Health and Safety

Tips for your safety

It is a condition of joining any of our holidays that you are insured against medical and personal accident risks (to include repatriation costs, air ambulance and helicopter rescue services). We also strongly recommend that you take out delayed departure and cancellation insurance, as all deposits paid are non-refundable. A relaxed trip is not possible without good travel insurance. In the event of any sickness or injury, the cost of emergency treatment and evacuation is shocking. Therefore, travel insurance is strongly recommended for everyone who signs up with Gorkha Adventure.

We strongly recommend that you have to be careful while choosing a policy as some makes special exceptions for adventure travel. Before buying your insurance, please ensure that your insurer is aware of your Gorkha Adventure itinerary and can agree to cover the activities being undertaken in the trip to Nepal, Tibet, Bhutan & India. Such as if you are planning trekking or climbing/expedition in Himalayas your insurance must cover emergency air ambulance/helicopter rescue including medical expenses. For a group tours in urban areas, your insurance coverage of ambulance or helicopter rescue is not mandatory, however better to have with them too. You need send us your copy of your insurance policy (e.g. your insurance certificate) or carry it with you while you come on the trip.

Other Health Risks 

There are some health risks that are more acute when trekking at high altitudes.

Dehydration: Since you are prone to sweat a lot when hiking, it is very important to keep hydrated. Keep water with you at all times, and drink lots!

Altitude Sickness: This occurs when ascending from low levels to high levels, especially when done rapidly. Altitude sickness begins with shortness of breath from lack of oxygen. Symptoms include exhaustion, loss of appetite, headache and nausea. It’s important to go slowly and monitor your body’s reaction to the change in altitude. Trekkers should descend immediately if their condition worsens. See here for more information.

Blisters: Walking for a long periods of time can cause blisters to develop on your feet. Be prepared and bring a first aid kit with you. Try to keep your feet as dry as possible. Be sure to ‘wear in’ your hiking boots before your trip to Nepal.

Sunburns: At high altitude, the suns rays are more powerful. Pack a hat, sunglasses and wear lots of sunscreen to avoid getting sunburn,

 Altitude Sickness/Acute Mountain Sickness (AMS)

Altitude sickness, also called Acute Mountain Sickness (AMS) generally occurs above 2,500 m (8,000 ft), but serious altitude illness is rare below 3,000 m (10,000 ft). It ranges from Preparation a mild headache and weariness to a life-threatening disease, when fluid in the lungs (HAPE) or brain (HACE) is built-up.

AMS is caused by the body having difficulty adapting to the lower oxygen level at higher altitudes. Usually this is due to a too quick ascent, and sometimes personal sensitivity. As AMS can be fatal, it is important to know about the disease, its symptoms, how to prevent them and how to treat AMS.

Acute Altitude Sickness

Acute altitude sickness is the mildest and most common form. Patients usually have a (mild) headache and/or less appetite, and nausea. These symptoms are quite common above 3,000 meters (10,000 ft). Nothing to be worried about (yet), but it is important to tell you guide or trekking companion about your symptoms, and keep close watch that they don’t get worse. Symptoms:

  •  Headache
  •  Fatigue
  •  Dizziness
  •  Insomnia
  •  Shortness of breath during exertion
  •  Nausea
  •  Decreased appetite
  •  Swelling of extremities
  •  Lack of sleep
  •  Social withdrawal

High Altitude Pulmonary Edema (HAPE)

HAPE occurs when fluid builds up within the lungs, a condition that can make breathing extremely difficult. Onset of HAPE can be gradual or sudden. HAPE typically occurs after more than one day spent at high altitude. If left untreated, it can progress to respiratory collapse and ultimately to death. Symptoms:

 Shortness of breath at rest

  • Extreme fatigue
  • Gurgling respiration
  • Dry cough or wet cough with frothy sputum
  • Possible fever
  • Respiratory failure

High altitude Cerebral Edema (HACE)

Another serves form of altitude sickness is high altitude cerebral edema (HACE), in which fluid builds up within the brain. As the brain swells with fluid, the person’s mental state changes. Loss of coordination, coma and finally, death are the cause if not recognized and treated promptly. Symptoms:

  •    Difficulty with balance and coordination
  •    Hallucinations, lethargy, confusion
  •    As the brain continues to swell unconsciousness or coma will develop.

How to identify if someone is seriously suffering from AMS, HAPE, or HACE:

Ask the person to walk in a straight line

Ask the person to close his eyes and brings his fingers to the tip of his/her nose.

Ask the person to put on pants (put his leg into one of the legs)

If he is not able to do so, the situation is serious!!

How to Treat AMS ?

  • In case of mild symptoms, stay at the same altitude. Ascend only when the Symptoms have resolved completely
  • In case your symptoms are getting worse while resting at the same altitude, descend
  • In case of serious symptoms go down immediately! Helicopter rescue may be necessary.
  • If the patient is not able to w3alk (due to serious symptoms) and can’t be carried down, an inflatable high pressure bag (Gamow Bag) can help. The bag restores the oxygen level and air pressure and is used as   a treatment in acute situations. Some trekking groups carry a pressure bag, besides they are available in some lodges, especially in the Khumbu/Everest area.
  • Never let a patient descend unattended
  • If available, consult a doctor, also if symptoms are not yet very serious

How to prevent AMS ?

The best way to prevent AMS is to ascend gradually. Above an altitude of 3,000 meters (10,000ft) you should not ascend more than 300 m (1,000 ft) a day. If due to the itinerary this is not possible, a rest day to acclimatize recommended. Drinking lots of water can help to prevent AMS. Per day, you should be drinking 1 liter of water for every 1,000 meter (3,000 ft) altitude. This means that at an altitude of 4,000 m (12000 ft), you should be drinking 4 liter of water a day (or tea, juice or other fluids, expect alcohol). More asmore people use Diamox (Acetazolamide) as a prophylaxis, to help the body acclimatize more quickly. You start taking Diamox shortly before you start to ascend above 3,000 m (10,000 ft) and continue taking it until you descend again. Consult with your doctor if you consider using Diamox. Persons with allergy to sulfa drugs should not take the drug. Drink extra amounts of water, as Diamox dehydrates the body.


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