The point of this design choice is, of course, to evoke a feeling of Qelong's hostility - a slow corruption of the characters' bodies that might take a while to build up, but nevertheless inexorably forces them out of the province. Aakom will affect the player characters in basically the same way that it has affected the setting - nothing apparent at first, but with catastrophic effects and no way to easily recover. It forces the players to really integrate themselves into their environment, and experience the war and devastation as inmates, and not tourists. It turns Qelong into a negadungeon. For these reasons, it's taken me a while to figure out the best way to simplify the aakom poisoning rules, because their complexity is so important to their purpose in the module.
Part of the solution is in slightly realigning the module's structure. Qelong assumes a seasoned party, having had some adventures under its belt, traveling across the world and arriving here. The players will have established their own baseline, and they are strong and tough enough to weather the River's hardships for a week or two and come out unscathed. Of course, aakom should have started making things go awry by that point, and then the module sinks in its teeth. But even then, a way out is consistently within reach - just a plundered stupa, or a cardamom caravan, or a midnight raid on Sajra Amvoel away.
I'm going to run Qelong for a first-level party, and that means a lot of those assumptions won't be true. There's much less gear, magic, and hit points for the players to fall back on, making it commensurately more difficult for them to pull off a big treasure load to pay for a ticket home, or for a well-executed plan to actually allow them to capture the lich-garuda and fly to safety. There isn't technically even a home to return to, or at least a "home" that the players have tangibly experienced. Qelong's primary objective becomes survival, not escape and profit. And in a survival story, the main antagonist is resource management.
In the module, aakom poisoning is inflicted in these five ways: breathing air, eating food, drinking water, and taking damage. The last one is even more granular - there are four different ways of taking damage that lead to varying levels of aakom poisoning. Fighting the Naga faction is the most dangerous - every wound they inflict causes an equal amount of aakom contamination.
Most of these are easily conceived of as effects on resource management. Breathing air makes time spent in Qelong its own resource. Consuming food and water do this as well, though there are some ways to mitigate this. The damage effects are an additional cost to the existing resource trade-offs that occur in combat. Since a 1st-level party can be expected to be spending a lot of time in Qelong already, and mundane damage and disease are inherently more significant costs to the characters, I'd change the poisoning conditions to this:
- 1 point per water ration consumed (as normal) and 3 in 6 chance per food ration consumed, ignored for mountaintop springs or alpine plants
- Points equal to damage from Naga faction
- Snake poison adds 1d4 aakom for three rounds, rather than inflicting 1d4 HP damage
Now, time (measured by meals consumed) is a trade-off. The party can either move freely, at the cost of aakom from the natural environment, or it can stay put in a mountain hex, avoiding aakom accumulation but not taking any actions. Since I'm running the four factions as active and dynamic groups, "staying put" can incur significant costs on Qelong's power situation. Survival in Qelong is thus about balancing food needs, water needs, and aakom contamination, with encounters and combat positioned as the opportunity cost of engaging in exploration or treasure-hunting.
The rest of the aakom rules stay the same, though with significantly less granularity due to a 1st-level party's lower HP totals.