Health and Altitude, General Health and Local Clinic for Travelers in Nepal

Health & Altitude:

A comprehensive first-aid kit is carried.  Senior staff are also trained to prevent, detect and, if necessary, to deal with AMS (Acute Mountain Sickness).  Contrary to popular hype, AMS is not common – at least not on well-paced treks.  However higher treks are equipped with a PAC (Portable Altitude Chamber).  This inflatable, tube-shaped, pressurized, windowed bag creates low-altitude air pressure conditions.  A trekker’s one or two hour ‘stay’ can be sufficient response.  However, sometimes the patient will need to descend, with an escort, at least 1,000m to better oxygenated conditions.

General Health: 

Nepal cannot be considered an entirely healthy country, largely perhaps because of a climate that includes long months of mountain monsoon (mid-June to mid-Sept).  This, combined with Kathmandu’s pollution, are causes of illness often in the form of chest infections.  Warm, dry accommodation and bedding and sleeping/relaxing in warm, dry clothes are the primary rules but, better still, is getting into the fresh air that’s awaiting you outside the city!

Western Tummies: 

don’t always handle the change in diet that occurs when visiting a foreign land.  In Nepal, this is aggravated by some poor hygiene practices at restaurants and at tea-houses along the busier trekking routes.  Most bodies adjust quickly and a mild case of tummy problems can be waited out without the need for medication.  Sometimes more tiresome cases could need a course of diarrhoea tablets.

We live in an age of mega-antibiotics, now known to be over-prescribed; however, we sometimes find them necessary. 

Malaria:

is endemic only in small, lowland areas of Nepal (in and either side of the monsoon).  Doctors differ on prescribing. Most people are in Nepal without Malarial prophylaxis, and without any problem whatsoever – HOWEVER your health is your concern and we recommend discussing this issue with your doctor.

Immunizations:

We recommend discussing immunization requirements with your doctor. There is no airport or other border inspection of health certificates either on entry or exit to/from Nepal.

Drinking Water:

Although most Kathmandu hotels and restaurants treat water for drinking, many people still consider it best to purchase bottled water (in 1 litre plastic bottles).  On treks we boil and sterilize all drinking water, which is readily available to you (own water bottles required).  We DO NOT supply plastic bottled water and we do not advocate it at these times.  This adheres to the environmental code of discouraging ‘disposable’, non-biodegradable containers in the mountain wilderness.

Local Clinic:

The medical infrastructure in Nepal is limited.  However, both Kathmandu and Pokhara have ‘Western’ clinics which deal professionally with foreigners.  Also at Pheriche, in the Everest trekking region, there is a remarkable, small clinic – The Himalayan Rescue Association.  The costs, which are usually pretty reasonable, are paid by the patient who would then claim any significant refund from his/her insurance.

The Drug Scene

…..:is low key and fairly unobtrusive but 90% of all foreigners in jail in Nepal are there on drug-related issues, wallowing until someone (not their embassy) negotiates their release.

Seasons & Weather:

Try to avoid the monsoon – approximately mid-June to second week of September. The rest of September, October, November and most of December are excellent ‘picture perfect’ months.

The Christmas and New Year period – even though already cold (freezing temperatures at 3,000m and above)  – is ideal in the Annapurnas.   January to mid-February are great for winter trekking – ‘icy morning, clear day, cold night, bright new moon’.  Generally it’s best for shorter treks not to go much higher than 4,000m.  The usually crowded Annapurna and Everest tea-houses are quite empty and their people have time to chat.

Himalaya Encounter’s tented trekking programme starts again in mid-February when days are longer, the sun warmer and the glorious rhododendrons are coming into full bloom.  The spring season – March, April, May – for trekking then continues until the end of May/early June.  The Himalaya, not being Disney Land, delivers the real thing. 

Monks

Let no one have you suppose that all and always is it an azure blue, above the cloud, sun blessed idyll.  You may well get to see avalanches and electrical storms and not get to see two metres in front of your face – clearly the organisation and the team need to be prepared.

Tipping: 
Nepal has recently introduced a 10% ‘service charge’ on hotel and restaurant accounts however, a modest, friendly tip is more or less expected by taxi drivers, porters etc.

Trekking Staff, who have been so involved in your welfare over several days; for them tipping has as much to do with a sense of recognition as it does with actual money.  Some people want to be particularly generous but, because clients often ask, the following are something like the norms:

- a)  Full supported (suggested) - $US4-5.00 per group member per day, to be handed to the Sirdar in the presence of other staff for later ceremonious distribution to ALL staff at end-of trek party.  (The staff-to-client ratio on these wilderness treks is never less than 3 staff per client).  Sometimes an especially good Sirdar might be recognised separately.
- b)  Tea-house (suggested) - $US2-3.00 per group member per day for guide, something more for porter(s).
- c)  Rafting Staff (suggested) - $US2-3.00 per group member per day on same basis as above.
- d)  Tour Leader (suggested) - $US2-3.00 per group member per day.

We recommend that you DON’T do any tipping, or give gifts, clothes etc until full completion of service.

Feedback:
We request each member of any trek to complete a one-minute ‘Feedback Form’.  They are read.  They really do help…if you will.  Thanks!