Health Issues for Trekking in Nepal

This advice is from the Lonely Planet Nepal guide mixed with my own personal experience. You must ask your doctor what is suitable for you; it may not be the same.

Before You Leave:

Diphtheria and Tetanus boosters

Polio booster

Hepatitis shots are given as a series. Don't forget to finish the course of shots AFTER trekking if you don't get them all before you leave for Nepal.

Typhoid

Meningococcal Meningitis - not the strain, which youngsters in Australia catch, but the international strain.

You don’t need a Rabies cover. However, if a monkey wants your fruit – let him have it.

Anti-malarials are not necessary for my part of the journey. However, if you're going on to the southern part of Nepal, say the Chitwan National Park you will need to consider your individual requirements and know when to start taking them.

You need a good supply of your own medication and a clearly written script to identify the drugs to customs, etc. Know the generic name of what you take – the brand name you are used to may not be available in Nepal.

ON TREK:

One of the most effective ways to stay healthy in Nepal is to watch your hygiene and what you eat and drink. I tend to wash my hands with soap and water every time they are available. Small bottles of anti-bacterial hand gels are a ‘must have’.

You should take responsibility for your personal drinking water. Very often we will be given boiled water after dinner at the lodge if you bring your empty bottle (s) down to dinner. I prefer the clear Nalgene bottles as they have a larger opening and you can see the water. I am using a ‘Steri-pen’ these days. Bring spare batteries, especially if yours takes the 123 size. Very efficient. Alternatives are iodine drops or a crystal or chlorine tablets, often sold as ‘Micro-pur’. Readily available and VERY CHEAP in Nepal. If you leave the top off your bottle for half an hour most of the chlorine gas escapes and there is very little after-taste. Some folks like to add Tang (cordial crystals sold all over Nepal) or Hydralite  tabs (buy them at home).

Food choices. DON’T EAT THE ICE CREAM! Or salad (except when I tell you it’s an ok restaurant) or fruit juices on the street. In the days of the Indian Raj they used to say ‘if you can cook it or peel it then it’s ok to eat’.  Still reasonable advice.

A tot of rum or whisky in the evening won’t do your tummy any harm.

If you do encounter a tummy bug then modern medicines will usually render it more of an inconvenience than a serious problem. With blockers such as the ‘loperamide’ drugs  (Gastro  Stop for example) to firm you up and antibiotics such as ciprofloxin or norfloxacin you should be fine in a day or so.

You might get a bigger tummy bug like Giardia but these amoeba-sized bugs are much less common. Anti-protozoa medications like Flagyl are a handy addition to your personal medical kit. 2 grams overnight and the problem is usually solved.

Main thing is hydration. Lots of drinks, a little suger, a little salt, some rehydration salts in your water bottle and you will soon be back to your old self .

Speaking of hydration, this is a very important issue on trek as we are often at high altitude. AMS is usually the name given to severe reaction to high altitude. Rather surprisingly there is the same percentage of oxygen in the air at any altitude; it is just that the air pressure is much lower. It could leave you feeling breathless, lethargic, a bit headachy or, more commonly, a bit grumpy. You might awake several times a night gasping for air. It is because the shallow breathing while sleeping is not quite enough for you. None of these symptoms are dangerous by themselves BUT if they don’t subside after acclimatisation you may have a problem. I find Diamox helpful in moderate doses, as and when needed. Taking it as a prophylactic seems odd to me but, hey, I am not YOUR doctor. I will always have a plentiful supply.

We plan to always ascend slowly and trek slower than other groups. Consequently we don’t have many problems with altitude sickness. HOWEVER, we will be monitoring your health. If it is deemed necessary for you to stay down for another day or, more seriously, descend to a lower altitude then you MUST. No question.

I have never had a customer taken down in a chopper, ever!

There are several Himalayan Rescue Association clinics along the way. They have interesting talks and sensible advice. Mostly it boils down to ‘drink more and go up more slowly’.

Women still menstruating will need to take along pads and tampons as they are not always available on trek, though they are nowadays in the supermarkets here in Kathmandu.
You will want a small first-aid kit with the usual band-aids and blister plasters.

If you don’t get to wash your sweaty feet as often as you would like you may find a small tube of Canestan   (anti-fungal) cream useful. Also handy for what I think is called’ jock itch’ but surely has a different name for women??

Sunscreen is an absolute must (along with a shady hat and dark sunglasses). Aero guard or similar is handy too. If you wear shorts the flies,  attracted to yak shit on the trail, can be bothersome.
I hope all this information doesn’t put anyone off. Chances are that trekking in the great outdoors will make you feel healthier (and happier) than you’ve ever felt in your life. All that walking and vegetarian food will keep you regular and you will be so tired you will sleep like a baby. I know I do.

If you do have any serious personal health issues then please run them past your doctor before you come to Nepal. If there are issues that your support team need to know about then do keep us informed. Please.

Cheers
Teresa
PS email me at vonschwichtenberg@gmail.com if you need to clarify any od this.