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)
 

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 full articles were also published in ACTA ANDINA.

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.

VI WORLD CONGRESS IN CHINA AND TIBET.