When I was led on Kilimanjaro by Alan Ward four years ago I was very grateful for his expert medical and first aid support as Kilimanjaro is a significant challenge even for fit participants.
This is partly because of the impact of altitude. Although most ascents are planned with an awareness of the necessity to acclimatize carefully the height gain on summit day in particular is substantial. Many have commented also that the impact of altitude on trekkers climbing Kili can be higher than on similar height peaks elsewhere in the world. Certainly I found this compared to similar ascents in the Himalayas.
Another factor is that essentially this is Third World travel and although trek conditions tend to me reasonable, both hygiene and health are inevitably more compromised than in equivalent activities in more developed countries.
On the day and night before summit day I was unwell due both to a stomach ailment and the effects of altitude.
Alan was able to recommend Cipro as treatment for my stomach bugs (a broad spectrum antibiotic), which made a substantial difference to my ability to complete the summit day, the very long descent after and to finish the trip in good shape. He also treated me with Diamox, which significantly moderated the effects of altitude and allowed me to summit. Throughout the most physical part of this trip he also closely monitored my hydration and nutrition needs. When engaged in this kind of activity at altitude even experienced trekkers can neglect this, partly due to the effects of altitude on mental acuity – and this can have serious consequences.
For most participants the journey to and summiting of Kili is a very large commitment, both psychologically and financially. Not being able to summit because of easily treatable and relatively common high mountain ailments would have been very disappointing.
I would strongly recommend that any trek to summit Kili had the benefit of expert and qualified medical support, both for First Aid – which is also quite likely to be needed due to the physical risks and injuries that are possible – and for the type of ailments that I encountered.