Should a medical exam be required before a major trek?

Physicians and politicians in Australia are calling for mandatory physicals for any trekkers preparing to hike the Kokoda Track according to Aussie newspaper The Age. The Kokoda is a difficult and remote trail in Papua New Guinea, which has claimed the lives of three hikers this year alone. The track runs 60 miles in length through a region where the Australian military fought a pitched battle with the Japanese during WWII, and it has become a popular tourist attraction in recent years.

The latest person to die on the Kokoda was a 38 year old man named Paul Bradfield who was hiking the trail as part of a fund raising effort for a children’s charity. Before the hike he was believed to have been in good health and spent weeks training for trip. The exact cause of his death is still unknown, but it is believed that he suffered a heart attack while hiking. The other two people to die on the trail this year were also quite young as well. One was a 26 year old man, and the other a 36 year old woman.

This story brings up an interesting debate. Should a physical be required before embarking on any major trek? At what point does a government begin enforcing such requirements and how exactly do they do so? At the moment, Australia has no requirements of the trekking companies that operate on the Kokoda, but they are developing a “code of conduct” for those hiking the trail, and are now strongly considering the requirement of a medical check as well.
While three deaths is certainly something to be concerned about, it is also a very small number when you consider that 6000 people take on the Kokoda each year. Similarly, on Kilimanjaro in Tanzania, roughly ten people die in a given year as well, usually due to altitude sickness. But that too is a small number when you consider the thousands that climb the mountain each year. Should these relatively minuscule numbers of deaths cause a change in policy that will effect all the trekkers that go to these places? And would a mandatory health check have saved these three hikers to begin with?

On the other hand, there is a certain inherent danger to these kinds of trips, and obviously anyone can be at risk, no matter what condition they’re in. Wouldn’t a responsible traveler want to ensure their safety by having a physical anyway? Don’t they owe it to themselves and their families?

If Australia does institute a change, it’ll probably require the tour operators to be the ones that have to enforce it by requiring all hikers to show proof of a medical examination before they join the trek. The question is should they make this change, and if so, should other major treks around the world follow suit?