Abstract
The first World Congress was held in 1994 in La Paz, Bolivia. As altitudes go, we started at the top. La Paz is one of the higher cities in the world, and its airport, El Alto, is at the extraordinary altitude of 4100 m. This is well above the cabin altitude of commercial aircraft during flight so that on landing the cabin pressure falls rather than rises as is the usual sequence. Another feature of La Paz is that the richer you are, the lower you live. Many registrants had first-hand knowledge of acute mountain sickness for a couple of days and acetazolamide was much in evidence.
The second World Congress was held in the very historic city of Cusco in Peru. This was the old capital of the Inca civilization, and we were reminded that the Incas had remarkable insights into some of the problems of high altitude. For example they kept two armies: one to operate at high altitude and the other to operate near sea level.
It was very fitting that the first two Congresses were held in South America because of the very large population of people who live at high altitude in the Andes, and the classical studies done on these beginning in the 1920s with the work of Carlos Monge Medrano. However for the next Congress a move was made to the Northern Hemisphere in Matsumoto, Japan, which is a gateway to the Japanese Alps. In contrast to the Andes, many lowlanders are exposed to high altitude there, and many advances in mountain medicine stem from that region.
The fourth Congress returned to South America, this time to Arica on the coast of north Chile. It may seem odd that a meeting on high altitude medicine should be held at sea level but this town is not far from a number of areas of great interest to high altitude medical scientists. In 1913, Thomas Ravenhill gave the first clear descriptions of acute mountain sickness, high altitude pulmonary edema, and high altitude cerebral edema from the Collahuasi mine only a few hours away. In addition the modern mine in Collahuasi uses a commuting pattern whereby workers spend a week at high altitude, a week at sea level, and the process continues indefinitely. Also not far away is the Chajnantor Plateau at an altitude of 5000 m where the gigantic ALMA radiotelescope is now operating and the astronomers at that facility work in oxygen-enriched rooms.
The fifth World Congress returned to the Northern Hemisphere, this time to Barcelona, Spain. This is not far from the European Alps where many of the original observations on high altitude problems were made in the Nineteenth Century. Remarkably, the high altitude laboratory, the Capanna Margherita at an altitude of 4559 m, dates from the 1890s but continues to be very active today.
The sixth World Congress was the most enterprising of all. The meeting began in Xining, Qinghai in western China and ended in Lhasa, the capital of Tibet. In a sense this shift to China echoes the evolution of high altitude medicine. Today there is probably more research on high altitude medical problems in China than anywhere else in the world.
The seventh World congress was held in Aviemore, Scotland where the altitudes are modest but hill-walking is popular. Indeed Alexander Kellas who knew more about the physiology of extreme altitude than anybody else in 1920 cut his teeth in the Cairngorms near Aviemore.
For the eighth World Congress we were back in Peru, this time in the beautiful and historic city of Arequipa. It was a memorable meeting with many opportunities to meet physicians and physiologists from all over the world but particularly South America.
So the upcoming meeting in Taipei follows a very rich tradition and shows every indication of being just as successful as all the other meetings. We hope to see you there.