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IPPA
HIGH ALTITUDE PATHOLOGY INSTITUTE
La Paz, Bolivia (3510 m)

AN INSIDE VIEW: ORGANIZING THE FIRST WORLD CONGRESS ON HIGH ALTITUDE MEDICINE AND PHYSIOLOGY

As published in the International Society for Mountain Medicine Newsletter Vol 4, Number 4, November 1994.

Attending an invitation to a cocktail by the U.S. Embassador in
Bolivia, Dr. Gustavo Zubieta (Jr.) and his wife Lucrecia were
introduced by Ambassador Charles Bowers, to Dr. John C. Triplett
(John), medical officer of the Embassy for Bolivia, Peru, Chile,
Colombia and Ecuador. John had just arrived from a two year stay
in Nepal, and was an enthusiastic mountain climber. He was very
impressed by the fact that La Paz, was such a wonderful place to
climb, yet little known. After a few minutes interchanging common
interests, he suggested we do a meeting in La Paz. Gustavo Jr.
went back home and told Dr. Gustavo Zubieta (Sr.) about the idea,
who immediately supported and further extended aggresively the
idea to make it a World level Congress. He insisted that we print
10,000 brochures and 5000 posters to be distributed worldwide,
considering that the support for the sucess was granted, with the
0composition of a tripod of three enthusiasts with high altitude
passion like John, Gustavo Jr. and Gustavo Sr. On the second
meeting we discussed what organizations should participate. The
two international organizations that immediately came to mind
were the ISMM and the Wilderness Medical Society. Gustavo Jr.
asked Bengt Kayser, through E-mail for his opinion and he
approved the idea, and suggested we consult with Dr. John B.
West, who immediately gave his full support. Dr. Bengt Kayser
printed an advertisement in the ISMM Newsletter with the
denomination "FIRST WORLD CONGRESS ON HIGH ALTITUDE MEDICINE AND
PHYSIOLOGY" and also suggested we talk to Dr. Roland Favier who
was at the time working at the IBBA, in order to arrange their
participation, with whom we had a good steak and beer in the
restaurant Gringo Limon. It was agreed that Dr. Favier would
inform the people of IBBA, for the next meeting. One week later,
he called and said he was sorry but the IBBA could not
participate.

In the mean time support from many parts of the world, was
encouraging. Dr. Peter Hackett, Dr. Charles Houston, Dr. Oswald
Oelz, Dr. Lorna G. Moore, contacted by John, among others gave
their garded agreement. Dr. Houston, mentioned that it would be
very difficult to carry out a meeting like this because someone
had tried to do one in Nepal, and had not been sucessful, yet he
supported the idea and later suggested the attendance of Dr.
Robert Roach. Several physicians insisted that IBBA participate
and with wholehearted agreement, we tried numerous times to
induce them to join us. Letters coming and going trying to solve
this matter took most of our time. Even the Embassy of France was
contacted but all efforts were fruitless. At one point, John,
Gustavo Sr. and Gustavo Jr., went personally to visit the
director of IBBA, and we took a photograph shaking hands and the
little hope of participation that transcended was soon followed
by yet another refusal.

Nevertheless, the enthusiasm continued to grow with Dr. Kayser
and Dr. West spurring us on. Wednesday afternoon meetings became
routine mostly carried out in the living room of Gustavo Sr's
house located one floor above the High Altitude Pathology Clinic,
that some of the ISMM members have visited. We gathered around a
long table, ate some homemade sandwiches, and solved problem
after problem.
Dr. West and Dr. Kayser suggested more names of distinguished
researchers from all over the world, and we hurried to invite
them.

We knocked on many, many doors and wrote hundreds of letters to
obtain some help and funds. We enlisted the help of the WMS and
ISMM to distribute advertisements and brochures. American
Airlines gave free tickets, a local printer printed programs for
free, Iberia gave an excellent discount on tickets and the Hotel
Plaza promised free conference rooms. USAID promised money and
the U.S. Ambassador continued support. The Third World Academy of
Sciences collaborated with some funds for travel expenses of
local regional scientists. These developments spurred us onward
to define a curriculum and confirm the best speakers and
researchers
Definitely, doing a meeting in a developing country is
difficult... But nothing, suppressed our determination to carry
out this meeting.

About 7 months into the meeting we gained the participation of
Dr. Cesar Moreno and Dr. Milton Soria, two other interested
Bolivian Physicians. Dr. Jean Paul Richalet cancelled his
attendance, because he was going to have a Baby those days, Dr.
Oswald Oelz, very enthusiastic from the beginning, had to attend
to a Parliament meeting in his country, Dr. Peter Bartsch and Dr.
John Sutton both had some complications with their Universities
and also cancelled their assistance for whom we felt a great
loss.

It seemed to us that time became exponentially shorter as the
final date arrived. Two weeks before the initiation, Dr.
Triplett, said "O.K., we are now on automatic pilot".

The opening ceremony

It started with an inaugural ceremony, assisted by the Vice-
President of Bolivia, the Ambassador of the U.S. in Bolivia, the
Secretary of Health, President of the Bolivian Academy of
Sciences, and several other important authorities. 250 people
from 27 countries gathered in the auditorium of the Palacio de
Comunicaciones, where translation facilities were available.
Buses then took all attendees to the National Art Museum, where
Mr. Terwilliger, a brilliant young American violinist, delighted
the audience in the patio of the colonial building.
One physician had high altitude syncope, and established the
reality that although surrounded by world experts, very little
could be done, but follow the basic medical maneuvers for loss of
consciousness. His recovery was uneventful. We were aware of 5
attendees and some guest speakers who suffered acute mountain
sickness, received adequate treatment and made a full recovery
for the third day.

The conferences

For the first time in the history of high altitude research, a
group of scientists of unusual intelligence and knowledge
gathered in an environment befitting the topic to discuss
medicine and physiology in the highest capital city in the world
(3600 m). New theories, and discussions of old problems, greatly
absorbed our attention and impregnated our minds. It was a real
effort to keep English time but we pretty well managed to do so.
Audiovisual support was adequate. Posters were set up and enjoyed
during coffee breaks.

We apologized for having to make a few last minute changes to the
program, due to the unavoidable absence of some of our speakers.
The attendees were most impressed with unpublished primary
research on mining at high altitude, work and exercise at high
altitude, coca chewing and work, child and maternal health
issues, hypobaria as a cause of altitude illness, discussion on
Chronic Mountain Sickness and the emergence of proven genetic
adaptation to high altitude. Many new excellent researchers
emerged and presented very sound data and information from
localities not frequently heard from.

Dr. Wu Tiany, about 3 months before asked us if we could finance
the trip of his collaborator Dr. Li Yan. We unfortunately, had to
explain that we were short of funds. About a month before the
meeting, he said his collaborator had the funds, if we could get
him a plane ticket. Iberia was more than willing but there was no
room on the plane so we got him one on VARIG. Two days before he
wrote and said he had to travel with his assistant because he was
almost blind!!. Tremendously shocked, we tried our best to change
his ticket. E-mails coming and going between the Embassies of
Bolivia and Beijing with great cooperation from Embassy Dr. Tom
Yun on the other end, created a true suffering for all of us
involved, since everyday we were told they would get on the plane
and after 4 gastritis causing attempts to board a plane, we
finally gave up and felt a great loss for not having Dr. Wu Tiany
with us.

On Wednesday noon, most of us boarded a train in the old English
style train station and rode slowly up the west side of the bowl
shaped city of La Paz, appreciating the extension of the city
overlooked by the mountain of 6080 m, Illimani (climbed by some
attendants after the meeting). After a couple of hours of a slow
ride we arrived in Tiahuanacu (ancient Pre-Incan Ruins). The ride
permitted discussion, which went from highly scientific to jokes
and loud laughing and upon returning to review the entrance to La
Paz, this time greeted by thousands of lights in the city and
surrounding mountains.

Closing dinner

After brief words from Dr. Triplett, Dr. West and Dr. Zubieta
Sr. (Closing speech), and following a buffet dinner, visitors appreciated the
typical folkloric dances and music of the different regions of
Bolivia. We regretted the need to have this on thursday but some
had to depart early.

Conclusions:

It is our belief, that a new era in high altitude research is
emerging. Many scientists have opened their eyes to disease at
high altitude. Older generations, rich in knowledge and
experience opened up and gave support to a very strong,
enthusiastic, highly trained, well equipped, and very bright new
generation of scientists, from all over the world, that will
change the way we now see hypoxia, and lead to the realization of
the motto of the congress "Defeating Hypoxia". We hope that most
of the presentations will be published in a early 1995 symposium
of the Acta Andina from Lima, Peru, with Bengt Kayser, M.D.,
Ph.D., Peter Hochatchka, Ph.D., Carlos Monge, M.D., Fabiola Leon-
Velarde, Ph.D. Gustavo Gonzales, M.D. & Arturo Villena, M.D. as
Editors. Modern communications are blowing away frontiers, and
hence the publication in this magazine will be catalogued in the
LILACS, the Latin American "Index Medicus", making the articles
readily available on searches, worldwide.

Finally, after a month past the meeting and recuperating our
energy, we were faced with the surprise that we had a negative
balance in the finances. We literally, have a personal debt of
14,000 US$. for which we are struggling to find funds. We would
like to take the opportunity to ask anyone willing to give any
suggestions to contact us. It was merely in the scientific
interest that this meeting was held, and from the very beginning
we specified that it was to be non-profit. We will acknowledge
any cooperation, during the SECOND WORLD CONGRESS ON HIGH
ALTITUDE MEDICINE AND PHYSIOLOGY to be held in Cuzco, Peru, in
September 1996, enthusiastically being organized by Dr. Carlos
Monge and Dr. Fabiola Leon-Velarde. You are all invited, and we
will all meet and enjoy high altitude and related research along
with friendship, once more......

Dr. Gustavo Zubieta-Calleja Jr., Secretary (High Pathology Institute - Clinica IPPA, La Paz)
Dr. John C. Triplett, Chairman (US Embassy, La Paz)
Dr. Gustavo Zubieta-Castillo, Chairman of the Scientific Committee (High Pathology Institute - Clinica IPPA, La Paz)


FOLLOW-UP COMMENTS

The abstracts were published in a book called "FIRST WORLD CONGRESS OF HIGH ALTITUDE MEDICINE AND PHYSIOLOGY" Sept 1994, La Paz, Bolivia.

Since then, full congress articles have been published by ACTA ANDINA Volumen IV, Numero 2 1995 and Volumen 5, Numero 1, 1996.



The SECOND WORLD CONGRESS ON HIGH ALTITUDE MEDICINE AND PHYSIOLOGY was held in Cusco, Peru on Sept 24 to 27, 1996 with Dr. Fabiola Leon Velarde as Chairman and Dr. Carlos Monge C. as Honorary Chairman.

The full articles were also published in ACTA ANDINA.



The THIRD WORLD CONGRESS ON MOUNTAIN MEDICINE AND HIGH ALTITUDE PHSYIOLOGY AND THE 18TH JAPANESE SYMPOSIUM ON MOUNTAIN MEDICINE, was held in Matsumoto, Japan on May 20th - 24th, 1998. The Chairman was Dr. Michiro Nakashima, and Honorary Chairman, Dr. Gou Ueda. Dr. Toshio Kobayashi and Dr. Shigeru Masuyama Administrative Secretariats. Program and abstract book published at the time.

The book "PROGRESS IN MOUNTAIN MEDICINE AND HIGH ALTITUDE PHYSIOLOGY" published by the press committee of the Congress, with editors Hideki Ohno, Toshio Kobayashi, Shigeru Masuyama and Michiro Nakashima was published a few months after the meeting.



The FOURTH CONGRESS ON HIGH ALTITUDE MEDICINE AND PHYSIOLOGY took place in Arica, Chile on October 1st-6th, 2000.
Dr. Claus Behn was the Chairman.
E-mail: cbehn@machi.med.uchile.cl


V CONGRESO MUNDIAL DE MEDICINA DE MONTA√ĎA
The V WORLD CONGRESS ON MOUNTAIN MEDICINE AND HIGH ALTITUDE PHYSIOLOGY
Barcelona, Spain April 16-20, 2002
The VI WORLD CONGRESS ON MOUNTAIN MEDICINE AND HIGH ALTITUDE PHYSIOLOGY
Xining, China and Lhasa, Tiber April 16-20, 2004


 


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