Lhasa Warnings Or Dangers

Ariving in Lhasa 2 days before Christmas is the arse end of the tourist season so to speak. Following a weeks trekking in China's Yunnan Province, starting in Lijiang, the trip to Tibet was a lucky one. 5 weeks of working and living at altitudes around 3000m, firstly near Kunming (2800m), then Zhaotong (3200m). A trek through Yunnan and Tiger Leaping Gorge around 3500m, then higher up to Zhongdian, with a highlight in that area of going to a natural hot spring at 3900m!

All of this culminated in acclimatisation up to 4000m. The river near Lhasa is at about 3950m, and any little venture out of the city means you’re heading easily towards 5000m. We both encountered a few hours feeling the effects of increased altitude, but fortuntaely short lived. We encountered a few individuals, who after flying directly from USA to Shanghai, Chengdu and straight to Lhasa looked like death incarnate. A grey complexion and tiredness had these folk almost bed bound for the duration of their trip. Its not worth it, so please take care and consideration to acclimatise somewhere else in China for example before you arrive in Tibet. When you get there, you cannot get lower, unless you start digging!

Do not take the effects of altitude (AMS – Acute Mountain Sickness) lightly, it can severely affect you, and you can’t pre-empt it. As in our case, re-acclimatisation to above 4000m was sudden, but fortunately limited to a few hours. You need to drink lots of water, and rest frequently. We found that we were getting back to either hotel or restaurants and drinking loads of soft drinks, but then we’d being doing that for a few weeks on our other treks. A can of sprite is remarkably refreshing at 4000m when the temperature is –20 degrees C! More often though, we were mainly drinking ginger and/or mint tea, having a similar revitalising effect. Carrying a flask at all times is a great option for hydrating on the go, and keeping it topped up with hot water is essential given the coldness of your surroundings.

When I was in Lhasa walking through the Barkhor after dark I was accosted by a very aggressive 'monk' tapping me on the shoulder, walking in front of me and demanding money. In my opinion he was probably not a monk. I have heard of this scam in Tibetan areas-one begging monk in McLeod Ganj showed me his monk's ID-likely because there are so many scammers. His rude, agressive manner was unlike other monks I have seen in Tibetan areas, who tend to be polite even when begging, and as a monk he should not have touched me(a woman)-doing so violates the rules of conduct(Vinaya). I did give money to monks or nuns(more to nuns-they don't get as much support from the local people) I saw sitting in groups on the ground chanting sutras-they seemed genuine to me.

The guide books will tell you that your tour bus will take you to the top of Potala and you walk down through the palace – that is no longer the case! Because the road was slowly crumbling away, buses and cars are no longer permitted to drive to the top – you now have to walk! It is equivalent to a 13 storey building, which in itself is quite a feat, but considering that Lhasa is located at an altitude of 3600 metres above sea level – it makes for quite a strenuous climb. Take it easy!

If your passport is lost or stolen in China, you must complete the following process:

Step 1: Obtain a “Statement of Loss of Passport” from the Chinese Public Security Bureau (PSB) in the city in which the loss/theft occurred
The loss or theft of a passport must first be reported to the Police Station closest to where the loss/theft occured. A receipt will be issued by the Police Station. The loss or theft of a passport must then be reported to the city PSB. The PSB will then provide you a “Statement of Loss of Passport” based on the receipt issued by the Police Station. In other cities, applications should be made to the main PSB offices (the city level police).
Please note: You should report your lost or stolen passport immediately. A delay in reporting the loss or theft of a passport to the PSB can result in a delay in the issuance of a replacement visa by the PSB.
Step 2: Apply for a replacement passport at your nearest Embassy or Consulate
To apply for a replacement passport, you must usually provide the following:
1. "Statement of Loss of Passport” from the PSB in the city where the passport was lost/stolen (see Step 1)
2. Two (2) recent passport photographs (2” x 2” = 5 x 5 cm). They must show a full frontal view (without head covering) and light background.
3. Completed passport application form and Statement Regarding Lost or Stolen Passport form .For US citizens Forms are available for printing at www.travel.state.gov or at any U.S. Embassy or Consulate.
4. Satisfactory evidence of citizenship. Applicants have the burden of proving that they are citizens of that country and a passport will not be issued until evidence satisfactory to the consular officer has been provided establishing this citizenship. This could consist of:
a) The original or a certified copy of your birth certificate
b) If naturalized, your Certificate of Naturalization
Step 3: Obtain a Chinese visa from the city level PSB. (This is required, without exception, to remain in China and to leave China.)

PSB 's Racket
When I was traveling to Lhasa flying in from Chengdu then renting a TLC (Toyota Land Cruiser) we were listening to Pet Shop Boys and we had a laugh as Chinese Public Security Bureau (PSB) had the same initials.
People who wish to follow the chinese regulations concerning Tibet travels pass through Agreed Travel Agencies having their main office in Lhasa. If you wish to visit some places nearby the most common monasteries proposed usually you will be victim of the local PSB' officers. The document or permit delivered by Lhasa authorities has no value in distant prefectures and the local officials will declare to you that you are in an area forbidden to foreigners. You have to go back and your travel agency will have to pay a fine. That's the way that those people has found to increase their poor salaries and get money to play, drink or finish their days in local restaurants. As I was personally witness. The only attitude when travelling in such areas is to avoid all guesthouses in villages where PSB civil servants are present. To resume: the places where you spend nights, guesthouses or hotels, should be located in large towns located on the 3 main roads listed above. Otherwise you have to look for an isolated house. In the day you can run any place 100/125km on each side.
It is hoped that the situation will improve in the future and that methods dating from the Emperors period (where province generals where imposing their law and were racketing travellers) will be give up. Tibet is a safe country where civilized rules should be applied. It it not China interest that the present situation go on.

Acute Mountain Sickness
When acclimatization lags significantly behind ascent, various symptoms occur. Acute Mountain Sickness (AMS) represents the body's intolerance of the hypoxic (low oxygen) environment at one's current elevation.

Who can get AMS? Anyone who goes to altitude. It is primarily related to rate of ascent. No way been found to predict who is likely to get sick at altitude. Which brings us to:

GOLDEN RULE 0.
It is OK to get altitude illness. It is not OK to die from it.


Don't violate this rule! Anybody can get AMS, there is no prevalence based on age, gender, physical fitness, or previous altitude experience. If you know what to do you should be able to avoid the severe, life-threatening forms.

GOLDEN RULE I.
Any illness at altitude is altitude illness until proven otherwise.


RECOGNIZE AMS. In the context of a recent ascent, a headache, with any one or more of the following symptoms above 2500 meters (8000 feet) qualifies you for the diagnosis of AMS:
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Loss of appetite, nausea, or vomiting
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Fatigue or weakness
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Dizziness or light-headedness
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Difficulty sleeping
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Confusion
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Staggering gait

It is remarkable how many people mistakenly believe that a headache at altitude is "normal" when it is actually AMS. Be willing to admit that you have altitude illness.

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 to a more concentrated level. This results in an altitude diuresis as the kidneys dump 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 is normal at altitude to be urinating several times per night. If you are not, you may be dehydrated, or you may not be acclimatizing well.
Persistent hyperventilation (to glean oxygen from the thin air) results in an over-reduction in the level of carbon dioxide (a normal metabolic waste product) in the blood. It turns out that the presence of carbon dioxide is the key signal to the brain that it is time to breathe (the lack of oxygen is a much weaker signal, kind of an ultimate safety valve). As long as you are awake it isn't much trouble to remember to breathe, but at night, an odd breathing pattern develops due to a prolonged argument between these two "respiratory centers" in the brain. Periodic breathing consists of cycles of normal breathing, breath-holding, and accelerated breathing. The breath-holding may last up to 10-15 seconds. This is not correlated with altitude sickness. It may improve slightly with acclimatization, but does not usually resolve until descent. Periodic breathing can cause a lot of anxiety in trekkers:
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In the trekker who wakes up during the breath-holding phase and knows he has stopped breathing.
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In the trekker who wakes up in the post-breath-holding hyperventilation phase and thinks he's short of breath and has HAPE.
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In the trekker who wakes up and realizes his neighbor has stopped breathing.

In all these cases waiting a few moments will establish a normal breathing pattern. If periodic breathing symptoms are troublesome, a medication called acetazolamide may be helpful.

ALTITUDE SICKNESS.....stomach problems.
I drank 1 Chinese beer and felt high as a kite!!
This information is intended to be educational in nature and should not be construed as medical advice. You should consult your physician regarding any specific medical conditions or questions and before taking any medications.

Normal Acclimatization
What is meant by high altitude? Some "formal" medical definitions:
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High Altitude: 1500 - 3500 m (5000 - 11500 ft)
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Very High Altitude: 3500 - 5500 m (11500 - 18000 ft)
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Extreme Altitude: above 5500 m

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. Acclimatization is the process of the body adjusting to the decreasing availability of oxygen. It is a slow process, taking place over a period of days.

Certain normal physiologic changes occur in every person who goes to altitude:
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Hyperventilation (breathing fast)
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Shortness of breath during exertion
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Increased urination
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Changed breathing pattern at night
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Awakening frequently at night
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Weird dreams

As one ascends through the atmosphere, barometric pressure decreases (though the air still contains 21% oxygen) and every breath contains fewer and fewer molecules of oxygen. One must work harder to obtain oxygen, primarily by breathing faster. 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.

As the amount of oxygen in the lungs decreases, the blood becomes less and less efficient at acquiring and transporting oxygen . This means that no matter how fast one breathes, attaining normal blood levels of oxygen is not possible at high altitude.