Some years ago now – perhaps in November 2012 – I led a weekend hike to Vaalribbokkop Cave in the Monk’s Cowl Wilderness Area. This is one of my favourite lower Berg caves. There are several route options so it never gets boring. While nearby Stable Cave offers far more spectacular views and some vulture watching, finding water there is often a challenge so I usually avoid it except in high summer.
On this particular occasion, our outbound route took us via Jacob’s Ladder. This is not an actual ladder but a series of zigzags on a well-worn path up the southern side of the Culfargie “bowl”. The bowl is a semicircular valley, and it is notorious for trapping heat, so inevitably, in all but the coldest weather, Jacob’s Ladder is a good 5° Celsius or more warmer than anywhere else on the route.
We had just settled down in the shade of some proteas at the top of Jacob’s Ladder to cool off and take in the views over the Natal Midlands, when one of the ladies in our group named Jenny mentioned that she was not feeling well. We were all extremely hot and bothered, so we assumed she had heat fatigue. She downed some electrolyte and after about 30 minutes, when she said she was feeling a little better, we set off to complete the rest of the climb up to the small plateau near Stable Cave.
Jenny took another break in the shade of some more protea shrubs while the rest of us paid a quick visit to Stable Cave. There was no water there, so we set off to complete the remaining 2,5 km to Vaalribbokkop Cave. By now she was straggling, but we were so close to our overnight stop that we pressed on slowly and arrived there in the mid-afternoon.
Jenny was starting to feel quite ill, so we got a sleeping spot arranged for her under the yellowwood trees, organised some more electrolyte drinks, and left her to recover with some ladies in attendance. However, her condition deteriorated further and she had a resting heart rate of around 120. This was alarming, and considering that she was now well-rested and rehydrated, the problem was looking less and less like heat fatigue or heat exhaustion to me. She was also becoming extremely anxious and upset.
Late in the afternoon, she confessed that she was suffering from hypertension, that she had just changed her medication, and that it was obvious to her that her doctor had not got the dosage correct yet. This was now clearly a very serious situation, and there was no way our patient was going to be able to hike back to our starting point.
There is no cell phone reception at the cave, so we sent some runners out towards the cliffs above Culfargie to contact Monk’s Cowl and relay our predicament, indicating that we were going to need a helicopter extraction. They agreed and said they would arrange a helicopter to collect her early the following morning. Jenny calmed down a bit after hearing the news. With ladies attending to her all night, her condition still did not improve, but it did not deteriorate either.
Before dawn the next day, our runners went out to report on her condition and confirm that a helicopter was still needed. An Oryx from No. 15 Squadron was ready to leave from Durban, but the Midlands where clouded in. The rescue coordinators decided to contact Cathedral Peak Hotel and ask them to send the helicopter based there for sightseeing trips to come and fetch her instead. The Robinson 44 arrived as soon as the sun was up, Jenny and her kit were loaded into it, and the pilot flew her away to Ladysmith Hospital. This is the standard destination for the completion of rescue flights, because Ladysmith seldom has mist. She made a quick recovery once the doctors sorted out her medication.
