Trekking

Nepal has some of the famous trekking in the world, to and around several of the world’s highest mountains, including Mount Everest trekking. Most people visit the country just to do trekking and the tourism industry is well prepared to facilitate all manner of trekking styles and destinations. On the one hand you could spend a year planning an expedition to wild and lofty places; on the other you could land in Kathmandu with no plans and be on the trail to Everest Base Camp (EBC) in a matter of days.

“Nepal Teahouse trekking” along the main trails is the most common style, with decent lodges in every settlement (and between), it is possible to dotrekking in comfort with minimal preparation, equipment and support. There is no need to camp and a selection of western style foods are readily available from a mixed menu system. special permits are required, (Trekking Information system management) and each national park entry tickets for trekking. The main areas for these trekking are Everest/Khumbu, Annapurna and Langtang/Helambu.

Facilities available in remote areas are less extensive than in the more popular areas. Off the main trails where there are no lodges and food from menus a Nepali guide becomes essential, and it may be advisable to visit such regions with organised groups, including guide, porters and full support. Mustang, Kanchenjunga, Manaslu, Dolpo and Humla are in remote areas. Many of them require also special permits.

There are lots of agencies in Kathmandu and Pokhara who are always keen to broker the services of a guide and/or porter. During the main seasons the agencies run regular group treks, both teahouse and camping styles, and it generally possible to join a group doing a trekking of your choice. Independent trekking is quite easy with straight forward preparations.

All Trekking Trips

Everest Base Camp Trekking Everest Base Camp Trekking
days17 Starting from USD 1299

'EVEREST BASE CAMP TREKKING COST, an adventure in the heart of world’s highest Mt. Everest…

View Trip Details

Around Manaslu Trekking Around Manaslu Trekking
days18 Starting from USD 1490

AROUND MANASLU TREKKING 'an adventure around Nepal North Mid West Himalaya and traverse over high…

View Trip Details

Annapurna base camp trekking Annapurna base camp trekking
days14 Starting from USD 999

ANNAPURNA BASE CAMP TREKKING 'a short, moderate & adventurous walks into beautiful Annapurna sanctuary' Trekking…

View Trip Details

Everest short trekking Everest short trekking
days12 Starting from USD 999

Everest short trekking - THYANGBOCHE MONASTERY & EVEREST PANORAMA Trekking Highlights: "Sweeping scenic flight to…

View Trip Details

Nepal Everest Base Camp Trekking – 2018 departure dates Nepal Everest Base Camp Trekking – 2018 departure dates
days17 Starting from USD 890

NEPAL EVEREST BASE CAMP TREKKING 'walking in the shade of world's highest peaks around high…

View Trip Details

Tengboche Mani Rimdu Festival Tours Tengboche Mani Rimdu Festival Tours
days18 For PriceAsk our expert

Trip Facts - 18 days Trip • Group size: 1+ • Best Season: March, April,…

View Trip Details

Royal Trek Royal Trek
days5 For PriceAsk our expert

Trip Facts - 5 days Trip • Group Size: 2+ • Best Season: March, April,…

View Trip Details

Nepal Honeymoon Tours Nepal Honeymoon Tours
days8 For PriceAsk our expert

Nepal Honeymoon Tours Facts - 8 days Trip • Tour Cost: USD 1990***** • Group…

View Trip Details

Langtang Trekking Langtang Trekking
days11 For PriceAsk our expert

Trip Facts - 11 days Trip • Group Size: 1+ • Best Season: March, April,…

View Trip Details

Langtang Gosainkunda Trek Langtang Gosainkunda Trek
days14 For PriceAsk our expert

Langtang Gosainkunda Trek Facts - 14 days Trip • Group Size: 1+ • Best Season:…

View Trip Details

Langtang Gosainkunda Helambu Trekking Langtang Gosainkunda Helambu Trekking
days16 For PriceAsk our expert

Langtang Gosainkunda Helambu Trekking Facts - 16 days Trip • Group Size: 1+ • Best…

View Trip Details

Jugal Himal Trek Jugal Himal Trek
days13 For PriceAsk our expert

Jugal Himal Trek Trip Facts - 13 days Trip • Group Size: 1+ • Best…

View Trip Details

Himalaya Holiday Tour Himalaya Holiday Tour
days13 For PriceAsk our expert

Trip Overview Himalaya holiday tour is an ideal family holiday destination. Nepal is a country…

View Trip Details

Helambu Trekking Helambu Trekking
days8 For PriceAsk our expert

Helambu Trekking - 8 days Trip • Group Size: 1+ • Best Season: March, April,…

View Trip Details

Gosainkunda Trekking Gosainkunda Trekking
days7 For PriceAsk our expert

Gosainkunda Trekking - 7 days Trip • Group Size: 1+ • Best Season: March, April,…

View Trip Details

Ghorepani Poonhill Trekking Ghorepani Poonhill Trekking
days7 For PriceAsk our expert

Trip Facts - 7 days Trip • Group Size: 1+ • Best Season: March, April,…

View Trip Details

Ghandruk Loop Trekking Ghandruk Loop Trekking
days5 For PriceAsk our expert

Ghandruk Loop Trekking- 5 days Trip • Group Size: 1+ • Best Season: March, April,…

View Trip Details

Everest View Trekking Everest View Trekking
days10 For PriceAsk our expert

Trip Facts - 10 days Trip • Group Size: 1+ • Best Season: March, April,…

View Trip Details

Everest Easy Trekking Everest Easy Trekking
days8 For PriceAsk our expert

Everest Easy Trekking - 8 days Trip • Group Size: 2+ • Best Season: March,…

View Trip Details

Everest Base Camp Trek Shortest Duration with Helicopter Everest Base Camp Trek Shortest Duration with Helicopter
days14 Starting from USD 2990

Everest Base Camp Trek Shortest Duration Helicopter- 10 days Trip • Group Size: 1+ •…

View Trip Details

Everest Base Camp Trek Everest Base Camp Trek
days16 For PriceAsk our expert

Everest Base Camp Trek- 16 days Trip • Group Size: 6+ • Best Season: March,…

View Trip Details

Everest Base Camp Luxury Trek Everest Base Camp Luxury Trek
days19 For PriceAsk our expert

Trip Facts - 19 days Trip • Group Size: 1+ • Best Season: March, April,…

View Trip Details

Annapurna Circuit Trekking Annapurna Circuit Trekking
days21 For PriceAsk our expert

Annapurna circuit trekking is the popular name for a 300 km trek in the Annapurna…

View Trip Details

Nepal volunteer trekking Nepal volunteer trekking
days16 For PriceAsk our expert

Nepal volunteer trekking volunteer Eco trekking in Nepal Day 01-Arrival in Kathmandu Day 02- Tours…

View Trip Details

Everest Base Camp Gokyo Lake Trekking Everest Base Camp Gokyo Lake Trekking
days20 For PriceAsk our expert

Trip Facts - 20 days Trip • Group Size: 1+ • Best Season: March, April,…

View Trip Details

Annapurna Base Camp Trek Annapurna Base Camp Trek
For PriceAsk our expert

Trip Overview Annapurna Base Camp Trek is a moderate nature trek that starts at Phedi,…

View Trip Details

Traveler Reviews

Me and my team have had great experience with Team Himalayas Holiday Services. Our guide was helpful and friendly through out the trip.

Review submitted -

Guide / Porter for a Trek

Himalaya Holiday Service (Himalayas guide) is proud to announce booking facilities of Rooms, Guide and porter for the trekkers during the Trekking in Nepal. It is the best option for the travelers who want minimum help from our company. It is the cheapest way to do hiking in Nepal. Himalayas Guide arrange an English speaking Mountain guide, booking of the rooms as your need in local lodges while you are in trek and manage porters and travelers pay for food directly to the guest house . This offer is only for certain areas in Everest region, Lang tang region, Annapurna area where hiking routes are served by local tea houses. Other operations are exactly same as Tea House trekking except you pay for your own foods. We take care of all expenses of our crews.

Are you travelling with very small Budget? Or not interested to take any of our all services, but still Interested in our daily activities?

It is suggested for your most economic way of trekking. Hire the experienced mountain guide or just a porter for your trekking. We highly suggest taking at least a porter/helper for your trek. we advice because you are doing hiking in remote and high Altitude of mountain and to avoid unseen risks when in case you feel sick or need any kind of help, at that time guide or porter could be best friend for you. They are helpful not only to show trails, share local cultures, religions, sites or carrying the Luggage but also helpful wherever and whenever you need help. Most of the guides have General Knowledge of First-aid, they speak your language as well as very friendly and honest at service and of course professional in services. Beside Guides, Our porters are also sincere to handle your entire valuable luggage and never say tired from their jobs. This is advantage that you are recommend to hire at least Guide or Porter from our Company.

For Further Information please Write us with trekking area,days, number of travellers.

Clothing For Trek

we will normally provide two person waterproof tents, foam mattresses, and all cooking and eating utensils. You will need your own warm clothing, walking shoes, sleeping bag and personal equipment. During the day you will carry your camera, jacket, and water bottle in a rucksack. The rest of your equipment, including your sleeping bag, will be carried by porters.

All hiking will be on trails. You will not need any climbing equipment such as ropes, ice axe, or crampons at any time during the trek. The equipment check list that follows details the equipment you will need for your trek. Most of these items are available for rent or sale in Kathmandu, but all trekking equipment in Nepal is either used equipment that was sold by other trekkers or mountaineering expeditions or locally made reproductions of internationally known brands. The local rucksacks, duffel bags and rain ponchos are inexpensive and will usually stand up to the rigors of a trek or two. Don't be fooled into thinking that you are getting a brand name item, however; most new looking rucksacks available in the bazaar are made in Nepal from imported Korean nylon.

In Kathmandu casual clothes are the rule, unless you get invited to a formal Nepal government or embassy reception.
Equipment Check List

* Jeans or slacks
* Towel and toilet kit
* Underwear
* Gloves or mittens
* Sleeping bag, warm to 20 degrees F, either down or fibrefill (or you can rent one in Kathmandu)
* Parka, down or fibrefill; a ski jacket is ok
* Sweater, wool shirt or acrylic pile jacket.
* Duffel bag, canvas or nylon, without a frame (for porters to carry)
* Daypack or rucksack, waterproof, for you to carry
* Water bottle 1 litre or 1 quart; be sure that it does not leak.
* Flashlight or headlamp
* Walking shoes: either boots, light hiking or running shoes, well broken in. As there may be rain, mud or snow; boots are sometimes necessary therefore you should bring them despite the extra hassle. Many times the entire trek can be done in tennis shoes, but if there is snow, you run the risk of frostbite, or at least cold feet if you do not have boots. If your feet are small (size 10 or less), you can rent boots in Kathmandu.
* Hats, one with a brim for sun; one wool for cold weather.
* Sunglasses or goggles - very important for travel above 12,000 feet. Absolutely essential for Everest treks, optional for Annapurna treks (though they may be necessary in December and January when there is snow).
* Shorts - it may be warm during the day, especially near Pokhara. You will probably not wear shorts on Everest treks. Women should wear skirts instead of shorts.
* Socks - two or three pairs thick wool or artificial fibre.
* Shirts - three are recommended: two T shirts and one long sleeve shirt.
* Pocket knife (Be sure this is packed in your checked baggage to avoid hassles with airport security).
* Rainwear - a poncho; or you can buy an Indian umbrella in Kathmandu for about $2.
* Slippers or sandals for campsite wear. Rubber "shower shoes" are available in Kathmandu for about $1

This list is suitable for most 8 to 10 day treks. Although you can wash clothes during the trek, you may need extra socks and shirts etc. for longer treks. If your trek goes above 3500 metres (about 12,000 feet) for more than one day you should pay particular attention to warm clothing. If you are trekking to higher elevations or during the cold season you should carry both a pile jacket and a down or fibrefill parka.

An altimeter is an interesting addition to your gear. The weight limit on treks and domestic flights is 15 kg (33 pounds); please make an effort to keep your baggage within this weight limit.

Medical for Trek

On most treks, you will always be within a few days of medical help. If you are on a group trek, the leader should have the medical knowledge necessary to deal with emergencies and evacuation. If you are on your own, you will have to shoulder most of the responsibility for medical problems yourself. The sherpas who will accompany you are not doctors, nor are they first aid practitioners. It is essential that you bring your own first aid kit and be prepared to take care of your own blisters, cuts and scrapes. In the event of a real emergency, the sherpa sirdar will do his best to get you transported quickly to a qualified physician or an airstrip from which you may be evacuated to Kathmandu.

Medical Supplies
The supplies listed here are recommended for any trek. Since some of them are prescription drugs, you should visit your doctor and discuss the trip with them and obtain prescriptions. If your doctor makes recommendations contrary to the suggestions here, follow your doctor's advice, and obtain substitutes for these items. It is not necessary to burden yourself with a lot of medicines for the trek, though you should carry enough to take care of minor problems. The ones listed here are sufficient for most situations. You should be sure to provide your supply of own aspirin, band aids, etc. If you are taking an extended trek, you should consult Dr David Shlim's medical chapter in Stan Armington's Trekking in the Nepal Himalaya and equip your party to deal with possible problems and emergencies.

Basic first aid supplies

* Suntan lotion or sun blocking cream
* Lip salve (Chapstick, Blistex, or Glacier Cream)
* Foot powder
* Bandaids (plasters) and tape
* Moleskin or other blister pads
* Elastic (Ace) bandage
* Antiseptic cream
* Aspirin
* Throat lozenges or cough drops
* Decongestant tablets
* Iodine - small bottle for water purification
* Toilet paper & matches or a cigarette lighter to burn used TP
* Bactrim, Norbactin or other diarrhoea remedy

Immunisations
Your own physician and your local Public Health Service are the best sources of information about immunisations necessary for Nepal. The list of recommended injections here includes immunisations usually recommended for trekkers in Nepal. Hepatitus and Meningitis protection is also strongly recommended. It is a good practice to have your jabs recorded in a yellow international health certificate.

Recommended Injections

* Cholera
* Typhoid-paratyphoid
* Tetanus
* Polio (oral)
* Malaria (only if you will be visiting a jungle lodge)
* Typhus
* Hepatitis
* Meningitis Meningococcal A/C vaccine

Some Advice about Food and Water
In Nepal you should drink only treated water and eat only freshly cooked food. You should always wash your hands before eating, especially if you eat things like biscuits and bread with your fingers. If you follow these simple rules, you should not experience any severe stomach problems. Be forewarned, however, that it is not unusual to have some mild diarrhoea in Nepal while your system adapts to a new environment. If, however, you have diarrhoea accompanied by severe cramps, high fever and chills, you may have a bacterial or parasitic infection that requires additional medication. For any medical advice and assistance you require in Kathmandu go to the CIWEC Clinic, near the Yak & Yeti Hotel, phone 228531.

The food in most hotels in Kathmandu should pose no health problem. Some conservative physicians recommend that you yourself see any water you drink boiled or treat the water yourself with iodine. The bottled mineral water available in Kathmandu is the safest water to drink. Do not drink tap water under any circumstances. If you eat in restaurants outside the hotel, you should follow the cooked foods rule. Salads and fruits that cannot be peeled should be regarded with suspicion. Open air sweets, dried fruits, local chhang, candy coloured soda pop in the bazaar, and the wares of small pie shops are all tempting, but can harbour germs and parasites that can upset your stomach and ruin your trek. During the trek, the sherpa cook and kitchen crew thoroughly cook all food and wash dishes in boiling water. You should have no stomach problems if you eat only the food served by the sherpas. The most important consideration for staying healthy is to take extra care with your own personal hygiene. Keep your hands clean by washing them frequently in the washing water that the sherpas provide.

Read for Trekking

Readings for Ttrekking

Background Informations
A trek is not a guided tour. The sherpas who accompany you are there to show you the trail, take care of problems, cook, set up tents, and do other camp chores. Most sherpas can speak and understand simple English, but it's rate to find a trekking sherpas that is fluent in English. They will not be able to give you detailed information on religious practices, culture and natural history, although the trek itself will provide a good opportunity to observe these things and to learn about them.

If you wish to learn more about a particular subject, you should research it yourself. There are many good books covering every aspect of life in Nepal. Many of these are suggested in the reading list below. If you are seriously interested in a particular subject or just want to prepare yourself further for the trek, it will be useful to visit your local library armed with our reading list and spend a few hours gaining some background about Nepal and its people. If you want to get the most out of your travel experiences and make the journey more than just an exercise in following an itinerary, then your research has just begun. A trek operator can provide just so much information about a trip. Researching an adventure beyond that level can mean the difference between just a vacation and an unforgettable experience. The unexpected will still happen; but the better prepared you are, the more you'll be able to understand and appreciate during the trek.

Recommended Reading
Many of these books are out of print or available only in Nepal. You may be able to find them at Pilgrims Book House in Kathmandu.

General Background

* Nepal, Tony Hagen
* Trekking in the Nepal Himalaya, Stan Armington
* Nepal Namaste, Robert Reiffel
* People of Nepal, Dor Bahadur Bista
* The Festivals of Nepal, Mary Anderson
* Kathmandu Valley, Robert and Linda Fleming
* Sherpas of Nepal, Christoph von Furer Haimendorf
* Gurungs of Nepal, Donald Messerschmidt
* Himalayan Traders, C. von Furer Haimendorf
* The Wildest Dreams of Kew, Jeremy Bernstein
* Mount Everest, the Formation, Population, and Exploration of the Everest Region, T. Hagen, G.O. Dhyrenfurth, and E. Schneider
* The Snow Leopard, Peter Matthiessen
* National Geographic Magazine: Check the index under Nepal
* Tibet, Thubten J. Norbu and Colin Turnbull
* Seven Years in Tibet, Heinrich Harrer
* My Life and My People, His Holiness the Dalai Lama
* Tantric Mysticism of Tibet, J. Blofeld
* Magic and Mystery in Tibet, Alexandra David Neel
* Tibet: Land of the Snow, G. Tucci

Mountaineering Expeditions

* Everest: Mountain Without Mercy, Broughton Coburn
* Into Thin Air: A Personal Account of the Mount Everest Disaster, Jon Krakauer
* Mount Everest National Park: Sagarmatha Mother of the Universe, Margaret Jefferies
* Everest; The West Ridge, Thomas Hornbein
* Americans on Everest, James Ramsey Ullman
* The Ascent of Everest, John Hunt
* Forerunners to Everest, R. Dittert
* Annapurna, Maurice Herzog

Natural History

* The General Ecology, Flora, & Fauna of Midland Nepal, R. Fleming
* Natural History and Economic Botany of Nepal, D.D. Bhatt
* Birds of Nepal, R. Fleming
* Maneaters of Kumaon, Jim Corbett
* The Book of Indian Mammals, S. Prater

Preparation for Trek and Visa

Preparing for hiking
Introduction
The following information will assist you to get ready for a trek in Nepal. Nepal treks allow you to experience the Himalayan countryside and to meet the people of the hills with a minimum of formality and preparation. If you follow the suggestions here, you will have all the equipment and permits you need to enjoy your trek. Read this information carefully so that you will know what to expect when you arrive in Nepal.

If you are not joining a group trek, you will not have a professional trek leader. If there are more than 3 or 4 people in your party, one of you should assume an informal leadership position to act as spokesman for the group both in Kathmandu and on the trail.

There are many preparations that you can make before you depart for Nepal. Most important are your clothing and trekking equipment, medical supplies, your passport and a visa for Nepal. While some of these projects can be postponed until the last minute (by getting a visa at the airport in Kathmandu or renting your trekking equipment in Nepal, for example), it is recommended that you make most preparations in advance so that you do not waste time during your holiday satisfying bureaucratic formalities or searching for some item of equipment that is temporarily unavailable for rent in Kathmandu.

Formalities
Visa for Nepal
You can obtain a visa before you come to Nepal or upon arrival in Kathmandu. You need only to fill in a form and pay a fee (in US dollars cash only), but it takes a bit of time at the airport after you arrive. To obtain a visa for Nepal in advance, write to one of the addresses below for instructions and a form. Fill in the form and return it with the appropriate fee, photos and your passport. If you are making a side trip to India or Tibet and then returning to Nepal, be sure to get a double entry visa. Your passport with a visa stamped in it should be returned to you by mail.

The visa regulations for Nepal are a bit complex. You need to decide what kind of visa to purchase depending on how long you plan to stay in Nepal. Visa fees are:

Tourist Visa

Multiple entry,15 days
Fees:US$ 25 or equivalent convertible currency

Multiple entry,30 days
Fees:US$ 40 or equivalent convertible currency

Multiple entry,90 days
Fees:US$ 100 or equivalent convertible currency

Tourist Visa Extension

» Visa extension fee for 15 days or less is US $ 30 or equivalent convertible currency and visa extension fee for more than 15 days is US$ 2 per day
» Tourist visa can be extended for a maximum period of 150 days in a single visa year (January – December).

Other Documents
Some other items that you should carry are:

* Your passport and extra photographs
* A vaccination certificate and record of medical history
* Your insurance form (especially insure your camera)
* Travellers cheques (carry a minimum of cash)
* A US$100 bill to be used for emergencies while trekking
* A photocopy of your passport (in case of loss)

Trekking Permits
Trekking permits are no longer required for treks to the Everest region, Annapurna and Langtang.

A trekking permit is still required to visit restricted areas and far eastern and western Nepal. The permit specifies the places you may visit and the duration of your trek. It requires one full day to obtain a trekking permit and involves a lot of queuing and waiting in the Immigration Office unless your agent obtains the permit for you. The cost of the trekking permit is usually included in the trek cost. If you are going to a place where a permit is needed, your travel schedule should include two nights in Kathmandu or Pokhara before the trek so that your trekking permit may be processed. You should keep your passport and air ticket in your hotel safe in Kathmandu during your trek.

A normal trekking permit costs US$5 per week for the first four weeks of trekking and US$10 per week thereafter. Permits for Dolpo and Kanchenjunga treks cost US$10 per week for the first four weeks and US$20 per week thereafter. The exorbitant fees for restricted-area trekking permits are detailed in the section on restricted areas. You must have a valid visa extension for the full period of trekking before you can apply for a trekking permit.

National Park & Conservation Fees
If you trek in the Annapurna, Makalu or Kanchenjunga regions, you will enter a Conservation Area and must pay a conservation fee of Rs 1000 (Rs 2000 for Annapurna). This must be paid in advance in Kathmandu. A national park fee of Rs 1000 is also collected at the time you enter a national park.

Physical Conditioning
The better your physical condition, the more you will enjoy the trek. You do not have to undergo a rigorous training programme. Just do as much walking as you can up and down hills, up (and down) stairs in your office. Take weekend hikes in the mountains. Walk to work. Jogging and cycling are useful training for a trek. Whenever possible, make your hikes in the same shoes that you will use for the trek. You must remember that you are going on a hiking trip among the highest mountains on earth. The hills are steep and you may be travelling in hot weather, in snow or in rain. You will often be tired, and you must be prepared for this. However, anyone in good health can complete a trek if you hike slowly, and spend a little effort now to get into good physical condition.

Types of Trekking

Types of Trekkings
In Nepal there are numerous ways to arrange a trek because of two major factors. Firstly, inexpensive (by Western standards) professional and nonprofessional labour is available to carry loads and to work as guides and camp staff. Secondly, you can almost always find supplies and accommodation locally because there are people living in even the most remote trekking areas.

The many possible ways of trekking can be categorised into four approaches: backpacking, teahouse treks, self arranged treks and treks with a trekking company. There is a lot of overlap among these, because many aspects of each trekking style spill over into the next. A backpacking trek that stays a few nights in hotels has many of the attributes of a teahouse trek. A teahouse trek with porters starts to become a self-arranged trek. A self- arranged trek that uses the services of a trekking agency in Nepal is similar to the trekking company approach.

Backpacking
The backpacking approach of a light pack, stove, freeze-dried food and a tent really is not an appropriate way to trek in Nepal. So much food is available in hill villages that it doesn't make much sense to try to be totally self-sufficient while trekking. This is true throughout Nepal except in the high mountains above 4500 metres. Backpackers violate two cardinal rules for travellers in Nepal. Because they are self-sufficient, they do not contribute to the village economy. Also, they must do so many camp chores that they do not have the time or energy to entertain the villagers that will gather to watch them.

At higher altitudes, however, the backpacking approach works. Depending on the terrain and local weather conditions, villages are found up to 4000 metres, but above this there isn't much accommodation available except in tourist areas such as Annapurna Sanctuary and Everest. It is also difficult to arrange to hire porters who have the proper clothing and footwear for travelling in cold and snow. If you plan to visit these regions, you may wish to alter your trekking style and utilise a backpacking or mountaineering approach to reach high passes or the foot of remote glaciers.

A good solution is to leave much of your gear behind at a temporary "base camp" in the care of a hotel or trustworthy sherpa. You can then spend a few days carrying a reduced load of food and equipment on your own. This will provide you with the best of both worlds: an enriching cultural experience that conforms to the standards and traditions of the country in the lowlands, and a wilderness or mountaineering experience in the high mountains.

Teahouse Treks
The Nepali word bhatti translates well as "teahouse". It is a bit pretentious to call some of these village establishments a hotel, but the Nepalese use of English translates restaurant or eating place as "hotel". Since the word hotel has, therefore, been pre-empted, Nepalese use the word "lodge" for sleeping place or hotel. Thus, in the hills of Nepal a "hotel" has food, but may not provide a place to sleep, while a "lodge" always offers accommodation. Many innkeepers specify the services they provide by calling their establishments "Hotel & Lodge". To avoid all this semantic confusion, most people use hotel, lodge and teahouse interchangeably. In reality you can almost always find both accommodation and food at any trailside establishment.

The most popular way to trek in Nepal for both Nepalese and Westerners is to travel from teahouse to teahouse. Hotel accommodation is most readily available in the Khumbu (Everest) region, the Langtang area and the entire Annapurna region. In these areas you can operate with a bare minimum of equipment and rely on teahouses for food and shelter. In this manner, it will cost from US$3 to US$10 a day, depending on where you are and how simply you can live and eat. It becomes much more expensive at high altitudes and in very remote areas.

Most Thakali inns (found along the Pokhara to Jomsom Trek) have bedding available - usually a cotton-filled quilt. Sometimes the bedding has the added attraction of lice and other bed companions. Bring along your own sheet or sleeping bag to provide some protection against these bugs. During the busy trekking seasons in October to November and March to April, it may be difficult to find bedding every night on the Jomsom Trek. Bedding is not usually available at hotels on the Everest trek or around Annapurna, so on these treks you should carry your own sleeping bag.

Although many hotels in the hills are reasonably comfortable, the accommodation in some places may be a dirty, often smoky, home. Chimneys are rare, so a room on the 2nd floor of a house can turn into an intolerable smokehouse as soon as someone lights the cooking fire in the kitchen below. Often it is possible to sleep on porches of houses, but your gear is then less secure. The most common complaint among trekkers who rely on local facilities is about smoky accommodation.

By arranging your food and accommodation locally, you can move at your own pace and set your own schedule. You can move faster or slower than others and make side trips not possible with a large group. You can spend a day photographing mountains, flowers or people - or you can simply lie around for a day. Hotels provide a special meeting place for trekkers from throughout the world. You are free (within the limits imposed by your trekking permit) to alter your route and change your plans to visit other out-of-the-way places as you learn about them. You will have a good opportunity to see how the people in the hills of Nepal live, work and eat and will probably develop at least a rudimentary knowledge of the Nepali language.

You are, however, dependent on facilities in villages or in heavily trekked regions. Therefore you must trek in inhabited areas and on the better known routes. You may need to alter your schedule to reach a certain hotel for lunch or dinner. You can miss a meal if there is no hotel when you need one or if the hotel you are counting on is closed. A few packets of biscuits in your backpack are good insurance against these rough spots. Most of the major routes are well documented, but they are also well travelled. A hotel can be out of food if there are many other trekkers or if you arrive late. You may have to change your planned destination for the day when you discover that the lunch you ordered at an inn will take a very long time to prepare. You will usually make this discovery only after you have already waited an hour or so. It is wise to be aware of these kinds of problems and to prepare yourself to deal with them.

If you deviate from popular routes, be prepared to fend for yourself at times. If, however, you carry food, cooking pots and a tent to use even one night, you have already escalated beyond the teahouse approach into a more complex form of trekking with different problems.

Self-Arranged Treks
A third style of trekking is to gather sherpas, porters, food and equipment and take off on a trek with all the comforts and facilities of an organised trek. On such a trek you camp in tents, porters carry your gear, sherpas set up camp and cook and serve meals. You carry a backpack with only a water bottle, camera and jacket.

Trekkers who opt for this approach, particularly with a small group of friends, often have a rewarding, enriching and enjoyable trip. You can use a trekking company in Nepal to make some or all of the arrangements, though you may have to shop for an agency that suits you. Some Nepalese trekking companies offer equipment for hire, some will arrange a single sherpa or porter and some will undertake only the entire arrangements for a trek.

If you want to have everything organised in advance, you can contact a Nepalese trekking company by mail or fax and ask them to make arrangements for your trek. There are more than 300 trekking companies in Kathmandu that will organise treks for a fee and provide all sherpas, porters and, if necessary, equipment. Unless you have a good idea of what you want, it will require a huge volume of correspondence to provide you with the information you require, to determine your specific needs, to define your precise route and itinerary and to negotiate a price that both parties understand. Mail takes up to three weeks each way to and from Australia, the Americas or Europe, so it's better to use fax or e-mail. Be specific in your communications and be sure that the trekking company understands exactly who will provide what equipment. It is most embarrassing to discover on the first night that someone forgot the sleeping bags.

One solution is to go to Nepal and simply sort out the details in an hour or two of face to face negotiations with a trekking company. You should be prepared to spend a week or so (less, if you are lucky) in Kathmandu settling these details. An alternative to endless correspondence with Nepal is to use a trek operator in your own country.

Trekking with a Trekking Company
Companies specializing in trekking can organise both individual and group treks. One major advantage to dealing with someone close to home is that it's easy to communicate by phone and the agent can assist you with travel to and from Nepal.

On an arranged trek the group must stay generally on its prearranged route and, within limits, must meet a specific schedule. This means that you may have to forego an appealing side trip or festival and, if you are sick, you will probably have to keep moving with the rest of the group. You also may not agree with a leader's decisions if the schedule must be adjusted because of weather, health, political or logistical considerations.

You will be trekking with people you have not met before. Although some strong friendships may develop, there may also be some in the party you would much rather not have met. For some people, this prospect alone rules out their participation in a group trek. The major drawback, however, will probably be the cost. Organised treks usually start at US$100 per person per day of the trek. One of the major expenses is the services of a Western leader who acts as guide, cultural interpreter and social director. On the positive side, by fixing the destination and schedule in advance, all members of the group will have prepared themselves for the trip and should have proper equipment and a clear understanding of the schedule and terrain. Read the brochures and other material prepared by the agent to see if it is likely to attract the type of people you'd get along with.

Most prearranged treks cater to people to whom time is more important (within limits) than money. For many, the most difficult part of planning a trek is having the time to do so. These people are willing to pay more to avoid wasting a week of their limited vacation sitting around in Kathmandu making arrangements or waiting along the way for a spare seat on a plane. A trekking agent usually tries to cram as many days in the hills as is possible into a given time span. Trekking agents make reservations for hotels and domestic flights well in advance. Thus theoretically, these hassles are also eliminated.

Because the group carries its own food for the entire trek, a variety of meals is possible. This may include canned goods from Kathmandu and imported food bought from expeditions or other exotic sources. A skilled cook can prepare an abundant variety of tasty Western-style food. The meals a good sherpa cook can prepare in an hour over a kerosene stove would put many Western cafes to shame.

A group trek carries tents for the trekkers. This convenience gives you a place to spread out your gear without fear that someone will pick it up, and probably means that you will have a quiet night. In addition, a tent also gives you the freedom to go to bed when you choose. You can retire immediately after dinner to read or sleep, or sit up and watch the moon rise as you discuss the day's outing.

Money and staff hassles rarely surface on an arranged trek. The sirdar is responsible for making minor purchases along the way and ensures a full complement of porters every day. Unless you are particularly interested, or quite watchful, you may never be aware that these negotiations are taking place.

A group trek follows a tradition and routine that trekkers and mountaineers have developed and refined for more than 50 years. You can travel in much the same manner as the approach marches described in The Ascent of Everest, Annapurna and Americans on Everest, a feature not possible with other styles. If your interest in the Himalaya was kindled through such books, you still have the opportunity to experience this delightful way to travel. There are many reasons why these expeditions went to all the trouble and expense to travel as they did.

It is an altogether refreshing experience to have all the camp and logistics problems removed from your responsibility so you are free to enjoy fully the land and the people which have attracted mountaineers for a century.

Trekking Equipments

The following basic equipments check lists should help you with your packing. Please remember that you should always try to keep the weight of your equipment to a minimum. At the start of the trek your packed trek bag should not weigh more than 33 pounds or 15 kg.

<p>Head:
- Sun hat or scarf
- Light balaclava or warm fleece hat
- Sunglasses with UV protection

Lower Body:
- Under Garments
- Hiking shorts
- Lightweight cotton long pants
- Light and expedition weight thermal bottoms
- Fleece or wool pants
- Waterproof (preferably breathable fabric) shell pants

Feet:
- Thin, lightweight inner socks
- Thick, warm wool hiking socks
- Hiking boots with spare laces
- Camp shoes (sneakers and/or sandals) Gaiters for hiking in winter to the base camp

Upper Body:
- T-shirts
- Light and expedition weight thermal tops
- Fleece jacket or pullover
- Fleece Wind-Stopper jacket (optional)
- Waterproof (preferably breathable fabric) shell jacket
- Down vest and/or jacket *

Hands:
- Lightweight gloves
- Heavyweight gloves or mittens with a waterproof shell outer

Accessories:
- Sleeping bag rated to zero degrees F *
- Headlamp (e.g. Petzl Zoom) with spare bulbs and batteries
- Small pad or combination lock-to-lock
- Trekking Bags *
- Basic First Aid Kit *
- Large plastic bags - for keeping items dry insidetrekbag
- Daypack (approximately 2500 to 3000 cubic inches)
- Thermarest sleeping pad
- Water bottles
- Toiletries (Small wash towel, Toilet papers etc)

Toiletries:
- 1 medium sized quick drying towel
- Tooth brush/paste (preferably biodegradable)
- Multipurpose soap (preferably biodegradable)
- Deodorants
- Nail clippers
- Face and body moisturizer
- Feminine hygiene products
- Small mirror

Personal Hygiene:
- Wet wipes (baby wipes)
- Tissue /toilet roll
Extras/Luxuries:
- Binoculars
- Reading book
- Trail Map/Guide book
- Journal & Pen
- Walkman
- Pencils and small notebooks
- Travel game i.e. chess, backgammon, scrabble

Altitude Sickness

Travelers are drawn to high altitude places in ever increasing number- Nepal alone now receives more than Five hundred thousand trekkers from around the world every year. It can be easy to under-estimate the dangers of altitude illness; deaths from these conditions are all the more tragic because they are entirely preventable.

Mountain climbers, serious trekkers, romantics sauntering through the foothills of the Himalayas, native porters, skiers in North America and Europe, pilgrims to high altitude shrines, diplomats posted to La Paz or Lhasa, miners in South America, and Everest marathon runners have something in common: they are all exposed to the effects of high altitude, and may be at risk from a potentially fatal but eminently preventable problem: Acute Mountain Sickness, commonly referred to just as AMS.

AMS consists of headache plus any one of the following symptoms in different degrees: nausea tiredness, sleeplessness or dizziness, occurring at altitudes of around 8000 ft or higher where pathophysiological changes due to lack of oxygen may manifest. Another term, "altitude illness', is also widely used - an umbrella term that includes the benign acute mountain sickness and its two life-threatening complications, water accumulation in the brain (high altitude cerebral edema, HACE) or high altitude pulmonary edema (HAPE, water accumulation in the lungs). The latter two complications may follow AMS, especially when people continue to ascend in the face of increasing symptoms. In keeping with the Jesuit tradition of painstaking documentation, Father Joseph de Acosta, a sixteenth century Spanish Jesuit priest, is credited with having first described the effects of high altitude in humans. In vernacular Nepali, mountain sickness is called "Lake Lagne": in Sanskrit it is aptly called "damgiri" ("dam" means breathlessness and "giri" Means Mountain).

Those most at danger from complications are people who do not "listen to their body", and heed the early warning signals of AMS; they can go on to suffer from HAPE and HACE and may even die-a process that has been carefully documented in important autopsy studies performed by Walter Bond and John Dickinson during the Seventies in the old Patan hospital in Kathmandu.

Chronic mountain sickness is an entirely different condition, recognized by Carlos Monger Medrano in high altitude long-term residents of South America during the Twenties. Such maladaptation is seldom found in the Sherpas or Tibetans, possibly due to thousands of years of exposure to high altitude living. (South Americans populations are relative newcomers to high altitude.) The present discussion will be confined to acute exposure to altitude in short-term sojourners.

Acute Mountain Sickness (Ams)
If a participant on an Everest trek suffers from a mild headache and nausea at Namche Bazaar (12,300ft), he might take an aspirin and wait for these symptoms to go away; however if the symptoms progress to vomiting and a splitting headache, he must assume that he is suffering from AMS and make plans to descend. It is amazing how many people in this situation ignore the dangers and continue to ascend with their friends, trying to blame their symptoms on poor fitness or flu. For some people, it's the high investment of time, effort and money, for others perhaps it's peer pressure or reluctance to accept defeat. A further is that many in the burgeoning adventure travel industry are clueless about mountain sickness.
AMS may set in within hours to days of arrival at high altitude: the onset of symptoms is usually gradual, which is why it is so vital to watch out for early warnings: does a person feel excessively tired; is she the last one to drag herself in to camp?

What causes AMS?
AMS is caused by a lack of oxygen. Although the proportion of oxygen in the atmosphere always remains the same (21%), as we go higher the "driving pressure" decreases. The driving pressure depends directly on the barometric pressure, and forces oxygen from the atmosphere into the capillaries of the lungs. Reduced driving pressure results in decreased saturation of oxygen in the blood and throughout the tissues.

Just what causes some people to suffer from AMS but not others is largely unknown, but there are clear-cut and important preventive factors that are now well- established (see below). The exact mechanism (pathophysiology) of AMS has similarities to that of HACE.

High Altitude Cerebral Edema (HACE)
Our trekker in the above example would probably go on to suffer form HACE if he continue to ascend despite the headache and vomiting; the symptoms of HACE are an extension of those to AMS.
From fatigue, there is progression to lethargy and then to coma. Or there may be confusion and disorientation, A useful test is to see if the person can walk a straight line. If he walks like a drunk or is unsteady, it has to be assumed that he has life-threatening HACE and needs to descend promptly with assistance. This situation is serious enough to justify immediate helicopter evacuation.
HACE is probably caused by shifts of fluid into the tissues of the brain. Reduced oxygen levels cause swelling within the confines of the bony skull. The resulting rise in pressure may lead to lethargy and eventually coma.

High Altitude Pulmonary Edema (HAPE)
This disease may follow AMS, but often it may appear independently. The typical scenario would be a trekker who has no headache or nausea, but finds he has a harder time walking uphill, that he is out of breath on slight exertion compared with the initial days of the trek. There may be a nagging cough and he too may have ascribed these symptoms to a cold. He may be suffering from sub-clinical or early HAPE, a well-recognized entity. With further ascent this may progress to shortness of breath even at rest - descend is now obligatory, or the outcome may be fatal.
Low oxygen causes the pulmonary artery to narrow and this results in exudation of blood near the smaller branches of the lungs (the alveoli). If the exudation continues, blood may escape into the alveoli leading to a cough with watery, blood-tinged phlegm. Such exudation, or "water logging" of the lung tissue interferes further with oxygenation. A popular, compact device called a pulse oximeter can measure the oxygen level in the blood simply and rapidly, using a sensor attached to the index finger. It can be very helpful in confirming if HAPE is present.
What is acclimatization?

Acclimatization is a state of physiological "truce" between the body of a visitor and the hostile low-oxygen environment of high altitude. This truce permits the trekker of ascend gradually. (This is distinct from "adaptation" - permanent change to the organism, perhaps over thousands of years, perhaps even at a genetic or evolutionary level, to facilitate survival at altitude. Scientists are trying to decipher if the Sherpas or Tibetans have made such an adaptation.)
For acclimatization to take place the single most important step is hyperventilation- the trekker unconsciously breathes faster and more deeply than normal, even at rest, to make up for the lack of oxygen. However, hyperventilation also leads to loss of carbon dioxide from the blood, making the blood more alkaline, and it turn depressing ventilation. However, 48 to 72 hours after exposure to high altitude, the kidney comes to the rescue and begins to excrete alkali from the blood to restore a more balanced environment in which hyperventilation can continue unabated.

Preventing altitude illness
There is little doubt that altitude illness is one hundred percent a preventable illness. No one should die from it. For the past quarter of a century, one of the most important objectives of the Himalayan Rescue Association in Nepal has been to preach the gospel of prevention, from its aid posts in Pheriche (at around 14000ft in the Everest region) and Manang (at around 12000ft in the Annapurna region). There are four golden rules, plus some important general principles that should always be followed:
1. Understand and recognize the symptoms of AMS. Recent growth in adventure travel has made trekking at high altitude simpler and more accessible, with the result that more and more people who go trekking are ignorant of the basic facts of altitude illness.

2. Never ascend with obvious symptoms. Incredibly, I have known people who have hired a horse or a yak to go up higher when they were too sick to walk. This is courting disaster.

3. Descend if symptoms increase. It is amazing how striking and dramatic the relief may be with even a couple of hundred feet of descent. People with signs of HAPE or HACE have to descend.

4. Group members need to look out for one another

(Perhaps like the buddy system in SCUBA diving). This rule gets broken with unfailing regularity every trekking season in the Himalayas, because people are just too anxious to complete their trek, even if one of their party members is ill. A trekker with AMS, HAPE or HACE will want nothing more than to be left alone, unbothered, at the same Altitude- potentially a fatal option. There is no alternative but to bring the person Down to a lower altitude accompanied by a friend who speaks the same language.

Following a conservative rate of ascent

Going too high, too quickly, is the single most important cause of susceptibility to AMS. Beyond about 9000ft, the sleeping altitude should be no higher than about 1500ft from the previous night's altitude. The sleeping altitude, not the altitude achieved during the daytime, is what is important. Altitude sickness often manifests at night because during sleep the oxygen level in the blood may dip further. Many mountain climbers will have been to 14000ft or high in the Alps or in North America but few will have slept at the altitude. In the Himalayas, you don't have to be an experienced climber, or use crampons, to be able to "hang out" at 15000ft or higher for days: easy accessibility to these altitudes makes exposure to AMS also mush easier.

While ascending, every second or third day should be rest day for acclimatization. "Climb high and sleep low" is the dictum, but it is important not to exert oneself excessively in trying to fulfil this.
The trekker should not be in a hurry in the mountains. The itinerary should be planned so that there are enough "leeway days" in case more time is needed to acclimatize. Trying to do a high-altitude two-week trek in one week is always fraught with problems.

Avoiding of excessive exertion in the initial days
Excessive physical exertion at high altitude makes one more susceptible to AMS. It is important to take it easy at high altitude, especially in the initial days. People who are very fit for example marathon runners or those who carry very heavy backpacks seem more vulnerable to AMS than others, probably because they push themselves harder. I once looked after a trekker who felt he could not break his morning jogging sessions despite a strenuous trek day ahead, even at 4000m! The feeling of" man against nature" may be stronger in this fitter group.

Avoiding alcohol

Jim, a rock star, decided to "whoop it up" with four bottles of beer, on arrival at 3500meters in the Everest region. He felt ill with severe AMS and needed to be helicopter out two days later. He had been warned not to drink alcohol on the trek, especially while ascending. Alcohol may dehydrate the trekker but more importantly it depresses breathing or ventilation. Sleeping pills may have a similar effect.

Maintaining adequate hydration

Adequate amounts of fluid (about 3 liters a day) are necessary in the mountains:- dehydration mimics altitude sickness and may even predispose to it. On the other hand excessive water drinking should also be avoided as this may lead to electrolyte imbalances.

Maintaining a high carbohydrate diet

A high carbohydrate diet aids ventilation and efficient use of oxygen. The good news is that - in many high altitude places - there is not much alternative: rice, potatoes and other strach-laden foodstuffs tend to be the staple, with not much else to choose from.

Drug prevention (prophylaxis)

Diamox (actazolamide) may be necessary for people going on rescue missions at high altitude or flying in to high altitude cities like La Paz or Lhasa. People with sulpha allergy should not take diamox, the primary drug for prevention, and further details are given below. A second drug, dexamethasone (see below) should also be carried, particularly if the destination is remote: this can be life saving if HACE supervenes.

Treatment of Sickness

Descent

Wherever, possible this has to be attempted. There is really no magic altitude to descend, but the sick patient may suddenly feel something lift and feel hungry. This is the altitude to which the body is adjusted. Patients with HAPE need to descend slowly and with assistance: excessive exertion even during descent may increase the blood flow to the lungs and exacerbate the problem.

Oxygen

Lack of oxygen at altitude is the chief reason why people suffer from altitude sickness, so breathing supplemental oxygen is obviously going to make a difference. But oxygen is a hard commodity to come by in the mountain - cylinders of oxygen are not easily portable. When oxygen available in AMS settings, it should be used.

Drugs

Acetazolamide (diamox): This is the most tried and tested drug for altitude sickness prevention and treatment. Unlike dexamethasone this drug does not mask the symptoms but actually treats the problem. It seems to works by increasing the amount of alkali (bicarbonate) excreted in the urine, making the blood more acidic. Acidifying the blood drives the ventilation, which is the cornerstone of acclimatization.

For prevention, 125 mg twice daily starting the evening before and continuing for three days once the highest altitude is reached, is effective. A recent article in the British Medical Journal suggested taking a higher dosage -- 750mg daily. Our experience in the Indian subcontinent has consistently been that 250 mg per day has been rewarding, while excessive dosage may just increase the side effects.

Side effects of diamox are: an uncomfortable tingling of the fingers, toes and face (called "jhum jhum" in Nepali); carbonated drinks tasting flat; excessive urination; and rarely, blurring of vision. In most of the treks in Nepal, gradual ascent is possible and prophylaxis tends to be discouraged. Certainly if trekkers develop headache and nausea or the other symptoms of AMS, then treatment with diamox is fine. The treatment dosage is 250 mg twice a day for about three days.

Dexamethasone: This steroid drug can be life saving in people with HACE, and works by decreasing swelling and reducing the pressure in the bony skull. The dosage is 4 mg three times per day, and obvious improvement usually occurs within about six hours. Like the hyperbaric bag (See below), this drug "buys time" especially at night when it may be problematic to descend. Descent should be carried out the next day. It is unwise to ascend while taking dexamethasone: unlike diamox this drug only masks the symptoms.

Dexamethasone can be highly effective: many people who are lethargic or even in coma will improve significantly after tablets or an injection, and may even be able to descend with assistance. Many pilgrims at the annual festival at Gosainkunda lake in Nepal suffer from HACE following a rapid rate of ascent, and respond remarkably well to dexamethasone. Mountain climbers also sometimes carry this drug to prevent or treat AMS. It needs to be used cautiously, however, because it can cause stomach irritation, euphoria or depression.

It may be a good idea to pack this drug for a high altitude trek for emergency usage in the event of HACE In people allergic to sulpha drugs (and therefore unable to take diamox) dexamethasone can also be used for prevention: 4 mg twice a day for about three days may be sufficient.

Nifedipine: This drug is generally used to treat high blood pressure, but also seems able to decrease the narrowing in the pulmonary artery caused by low oxygen levels, thereby improving oxygen transfer. It can therefore be used to treat HAPE, though unfortunately its effectiveness is not anywhere as dramatic that of dexamethasone in HACE. The dosage is 20 mg of long acting nifedipine, six hourly.

It can cause sudden lowering of blood pressure so the patient has to be warned to get up slowly from a sitting or reclining position. It has also been used in the same dosage to prevent HAPE in people with a past history of this disease.

The hyperbaric bag

This is a simple, effective device, made of airtight nylon; it is about 7 feet long ad looks like a long duffel bag. With the patient inside, the bag is inflated with a foot pump until it becomes like a large sausage-shaped balloon. There is a one-way valve to avoid carbon dioxide build up inside, and it has transparent panels to assist communication with its occupant.

The pressure insde the bag is 2 p.s.i,. so the effect is about the same as bringing the patient down a couple of thousand feet. For both HACE and HAPE (but especially, in our experience, for HACE) the changes are usually dramatic within an hour. However there may be a "rebound" tow or three hours after therapy and the patient may need to get in the bag again. Just like the dexamethasone, this bag only helps to "buy tome". Descent is still mandatory as soon as possible.

Other problems at altitude:-

Periodic breathing
An abnormal breathing pattern whilst asleep is a common occurrence at high altitude: short spells of an increased breathing rate alternate with brief periods when breathing slows down seems to stop the medical term for this is "Cheyne Stokes" respiration. It is only a problem if it makes the suffers wake up repeatedly, breathless, anxious and unable to sleep. An effective remedy is Diamox 125 mg before dinner, which counteracts the low oxygen dips during sleep that trigger the problem. Sleeping pills should be avoided.

Upper respiratory tract infections and symptoms
Many people develop a persistent, bothersome cough and cold-like symptoms in the cold dry air of high altitude. An antihistamine at night like Benadryl 25 mg may help suppress the cough. Antibiotics are sometimes useful, but keeping the head and face covered and breathing through a silk or wool scarf to humidify the air may also help. many studies have shown that upper respiratory tract infections can predispose to AMS.

Peripheral edemar />
There may be swelling around the eyes, fingers, ankles at high altitude, but this may not indicate AMS per se unless accompanied by the symptoms of AMS. These symptoms without AMS usually require no treatment.

High altitude syncope (fainting): This is well known but harmless problem, in which fainting occurs suddenly, usually shortly after arrival. Simple measures like keeping the individual in a reclining position and raising the legs is helpful.

Travelers with pre-existing health problems; children, and birth control pills
High blood pressure: Blood pressure initially increases at high altitude due to the initial stress of low oxygen triggering neurohumoral changes. However people who suffer from high blood pressure can go up to high altitude as long as this is well controlled and they continue to take their medication.
Coronary heart disease: People with a history of heart attack (moycardial infarction) and even those with coronary artery bypass grafts or angioplasty but with no angina, can trek up to high altitude provided they are fit and able to walk rigorously at low altitude. The high altitude does not seem to add any extra burden to the heart.

Epilepsy: Although seizures may be provoked by altitude there is no convincing evidence that it is unsafe for well-controlled epileptics travelling to travel to high altitude, though such people should always take their anti seizure medications conscientiously.

Migraine: Sufferers may possibly have more attacks in the mountains and this may sometimes be difficult to distinguish from AMS. In doubt it is best to descend.

Lung disease: Also noteworthy is the limited observation that bronchial asthma does not seem to get exacerbated at high altitude due to the cold and exercise. However it is prudent for asthmatics to carry inhalers and other medications. Obviously people with chronic obstructive lung disease may be more short of breath and travel at high altitude would be inadvisable.
Neck surgery and radiotherapy: People with treated cancers like lymphoma or tumors in the neck who have had extensive surgery or radiation treatment may be especially prone to AMS because of damage to the carotid bodies - tiny organs within the carotid arteries that sense oxygen and aid ventilation.

Diabetes: Diabetics on insulin should have a reliable glucometer to check their blood glucose regularly, but high altitude does not seem to cause additional risks.

Corneal surgery: people who have had non laser surgery (radial keratotomy) to correct their short sightedness may run into problems at high altitude due to swelling of their cornea caused by the low oxygen. Such people should carry corrective lenses as well if travelling to high altitude.
Pregnancy: Pregnant women should not sleep higher than 12000ft as this may endanger the fetus; a further problem is that high altitude places are generally remote, making emergencies more difficult to deal with.

Children: Children do not suffer any more from the effect of altitude than adults. However, it is important that a child should be able to communicate any symptoms to responsible adult, so that prompt descent can be arranged. It may therefore be dangerous to take children to high altitude that is not yet old enough to do this.
Contraception: Oral contraceptive pills may predispose to abnormal blood clotting (thrombosis) at high altitude. the hypoxia (low oxygen), the excessive red blood cells (polycythemia) in the blood, and the possible dehydration in this environment may already be other predisposing factors for thrombosis. Hence it if best to use other forms of contraception at high altitude.

Other disease risks
Many high altitude destinations are in developing countries, so it is important to be up to date with vaccinations against disease like typhoid and hepatitis, to know about travelers' diarrhoea and its treatment, and to understand the other precautions described elsewhere in this book. Malaria is not a risk at altitude - transmission does not take place above 2000 meters.

Conditions that mimic altitude sickness
Improving medical facilities in countries such as Nepal have made it much easier to distinguish between altitude illness and conditions that can produce similar symptoms, such as bleeding in the brain (subarachnoid hemorrhage), strokes, dehydration and blood viscosity related problems like venous thrombosis.

Conclusion
Most of the problems of high altitude are totally preventable. With careful precautions, your experience in the mountains should be safe and rewarding.

Importance info for Trekking

Prepare for trekking

When to go for nepal trekking: The best seasons for nepal trekking are either side of the monsoon season, March-June and September-November. During this time the weather is generally fine and the skies clear. It is possible to trek out of season, but expect lots of rain (and leaches) during the monsoon and severe cold and closed passes during the winter months. See also the Nepal trekking climate section.

Experience & Fitness for nepal trekking- there are treks suitable for a wide range of experience and physical fitness, for age 5 to 85. An easy teahouse trek with Nepali support (guide/porter) is quite attainable for anyone who is reasonably walking fit - if you can walk for a few hours each day for a week and are not averse to the occasional (frequent!) hill climb then you can trek in Nepal. Longer treks, crossing high passes and into remote regions do tend to demand a higher degree of endurance. For Trekking Peaks it is usually desirable but not necessarily essential to have some alpine climbing experience.

Nepal trekking Equipment: the main essentials are sturdy and comfortable hiking boot, a sleeping bag and a few clothes (be prepared for a range of weather). It is best to travel light, take only what you need and leave the rest behind. If you have the services of a porter then you will need a day-pack for your essentials and the rest goes in a kit-bag or duffel to be conveyed to your next stop. It is possible to buy everything in Kathmandu and Pokhara but it is all copies.

Hiring support for nepal trekking: Whether to join a group, trek with other independent travelers or to hire your own guide and/or porter is a personal decision to be based on the difficulty of the trek and available budget. When signing up with an agency you should speak with several and make detailed enquiries about the differences in service besides just the base cost. If hiring staff independently the be mindful of your responsibilities to ensure that your man is suitably equipped for the job and stays safe.

Permits and TIMS: "nepal Trekking permits" are not required for the main teahouse treks. Recent rule brought in by the Trekking Associations in Nepal require that all trekkers register with TIMS ("Trekking Information Management System"), this can be done via official trekking agencies or the Nepal Tourism Board. Trekking to remote areas and climbing the designated "Trekking peaks" require extra permits, these are generally obtained by the agent/guide who will be arranging your trek.

Arriving mid-travel: If you arrive in Kathmandu part way tour of Asia and decide to go trekking then you can easily get equipped in Kathmandu. Plenty of shops in Thamel sell (or rent) any trekking gear that may be required. The local copies of brand name goods are not good quality, but good bargains can be had on fleeces and down jackets. Whilst walking boots are readily available it would be advisable not to be breaking on Nepali made boots along the trail, comfortable and reliable footwear is essential. Permits and (if required) guides can be arranged in a day or two.

Rescue insurance: Before the departure check that your insurance covers trekking activities and the conditions. It would be very costly to pay a helicopter rescue at 5000 meters.

More on Nepal Trekking

Main "teahouse trek" regions, in each of these areas there are a number of trail options, there is plenty of scope for short treks of less than a week to much longer if you have time and wanderlust.

Khumbu - Bus to Jiri or fly to Lukla then hike up to Namche Bazzar, capital of the Sherpa lands at the foot of Everest. The most popular trek is up to Everest Base Camp and an ascent of Kalar Patar. Visit the Buddhist Tengboche monastery for the Mani Rimdu festival in November. Explore the Gokyo valley with its sacred lakes and stupendous views of four 8000m peaks. Or a circuit of the region crossing the high passes or Cho La and Renjo La.

Annapurna - North of Pokhara, from lush middle hills into high mountains. A circuit leads up the Maryangdi river to Manang, over Thorung La (5400m) to the Hindu temples at Muktinath. Down the Kali Gandaki on the Jomsom trail enjoying Gurung and Thakali hospitality. Up through spring rhododendron blooms to Poon Hill for a dawn Himalayan vista. Trek up into the very heart of the Annapurna Sanctuary for an awesome 360' high mountain skyline.

Helambu Langtang - a short taxi ride from Thamel to the roadhead at Shivapuri leads to a trail through the middle-hills countryside of Helambu, either circuit around and return to Kathmandu or cross the pass to the sacred lake at Gosainkhund, descend and then hike up the Langtang valley beneath mountains that form the border with Tibet. Descend back to catch a bus on a rough road through Trisuli to Kathmandu.

Other more remote regions will require a bit more planning and probably local assistance, not least as the required permits are only issued via Nepali guides/agents. Camping is required on one or more nights.

Kanchenjunga - far eastern Nepal, accessible via Taplejung (from Kathmandu 40min by plane, 40hrs by bus), a strenuous trek through sparsely populated country to the third highest mountain.

Dopla - Upper Dolpa is the remote Land of the Bon, almost as Tibetan as Nepali. Lower Dolpa is more accessible and can me reached by plane

Manaslu - Unspoiled trails through remote villages and over a wild pass to circuit an 8000m mountain

Trekking Peaks require a qualified "climbing guide", permits and deposits to cover camp waste disposal

Island Peak Trek - The Island Peak trek in the Khumbu region takes in some of the most spectacular scenery in the Himalayas.

Mera Peak Climbing - Enjoy panoramic views of Mt. Everest (8,848 m; 29,030 ft), Cho-Oyu (8,201 m; 26,910 ft), Lhotse (8,516 m; 27,940 ft), Makalu (8463 m; 27,770 ft), Kangchenjunga (8,586 m; 28,170 ft), Nuptse (7,855 m; 25,770 ft), and Chamlang (7,319 m; 24,010 ft).

Stay safe during Nepal trekking

Altitude sickness - a significant risk when trekking on any trails above about 2500m. Be familiar with the symptoms and do not ignore them. If you keep to a conservative ascent schedule and drink plenty of fluids then most people can acclimatise. If you or anyone in your party begins to experience symptoms of AMS then do not ascent, and if they do not improve then descent to a lower altitude is to only option to consider.

Water - The streams should be considered polluted and whilst bottled water is often available the disposal of plastic bottles is a problem. Have some means to purify water, iodine and/or a fine ceramic filter are the best options.

Lone travelers - arriving in Kathmandu it is usually easy to find other like minded people with similar travel plans and trek together. Even if you start at the trailhead alone you are likely to meet the same people along the tail and sharing lodges at nights. It is not wise to trek alone (this is true not just in Nepal but anywhere). In the unlikely event that you should encounter troubles or become ill then it is far easier and safer to have some companion to help out.

Maoists - In recent months the political situation has changed to bring the maoists back into government. Consequently there is no "official" justification for the old practices of "taxing" trekkers. That said, it is possible that this habit may continue and if a "donation" is demanded with threats of menace then it is probably best to pay the fee in return for the "official" receipt.

Leave no traces
Please make sure you pack out all of your trash, including bottles and cans from goods consumed in restaurants. Bring the trash to the nearest truck-accessible road for the most proper disposal available.

Trekkers are also asked to refrain from relying on bottled water, since there is nowhere to dispose of the used bottles. Filtering or treating your water will reduce the amount of trash left behind in this fragile environment. Iodine pills are a cheap, lightweight solution.

Take the time to look at the pollution and lack of trash management all around you, from the trash-clogged rivers in the cities to the mounds of discarded beer bottles in the mountain villages. This is a country struggling with its rapid Westernization and hasn't yet figured out how to dispose of its waste. Don't contribute to the problem any more than necessary!

Nepal Trekkking informations
Trekking in the beautiful high mountains of the Himalayas is for many people the main reason for coming to Nepal.
Trekking in Nepal means walking on trails. The walking trails have existed for thousands of years, and have been used for trade and communication. Even now the only way to reach many villages is on food. Trekking does not mean climbing a mountain. Many of the trails used have been used by mountaineering expeditions for reaching a base camp of a mountain, but most are trails used every day by Nepali just to get around.

A trek can be short, one day, two days or three days, or can be a longer one of a week or a month. Treks can be combines and one could trek for months. Most treks last at least a week in Nepal and often they can be three weeks. You may want to go out on a day trip to see if you really want to take a longer trek. Some of the longer treks can be rather tough, so if you are having a health problem, you may want to reconsider your decision to make a long trek.
Until the 1950s when the Tribhuvan Highway to Kathmandu was constructed there were no motorable roads in Nepal. The road to Pokhara wasn’t constructed until the 1970s. Trekking first became popular in Nepal in the 1960s.

The two main areas to trek are the Annapurna and Everest areas. The Helambu region, north of Pokhara and the Langtang region, north of Kathmandu are also popular area to trek. There are several other areas for trekking in eastern and western Nepal. Several area that treks could not be performed in the past are now open for trekking such as Mustang, the Kanchejunga base camp, Manaslu, upper Dolpo and Humla.

The following chapter gives an idea of different trekking routes, but for more detail you want to get a trekking book and detailed maps of the areas.

Most treks follow a well established route, often with lodge and restaurants along the way. No major trek goes above 5500m, which is the elevation that most climb expeditions begin. Often treks can be quite strenuous, sometimes uncomfortable and there is an element of risk.

As defined by the Nepali government the trekking region is any area more than a day’s walk from a main road. To go to any of these areas you need a trekking permit.

Trekking is the Himalaya can be hard at times, so you should be prepared for some strenuous walk, especially if you are going to go to some high elevations. You should give yourself a few days for off-days. It is usually best to begin early in the morning, when the weather is the clearest.

It is best not to do trek alone, in case your get hurt or starting suffering from attitude sickness.

What You Will See during trek
Nepal has some of the spectacular and most intense scenery in the world. Eight of the ten highest mountains in the world are found in Nepal. While trekking you will see some of the most beautiful mountains to seen. You can see the mountains from many places in Nepal from a distance, but almost nothing can beat the experience of standing at the base of an 8000m mountain, close enough that you feel like you can reach out and touch it.

Beside the mountains there are also many other interesting things to see. There are beautiful valleys, attractive villages, interesting temples and houses, flowers and trees. Treks can go from subtropical forests, past deep ravines, over fast moving rivers, deep canyons, mountain meadows and then one reaches the desolate rocky areas going over a high mountain pass. Depending on the season the terrace changes. In the spring and autumn there can be a great selection of wild flowers and green scenery.

Actual Treks
The six most popular treks are the Jomsom trek, Annapurna Circuit, Annapurna Sanctuary Trek, Everest Base Camp Trek, Helambu and Langtang. If you have limited time or budget you will most likely trek in the Annapurna region north of Pokhara or Helambu-Langtang region north of Kathmandu. If you have more time you can do a longer Annapurna trek or trek to Everest base camp.

You could also take a trek in the more remote area in western or eastern Nepal.

People
One of the highlights of trekking in Nepal is the chance to meet the interesting and friendly mountain people. During a trek one will meet people from many different ethnic groups. During a trek in Nepal there will be a constant flow of people along the trail, unlike the near-deserted trekking routes in other parts of the world.
Words of Advice

It is best that trekkers follow take into consideration the local customs and culture.
It is important for women to dress conservatively. Women for the most part should not wear shorts or low cut shirts. Men are expected to always wear a shirt in public.

Bargaining should not be done too aggressively during trekking. The mountain people are basically simple hard working people. Competition is tough and often the prices charged are very reasonable. Food is much more expensive in the mountains because it has to be brought in by foot. One should not get angry while bargaining. It should be a pleasant good-humored experience. To the seller Rs 5 may be the different between making a profit or not, while too many foreigners this is just 8 US cents

It is a good idea not to give to children begging along the trail. It is not good for the children self-esteem. Accept in the rare case the parents of the children do not know they are begging and would be very displeased with them (and you), if they knew they were doing it. Also, if you give to children, every trekker behind you may be subject to the begging of children.

Trekking Conditions
Often trails can be steep and it is hard work to go up them. You should be prepared for some hard, strenuous walking. Treks are often well-maintained as many locals use them. On many treks the trail is easy to follow.

During many treks there are a great amount of altitude gain and loss, which can make it much more difficult going than normal. Most treks are between 1000m and 3000m, but during the Annapurna Circuit and Everest treks, passes of over 5000m are crossed. During a high-altitude trek it is important to allow adequate time for acclimatization.

A normal day’s walk is from five to seven hours, during which there are several ascents and descents, and most of the time one of them is being done. Most trekkers get up early before 6 am, and then start walking between 6 and 7 am. The schedule then continue with stopping at 10 am for lunch, start walking again at noon and then walk until 3 or 4 pm. A second meal is then taken in the evening and then go to sleep early.

It is usually clearer in the early morning and you usually can get good mountain views in the morning. It gets cloudier in the afternoon.

It is a good idea to allow a few days as rest days, weather problems or to go on an interesting side trip. You may get lost now and then on the trail, but not usually for long.

General Information of trek
You should register with your embassy in Kathmandu before going on a trek. If you have a problem while trekking it will help to speed up your rescue. Also some payment has to be made for a helicopter rescue; they can contact your parent to insure payment, as a helicopter will not come for a rescue until they are sure of payment. The Kathmandu Environment Educational Project or Himalayan Rescue Association can forward details to your embassy for you.

Some health insurance policies do not cover trekking, and sometimes you are required to pay an extra amount to cover “high-risk sport.”

The best sources of current trekking information are the Trekkers’ Information Centre (run by Kathmandu Environment Education Project – KEEP), Jyatha Road in Thamel (open daily except Saturday and holidays 10 am to 5 pm), and the Trekkers Information Centre (Himalayan Rescue Association) (262-746; email: hra@aidpost.mos.com.np), opposite Shree Guest House, Jyatha Road in Thamel (open Sunday to Friday, 9 am to 5 pm). Both have comment books that contain tips from past trekkers that give information on trekking routes, trail condition, equipment and people opinion of trekking agencies that they used. Both have a small library. They both have notice boards, which are useful for finding trekking partners and finding used equipment. KEEP refills mineral water for Rs 10 per litre. KEEP sells trekking books, iodine and other items for trekking. KEEP may also have an office in the Lakeside area in Pokhara. HRA provides information on health places, weather conditions and altitude sickness. Himalayan Explorers Club (259-275), in the same building as the Himalayan Rescue Association on Jyatha Road in Thamel, has trekking information.

There are several good notice boards in the Thamel area with information on yoga courses, trekking partners, apartments, cultural events and language courses. There are good boards at the Kathmandu Guest House, Fire & Ice Restaurant, and Pumpernickel bakery.

There are regular slide shows in the Kathmandu Guest House, often on independent trekking. The slide show by Chris Beall, who is a writer and trek leader, is an introduction on trekking in Nepal. At the end you can ask questions about the latest trekking conditions. The cost is Rs 500 which includes a snack. You should look for posters or ask at the Kathmandu Guest House when slide shows are being done.

Changing Money
It can be difficult to change money during a trek except for during the Annapurna and Khumbu areas. You should bring enough money in Nepali rupees for the entire trek. It may be difficult to change Rs 500 or Rs 1000 rupee notes. If you have to change money outside a bank or legal money changer, you should expect to be offer much less than the bank rate by a black market money changer.

Independent Trekking
You can either make your independent arrangement or organize things through a travel agency. The main trekking routes have accommodations and places to eat along the entire route.

Budget travelers usually arrange everything themselves, carrying their own pack and stay in teahouses. The cost to do this should be least than $30 a day, and can be as little at $25 per day. A porter costs around $20 per day and a guide 30$ to $40 per day.

The advantage of doing it yourself means you can go at your own pace, stop for a while at a place, stop where you like, take a side trip and you can choose who you go with. On the other side you have to spend more time arranging everything and you have to use a route that have teahouses and lodges on them. You have to get your own trekking permit, bus tickets, buy supplies, rent equipment, and maybe find a porter or guide.

Usually independent trekking is less comfortable then a good organized tour. Lodges usually are crowded and lack privacy, and usually the food is nothing to brag about. On the other hand teahouses usually have a good social scene and are a good place to meet people.

On the Annapurna or Everest treks a guide or porter is not necessary is one is decently fit. On the other hand a porter can really make a trek more comfortable. If you are with two or three people a porter can carry a portion of each person’s gear and make it much easier on each person. A good guide or porter can make one life much easier and more enjoyable, but a bad one can be nothing but a hassle.

Finding a Trekking Partner
In some area it is a good idea not to trek alone. If you want to find a trekking partner, you can check the notice boards in Kathmandu or Pokhara. In Kathmandu, you can check the board at the Kathmandu Guest House or at the KEEP Information Centre.

You could also hire a porter to be a trekking guide with you.

Books and Maps
There are some good maps of the trekking routes. Schneider makes the best maps of the trekking route including Annapurna, Everest, Langtang and Helambu areas. They are not cheap as each one is Rs 700. A good map of Annapurna is the ACAP map Mandal are locally made maps that cover Round Annapurna, Khumbu, and Helambu & Langtang for Rs 100 to Rs 200. Himalyan Map House and Nepal series also makes good maps.
For out of the way area you can get the HMG/FINNIDA maps which were produced by the Nepal government and a Finnish aid agency.

There are weaknesses to all the maps. On different maps the names of villages may be different or depending whom you ask they may use a different name for a village. The trails often change because of avalanches or because trails may wash away.

Trekking in the Nepal Himalaya by Stan Armington’s and Trekking in Nepal: A Traveler’s Guide by Stephen Bezruchka are good trekking guides for all of Nepal. If you want to get some real detail you should get the

Trekking Precautions
In some areas it is not a good idea to walk alone. There are been some cases of thief and muggings in secluded areas. It is a good idea not to leave your door open in a lodge and not to let people to see his valuables.

The embassies highly recommended that everyone registers with them before going trekking. They have forms where you fill in your trekking route, family contacts, insurance details and name. This can real have if you need an emergency evacuation. This form can be filled in at your embassies and at the KEEP or HRA information centers.

Whenever crossing a high elevation pass, you should not underestimate the chance of the weather changing immediately for the worst. At any time of the year it can suddenly start snowing. While crossing a high pass you should go with at least four people. In this way if a couple people get injured or have altitude sickness the other people can help the injured ones. You should carry some emergency rations, a compass and a map. Also you should have gear to deal with a sudden rain or snow.

Trekking with Children
You may want to travel with a bit more comfort while traveling with children. You may want to take a taxi or a plane ride instead a long bus ride. It would be a good ideal to arrange a trek through a travel agency to hire porters so nothing will go wrong. If you have two children, say one is 3 and the 7, you will need a porter to carry one of the children and a few porters to carry your bags. It will be difficult to take care of children while carrying a bag. Porter will be around $5 per day or $15 between them.

You will usually have to walk at a slower rate than normal, so your children can keep up. In this way you will work less distance daily and have more energy to take care of the children. Also you most likely will not want to take too long of a trek, so the children do not get bored.

Environmentally it is best to use iodine in the water, but often child will not drink it and will only drink bottled or boiled water.

FAQS

© 2019, Himalaya Holiday Service Pvt. Ltd. All rights reserved & may not be reproduced without our permission