East Africa's high peaks are notorious for altitude sickness. Partly, this is because they are so accessible; each can be climbed by hikers with no experience, especially if guides and porters are used. The short, direct routes also contribute to the problem by allowing people to gain elevation faster than a normal body can acclimate.

If you plan to climb Kilimanjaro, it's worth acclimating on another mountain first. Meru is just across the plain, in clear sight of Kilimanjaro, easily accessible, and less expensive to climb, even with guides and porters.

Another strategy: Climb slower. On all four of the mountains, we took the longest routes and longest times possible in order to acclimate. On Kilimanjaro, for example, we took the longer, supposedly more challenging Machame Route, called the whiskey route by the porters, because that's what they want to drink after they've done it! We spent seven nights and eight days (the normal "tourist route" climb is four nights and five days; the normal Machame climb is five nights and six days). The result for us was that all of our party of four made it to the top, not just the crater rim, where many hikers turn around. It cost a little more, but it was worth it: Three of us had no signs of altitude sickness at all, and all of us enjoyed ourselves.

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