFE that was very applicable to the challenges ahead of us and a blessing for us all: "Thank you God for this incredible opportunity to climb this mountain. May joy, love, peace and compassion be part of the lives of all of us, all of Tanzania and all of Africa. May we all be healing and may be all be healed."

Mama Minde made it into camp around 3 p.m. today and the porters sang beautiful a Capella to welcome her. We got a few welcome drops of rain this afternoon (it is so dry), but the sun is shining again as it does each day.

There are many strong women on the mountain, Hillary Tenenhouse, is one of them, she has had a rough few years in her life with sickness and now she is healthy and she celebrated her birthday today on the mountain, very much alive and well and enjoying the moment.

Climbing to the Roof of Africa - Day 2





Today is Thursday, January 22, 2009.

We walked four hours to camp today at second cave on Kilimanjaro 'journey' in Swahili. It was a slow (pole pole), steady uphill climb. When we see our porters we say “pole Kaka” which means SORRY brother, or I feel for you brother, or we are one and they respond with asante sana (thank you very much). Their language is teaching me to be more compassionate!

The weather today is incredible. It is sunny and warm and our clothes are drying after yesterday's rain.
Breakfast is amazing. Fresh fruit, eggs and toast. We have warm soup at midday and evening meal and today it was served with fresh cilantro. We enjoyed fresh vegetables, chicken, potatoes rice and beans, all cooked over a small camp stove in a tent.

Ironically many of the women that come to the clinic are suffering from violence at the hands of men, but here in the mountain all of us (including the HIV+ women who have suffered from gender inequality) are being cared for by men who are carrying our equipment up the mountain, setting up camp each day and cooking warm nutritious meals for us each day – more dichotomies in Africa. When I asked Samson how he feels about the HIV+ women climbing the mountain he thinks it is a good thing for women to climb. HIV+ men have climbed and it is time for women to do the same. Women need more equality in Tanzania and this is a step in the right direction.

Mama Minde is climbing with us. She has her own personal porter because she is going pole pole (more slowly than the rest of us). Kashini (a strong fit 18 year old girl who dreams of being in the Olympics one day representing Canada in the javelin throw event) could climb the mountain quickly, but she spent the first two days climbing with Mama Minde and enjoying her company. She said Mama Minde reminds her of her grandmother. She encouraged Mama Minde to take more steps (up to 40) before stopping for a break so they could get to camp before dark, but Mama Minde still came into camp after dusk each day after 12 hours of slow uphill walking. She was aclimatizing better than the rest of us at that pace. We hope that one day Kash can say she climbed Kilimanjaro with the Prime Minister of Tanzania, Elizabeth Minde.

As we climb we can see pinnalces and snow on Mawenzi, the second peak on Kilimanjaro, it reminds me of Black Tusk in Garibaldi Provincial Park in B.C., except Mawenzi cannot be climbed because the rock it too loose. The main peak of Kili, taht we will summit is called Kibo. The top is called Uhuru, which means 'freedom' in Swahili. We are climbing for the freedom of all women in Tanzania. The photo is of Kashini and Agnes Mtambo, one of the HIV+ women climbing as a representative of all women whose lives have been touched by HIV.

I am also reminded of the mountain meadows in B.C. coastal mountains as we climb through mountain meadows today.

I taught yoga on the mountain today. That’s the first time I have taught a class at altitude. It was not a real physical class, but more of a spiritual class with all of us grounding into the mountain to absorb the power and energy of the mountain to give us strength and confidence to climb and we reached up and opened our hearts to bring the energy of one of the most spiritual places on earth into our hearts.