Abstract
This issue of our Journal contains the abstracts of the VIII World Congress on High Altitude Medicine and Physiology that was held in Arequipa from August 8 to 12 of this year. The large number of abstracts from Peru and neighboring countries emphasizes the vigorous interest in high altitude studies in South America.
Peru has a long tradition of medical and physiological research at high altitude. An early important study was the International High Altitude Expedition to Cerro de Pasco, Peru in 1921-1922 led by Joseph Barcroft of Cambridge University. The expedition covered a wide area of scientific topics, and there was particular interest in the people who lived at this impressive altitude of 4300 m. Barcroft and his colleagues were amazed at the physical ability of the local inhabitants and their fondness for athletic games such as football. This was in great contrast to the greatly reduced exercise ability of the expedition members. An interesting contribution of the expedition was their measurements showing impaired neuropsychological function and the recognition of how frequently members made simple errors. Barcroft famously concluded that “all dwellers at high altitude are persons of impaired physical and mental powers.”
A contemporary of Barcroft was Carlos Monge Medrano, a physician in Lima, who is rightly regarded as the father of studies of permanent residents of high altitude. Monge was the Dean of the School of Medicine of San Marcos University, the oldest university in South America, and he founded the Instituto de Biologia y Patologia Andina in Morococha at an altitude of 4540 m. Monge's studies had an enormous influence on high medicine, and his work was continued by his pupil Alberto Hurtado, and most conspicuously, by Monge's son, Carlos Monge Casinelli. The tradition continues to this day particularly in the Universidad Peruana Cayetano Heredia. A group here organized the Instituto de Investigationes de la Altura in Cerro de Pasco at an altitude of 4300 m. One of the most distinguished products of this school is Fabiola León-Velarde who was the president of the Arequipa Congress.
The Chulec General Hospital at La Oroya was set up in association with the Cerro de Pasco mine, and a remarkable event in the history of high altitude medicine occurred there in 1959. Herbert Hultgren, a cardiologist at Stanford University, visited the hospital and was astonished to see a number of cases of pulmonary edema that he astutely recognized as a new disease. The result was that he studied the clinical records of 41 of the patients with High Altitude Pulmonary Edema, and he wrote an extensive report in the Stanford Medical Bulletin when he returned home. Is it too fanciful to compare this incident with that of stout Cortez when with eagle eyes he got his first view of the Pacific Ocean according to Keats' poem?
Today, many new challenges are posed by high altitude in the Andes of Peru. For example work has started on a new mine at Toromacho near Morococha where the ore is located at altitudes of 4700 to 4900 m. The processing plant will be at 4500 m, and the living quarters of a substantial number of people will be at the same altitude. The mine is owned by the Aluminum Corporation of China (Shinolco) who plans to spend over $2 billion U.S. dollars with production beginning in 2012. This open pit mine will be the largest copper mine in Peru. The problems of dealing with the hypoxia posed by these altitudes are daunting and are a reminder that our disciplines of high altitude medicine and biology are alive and well.