THE ANSWER BOOK - Tanzania & Uganda Sep 2019

Air Tanzania - Kilimanjaro Airport to Entebbe, Uganda

Operated by Bombardier Q400
Maximum baggage allowance of 23kgs (50lbs) per person and 7kgs hand luggage.

Additional Extra Bags
Tanzanian Shillings 60,000 (Approx US$26.00/CAD$35.00) per bag weighing up to
23KG. This fee must be pre-paid to Air Tanzania city office, 3 business days prior to
departure date and obtain an official receipt.

Aerolink - Entebbe to Kisoro (Bwindi)

Operated by 10-seater Cessna Grand Caravan
Maximum baggage allowance is 15kgs (33lbs) per person in soft backpacks or duffle
bags. These allowances shall include all hand baggage. Due to limited capacity in the
smaller aircraft, we urge you to limit your luggage for the 3 day stay in Bwindi to no
more than 15 KG's

Kilimanjaro Duffle Bag & Your Day pack

There are two types of bags that you need to have on your Kilimanjaro trek –
a Kilimanjaro duffle bag and a daypack.

The type of Kilimanjaro duffle bag you choose is important as it will hold all of your gear,
including your sleeping bag.

Your Kilimanjaro duffle bag will be carried by your porter who will transport your gear
from one camp to the next every day. Porters carry bags on their head so it is important
that the bag is soft and weighs no more than 15kg when fully loaded (33lb)

Key characteristics in a duffle bag:

• Greater than 80L capacity
• Constructed from waterproof laminate material to ensure your gear stays dry. We

recommend packing your gear into separate plastic bags or packing units to
provide extra waterproofing and easy access to sorted gear
• A strong zipper system that is not susceptible to breaking and can be easily
locked. Take a small lock to secure your bag
• A hand and shoulder strapping system to provide extra versatility

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Your Kilimanjaro Daypack

In addition to your duffle bag (which is carried by your porter) you will be carrying your
own daypack.

Normally you will not see your duffle bag from the moment you hand it to the porter in
the morning to at least lunchtime, and maybe not until the end of the day. It’s therefore
necessary to pack everything that you may need during the day in your daypack that
you carry with you. Some suggestions, in no particular order:

• sun cream You will need an SPF 50 or higher preferably one that
contains zinc oxide or titanium dioxide. Reapply often and make sure it
goes on all unprotected places. You would be surprised how many
trekkers get sunburnt ears, nostrils and under chins.)

• sunglasses
• snacks
• water
• rain jacket/poncho and rain pant
• personal money, passport etc.
• camera, phone. Medications, if any
• Memory cards, spare batteries
• Water purifiers
• Sun hat
• Toilet paper or wet wipes
• Knee supports
• Chapstick
• Personal first aid kit
• Watch
• Picnic Lunch (if supplied by the crew)
• Remember, your daypack should be able to carry at least 2-3 litres of

water bottles or 2-3L hydration tank.

Key characteristics in a good daypack:

• Ideal size would be 25-32L capacity
• Compression straps to reduce weight stress on your back
• Side mesh pockets for easy access to your water bottle and other useful

stuff
• Ensure your backpack has a rain cover

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Packing for Your Safari

When packing for safari, consider the following:

• Our return trip to city includes a light aircraft journey, which can only carry
maximum of 20KG (33lbs) per person. You might want to rethink which suitcase
to bring on the safari. Consider packing light or bringing a smaller soft bag or
duffel that you’ll pack the essentials needed on that leg

• Essential Clothing & Personal items - you must pack your must have clothing
and personal items to last for 7 days

• Avoid bright colours - Neutral colours will allow you to blend in better with the
surroundings and remain inconspicuous. Bright colours and even white-coloured
clothing will make you stick out like a sore thumb. Plus, neutral colours will be
easier to wash, and less likely to show stains when travelling.

• Pack many layers - Though the game parks generally maintains consistent
temperatures year-round, those temperatures do change depending on the time
of day. Consider packing light layers for early Fall that you can easily peel off and
put back on when the temperature changes.

• T-shirts or tops - Light, breathable pieces (preferably with long sleeves) will go
a long way to keep you comfortable, especially around midday when it’s warmer,
and still provide enough protection from the sun.

• A jacket - You certainly do not require anything too thick, but a jacket to keep
you warm in the early mornings and after sundown is absolutely necessary.

• Two pairs of safari pants Comfortable safari pants that zip off at the knee give
you the flexibility of removing or adding coverage, depending on the
temperatures. Take an extra pair just in case the first pair gets soiled. If safari
cargo pants aren’t your thing, your regular trousers and shorts are welcome so
long as they’re comfortable and breathable.

• A pair of camp shoes or boots Your sneakers or sandals may not work,
You’re going to need proper outdoor camping shoes, a pair that gives you the
proper support while walking inside the safari lodges and tented camps, and
getting on and off your safari jeep.

• A few pairs of socks - Remember, a good pair of socks is just as essential as a
reliable pair of shoes. Take socks that won’t overheat your feet or restrict your
circulation.

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• A hat - No need to get fancy. A hat that properly covers your face and possibly
the back of your neck will keep away the sunburn.

• A swimsuit – We stay at a couple of nice safari lodges with a pool, you’ll
definitely want to do a couple of laps or take a lovely dip after a long day viewing
game in the bush

Safe Keeping Your Extra Luggage

Prior to the Kilimanjaro Climb
Your safari luggage will be safely stored at the Rivertrees Country Inn until your return
to the lodge from the climb.
Prior to the Migration Safari
Your climb luggage and any excess luggage will be safely stored at the Wanderlust
Adventures office in Arusha and these will be waiting for you at the Pink Flamingo
Boutique hotel in Moshi on your last day in Tanzania.
Prior to the Gorilla Tracking in Bwindi
Since Aerolink flights from Entebbe to Kisoro only allows us to carry a maximum of
15KG in total, we will be leaving all other luggage at the Karibu Entebbe Hotel for pick
up on the final day in Entebbe.
**********

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Section G

Your Safety & Emergency Protocol

Who’s Responsible for Your Safety on Mount Kilimanjaro? You Are. After all, being at
extremely high altitude has its risks. And leading people up the mountain, some of
whom have little to no experience in the outdoors, means the outfitter is required to look
after their clients.

We at Wanderlust Adventures put our client’s safety first. More than anything, we want
everyone to come home in good health. You might even say we go overboard with
safety. Therefore, the precautions we take are very, very robust.

Every climb is staffed with a team of professional guides. Some of your guides on your
trek have climbed Kili more than 300 times, so our guides have the extensive
experience in the field. They have seen everything and know how to prevent, detect,
and treat altitude related illnesses. And because there is approximately one guide to
every three clients on our trips, we have enough " eyeballs on the climbers" at all times
to observe and evaluate everyone throughout the trek.

What are the guides looking at? Many things.

• Are you finishing meals or hardly eating?
• Are you asking for water refills or barely drinking?
• Are you strong on the trail or laboring through?
• Are you stable on your feet or losing balance?
• Are you breathing normally or out of breath?
• Is your personality the same or has your behavior changed?

Additionally, twice daily, our guides conduct health checks. Using a pulse oximeter, they
measure oxygen saturation and pulse rate. Also, they administer a questionnaire to
evaluate whether someone has symptoms of altitude sickness and their severity. Taken
as a whole, our guides can make a reasonable determination on whether someone
should or should not continue climbing.

Our team is well prepared for emergencies. We have established rescue protocols
in place.

• Our guides are certified Wilderness First Responders. They have the knowledge and
training to handle emergencies.

• Our staff carries emergency oxygen on all climbs and can administer oxygen to treat
AMS.

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• Our staff has access to portable stretchers to evacuate climbers who need to
descend but are unable to walk on their own.

• Our staff can initiate helicopter evacuation at short notice.

• But for all the things we do to protect climbers, they should all be considered
secondary.

The primary person who is responsible for your safety is you.

AMS usually starts with mild symptoms which become progressively worse if one is not
acclimatizing well. External symptoms and pulse oximeter readings may reveal some
extent of altitude illness. But no one knows how you feel better than you do. You might
feel good while still having some low oxygen readings. Or you might feel terrible while
having high oxygen readings. In either case, trust your body over a number on a
device. It’s the more accurate indicator.

It is very important that climbers be very completely honest with the guides about their
symptoms. It is a big mistake to hide or downplay symptoms of altitude sickness due to
fear or being told to descend. It is only with accurate feedback can guides take actions
to treat your sickness. We should mention here that AMS can cause confusion and
impair decision making. Some people may think they are good to go while other things
suggest more serious altitude sickness. Keep the lines of communication open at all
times.

With conflicting data and a willing participant, the guide’s judgement comes into play.
Usually they will give it more time in order to gather more information as long as there is
no medical urgency. We don’t want to cut a person’s trip off prematurely, nor do we
want to allow someone to unintentionally put their life in jeopardy. It’s a balancing act.
The guides understand that everyone wants to summit and will do their best to allow
everyone the opportunity – as long as the team can operate with a reasonable degree
of safety.

Having others along, whether members of the climbing party or friends from back home,
is generally beneficial. They can more quickly notice when something is different about
you as they are more familiar with your personality. For instance, if one is normally a
loud, jovial person but becomes quiet and reclusive, that is a sign that someone may be
feeling ill. Similarly, though more rare, someone who is normally an introvert then
suddenly is the life of the party may also be experiencing the effects of altitude (oxygen
deprivation induced euphoria). Having friends along helps to identify altitude sickness
and can help someone make the hard decision to turn around.

People get in trouble on the mountain when they think they can tough out
AMS. But that’s not how it works. AMS is a biological response to oxygen deprivation. If
the body does not adapt to the environment, then the only other solution is to adapt the
environment to the body (ie., descend). Our guides and the Trip Director will collectively
make the call when they feel it is absolutely necessary, but the climbers themselves can
and should make the call too. It is more than OK to tell your leader you do not feel right
and want to descend. It’s being a smart and responsible person.

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Section H

Adventure Travel Insurance

Get the Right Trip Cancellation & Emergency
Coverage. Protect Yourself & Your Investment!

As an adventure traveler, you know that being
prepared is everything. But while you might have the
best local outfitters, guides and trip leaders, the
newest equipment and be in the best shape of your
life, none of that may matter if you have an accident,
a severe form of altitude related sickness, a gastrointestinal emergency in a developing
country, an earthquake or a random rock rolls into your high mountain camp at
midnight. You know these unforeseen events are not always welcome surprises. Some
can sneak up before you ever set foot on the plane.

That’s why you need backup. For many of those who travel to explore remote locations,
climb mountains and engage in any outdoor
adventures that’s a tightrope walk with danger,
it’s about having emergency medical
evacuation coverage. Unfortunately, most
mainstream travel insurance providers,
including credit cards and group benefits plans,
do not cover high altitude trekking and
adventure activities like mountain climbing.

Kilimanjaro is a high-altitude trek and a serious undertaking. Considering the nature,
remote locations and the local conditions encountered, it is highly recommended for all
participants to have adequate coverage specifically
designed for high altitude evacuations which would
cover urgent medical emergencies, hospital of your
choice, air ambulance services and repatriation to your
home country.

Wanderlust Adventures Preferred Providers
(Ask Wanderlust to get you a free quote)

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Section I

Frequently Asked Questions

• How about the meals we consume on Kilimanjaro?
• Why do we need to drink a lot of water?
• What are the details discussed during the pre-trek briefing?
• What is the training hike at Arusha National Park like?
• What is quality of drinking water available to avoid altitude sickness?
• How does the emergency rescue work on Kilimanjaro?
• What is it like to be sleeping at the Crater Camp in the 5700m altitude?
• Do we get a summit certificate on successfully reaching the Uhuru Peak?
• Why Malaria is a much talked about topic in Tanzania?
• How does the Gorilla tracking program work in Bwindi, Uganda?

How about the meals we consume on Kilimanjaro?

You’re climbing the highest peak in Africa—the food that fuels you is an essential
ingredient in your summit success. What is important for your meals on the climb? First,
that the food must be nutritious. Meals should be high in calories with the proper
balance of complex carbohydrates, protein, and the right kind of fats to help sustain
your increased level of exertion. We’ve designed our menus to include the right nutrition
to keep you going on the climb, with three good meals a day, plus tasty trail snacks—
the simple sugars in these are helpful in providing a boost of energy to keep you going.

We employ two chefs in our climbing party who are, apart from being experienced
climbers themselves, qualified and well experienced in expedition nutrition. Their job,
apart from making sure the top-notch food and hygiene standards, is to source, prepare
and serve highest quality meals, snacks, drinks throughout your trek.

We Buy Local
Our local team is always honored to partner with small-scale farmers in the communities
surrounding Kilimanjaro who provide some of the tastiest ingredients in the region. The
fruit you’ll savor during your trip (think pineapple, watermelon, banana, papaya, mango,
and oranges) come from local farms nearby.

Food Safety

Fresh produce is washed in an all-purpose sterilizer used for fresh food products as this
is the best and most effective way to ensure that bacteria is removed for safe
consumption. As a result, we are able to safely serve salad and uncooked vegetables
on the mountain for a refreshing boost of fiber and nutrients.

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We have a separate dining
tent with food available upon
request at any time.
Following are some sample
menu items offered during
meals while on the
Kilimanjaro climb:

Wakeup Call: A cup of
Tea/coffee or Hot Chocolate
at your tent.

Breakfast: tea/coffee/hot
chocolate, sliced seasonal
fruit, eggs scrambled or omeletes with toast, bacon, porridge, granola, honey, peanut
butter and jam.

Snacks on the trail: A trail mix of roasted cashews, peanuts, chocolate, and raisins.
We also offer sugary sweets, which add much needed energy boosts at higher altitudes.
Dried fruit (pineapple, mango, and banana), is a perfect light-weight nutritional and
sweet trail snack.

Picnic Lunch: This is set up along the trail midway through the day’s hike. Menu is
generally 3-course meals with starters/main course and dessert. (Tea, coffee, hot
chocolate, sandwiches, vegetable soup with bread rolls, guacamole, peppers, tomatoes,
almond date bars, nuts, fruit, sun dried tomatoes, and cheese. Main course is often
Chicken or fish. Dessert is usually seasonal fresh fruits.

Dinner: 3- course meals- Leaks, cucumber or Tomato ginger soup with baked bread,
fresh tilapia/chicken or beef stew with fries, peas with butter and mint, avocado tomato
salad, apple pie and cream. At higher altitudes, we eat more starch-based food that is
easier to digest, including rice, pasta with garlic bread, spaghetti bolognese, cauliflower,
carrots, brownies, and fruit cake. We cater for the special needs including gluten-free,
lactose-free and vegetarian meals if requested.

Why do we need to drink a lot of water?

It is very important to stay hydrated throughout the Kilimanjaro climb. You should be
drinking nearly a gallon of water each day. Yes, that is about 4 liters minimum.

This may seem like a lot, but the lower oxygen levels make you breathe in and out
faster and more deeply, so you lose a lot of water through respiration. The low humidity
at high altitude will also tend to dehydrate you. Many climbers don’t realize how much
water they are losing due to exertion, since sweat tends to dissipate quickly.

Finally, high altitude can make you feel the need to urinate more often, putting you at
even greater risk of dehydration. All of these factors, as well as the impact of altitude
suppressing your thirst response, can add up to serious dehydration. Your guides and
trip Director will be in-your-face on this matter every day making sure everyone is
hydrated well throughout the climb.

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We provide unlimited purified water on Kilimanjaro. We use the top-of-the-line Katadyn
expedition filters (often used by organizations like the Red Cross), which are highly
effective because they have the smallest pore size available (0.2 microns) that remove
pathogens and 99.9% of viruses. These are large floor pump models that produce high
volumes of water (and come with a crew member who will fill your water bottles for
you!).

Many companies try to boil all of the drinking water, which demands a lot of time and
fuel. This method requires water be at a full rolling boil for at least 3 minutes, which is
difficult to guarantee even under the best circumstances. Others use a chemical based
water treatment, many of which are fine for American household tap water, but often
don’t kill all viruses and leave a bad taste, making hydration unpleasant.

What are the details discussed during the pre-trip briefing in Arusha?

Our Guide Said with guests This is an informal gathering
at our lodge in Arusha, to
discuss the nitty-gritty of the
entire trip in Tanzania and
Uganda and more
specifically the Kilimanjaro
climb and the Migration
Safari. The meeting will be
led by your Trip Director and
our Tanzania
Directors/Guides.

This will be the first of many
briefings to take place during
the trek and on safari.

The topics include the clothing, baggage limitations, day packs, food served on the trail,
questions on altitude sickness and how to prevent this, different roles played by the
local crew, where camps are set up for every night and the facilities available for the
group.

Gear Check for the Kilimanjaro Climb is an important part of this meeting as our local
mountain leader is responsible for taking a closer look at the clothing and equipment
each participant possesses. You will be asked to bring the gear for the meeting or
alternatively visit your guest room at the end of the meeting. Lay all your gear on the
floor! The guide will take a look at your gear to determine if you do have the essentials
and they are suitable for the hike and advise you accordingly. If you have any shortage
of gear or some items do not meet the standard for the Kilimanjaro weather, the guide
will let you know and help you to arrange the rental of the correct equipment. There will
also be opportunities for you to ask questions on various topics. This briefing could go
for about an hour or so.

What is the training hike at Arusha National Park like?

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We spend two nights in Arusha before our climb on Kilimanjaro. The rationale for this was the
long flights from North America with little rest would impact how we felt starting out straightaway.
Not to forget we are coming from basically sea level. Two nights in Arusha with elevation roughly
1,600m or 4000 ft would give our bodies a kick start to the acclimatization process.

We use our second day the "rest day" in Arusha to visit the nearby Arusha National Park, where
Kilimanjaro's sister mountain Mt Meru is located. Climbing Meru is another 4-day affair, instead we
will do an afternoon leisurely hike at the foothills, try our hiking boots and get our feet moving. The
idea is to get our body ad mind set for tomorrow, the start of the bigger challenge ahead of us.
Besides, Arusha National Park is a beautiful little reserve with some wildlife in view, yet another
introduction to African wilderness.

How does the emergency rescue work on Kilimanjaro?

Should you need to descend due to AMS or any other condition, Wanderlust mountain
team will get you down the mountain safely and our action plan goes like this:

• ASSESS THE SITUATION
Trip leader and/or Guides will determine the condition. If required explore the
safest and fastest descent route to lower altitude.

• CONNECT WITH BASE CAMP
A call to base camp ensures appropriate rescue option, medical attention (if
needed) and accommodations will be ready.

•

DEPLOYMENT OF MEDICAL NEEDS & FIRST AID
Guides will use Wanderlust’s extensive medical equipment, supplementary
oxygen and other available First-aid sources to stabilize the climber.

• DESCEND THE MOUNTAIN
An Assistant guide and trained staff accompany the guest down the mountain.
Worst-case, if the distressed climber is in a high camp like Crater Camp or
Kosovo Camp and unable to walk, an additional crew will be mobilized to carry
the climber down to the closest helipad for an air ambulance evacuation.
(Emergency Air Rescue insurance is mandatory for this purpose and guides will
ask for your policy information and insurance provider information to book the
rescue)

Emergency Air Rescue

1. First, you must have an insurance cover that include emergency air evacuation
and medical coverage. It is very important to ask your travel insurance provider
to include this type of coverage within the policy that you purchase.

2. A copy of your insurance policy certificate must always be with you during the
trek. Perhaps it is a good idea to keep a copy of it with your Trip Director.

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3. Your Guide or Trip Director will ask for this in the event of an emergency. The
rescue service will require two things - Policy number and the Name of the
Insurance Company for billing.

Wanderlust recommends World Nomads or Ripcord Rescue Insurance policies
which include an adventure sports coverage of trekking under 6,000m of
elevation.

World Nomads offers great value, however, they do not sell policies for 66 years
or older trekkers and the only option for them would be Ripcord Rescue
Insurance. Both operators have extensive rescue experience on Kilimanjaro and
the local air ambulance providers and hospitals are familiar with their resuce
operations.

What is it like at the Crater Camp in the 5700m altitude?

Crater Camp is a unique place. At 5,700m above sea level, it is the highest campsite on
Kilimanjaro. For most trekkers, this elevation is the highest they've ever been and a real
test of their physicality. It is located just 200m below the true summit, Uhuru. Our plan
is that we leave for the crater camp during daylight hours and stay one night at the
Crater Camp before attempting the summit bid next morning.

On all other Kilimanjaro routes, only the guides and clients go direct to the summit while
the rest of the mountain crew remains at the last high camp. Using Crater Camp
requires significantly more effort on our part as the entire mountain crew, along with all
the expedition equipment, must ascend 1,000m higher than they normally would. Well
acclimatized trekkers will enjoy this place thoroughly.

From Crater Camp, is one hour hike to Reusch Crater, and the areas around
Furtwangler Glacier. Reusch Crater is a magnificent sight. It is almost perfectly circular
and the ash pit measures 120 m deep and 400m wide. This is rarely seen by other
trekkers on standard routes.

We understand the excitement of
staying at Crater Camp and
understandably intrigued at the
opportunity to sleep next to the
disappearing glaciers. However, we
re-iterate the fact that there are
drawbacks of sleeping at this high
altitude. Serious AMS can develop if
adequate altitude acclimatization has
not been achieved by each trekker
during the hike prior to this day. Our
guides will be closely monitoring the
health of every trekker during the trek up from Kosovo high camp to Stella Point and the
Crater camp.

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Do we get a summit certificate upon successfully reaching the Uhuru Peak?
Every successful summiter receives a Summit Certificate from Kilimanjaro National Park
at the end of your trek. Here’s one of our happy summitters proudly displaying the
summit certificate.

Why Malaria is a much talked about topic in Tanzania (& Uganda)?
Malaria risk is high throughout the country except in high altitude mountains over 2000m
(including Ngorongoro crater rim, Mt Kilimanjaro and parts of the Eastern Arc
Mountains). Most safari parks are high-risk zones. The highest risk is in rural areas.
Precautions

• Malaria precautions are essential in all areas below 1800m, all year round.
• Avoid mosquito bites by covering up with clothing such as long sleeves and long

trousers especially after sunset, using insect repellents on exposed skin and,
when necessary, sleeping under a mosquito net.
• Check with your doctor about suitable antimalarial tablets: Atovaquone/proguanil
OR doxycycline OR mefloquine is usually recommended.
• If travelling to high risk areas, remote from medical facilities, carrying emergency
malaria standby treatment may be considered.

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• If you have been travelling in a malaria risk area and develop a fever seek
medical attention promptly. Remember malaria can develop even up to one year
after exposure.

Anti-malaria tablets
The information for malaria prophylaxis outlined here is intended as a guideline only and
may differ according to where you live, your health status, age, trip itinerary, type of
travel, and length of stay. Seek further advice from your physician or travel health clinic
for the malaria prophylactic regimen most appropriate to your needs.

Either atovaquone/proguanil (Malarone), or mefloquine (Lariam) or doxycycline may be
given. Atovaquone/proguanil (Malarone) is a combination pill taken once daily with food
starting two days before arrival and continuing through the trip and for seven days after
departure. Side-effects, which are typically mild, may include abdominal pain, nausea,
vomiting, headache, diarrhea, or dizziness. Serious adverse reactions are rare.

Mefloquine is taken once weekly in a dosage of 250 mg, starting one-to-two weeks
before arrival and continuing through the trip and for four weeks after departure.
Mefloquine may cause mild neuropsychiatric symptoms, including nausea, vomiting,
dizziness, insomnia, and nightmares. Rarely, severe reactions occur, including
depression, anxiety, psychosis, hallucinations, and seizures. Mefloquine should not be
given to anyone with a history of seizures, psychiatric illness, cardiac conduction
disorders, or allergy to quinine or quinidine. Those taking mefloquine (Lariam) should
read the Lariam Medication Guide. Doxycycline is effective, but may cause an
exaggerated sunburn reaction, which limits its usefulness in the tropics.
Long-term travelers who may not have access to medical care should bring along
medications for emergency self-treatment should they develop symptoms suggestive of
malaria, such as fever, chills, headaches, and muscle aches, and cannot obtain medical
care within 24 hours.

Learn More: https://malariaspot.org/en/eduspot/malaria-in-tanzania/

How does the Gorilla tracking program work in Bwindi, Uganda?

Gorillas live in montane forest, so treks to see them are at altitude and pass through
varied vegetation and terrain. You will need a reasonable level of fitness and a
willingness to climb up muddy slopes and through thick growth.

Are we guaranteed to see gorillas when you set out? It's not possible to 100%
guarantee sightings of the mountain gorillas. However, we have never heard of an
instance where a tourist group did not get to see a gorilla group during their trek. To
help ensure this, trackers set off at dawn to locate the gorilla groups and radio their
GPS co-ordinates to the park headquarters, so when you set off on your trek with your
guide, you know where you are headed. The trackers stay with the gorillas even if they
are moving.

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A typical day of trekking starts around 7:30 in the morning at a designated meeting point
for a short video and gorilla briefing with the Ugandan Wildlife Authority.
A tour group should consist of no more than eight people at a time. Small numbers are
easier to manage and do not overwhelm the gorillas. You set out to track down a
primate family. We follow ranger/guide through the thick of the wet and muddy rain
forest and up and down the rolling hills, we are at times accompanied by armed guards
for security.
Finding the gorillas can take anywhere from one to five hours (sometimes longer).
These are wild animals and the trackers have to locate where the gorillas have gone
each day. If we are lucky on the day we may track the family in less than two hours
deep in the jungle.
After we find the gorillas we usually spend about an hour to observe, ask questions from
guide, and take photos and video of our encounter. There is no drinking or eating
around the gorillas and flash photography is prohibited.
Too much time with the gorillas could do harm and make them agitated and
uncomfortable. We make the trek back through the forest and enjoy a packed lunch
while reminiscing about our once in a lifetime wildlife encounter.
What sort of clothing should I wear? When setting out you should expect to get muddy
and rained on, so a waterproof jacket is essential. The exertion will keep you warm, so
layers are best. We have also found it a good idea to wear long trousers to protect your
legs against nettles, and a T-shirt with a long-sleeved shirt over the top. A waterproofed
daypack is essential for your camera, water bottle and picnic lunch/snacks. For a small
fee, porters can be hired to carry your daypack and help you up the steeper slopes.

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SECTION J

An Altitude Tutorial
High Altitude & Acute Mountain Sickness

Normal Acclimatization

Acclimatization is the process of the body adjusting to the decreased availability of oxygen at
high altitudes. It is a slow process, taking place over a period of days to weeks.

High altitude is defined as:

- High Altitude: 1500 - 3500 m (5000 - 11500 ft)
- Very High Altitude: 3500 - 5500 m (11500 - 18000 ft)
- Extreme Altitude: above 5500 m (18,000 ft above)

Practically speaking, however, we generally don't worry much about elevations below about
2500 m (8000 ft) since altitude illness rarely occurs lower than this.

Certain normal physiologic changes occur in every person who goes to altitude:

- Hyperventilation (breathing faster, deeper, or both)
- Shortness of breath during exertion
- Changed breathing pattern at night
- Awakening frequently at night
- Increased urination

As one ascends through the atmosphere, barometric pressure decreases (though the air still
contains 21% oxygen) and thus every breath contains fewer and fewer molecules of oxygen.
One must work harder to obtain oxygen, by breathing faster and deeper. This is particularly
noticeable with exertion, such as walking uphill. Being out of breath with exertion is normal, as
long as the sensation of shortness of breath resolves rapidly with rest. The increase in
breathing is critical. It is therefore important to avoid anything that will decrease breathing, e.g.
alcohol and certain drugs. Despite the increased breathing, attaining normal blood levels of
oxygen is not possible at high altitude.

Persistent increased breathing results in reduction of carbon dioxide in the blood, a metabolic
waste product that is removed by the lungs. The build-up of carbon dioxide in the blood is the
key signal to the brain that it is time to breathe, so if it is low, the drive to breathe is blunted
(the lack of oxygen is a much weaker signal, and acts as an ultimate safety valve). As long as
you are awake it isn't much trouble to consciously breathe, but at night an odd breathing
pattern develops due to a back-and-forth balancing act between these two respiratory
triggers.
Periodic breathing consists of cycles of normal breathing which gradually slows, breath-
holding, and a brief recovery period of accelerated breathing. The breath-holding may last up
to 10-15 seconds. This is not altitude sickness. It may improve slightly with acclimatization
but does not usually resolve until descent.

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Periodic breathing can cause a lot of anxiety:

- In the person who wakes up during the breath-holding phase and knows he has stopped
breathing.

- In the person who wakes up in the post-breath-holding hyperventilation (recovery) phase
and thinks he's short of breath and has High Altitude Pulmonary Edema (HAPE).

- In the person who wakes up and realizes his neighbor has stopped breathing.

In the first two cases waiting a few moments will establish a normal breathing pattern. In the
final case, the sleeping neighbor will eventually take a breath, though periodic breathing
cycles will likely continue until he or she is awake. If periodic breathing symptoms are
troublesome, a medication called acetazolamide may be helpful.

Dramatic changes take place in the body's chemistry and fluid balance during acclimatization.
The osmotic center, which detects the "concentration" of the blood, gets reset so that the
blood is more concentrated. This results in an altitude dieresis as the kidneys excrete more
fluid. The reason for this reset is not understood, though it has the effect of increasing the
hematocrit (concentration of red blood cells) and perhaps improving the blood's oxygen-
carrying ability somewhat; it also counteracts the tendency for edema formation. It is normal at
altitude to be urinating more than usual. If you are not, you may be dehydrated, or you may
not be acclimatizing well.

Acute Mountain Sickness

Acute Mountain Sickness (AMS) is a constellation of symptoms that represents your body
not being acclimatized to its current altitude.

As you ascend, your body acclimatizes to the decreasing oxygen (hypoxia). At any moment,
there is an "ideal" altitude where your body is in balance; most likely this is the last elevation
at which you slept. Extending above this is an indefinite gray zone where your body can
tolerate the lower oxygen levels, but to which you are not quite acclimatized. If you get above
the upper limit of this zone, there is not enough oxygen for your body to function properly, and
symptoms of hypoxic distress occur - this is AMS. Go too high above than what you are
prepared for, and you get sick.

This "zone of tolerance" moves up with you as you acclimatize. Each day, as you ascend, you
are acclimatizing to a higher elevation, and thus your zone of tolerance extends that much
higher up the mountain. The trick is to limit your daily upward travel to stay within that
tolerance zone.

The exact mechanisms of AMS are not completely understood, but the symptoms are thought
to be due to mild swelling of brain tissue in response to the hypoxic stress. If this swelling
progresses far enough, significant brain dysfunction occurs (See next section, on HACE). This
brain tissue distress causes a number of symptoms; universally present is a headache, along
with a variety of other symptoms.

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The diagnosis of AMS is made when a headache, with any one or more of the following
symptoms is present after a recent ascent above 2500 meters (8000 feet):

- Loss of appetite, nausea, or vomiting
- Fatigue or weakness
- Dizziness or light-headedness
- Difficulty sleeping

All of these symptoms may vary from mild to severe.

AMS has been likened to a bad hangover, or worse. However, because the symptoms of mild
AMS can be somewhat vague, a useful rule-of-thumb is: if you feel unwell at altitude, it is
altitude sickness unless there is another obvious explanation (such as diarrhea).

Anyone who goes to altitude can get AMS. It is primarily related to individual physiology
(genetics) and the rate of ascent; there is no significant effect of age, gender, physical fitness,
or previous altitude experience. Some people acclimatize quickly, and can ascend rapidly;
others acclimatize slowly and have trouble staying well even on a slow ascent. There are
factors that we don't understand; the same person may get AMS on one trip and not another
despite an identical ascent itinerary. Unfortunately, no way has been found to predict who is
likely to get sick at altitude.

It is remarkable how many people mistakenly believe that a headache at altitude is "normal"; it
is not. Denial is also common - be willing to admit that you have altitude illness, that's the first
step to staying out of trouble.

It is OK to get altitude illness, it can happen to anyone. It is not OK to die from it. With the
information in this tutorial, you should be able to avoid the severe, life-threatening forms of
altitude illness.

High Altitude Cerebral Edema (HACE)

AMS is a spectrum of illness, from mild to life-threatening. At the "severely ill" end of this
spectrum is High Altitude Cerebral Edema; this is when the brain swells and ceases to
function properly. HACE can progress rapidly, and can be fatal in a matter of a few hours to
one or two days. Persons with this illness are often confused, and may not recognize
that they are ill.

The hallmark of HACE is a change in the ability to think. There may be confusion, changes in
behavior, or lethargy ness. There is also a characteristic loss of coordination that is called
ataxia. This is a staggering walk that is similar to the way a person walks when very
intoxicated on alcohol. This loss of coordination may be subtle, and must be specifically tested
for. Have the sick person do a straight line walk (the "tandem gait test").

Draw a straight line on the ground, and have them walk along the line, placing one foot
immediately in front of the other, so that the heel of the forward foot is right in front of the toes
behind. Try this yourself. You should be able to do it without difficulty.
If they struggle to stay on the line (the high-wire balancing act), can't stay on it, fall down, or
can't even stand up without assistance, they fail the test and should be presumed to have
HACE.

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Immediate descent is the best treatment for HACE. This is of the utmost urgency, and
cannot wait until morning (unfortunately, HACE often strikes at night). Delay may be fatal.
The moment HACE is recognized is the moment to start organizing flashlights, helpers,
porters, whatever is necessary to get this person down. Descent should be to the last
elevation at which they woke up feeling well. Bearing in mind that the vast majority of cases of
HACE occur in persons who ascend with symptoms of AMS, this is likely to be the elevation at
which the person slept two nights previously. If you are uncertain, a 500-1000 meter descent
is a good starting point. Other treatments include oxygen, hyperbaric bag, and
dexamethasone.

People with HACE usually survive if they descend soon enough and far enough, and usually
recover completely. The staggering gait may persist for days after descent. Once recovery
has been complete, and there are no symptoms, cautious re-ascent is acceptable.

High Altitude Pulmonary Edema
(HAPE)

Another form of severe altitude illness is High Altitude Pulmonary Edema, or fluid in the lungs.
Though it often occurs with AMS, it is not felt to be related and the classic signs of AMS may
be absent. Signs and symptoms of HAPE include any of the following:

- Extreme fatigue
- Breathlessness at rest and drowsiness
- Fast, shallow breathing
- Cough, possibly productive of frothy or pink sputum
- Gurgling or rattling breaths
- Chest tightness, fullness, or congestion
- Blue or gray lips or fingernails

HAPE usually occurs on the second night after an ascent, and is more frequent in young, fit
climbers or trekkers. In some persons, the hypoxia of high altitude causes constriction of
some of the blood vessels in the lungs, shunting all of the blood through a limited number of
vessels that are not constricted. This dramatically elevates the blood pressure in these
vessels and results in a high-pressure leak of fluid from the blood vessels into the lungs.
Exertion and cold exposure can also raise the pulmonary blood pressure and may contribute
to either the onset or worsening of HAPE

Immediate descent is the treatment of choice for HAPE; unless oxygen is available delay
may be fatal. Descend to the last elevation where the victim felt well upon awakening.
Descent may be complicated by extreme fatigue and possibly also by confusion (due to
inability to get enough oxygen to the brain); HAPE frequently occurs at night and may worsen
with exertion.

These victims often need to be carried. It is common for persons with severe HAPE to also
develop HACE, presumably due to the extremely low levels of oxygen in their blood
(equivalent to a continued rapid ascent).

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HAPE resolves rapidly with descent and one or two days of rest at a lower elevation may be
adequate for complete recovery. Once the symptoms have fully resolved, cautious re-ascent
is acceptable.

HAPE can be confused with a number of other respiratory conditions:

High Altitude Cough and Bronchitis are both characterized by a persistent cough with or
without sputum production. There is no shortness of breath at rest, no severe fatigue. Normal
oxygen saturations (for the altitude) will be measured if a pulse oximeter is available.

Pneumonia can be difficult to distinguish from HAPE. Fever is common with HAPE and does
not prove the patient has pneumonia. Coughing up green or yellow sputum may occur with
HAPE, and both can cause low blood levels of oxygen. The diagnostic test (and treatment) is
descent - HAPE will improve rapidly. If the patient does not improve with descent, then
consider antibiotics. HAPE is much more common at altitude than pneumonia, and more
dangerous; many climbers have died of HAPE when they were mistakenly treated for
pneumonia.

Asthma might also be confused with HAPE. Fortunately, asthmatics seem to do better at
altitude than at sea-level. If you think it's asthma, try asthma medications, but if the person
does not improve fairly quickly assume it is HAPE and treat it accordingly.

Treating Acute Mountain Sickness

The mainstay of treatment of AMS is rest, fluids, and mild analgesics: acetaminophen
(paracetamol), aspirin, or ibuprofen. These medications will not cover up worsening
symptoms. The natural progression for AMS is to get better, and often simply resting at the
altitude at which you became ill is adequate treatment. Improvement usually occurs in one or
two days, but may take as long as three or four days. Descent is also an option, and recovery
will be quite rapid.

A frequent question is how to tell if a headache is due to altitude. See Golden Rule I. Altitude
headaches are usually nasty, persistent, and frequently there are other symptoms of AMS;
they tend to be frontal (but may be anywhere), and may worsen with bending over. However,
there are other causes of headaches, and you can try a simple diagnostic/therapeutic test.
Dehydration is a common cause of headache at altitude.

Drink one liter of fluid, and take some acetaminophen or one of the other analgesics listed
above. If the headache resolves quickly and totally (and you have no other symptoms of AMS)
it is very unlikely to have been due to AMS.

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Acetazolamide (Also called Diamox)

Acetazolamide (Diamox®) is a medication that forces the kidneys to excrete bicarbonate, the
base form of carbon dioxide; this re-acidifies the blood, balancing the effects of the
hyperventilation that occurs at altitude in an attempt to get oxygen. This re-acidification act as
a respiratory stimulant, particularly at night, reducing or eliminating the periodic breathing
pattern common at altitude. Its net effect is to accelerate acclimatization. Acetazolamide isn't
a magic bullet, cure of AMS is not immediate. It makes a process that might normally take
about 24-48 hours speed up to about 12-24 hours.

Acetazolamide is a sulfonamide medication, and persons allergic to sulfa medicines should
not take it. Common side effects include numbness, tingling, or vibrating sensations in hands,
feet, and lips. Also, taste alterations, and ringing in the ears. These go away when the
medicine is stopped. Since acetazolamide works by forcing a bicarbonate diuresis, you will
urinate more on this medication. Uncommon side effects include nausea and headache. A few
trekkers have had extreme visual blurring after taking only one or two doses of acetazolamide;
fortunately they recovered their normal vision in several days once the medicine was
discontinued.

Acetazolamide Use & Dosage:

For treatment of AMS
We recommend a dosage of 250 mg every 12 hours. The medicine can be
discontinued once symptoms resolve. Children may take 2.5 mg/kg body weight
every 12 hours.

For Periodic Breathing
125 mg about an hour before bedtime. The medicine should be continued until you
are below the altitude where symptoms became bothersome.

There is a lot of mythology about acetazolamide:

MYTH: acetazolamide hides symptoms
Acetazolamide accelerates acclimatization. As acclimatization occurs, symptoms
resolve, directly reflecting improving health. Acetazolamide does not cover up anything -
if you are still sick, you will still have symptoms. If you feel well, you are well.

MYTH: acetazolamide will prevent AMS from worsening during ascent
Acetazolamide DOES NOT PROTECT AGAINST WORSENING AMS WITH
CONTINUED ASCENT. It does not change Golden Rule II. Plenty of people have
developed HAPE and HACE who believed this myth.

MYTH: acetazolamide will prevent AMS during rapid ascent
This is actually not a myth, but rather a misused partial truth. Acetazolamide does
lessen the risk of AMS, that's why we recommend it for people on forced ascents. This
protection is not absolute, however, and it is foolish to believe that a rapid ascent on
acetazolamide is without serious risk. Even on acetazolamide, it is still possible to
ascend so rapidly that when illness strikes, it may be sudden, severe, and possibly fatal.
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MYTH: If acetazolamide is stopped, symptoms will worsen
There is no rebound effect. If acetazolamide is stopped, acclimatization slows down to
your own intrinsic rate. If AMS is still present, it will take somewhat longer to resolve; if
not - well, you don't need to accelerate acclimatization if you ARE acclimatized. You
won't become ill simply by stopping acetazolamide.

Dexamethasone (Decadron)

Dexamethasone (Decadron®) is a potent steroid used to treat brain edema. Whereas
acetazolamide treats the problem (by accelerating acclimatization), dexamethasone treats the
symptoms (the distress caused by hypoxia). Dexamethasone can completely remove the
symptoms of AMS in a few hours, but it does not help you acclimatize. If you use
dexamethasone to treat AMS you should not go higher until the next day, to be sure the
medication has worn off and is not hiding a lack of acclimatization.

Side effects include euphoria in some people, trouble sleeping, and an increased blood sugar
level in diabetics.

Dexamethasone Use & Dosage:
For treatment of AMS

Two doses of 4 mg, 6 hours apart. This can be given orally, or by an injection if the
patient is vomiting. Children may be given 1 mg/kg of body weight, up to 4 mg
maximum; a second dose is given in 6 hours. Do not ascend until at least 12 hours
after the last dose, and then only if there are no symptoms of AMS.

Oxygen

AMS symptoms resolve very rapidly (minutes) on moderate-flow oxygen (2-4 liters per minute,
by nasal cannula). There may be rebound symptoms if the duration of therapy is inadequate -
several hours of treatment may be needed. In most high altitude environments, oxygen is a
precious commodity, and as such is usually reserved for more serious cases of HACE and
HAPE.

Hyperbaric Therapy

Treatment in a portable hyperbaric bag essentially equivalent to descent or treatment with
oxygen; the person is inside a pressurized bag breathing an atmosphere equivalent to a much
lower altitude. AMS symptoms rapidly resolve (minutes), but may recur if treatment is too
short - at least two hours are needed. Dexamethasone works as well, though not quite as fast,
is much cheaper, and far less labor-intensive than hyperbaric therapy. Hyperbaric treatment is
usually reserved for more serious cases such as HACE and HAPE.

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A Review of the AMS treatment options:

Descent
Pro Rapid recovery: trekkers generally improve during descent, recover totally within

several hours.
Con Loss of "progress" toward trek goal; descent may be difficult in bad weather or at

night; personnel needed to accompany patient.

Rest at same elevation
Pro Acclimatization to current altitude, no loss of upward progress.
Con It may take 24-48 hours to become symptom-free.

Rest plus acetazolamide
Pro As with rest alone, plus acclimatization is accelerated, recovery likely within 12-24

hours.
Con Recovery may take 12-24 hours; side effects of acetazolamide.

Rest plus dexamethasone
Pro Faster resolution of symptoms than with acetazolamide (usually in a few hours);

minimal side effects; cheap.
Con Can hide symptoms & thus give a false sense of security to those who want to

continue upwards. Does not accelerate acclimatization.

Rest plus dexamethasone & acetazolamide
Pro Fast resolution of symptoms from the dexamethasone, plus improved acclimatization

from the acetazolamide.
Con Side effects of acetazolamide. Same cautions as above regarding ascent after taking

dexamethasone.

Oxygen or Hyperbaric Therapy
Pro Very rapid relief of symptoms (minutes).
Con Expensive; hyperbaric bags are very labor-intensive; rebound symptoms may occur if

treatment is too short - several hours are needed.

Preventing AMS

The key to avoiding AMS is a gradual ascent that gives your body time to acclimatize. People
acclimatize at different rates, so no absolute statements are possible, but in general, the
following recommendations will keep most people from getting AMS:

- If possible, you should spend at least one night at an intermediate elevation below 3000
meters.

- At altitudes above 3000 meters (10,000 feet), your sleeping elevation should not
increase more than 300-500 meters (1000-1500 feet) per night.

- Every 1000 meters (3000 feet) you should spend a second night at the same elevation.

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Remember, it's how high you sleep each night that really counts; climbers have understood
this for years, and have a maxim "climb high, sleep low". The day hikes to higher elevations
that you take on your "rest days" (when you spend a second night at the same altitude) help
your acclimatization by exposing you to higher elevations, then you return to a lower (safer)
elevation to sleep. This second night also ensures that you are fully acclimatized and ready
for further ascent.

Things to Avoid

Respiratory depression (the slowing down of breathing) can be caused by various
medications, and may be a problem at altitude. The following medications can do this, and
should never be used by someone who has symptoms of altitude illness (these may be safe in
persons who are not ill, although this remains controversial):

- Alcohol
- Sleeping pills (acetazolamide is the sleeping tablet of choice at altitude)
- Narcotic pain medications in more than modest doses

Prophylaxis

Under certain circumstances, prophylaxis with medication may be advisable.

- for persons on forced rapid ascents (such as flying into Lhasa, Tibet, or La Paz, Bolivia),
for climbers who cannot avoid a big altitude gain due to terrain considerations, or for
rescue personnel on a rapid ascent

- for persons who have repeatedly had AMS in the past

Acetazolamide

We do not recommend acetazolamide as a prophylactic medication, except under the specific
limited conditions outlined above. Most people who have a reasonable ascent schedule will
not need it, and in addition to some common minor but unpleasant side effects it carries the
risk of any of the severe side effects that may occur with sulfonamides.

The dose of acetazolamide for prophylaxis is 125-250 mg twice a day starting 24 hours before
ascent, and discontinuing after the second or third night at the maximum altitude (or with
descent if that occurs earlier). Sustained release acetazolamide, 500 mg, is also available and
may be taken once per day instead of the shorter acting form, though side effects will be more
prominent with this dose.

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Preventing Severe AMS

This simply cannot be emphasized too much. If you have symptoms of AMS, DO NOT
ASCEND ANY HIGHER. Violating this simple rule has resulted in many tragic deaths. If you
ascend with AMS you will get worse, and you might die. This is extremely important - even a
day hike to a higher elevation is a great risk. In many cases of High Altitude Cerebral Edema,
this rule was violated. Stay at the same altitude (or descend) until your symptoms completely
go away. Once your symptoms are completely gone, you have acclimatized and then it is OK
to continue ascending. It is always OK to descend, you will get better faster.

The Golden Rules

If you've been paying attention to the tutorial so far, these will be familiar. If there is a nugget
of knowledge to take away from this tutorial, here it is:

GOLDEN RULE I
If you feel unwell at altitude it is altitude illness

until proven otherwise.

GOLDEN RULE II
Never ascend with symptoms of AMS.

GOLDEN RULE III
If you are getting worse (or have HACE or HAPE),

go down at once.

Source: www.ismm.org/

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Section K

Community Support & Responsible Tourism

The Story of Arusha Children’s Trust & Wanderlust Adventures

The Arusha Children's Trust was initiated in 1996 and registered as a non-profit charity in the
UK. The guiding principal of the Trust is to develop a sustainable way of assisting in those areas
without creating a dependence on tourism and other revenue or diluting the cultural heritage of
rural communities.
In 1997, during a trek operated by a UK based travel company on behalf of the National Society
for the Prevention of Cruelty to Children (NSPCC), participants recognized the need for a
project that would:

• Assist rural communities, primarily children improve access to education and health
programs increase the awareness of environmental issues

• preserve culture and traditions
It was for this purpose that Arusha Children's Trust was created. The Trust has its trustees in
UK, Guernsey, Channel Islands and Tanzania.

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Goals
The Arusha Children's Trust is non-religious and non-political. It does not impose or promote
western values but presents information that facilitates the development of knowledge to enable
young people to make decisions which will improve the future for themselves and their
communities. The Trust works in the following areas:

• Education
• Health
• Preservation of Traditional Cultures
• Wildlife and Environmental Awareness

Mission Statement
The Arusha Children's Trust actively and directly supports the children in the Arusha and Rift
Valley regions of Tanzania through enhancing education, improving health awareness,
increasing knowledge of environmental conservation and upholding the culture and traditions of
the people within the region.

Support of Wanderlust Adventures
Wanderlust's founder, Priyantha Amarasinghe first met Mike & Ishbel Brydon more than 15
years ago in Tanzania and have shared the common values of not just adventuring in a
beautiful country but giving something back to some of the impoverished local people.

First tour group led by Priyantha visited kindergartens and schools sponsored by ACT in 2005
and encouraged his visitors to support the needy children. Since then, every Wanderlust guest
has visited the projects and supported the sponsored schools by way of materials for kids,
school supplies, classroom furniture and sports equipment.

Supplies Needed at Arusha Children’s Trust sponsored kindergartens

• Children’s' and teens' vitamins (most needed)
• Lap-top computers
• Antibiotic first aid ointment
• Antibiotic eye and ear drops
• Fabric band-aids, Used hearing aids
• Simple teen and children's clothes sizes 4 - 18
• Pens and pencils
• Towels & Toiletries
• Embroidery thread, needles and hoops, sewing supplies
• Yarn and knitting needles

Contact Mrs Ishbel Brydon – Patron

Phone: +255 27 250 0358
+255 27 250 0360

Email: [email protected]

https://www.arushachildrenstrust.org/

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MAKE YOUR ADVENTURES MEANINGFUL

Have a Big Impact in the communities you visit. Simply use a small amount of space in
your luggage to pack supplies needed by community projects around the world.

Wanderlust Adventures are proud members of Pack for a Purpose, an initiative that
allows travelers like you to make a lasting impact in the community at your travel
destination.

If you save just a few kilos of space in your suitcase and take supplies for the projects
we support in need, you’ll make a priceless impact in the lives of our local children and

families. Please click here to see what supplies are needed for our community projects

in Tanzania.

Pack for a Purpose has a detailed page in their web site advising prospective donors
on How To Pack give away items in your adventure luggage. Learn more….

https://www.packforapurpose.org/

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Notes:
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Notes:
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