Personal travel insurance is not included in the prices mentioned. But every effort is made to ensure the safety of our guests at all times; it is condition of booking that you take out a personal travel insurance policy. To protect against unforeseen circumstances, it is advisable to take a “Trip Cancellation and Medical Insurance Policy” before your arrival into Kathmandu. Medical coverage is especially mandatory for those who are trekking in high altitudes. It covers injury, death, lost baggage, medical treatment and expenses, and air ambulance or helicopter rescue services in case of emergency.
No vaccinations are required for entry to Nepal.
Tips for your safety
Trekking in the mountains is a rewarding and unforgettable experience. However, it is important to keep your safety in mind. Weather conditions can change any moment and in case of an accident, medical help is not always easily available. It is good to be prepared, both before and during your trip.
Below are some guidelines and tips for safety during your trip.
Dehydration: You sweat a lot when hiking therefore, it is very important to keep hydrated. Keep water with you at all times, and drink lots!
Blisters: Walking for a long period of time can cause blisters to develop on your feet and underparts of your body. Be prepared and take necessary ointments and medication with you. Try to keep your feet as dry as possible.
Sunburns: At high altitudes, the sun rays are more powerful. Don’t forget to take a hat, sunglasses and wear lots of sunscreen to avoid getting sunburnt.
Altitude Sickness: Altitude sickness occurs when ascending from low levels to high levels, especially when done rapidly. Altitude sickness begins with shortness of breath from lack of oxygen. Symptoms include exhaustion, loss of appetite, headache and nausea. It is important to go slowly, and monitor your body’s reaction to the change in altitude. You should give necessary time for your body to acclimatize as suggested by your trekking company. Trekkers should descend immediately if their condition worsens. Descending to a lower altitude is the most important action to take.
Altitude sickness, also called Acute Mountain Sickness (AMS) usually occurs above 2,500 m, but serious altitude illness is rare below 3,000 m. It can start with a mild headache and weariness to a life-threatening condition, when fluid in the lungs (HAPE) or brain (HACE) is built-up. AMS is caused due to the body having difficulty adapting to the lower oxygen level at higher altitudes. Usually this is due a quick ascent in altitude in a short interval, and sometimes it may also occur due to personal sensitivity. As AMS can be fatal, it is important to know about the disease, its symptoms, prevention and treatment.
Acute Altitude Sickness
Acute altitude sickness is the mildest and most common form. Patients usually have a (mild) headache and/or less appetite, and nausea. These symptoms are quite common above 3,000 m. Since this is not uncommon, it is not as yet a worrying issue, but it is important to tell you guide or trekking companion about your symptoms, and keep close watch that they don’t get worse. Symptoms include, headache, fatigue, dizziness, insomnia, shortness of breath during exertion, nausea, decreased appetite, social withdrawal etc.
High Altitude Pulmonary Edema (HAPE)
HAPE occurs when fluid builds up within the lungs, a condition that can make breathing extremely difficult. Onset of HAPE can be gradual or sudden. HAPE typically occurs after more than one day spent at high altitude. If left untreated, it can progress to respiratory collapse and ultimately to death. Symptoms include, shortness of breath when at rest, extreme fatigue, gurgling respiration, dry cough or wet cough with frothy sputum, possible fever, respiratory failure etc.
High Altitude Cerebral Edema (HACE)
Another severe form of altitude sickness is high altitude cerebral edema (HACE), in which fluid builds up within the brain. As the brain swells with fluid, the person’s mental state changes. Loss of coordination, coma, and, finally, death can occur if not recognized and treated promptly. Symptoms include, difficulty with balance and coordination, hallucinations, lethargy, confusion, unconsciousness, coma etc.
How to identify if someone is seriously suffering from AMS, HAPE or HACE:
- Ask the person to close his eyes and bring his finger to the tip of his nose.
- Ask the person to walk in a straight line.
- Ask the person to put on pants (put his leg into one of the legs).
- If he is not able to do so, the situation is serious!!
How to treat AMS
- In case of mild symptoms, stay at the same altitude. Ascend only when the symptoms have resolved completely.
- In case your symptoms are getting worse while resting at the same altitude, descend and descend.
- In case of serious symptoms go down immediately! Helicopter rescue may be necessary.
If the patient is not able to walk (due to serious symptoms) and can’t be carried down, an inflatable high pressure bag (Gamow Bag) can help. The bag restores the oxygen level and air pressure and is used as a treatment in acute situations. Some trekking groups carry a pressure bag, besides they are available in some lodges, especially in the Khumbu/Everest area.
- Never let a patient descend unattended.
- If available, consult a doctor, even if symptoms are not yet very serious.
How to prevent AMS
The best way to prevent AMS is to ascend gradually. Above an altitude of 3,000 meters you should not ascend more than 300 meters a day. Stayovers for acclimatization is recommended. Drinking lots of water can be very helpful. More and more people use Diamox (Acetazolamide) as a prophylaxis, to help the body acclimatize more quickly. You start taking Diamox shortly before you start to ascend above 3,000 meters and continue taking it until you descend again. Consult with your doctor if you consider using Diamox. Drink extra water, as Diamox dehydrates the body.