HIGH ALTITUDE RESEARCH EXPEDITION: BOLIVIA, 2022
APEX was founded by medical students at the University of Edinburgh in 2001. Since then, hundreds of students have taken part in expeditions investigating the effect of altitude and hypoxia on the human body. The latest expedition took place from the 25th June - 8th July 2022. You can access the Expedition Report here.
The APEX 6 expedition began in La Paz (3700m) for an initial acclimatisation period of 5 days, before we ascended to our base on Huyana Potosi (4700m). We stayed on Huyana Potosi for 8 days.
Data and sample collection was carried out during the acclimatisation phase in La Paz and throughout our time at Huyana Potosi.
The expedition concluded on our return to La Paz.
RESEARCH DURING APEX 6
CIRCADIAN RHYTHMS AT ALTITUDE
We conducted a pioneering project examining the impact of individuals’ body clocks (also known as chronotype) on physiological and clinical outcomes. This addresses a key knowledge gap in wilderness medicine that affects the interpretation of previous high-altitude studies and has potentially contributed to conflicting data on interventions for preventing/treating acute mountain sickness. As well as the relevance of this research to human health in the context of jetlag and hypoxia, this will also set a new standard for chronotype-control in studies carried out in other wilderness environments.
DARK ADAPTATION AT ALTITUDE
Sight is critical for orientation, movement, and balance and so visual function is clearly essential for the safety and performance of pilots, mountaineers, and athletes training at altitude. Furthermore, as the only visible part of the brain, studying retinal function at altitude provides a unique opportunity to objectively assess the effects of hypoxia on the brain. In future, changes in retinal function may be used as a new variable in field research on altitude sickness, which was not available previously owing to the impractical nature of traditional methods of measuring dark adaptation. This is an exciting field of research, with the potential to benefit those exposed to hypoxia due to both environment and illness.
ALTITUDE AND THE MENSTRUAL CYCLE
This project aims to investigate the link between hypoxia inducible factor (hif) 1 alpha and menstrual blood loss, following on from the work of Edinburgh researcher Dr Jackie Maybin. This involved female participants self-analysing blood volumes using pictograms and analysis via questionnaires collected over the course of this research project. This work is especially relevant to women experiencing the very common condition of heavy menstrual bleeding.
LUNG FUNCTION AT ALTITUDE
This project aims to investigate a new approach of calculating lung oxygenation. This is very important for classing disease severity and is also an important measurement used in clinical trials. Currently non-invasive techniques used in medicine to calculate long oxygenation are less accurate than this new proposed technique. When at altitude this involved taking arterial blood from volunteers and calculating their lung oxygenation using current techniques and our new technique. This will allow us to compare our findings and confirm efficacy. This work is relevant for critically ill patients to class their disease severity.
THE ORGANISING COMMITTEE
Apex 6 was be lead by four Medical Students from the University of Edinburgh.
Oliver was a final year medical student and Expedition Leader for APEX 6. Besides making sure everything came together on time, he also be oversaw the logistics of the expedition - making sure everything was ready for us flying out, and that the expedition ran safely and smoothly. A keen traveller, Oliver has been to 50 countries, having caught the travel bug as a volunteer on APEX 5. Through travelling, as well as other areas, he has gained extensive experience in getting people and equipment from A to B and leading diverse groups of people. Aside from travelling, Oliver has an active interest in health policy, healthcare management, events management and politics. Oliver is co-leading the arterial blood gas research, but spends most of his time on organisational aspects.
Head of Research and Funding
Alastair was a final year medical student at the University of Edinburgh, who developed a keen interest in expedition medicine as a volunteer on the APEX 5 expedition. For APEX6 Alastair was responsible for coordinating the various research projects and ensuring sufficient funding was in place for the expedition to take place. He also be undertook his own research project investigating body clocks in Bolivia. Outside of medicine, Alastair's interests lie in sport and spending time away from his beloved bikes will certainly be his biggest challenge! Don't be surprised to see him hiking up Huayna Potosi in search of signal to check on the latest sporting news!
Head of Volunteering and Communications
Suzanne was a 4th year medical student at the University of Edinburgh and was head of volunteers and communications. This means she was is charge of managing our website and social media accounts as well as ensuring the welfare of our 34 volunteers on the expedition. Furthermore, she co-lead the Lung Function project alongside Oliver. Outside of medicine, Suzanne loves cooking and staying active through running and playing hockey. She has only travelled to South America once before APEX and loved going back to explore more of the continent!
Head of Events and Sponsorship
Isla was a 4th year medical student at the university of Edinburgh. She was head of fundraising and events for APEX6 and the dark adaptation at altitude project which Sarah and Denisa bravely entrusted her with. She joined the committee in 2021 and really enjoyed it and could not wait to visit South America for the first time. Outside of studying, Isla loves the outdoors, walking, running and skiing.
Sophie acted as Expedition leader for APEX 6 until she sadly had to step down due to her graduating medical school. She was key in setting up APEX 6 and we wish her all the best in her career.
Erin worked along side Alastair as Head of Sponsorship and Grants. She will be greatly missed and we wish her well in her studies.
Sarah worked as Head of Publicity and Volunteers until she sadly had to take a step back from APEX. She was key to setting up the website and in recruitment of the 2019 volunteers.
Denisa was Head of Correspondence and International Operations for APEX 6 prior to the COVID-19 pandemic. She played a key role in securing sponsorship for the expedition as well as bridging communications with the Spanish-speaking world.
APEX6 has recruited a fantastic group of volunteers. Meet the rest of the team!
Anna is a fourth year medical student who can’t wait to explore South and Bolivia during Apex! In her free time she loves cooking and swimming!
Hannah is a fourth-year medical student who is really excited to be joining APEX 6! She loves cooking, reading, dancing and music, and can’t wait to explore South America.
Camille is a first year medical student with a love for the outdoors and is eager to explore the adventurous side of medicine. Instead of studying, she enjoys hiking, skiing and baking. She is thrilled to join the apex team and can't wait to discover Bolivia.
Madryn is a fifth year medical student who is looking forward to seeing a practical, adventurous side to medicine on this trip! Outside studies, she enjoys dancing, a good book and sunny walks.
Alex is a fourth-year Biotechnology student interested in pursuing a career in medical research and development. He is very excited to be a part of the Apex 6 team and is looking forward to exploring Bolivia and all it has to offer. In his spare time, he can be found playing basketball, hiking, and overeating. As well as being a volunteer, Alex will be one of the researchers investigating the epigenetic changes that occur in neutrophils when exposed to hypoxic conditions.
Ella is a first-year medical student and is very excited to learn more about expedition medicine on the trip. In her spare time Ella loves the outdoors and enjoys spending time mountain biking or ski-touring in the hills or heading to the beach to surf. She can’t wait to explore Bolivia and throw herself into South American culture!
Colette is a second year medical student and feels very lucky to be part of the APEX 6 team! Having never ventured to South America she is looking forward to seeing what it will offer however is sad to be leaving her dog, Charlie. She is excited to see how much of her Spanish she can remember from high school...
Theodora is a first-year medical student who loves spending time outdoors, hiking, camping and as of recently climbing! Having never been to South America before, she is excited to participate in APEX6 and get involved in medical research while exploring this amazing part of the world!
Ella is a second year medical student who is very excited to attend APEX this year. Having joined university during lockdown she is particularly enthusiastic for the social aspects of the trip, as well as exploring a brand new continent. Outside of academics she enjoys music, psychology, and poker.
Calum is a second-year medical student who can’t wait to be involved with APEX6. Having never visited South America, he is very keen to explore part of the continent, take part in exciting research, and meet loads of new people. Outside of medicine he can be found playing as much sport as he can, eating, or listening to soundtracks from musicals.
Harry is a first-year medical student with a special interest in the effects of high-altitude training on performance. He is excited to visit South America for the first time and learn more about Apex’s research. Outside of medicine, Harry enjoys running and cross country.
Ben is a first year medical student and he is looking forward to gaining more experience of expedition medicine on APEX 6. He loves Spanish and travelling, and is very excited to be visiting South America for the first time. In his spare time he enjoys playing tennis and listening to music.
Pierre is a first year, studying Maths and Computer Science and is delighted to be a volunteer for APEX. As a first-timer to South America, the expedition represents a once in a lifetime opportunity to get to know lots of new people in an extraordinary place. Outside university, he likes to play the piano and stay active.
David is a first-year medical student, keen to explore South America and take part in the APEX6 expedition. Outside medicine, David likes outdoor sports such as climbing, mountaineering and surfing. David is keen on travelling and is looking forward to visiting his 5th continent and seeing the varying cultures and sights it has to offer!
Robert is a 5th year medical student and is greatly looking forwards to exploring South America for the first time and getting a taste of expedition medicine. He’s a big fan of the outdoors and looks forward to getting to know his fellow volunteers. In his spare time he enjoys playing hockey and chilling out to music.
Chloe is a 4th year medical student with a keen interest in emergency medicine, pre-hospital care and medical anthropology. She loves hiking, music and adventure sports, and uses her spare time to travel wherever she can. She’s excited to get involved with APEX and visit South America for the first time, but might have to pass on trying guinea-pig in honour of her beloved pet hamster.
Wiktoria is a second-year medical student studying at the University of Edinburgh. As her first hands-on experience in research, she decided it would be a great idea to fly half way across the world to do it. Besides loving medicine and travelling, she enjoys music, the gym and outdoors. She is really looking forward to joining the APEX 6 team and travelling to South America.
Gemma is a fifth-year medic who loves the outdoors and enjoys cycling and running. Having never visited South America before, she is really excited to be a part of APEX6 and looking forward to exploring this part of the world!
Ella is a fourth year medical student (unfortunately that’s not her degree in the picture!). Outside of medicine, she likes riding ponies and playing the violin at a questionable standard. She loves the outdoors and is very excited about getting to explore completely new scenery, having never been to South America before!
Hi! I’m Heather, a fifth year medical student intercalating in Global Health Policy. Alongside my studies, I enjoy advocating for better mental health and wellbeing through research, volunteering and running a peer support group. I am also a keen traveller, having travelled through over 50 countries via tuk tuk, slow boat, kayak and more! South America is the only continent I have not visited and I am keen to learn about a new mix of cultures there.
Martin is a fourth year medical student, excited to travel to Bolivia and take part in the Apex expedition. He is very interested in expedition medicine and plans to carry out research alongside medical practice. He is Latin-American and is excited of the opportunity of continuing to explore the continent. Besides medicine, he enjoys football, cycling and reading.
Anya is a third year medical student who enjoys cooking, reading and being in the outdoors. She is looking forward to visiting South America for the first time, and experiencing the culture (and food) while travelling!
Darcey is a third year medical student intercalating in global health next year. She is really excited to visit South America for the first time and take part in research. In her spare time she loves hockey, running and getting outdoors!
Cameron is a second year medical student with a keen interest in trauma and emergency medicine. He is excited for his first (hopefully of many) trip to South America, and to be involved in the exciting APEX 6 research projects. Outside of medicine he enjoys hiking and mountaineering; dislikes writing in the third person.
Gus is a third-year product design student. Coming from a non-medical background, he is keen to join the expedition and learn about the medical research process. Gus is also a keen surfer and you can find him on the weekend getting barrelled at Pease Bay. Gus is looking forward to exploring South America and sampling some of the Bolivian cuisine.
Bethan is a second year medical student excited to travel to south America for the first time as it has been at the top of her bucket list for a while! Outside of Medicine Bethan loves dance, baking and being up mountains. As a covid fresher she is excited to meet loads of people on the trip
Becky is a fifth-year medical student who came to Edinburgh from St Andrews last year. She loves reading, travelling, coffee shops, running, and meeting new people so is excited for all that Bolivia has to offer!
Renée is a second-year medical student at the University of Edinburgh and is looking forward to her first encounter with medical research on APEX 6. Besides medicine, she enjoys playing piano, hockey, and hiking. Having always loved travelling, she is excited to experience South America for the first time and can’t wait to see what it has to offer!
Jaime is a 5th year medical student really interested in research and sports medicine. Currently training for an IronMan, Jaime has become really interested in how the body works under extreme conditions and can’t wait to explore this more at APEX! Outside of medicine, Jaime loves playing the guitar and basketball.
Jonny is a 2nd year medical student volunteering on Apex 6. He is looking forward to taking part in some fantastic research, discover a continent and improve on his Spanish skills. During his free time, he loves to cook, work in his vegetable garden and skate Bristo Square.
Sarah is a third year medical student and is looking forward to lots of firsts with APEX6 – first time visiting South America, first time doing research and first time being at high altitude. She loves playing hockey, baking and learning BSL.
Karolina is a fourth-year medical student who can often be found on a run, or perfecting her multiple lemon cake recipes. She loves travelling, having visited 31 countries so far, and is very excited to explore Bolivia, take part in research, and polish up her Spanish!
DR BEN WARRICK
Ben currently works as a consultant anaesthetist in the Royal Cornwall Hospital. Previously, he has worked with the air ambulance service and worked as a consultant in critical care. In his spare time, Ben enjoys outdoor activities in particular kayaking and mountain biking.
DR KATIE FLOWER
Katie currently works as a anaesthetist registrar at the Royal Cornwall Hospital. Katie previously volunteered with AMREF flying doctors which is a charity-based service providing aeromedical evacuation across east Africa. In her spare time, Katie enjoys sailing and has previously circumnavigated the UK on a 29 ft yacht.
One of the UK's foremost explorers
"I am proud to support APEX 6. The Bolivian mountains are amongst the more beautiful in the world, but they are also a real test of human endurance. The work of the APEX6 team will be invaluable in gaining better understanding of the effects of altitude on the human body. I wish them a safe and successful expedition."
Sir Chris Bonington
“I am delighted to endorse APEX 6. APEX has been hugely successful over the past years, with much exciting research being done into the intricate effects of altitude and hypoxia on the human body. This year, students will take on this challenge once again, with a further aim of collaborating with local Bolivian researchers. The group have my full support, and I wish them all the best on this journey.”
University of Edinburgh Expedition Status
Approved by the University Expeditions Committee
APEX 6 is proud to be endorsed by the University Expeditions Committee. This endorsement follows a thorough review of the organisation of the expedition, safety measures put in place as well as the ascent profile. APEX 6 is officially recognised and approved by the University.
Just before the expedition started Oliver and myself (Suzie) flew out to La Paz to set-up and receive equipment prior to volunteers arrival. This was an excited yet stressful time for us which consisted and mostly cleaning out shops of their supplies of hand soap and sanitiser! After a couple of hiccups regarding oxygen supplies and finding the right size of saline, we got into a groove. Now we are just waiting in excitement for our lovely volunteers and committee to join us!
- Suzie Green, Head of Publicity and Volunteers
Today was most volunteers' first full day in La Paz, so after settling into our hostel, we went exploring. After a lunch on a roof top terrace overlooking the Basilica de San Francisco, we headed back to the hostel where people got to planning further trips and read in the sun. For dinner we headed out to Sagarnaga and the fell to sleep!
- Madryn Riewer, APEX6 volunteer
Exploring La Paz Sunday 26th June It was a slow start to the day completing our daily reaction tests and sats, for the research components of the trip, and enjoying some scrambled eggs for breakfast. Afterwards we collected some bolivianos from a local ATM machine and visited the Bolivian markets, where we purchased some Bolivian SIM cards. Cholita wrestling was the highlight of the day, the athleticism of the cholitas was impressive and the crowd interaction entertaining.
- Harry Henriksen, APEX6 volunteer
Today most of the group joined the walking tour around La Paz in the morning and visited the cornerstones of the city as well as learnt about the different indigenous rituals and some Bolivian history! After a well deserved lunch break and some shopping at the Witches Market and Calle Sagarnaga, some of us took the cable cars up to El Alto to enjoy the sunset and the views!
- Jaime Garcia Fernandez, APEX6 volunteer
Pachamama's influence was strong today, demanding a phone as sacrifice during our trip to the valley of the moon/spirits. One successful retrieval later, we found ourselves in possibly the nicest restaurant we've ever been to, which is now expecting an influx of apex volunteers. We put our lungs to the test with the cable cars and a rickety light house, and were rewarded with a lovely sunset and a slightly terrifying view of Huayna Potosi.
- Anna Prvulovich, APEX6 volunteer
News that multiple volunteers (and some committee members) had fallen ill during the night meant that it was a shaky start to the day...
However, the remaining volunteers set out to make the most of their last full day in La Paz. We had lunch on a roof terrace overlooking the Basilica of St Francis, before heading to the coca leaf museum and discovering the fascinating history behind the use of coca leaf in indigenous cultures and modern-day cocaine use. We then headed to Mirador Killi Killi viewpoint- after a significant struggle up a very steep hill (we are blaming the altitude not our lack of fitness) we made it to the top and finished the day overlooking La Paz
- Anya Tan, APEX6 volunteer
After a morning of rushed packing and final contacts with the outside world for the coming week, the 30 odd of us ascending Huayna Potosi got on the bus ready to embark on the next stage of the expedition. The 1200m ascent took us around 2 hours, with a short break halfway through which saw some of us already feeling the higher altitude. We arrived at Refugio Case Blanca, situated at 4,800m, at around 2 pm. After getting settled in we were a delicious (and much needed) lunch, after which some of us took a walk to a nearby lake and admired the beautiful mountain vista. After sunset, we wandered out again for a bit of stargazing and we're not disappointed by an absolutely spectacular view of the Milky Way.
- Karolina Futera, APEX6 volunteer
The first full day at base camp began with ERG testing and blood sampling. Everyone filled the rest of their day with a range of activities from lake swimming to card playing. The day finished with a pub quiz in the loft, victory secured by the team 'care of the elderly'!
- Cami Maezelle, APEX6 volunteer
Many of us were feeling the effects of altitude today. Therefore, we had a quiet morning in the Refugio reading, playing games and eating lots of snacks! In the afternoon, Chloe led a yoga session outside and we went for a walk above the Refugio.
- Hannah Appleton, APEX6 volunteer
One of the other studies this week is an eye study that is looking at the effects of hypoxia on retinal function. We are each doing two different tests at two time points up the mountain which will be compared to our results from baseline (Edinburgh). The tests involves initial data collection then either 10-20 mins of dark adaption before a further test set of data is collected.
- Becky Lillicrap, APEX6 volunteer
A relaxed day helping to set up the neutrophil study. The group decided to head out on a long hike to a reservoir high above the valley, providing excellent views and a very chilly swim! We returned via the aqueduct hugging the cliffs close to Zongo dam as the sun set behind the mountain. A riveting day!
- Johnny Lang, APEX6 volunteer
After 6 days up the mountain the altitude and lack of food (according to Calum) are taking their toll. However, the show must go on- today it is Alex's project, the neutrophil study. I can't say I understand it but there are lots of people helping so it must be complicated.
The arterial blood research took place on Sunday and was a major operation. The morning was a struggle as cold temperatures and ill-advised swim led to some less than ideal arterial conditions. However, the afternoon went more smoothly and good data was collected thanks to the work of our expedition doctors, Ben and Katy along with Oliver and Suzie.
Other than that it has been Isla's eye studies and Alastair's reaction tests which have been the focus of our days, with Alastair imposing a strict no fresh air before completing his research each morning- you really hate it see it.
- Calum Weir, APEX6 volunteer
The last supper. Today is descent day and for some (myself included) it couldn't come sooner. Bouts of D&V spread around camp quickly the past couple of days making life up the mountain grim for all (please come on APEX7). Although not all was bad. Alex's neutrophil project was a resounding success (he still won't tell me whether my high score is bad or good) and I've never seen Isla so happy after completing her final ERG of the expedition.
Decent went shockingly smoothly with zero spew on the bus, though things got very emotional when our leader Oliver gave a heart warming thank you speech to Nelly. Tears. We arrived back at Hostel Republica and the showers were immediately put to good use (the bus could probably do with a good bleaching now). After everyone scrapped themselves clean we headed to the team meal booked by head of keeping us sane: Suzie. The food was great!
I'd like to thank the amazing committee: Oliver, Alastair, Suzie and Isla for all the hard work they put in keeping us alive (and mostly happy) on behalf of all of us volunteers. A shout out to our hilarious expedition doctors Ben (head of socks and sandals) and Katy (head of bruising Chloe's arm) for dealing with our D&V is also in order. The expedition as a whole was incredible and I couldn't recommend it more. It's a truly once in a lifetime experience to meet new people, eat strange food (chip soup was a low point) and of course help take part in exciting medical research.
- Cameron Norton, APEX6 volunteer