PLA Struggles With Altitude Sickness
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PLA Struggles With Altitude Sickness

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Oxygen enriched barracks do not enable acclimatisation

by Dr P.S. Venkatesh RaoBANGALORE: THE PROBLEM: China’s People’s Liberation Army (PLA) is struggling in its ambition of capturing the Himalayan heights because of altitude sickness. The gravity of the earth leads to greater density of air at sea level and so progressively less air and hence less oxygen at higher altitudes. Sudden ascent from the sea level to altitudes above 2,500 to 3,000 meters, leads to breathlessness, tiredness, headaches, dizziness, vomiting, confusion and sleeplessness due to altitude sickness. The Galwan river, a tributary of Indus, and the Galwan valley are named after Ghulam Rasool Galwan, a Ladakhi explorer, and have an average altitude of 5,450 m. The Karakoram mountains in which this valley exists have 18 summits over 7,500 m. The entire Han population lives in eastern China, mostly at sea level. The highest Han townships are at only 2,800 m, whereas most Tibetan settlements are at 4.500 m. Ladakh and Lahaul Spiti are above 4,500 m.

THE PLA: Chinese law requires every person between the ages of 18 and 24 years to serve two years in the army. The youth are trained and indoctrinated soon after being drafted in September each year for 9 months, and in early summer are posted in Tibet and Xinjiang. Near the Tibet border these pampered kids are put up in oxygen enriched barracks. This does not enable acclimatisation. It’s like breathing from an oxygen mask for cabin decompression during a flight. These soldiers fall sick on stepping out in the open, especially when carrying heavy equipment and oxygen generators with power supply or cylinders and climbing steep sides of the valley. The PLA has very few non-commissioned officers who can be gradually acclimatised and posted for months at high altitudes. The senior officers posted to Tibet soon develop altitude sickness in addition to their age related and other health issues, requiring frequent changes of leadership.

ALTITUDE SICKNESS: Lack of oxygen at high altitude leads to acute mountain sickness (AMS), the mildest form of altitude sickness. It can progress to high altitude pulmonary Edema (HAPE)—fluid accumulation in the lungs and high altitude cerebral Edema (HACE)—swelling of the brain. Blood vessels in all parts of the body dilate to provide more oxygen rich blood where needed, except the lung blood vessels which constrict in those parts of the lung with low oxygen so as to divert blood to parts of the lung with more oxygen. At high altitude, when both lungs have less oxygen, non-acclimatised lung vessels constrict in all parts of both lungs. This raises blood pressure in the lungs which in addition to the damage caused by low oxygen and dry air leads to leakage of fluids into lung air spaces. This condition, called HAPE, is like drowning in one’s own fluids. Lack of oxygen dilates blood vessels elsewhere leading to body swelling and also swelling of the brain causing headache, confusion, poor cognition and loss of consciousness. Acclimatisation helps the body to slowly adjust so that instead of constricting, the vessels and the lungs increase their efficiency and the kidneys adjust the pH. Gradually, the bone marrows produce more oxygen carrying haemoglobin.

ACCLIMATISATION: To survive in the rarefied air of the Himalayas requires graded ascent for gradual acclimatization at about 300 metres per day. On the Indian side of the Himalayas there are many locations at progressively increasing altitudes where one can acclimatise step by step, a few days at each increasing altitude. On the Chinese side Tibet is a vast high plateau; hence lower altitudes are far off. The lowest areas near the border are river valleys of the Indus and Brahmaputra tributaries and even these are at high altitude and hence unsuitable for either acclimatisation or for recovery from sickness. Nyingchi at 3,040 m is the lowest settlement and too far to the east. Other important factors for acclimatisation are climbing down each night to sleep at lower altitudes, avoidance of alcohol, sleeping pills, and avoidance of exercise. Some healthy and fit persons can develop altitude sickness even after acclimatisation and will have to be rapidly evacuated to low altitudes. Pre-acclimatisation in sealed “altitude tents” with low oxygen levels can simulate high altitudes.

NATIVES OF TIBET AND ANDES: Researcher Cynthia M. Beall published in 2007 a study in which she found both native Tibet and Andes populations have a full range of oxygen-using metabolism as in populations at the sea level and in contrast with the curtailed range available to visitors at high altitudes. She found Tibetan women with genes for high oxygen saturation of haemoglobin have higher offspring survival, leading to evolution by natural selection. There are unconfirmed reports that Chinese military researchers have been tasked with genetic engineering and cross breeding to obtain desirable Tibetan genes for the Han race. Christopher Paik, in his postdoctoral research study reported that “Ethnic integration policy…will be harder to implement in the higher altitude regions,” and “even if you try to have integration happening there, nature works against those initiatives.”

BOOTS ON THE GROUND: The armies of Napoleon and Hitler were defeated more by the elements of the harsh Russian winter than the defenders. Exoskeletons do not help non-acclimatised soldiers. Efforts to avoid soldiers killed in action or by harsh environment include use of drones and robots, in air, on the ground, underwater and from space. Eventually there is no substitute to boots on the ground and support of the local population.

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