Doctor's Review: Medicine on the Move

January 19, 2022

© Dr Brad Bowins

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I prescribe a trip to Machu Picchu

A psychiatrist discovers you don't have to be a hardcore trekker to tackle the Inca Trail

With real estate, it's all about location, location, and location. Apparently, this concept wasn't lost on the Inca of Peru when they chose the fertile Urubamba Valley for the construction of Machu Picchu. This 15th-century Inca city is perched on a ridge between two mountain peaks, with spectacular views in every direction.

When many people think of a trip to this region they imagine a strenuous hike of several days along the Inca Trail to reach their goal. Typically, hikers arrive at Machu Picchu in the early morning when it's often fogged in, spend a few hours there and then head back via the train to Cuzco further in the valley.

Although experienced hikers might not have it any other way, this option is not for everyone, particularly considering the risk of Acute Mountain Sickness (AMS). The Andes are a high-altitude destination; many cities and towns sit around 3000 metres in elevation, and some of the Inca Trail is substantially higher.

Above 2440 metres, AMS can become an issue. The symptoms are roughly like a hangover, but without the fun night of alcohol consumption beforehand. Many hikers who are not fully prepared for this possibility have had to give up mid trek, some even have to be carried back down. Spending several days in the region to acclimatize prior to the hike, and taking medications that speed your natural breathing rate is required to ensure that you're fully prepared.

Trail or train?

At this point many readers will wonder why would I put myself through this? Isn't there another way? The answer is yes — with the added advantage that the other option allows you to experience Machu Picchu and other Inca wonders more thoroughly and in less time. As you can easily imagine, to take in all that Machu Picchu has to offer in terms of scenery, photo opportunities and history, you need more than a few hours at the end of a long hike.

An excellent alternative is to take a scenic train ride with Peru Rail (; from US$95) along the Urubamba Valley to Machu Picchu and spend a night or more at one of the hotels right on-site, like the Sanctuary Lodge (tel: 011-51-984-816-956; Before the day-trippers arrive and after they leave, you pretty much have the archaeological site to yourself and you can truly experience its beauty.

Given the challenging vertical world they lived in, the Inca were extremely well organized in constructing their cities. To ensure adequate crops, they constructed a terraces for agricultural, complete with ditches to collect water and devices enabling the water to be funnelled to the terraces and crops most in need. I recommend that visitors walk to the top of the agricultural zone at Machu Picchu, and perhaps a short way up the Inca Trail, to see the overall layout of the city with its separate agricultural and urban zones along with the central square. Classic photographs of Machu Picchu are often taken from this perspective.

The vast urban zone was subdivided into upper- and lower-class areas. The Royal Palace displays a unique feature of Inca architecture which is usually only seen in important buildings, that is the use of dry-wall masonry construction with very tight seams not using mortar, which provide a better capacity to withstand earthquakes.

Above the large central plaza is the Sacred Square, which is the site of the Temple of the Three Windows as well as a polished granite rock described as the Hitching Post of the Sun, designed to mark the solstices and equinoxes with shadows.

Sacred sites

From Cuzco, several tour options are available and well worth it. Highly recommended is a bus tour along the Urubamba Valley to the ancient city of Ollantaytambo. This Inca site is reminiscent of Machu Picchu with its vertical construction and agricultural terraces.

At the top is a sacred temple with a very unique double doorjamb, built with tight mortarless seams. A path descending into the Urubamba Valley points to how the massive blocks used in the construction process arrived. The grain storage buildings further demonstrate Inca ingenuity: they are perched high up on a near-vertical cliff face, where cooling breezes helped preserve the harvest.

Also included on this full-day tour are stops at markets at Písac and Chincero, the latter a high-altitude town complete with a whitewashed church and bell tower. The goods at these markets cost less than those found in Cuzco and are frequently made by the seller.

Heart of the empire

Cuzco was once the capital of the Inca empire, so it's no surprise that there are interesting sights to visit here as well, including the Temple of the Sun. Also known as Koricancha, this temple was the country's main astrological observatory and the most powerful religious site in the empire. Unfortunately, the Spanish church of Santa Domingo was built over it. All that remains of the original temple are some interior rooms featuring Inca architectural elements such as trapezoidal windows, mortarless seams and elaborate double doorjambs.

In the days of the Inca, Cuzco's central square was twice its current size, and reportedly had buildings sheathed in gold. Though there is no gold to be seen, the modern day Plaza de Armas is still quite picturesque with two impressive Spanish cathedrals, and a central square ringed by shops and cafés.

Overlooking Cuzco is Sacsayhuáman, said to have been both a temple and a fort. This site is flatter with a vast open area and tall stone structures. Great views of Cuzco and the surrounding area are part of the appeal here.

Cuzco has a good range of hotels; a particularl memorable one is the high-end Hotel Monasterio (tel: 011-51-84-60-4000;; doubles from US$235) set in a 16th-century monastery. The altitude of sleeping accommodations appears to be critical in terms of AMS, and this hotel's rooms are oxygen enriched, producing an effective decline in elevation to 2400 metres where AMS is not a concern.

Level off in Lima

When your visit to the world of the Inca is over, you'll return to sea level in Lima. Although the capital of Peru is a large city characterized by urban sprawl, there are some very nice areas and plenty of interesting attractions. A stay in a more upscale area such as Miraflores is best, as you can safely walk at night here. Miraflores is the site of the pre-Inca ruin of Huaca Pucllana, and is also home to a modern attraction: the Larcomar mall with its shops and restaurants overlooking the Pacific.

In central Lima, the Plaza de Armas contains the Government Palace and Church of San Francisco. A visit to the catacombs below the church to view the bones and skulls of many generations of priests is both a fascinating and eerie experience. Equally intriguing are visits to the Gold Museum ( containing a stunning private collection of pre-Inca and Inca gold pieces, and the National Museum of Anthropology and Archeology ( which offers an informative background on the history of the country.

By following this itinerary, you can take in Machu Picchu and other Inca sites, along with Lima in a leisurely one-week visit. For those fascinated by anthropology, architecture and natural beauty, the Inca world of Peru is a must-see.

This article was accurate when it was published. Please confirm rates and details directly with the companies in question.


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