Welcome to the start of your Annapurna Circuit Expedition!
““May your trails be crooked, winding, lonesome, dangerous, leading to the most amazing view. May your Mountains rise into and above the clouds.” – Edward Abbey
Forty-five years.
A mere fraction of time in the context of this ancient landscape.
That’s how long we, as guests of Nepal, have had the privilege to explore the mountain trails of Annapurna.
To walk it, is to see all of Nepal.
Every type of terrain that it has to offer.
Arid desert regions, alpine scapes to sub-tropical lands.
To walk it, is to feel it.
To walk it, is to breathe it in…
Annapurna is ‘The Goddess of Harvest’ or ‘The Goddess of Food and Nourishment’. Nepalese people believe that the goddess resides in the mountain and thus named it as Annapurna.
Your Journey
Your Journey
Day 1: Welcome to Kathmandu!
Day 2: Kathmandu City Tour: Buddhist Temple and Hindu Shrine
Day 3: Transfer to Besisahar (830m), then trek to Bulbule
Day 4: Jagat (1341m)
Day 5: Dharapani (1890m)
Day 6: Chame (2170m)
Day 7: Pisang (3190m)
Day 8: Manang (3540m)
Day 9: Rest Day
Day 10: Ledar (4250)
Day 11: Thorong High Camp (4880m)
Day 12: Thorong La Pass (5416m) / Muktinath (3800m)
Day 13: Jomsom (2665m)
Day 14 Jomsom to Pokhara
Day 15: Return to Kathmandu
Day 16: Departure
Guest Portal
You can update all your personal information directly in our Guest’s Portal. There, you can add your Insurance, Flight Details, and anything else we need for the trip. When you first click on the link you will be asked to reset your password. Please use the same email address you used for your booking.
Training
The Annapurna massif is protected in the Annapurna Conservation Area, the largest protected area in Nepal. Established in 1985, it covers 7629km2.
Fitness is perhaps the key factor in the trek.
Most people of average fitness for their age could complete most of our treks. Take your time, set your own pace, and enjoy the incredible surroundings.
Most first-time trekkers are concerned that they won’t keep up. They soon discover that a steady and moderate pace will have them in their destination much faster than originally expected.
These treks are not training runs for the fit, but walking holidays for people of all ages, however, the fitter you are, the more you will enjoy it, and you will have enough energy for extra activities.
The best physical preparation for a trekking and climbing trip is to walk.
Start today. Walk on paths that go up and down, or on hills and steps for 30 or 40 minutes, 3 to 4 times a week.
Carry your day pack and wear the boots you plan to wear on the trek around 3 – 4 weeks before your arrival to Nepal.
Jogging, swimming, gym work you do additional, are all very helpful.
Regularly within Victoria, New South Wales, and Queensland (we’re constantly working to try and get guides in other states on board as well), we’ll have a variety of guides and trekkers get to know one another whilst working on their fitness and sharing advice on monthly weekend walks.
For information on any upcoming walks, please keep an eye out on our Upcoming Events
NOTE: Every participant should consult a physician well before the expedition date and make sure that they do not suffer from any chronic heart, lungs, cerebral, physical or any other serious illness.
As your service provider and hosts, we will take all necessary steps needed to evacuate injured or ill clients on the understanding that all costs involved will be paid to us before leaving the country (See We’ve got you covered below).
GETTING THERE AND AWAY
Some villages in Mustang such as Thini and Lupra still practice the Bonpo religion. These are among the last places in the world to preserve this practice.
ARRIVAL IN NEPAL
Upon your arrival, please go through to collect checked luggage and security, then proceed out the EXIT door. Your group leader will meet you at the airport and take you to your hotel where you can relax, meet your teammates and take a stroll through Kathmandu’s bustling streets, before a traditional Nepali dinner together.
Please do let us know if there are any last-minute changes to your arrival time!
If there’s anything specific you feel we need to know before departure, or you’d like us to get flights costed for you, don’t hesitate to Contact Us.
TRAVEL DOCUMENTS
The Annapurna I was first scaled by the French expedition Maurice Herzog and Louis Lachenal on July 3, 1950. After this successful expedition, however, both Maurice and Louis lost their gloves and had to be amputated due to lethal frostbite.
All nationalities except Indians require a visa for Nepal. We advise you to ensure that your passport is valid for six months from the date of entering Nepal. A Nepal visa is readily available on arrival at the International Airport in Kathmandu (or any other entry point to Nepal).
To obtain a visa upon arrival by air in Nepal you must fill in an application form and provide a passport photograph. Visa application forms are available on a table in the arrivals hall, though some airlines provide this form on the flight.
For people with electronic passports, there are now visa registration machines in the immigration hall which, after inserting your passport, will automatically fill out the visa form for you. There is often someone at these machines to help you.
However you do it, getting through immigration can take up to an hour, depending on the numbers. A single-entry visa valid for 15/30/90 days costs US$30/60/120 (all subject to change). At Kathmandu’s Tribhuvan Airport, the fee is payable in any major currency, but at land borders, officials require payment in cash US dollars; bring small bills. We haven’t yet heard of it happening to anyone else but the last time we entered Nepal by air and asked for a ninety-day visa we were also asked to show our driving license.
Multiple-entry visas are useful if you are planning a side trip to Tibet, Bhutan or India. You can change your single-entry visa to a multiple-entry visa at Kathmandu’s Central Immigration Office for US$20.
Don’t overstay your visa. You can pay a fine of US$3 per day at the airport if you have overstayed less than 30 days (plus a US$2 per day visa extension fee), but it’s far better to get it all sorted out in advance at Kathmandu’s Central Immigration Office, as a delay could cause you to miss your flight.
It’s a good idea to keep a number of passport photos with your passport so they are immediately handy for trekking permits, visa applications, and other official documents.
It is best to bring exact change in US$ cash. However other currencies can be used.
Please also bring 2 passport-size photos just in case the machines are not working.
Nepal Visas are also available in all Nepalese Embassies and Consulates are located in several countries/cities around the world.
If you are connecting via New Delhi (or other ports) in India or if your travel includes India you need an India Visa before you leave your home. Please note visas are not available at the airports in India.
If you are traveling via Thailand you can get a Thai visa upon arrival in Bangkok for 15 days.
INSURANCE
Emergency Medical Evacuation Insurance is a requirement for all guests travelling on our expeditions. Once you have booked on an expedition we suggest booking your travel insurance as soon as possible to protect your investment. Trip cancellation insurance will reimburse you for any non-recoverable air or land expenses should you have to cancel your trip due to personal or family illness or leave the expedition early due to other reasons. For our Australian guests, we are offering policies from NIB Travel for adequate cover, and you can contact our office direct, via phone or email, to obtain an insurance quote from us.
For guests travelling with us from outside Australia, please check Travel Insurance options within your Country.
If you should receive an injury 12 months prior to your travel date, you must contact the Insurance Company with details to ensure you are covered for this injury whilst travelling. Should you not do this and require medical assistance for this injury whilst travelling you may not be covered by the insurance company.
In the event that an aircraft evacuation is required, No Roads Expeditions will undertake to arrange the evacuation on the condition that the expenses are reimbursed by the passenger before departing the Country.
Note: Accidents caused by the inappropriate consumption of alcohol or drugs may void your travel insurance.
Get a Quote
While we don’t anticipate any uninvited medical disruptions during your trek, No Roads wants to keep your mind at ease and help you get adequate assistance and cover for your well-earned time away. It is extremely important that we ensure you’re covered during your great alpine experience.
We are able to provide you with Travel Insurance for your trip, allowing you to tick this off your ‘To-Do Lis”t as soon as possible. (We strongly recommend that you take out baggage loss and accident insurance)!
Already have a trusted insurance provider?
That’s no problem at all, our primary concern is that you have adequate cover.
Got a Pre-Existing Condition?
Simply call our Insurance Team and quote the reference number we provide you with and they’ll complete an assessment on your behalf. In many cases, there is no additional premium that needs to be paid! Many common conditions are also automatically covered.
In the event that an aircraft evacuation is required, No Roads Expeditions will undertake to arrange the evacuation on the condition that the expenses are reimbursed by the passenger before departing the Country.
Again, if you’ve any questions, don’t hesitate to ask info@noroads.com.au.
Things to Remember with Insurance
A Credit Card/Travel Card that can be used internationally. Often, any medical centre or hospital will require payment sooner than some insurance companies will have approved payment (meaning you need to be able to pay them, then seek reimbursement from your insurer).
The international emergency contact number for your insurance company. We will initiate emergency procedures for you, however, it is a far easier process for you to coordinate matters with the insurance company directly (most things we are unable to finalise on your behalf).
Documents to keep on your person, or obtain in event of emergency:
A copy of your flight itinerary with information including – Ticket Number, Airline Reference Number (PNR), Agency Flight Reference Number (if purchased via a travel agency/3rd party as well as contact information for them)
A copy of a Medical report (if you required treatment) and keep copies of all receipts for anything that you have been required to pay.
Remember to travel with a copy of your policy or at least your policy number and provider
The death rate for attempts to summit Annapurna I is very high (38%). This number is remarkably surprising compared to other mountains above 8,000m. The death rate in Everest is around 6.5%.
IMMUNIZATION
In order to enter Nepal, all travelers must follow the Health Protocol Requirements.
These requirements are fluid and are changing according to international COVID 19 developments. Please click here for more information about arrival requirements in Kathmandu.
To enter Nepal there are no other mandatory vaccinations. However, we suggest you do consult a doctor before you leave your country for vaccination against Hepatitis, Tetanus, Typhoid and Meningitis.
We adhere to strict hygiene guidelines so all our food is hygienically prepared, cooked and served.
Typhoid: Recommended for Nepal. Ideally 2 weeks before travel.
Hepatitis A: Recommended for Nepal. Ideally 2 weeks before travel.
Tetanus: Recommended for Nepal. Ideally 2 weeks before travel.
Meningitis: Recommended for Nepal. Ideally 1-6 months before travel.
Hepatitis B: Recommended for Nepal. Ideally 2 months before travel.
Plan ahead for getting your vaccinations (seriously, vaccinations are one thing that should NEVER be left until the last minute when TIME can truly be your enemy). Some of them require an initial shot followed by a booster, while some vaccinations should not be given together.
You do not need to carry an extensive medical kit as your Trekking Group Leader carries a comprehensive first aid kit for the group and staff. However, we do advise you to carry your personal medicine.
Accommodation
When flying from Kathmandu to Lukla, sit on the left side of the plane, and right side when flying back to Kathmandu. It will reward you with breath-taking views of the mountains. Indeed, it will be a scenic flight!
HOTEL ACCOMMODATION IN KATHMANDU
Hotel accommodation details: Harati Manor Inn, Gangalal Marg, Kathmandu 44600 Ph: +977 9841230040
There is the opportunity to upgrade your hotel in Kathmandu if desired. Please don’t hesitate to contact us if you wish to discuss your options.
DURING THE TREK
Our treks include accommodation at a family-run lodge at each stop.
Lodges normally have a common dormitory sleeping 6 or more people with an attached restaurant and basic toilet facilities. Many also have a few private rooms for two or three persons each. Solar heated shower rooms are available at a small extra cost.
Along the more popular routes, lodges are very comfortable and charming, managed by friendly local families. As one reaches the higher mountains, passes, and remote valleys, lodges become more basic.
In some of our high altitude lodge-treks (e.g.: Thorung La and Cho La passes), trekkers may have to spend a few nights with basic facilities and make pass crossings or explorations alpine style.
Mount Everest is the Himalayas (and the world's) tallest peak at 8,844.43 metres (29,016 feet). Incredibly, it continues to grow at a rate of around 40 centimetres (16 inches) per century
Getting Outfitted
PERSONAL GEAR
Please note that we will provide you with a duffle bag to put all your clothing etc into as well as a Down Jacket, Sleeping Bag and a Rain Poncho. You DO NOT have to bring these to Nepal for your trip.
ESSENTIAL ITEMS: CLOTHING & EQUIPMENT
- Walking Boots: Suitable boots are made of leather or leather/cordura, depending on the length and difficulty of your trek, and should have ankle support and a durable sole, preferably vibram for better grip in muddy or icy/snowy conditions. Boots should be generous fitting with ample room for toes, noting that thicker weight socks are also worn in the cold and that feet can swell a little when you have been trekking in the heat or at altitude.
- Lightweight Walking Shoes or Joggers: These will be backups for your walking boots and also for clean, dry footwear around camp.
- Socks: Good quality socks are equally important as good quality boots. You should have at least 3 or 4 pairs of good quality walking socks with insulative and wicking qualities. This can be a wool mix for instance – Wigwam brand, Thorlo, Mountain Designs Alpin, Ultimax.
- Flip Flops/Crocs (optional): Suitable for around camp and at lunchtimes, washing and if you have to get up in the night.
- Rainjacket with Hood (Supplied): This is a poncho so if you would like a more durable jacket please bring your own
- Intermediary Warm Layer: This is very useful when trekking in a slightly cool climate. A good fleece top or lightweight wool jumper is very useful and can be worn under your jacket or raincoat comfortably.
- Thermal Pants & Top: This is especially needed when undertaking treks from September onwards.
- 2 x Lightweight Pants & 1 x Shorts: For trekking, these should be loose-fitting and quick-drying for instance polyamide or microfibre. Note that cotton often takes a long time to dry in the mountains. Jeans are not suitable for trekking.
- 2-4 T-Shirts: For trekking and travelling. Cotton is OK and inexpensive. Shirts with a collar or a scarf will protect your neck from the sun.
- Underwear: Approx 3 or 4 sets.
- Down Jacket (provided).
- Woolen or Fleece Hat
- Thermal Gloves: Polypropylene, chlofibre or Thermax are invaluable and inexpensive.
- Gloves/Mitts: A thicker pair, wool, ski gloves or similar is necessary for potentially cold conditions.
- Water Bottle: We recommend two 1-litre bottles as the minimum, to ensure maximum hydration. They should be of good quality to withstand being filled daily with boiling water and will always remain watertight.
- Cotton Scarf: To protect against sun on the neck and dust on the trail.
- Daypack: Minimum of 30-liter capacity, with a comfortable harness so that a majority of the weight rests on your hips rather than shoulders. A more durable fabric will be more waterproof.
- Pack Cover: To protect your day pack from inclement weather.
- Plastic Bags or Stuff Sacks: Useful for sorting your gear and keeping things clean and dry, in your duffel bag and day pack. Ziplock plastic bags are effective at waterproofing your valuables, maps, medicines, writing materials
- Toiletries: Keep to a minimum, biodegradable or germicidal soap and shampoo, comb or brush, deodorant, vitamin E cream for sunburn or cracked skin. Shaving gear for men, a battery-operated shaver is convenient. Please note that toilet paper is provided on the trek.
- Towel: Small size, lightweight. A quick-drying travel towel is convenient when washing (with hot water) each morning.
- Torch or Headlamp: With spare batteries.
- Sunhat/Cap: One that won’t blow off!
- Sunglasses: Good quality with 100% U.V. filtering. Bring a spare pair if you have prescription lenses. Consider bringing a pair of Ski Goggles as well, they give excellent face protection against the harsh high altitude sun.
- Snow Gaiters (for high altitude and winter trekking and climbing trips).
OTHER RECOMMENDED ITEMS
- Money Belt: Two can be useful, one for your valuables left at the hotel, and one for your cash on trek.
- Adjustable Trekking Poles: One or a pair help reduce the strain on your legs; they are excellent for steep descents and loose/slippery terrain.
- Small Padlocks: For travelling and storing your luggage at hotels.
- Binoculars (optional): Very useful
- Reading Material, Playing Cards, Journal: A trek provides time to relax and enjoy your wonderful natural surrounds in good company.
- Sports Drink Powder: Isosport, Gatorade, Powerade. Well worth having a supply for the trek and readily available in Kathmandu.
Supplied Equipment
We will provide you with the following personal gear (on both camping and tea-house treks)
- Quality Duffel Bag (to keep all your gear in while trekking)
- Down Jacket
- Warm Sleeping Bag with Inner Liner
- Rain Poncho
- Large Plastic Bag (to protect your clothes when in the duffel bag)
Staying Safe & Respectful
Kali Gandaki gorge is the deepest in Nepal and lies between the Annapurna range and Dhaulagiri. This gorge is also considered one of the deepest in the world.
It’s time for a confession.
We weren’t always this confident at what we do!
This was never through a lack of trying, but the reality is after 15 years sending people to remote parts of the world, we’ve picked up a thing or two…
TIPPING
Tipping is an accepted part of overseas travel although it is a completely personal matter.
In Kathmandu allow $20-25NPR per bag for bellboys and porters.
It is also an indication of your satisfaction with the job done by the trek crew on your trip as they work hard to make your holiday the most memorable one. Your Group Leader will assist you to collect what you wish to give/ contribute at the end of the trek.
As a guideline, average tipping is around 10% of your trip cost. For example, if your trip cost $2000, an average tip per trekker would be between $180 and $200, which is shared among the whole crew including porters. If you wish to tip your group leader, do it separately.
POWER IN NEPAL
Nepal’s Electricity is 220 Volt and 50 MHZ (50 Cycles per Second). The Electric Plug is two or three round prongs, but not flat prongs as found in use in the United States or in other countries. If your electronic uses 110 Volt 60 MHZ electricity, you will need a voltage converter.
Nepal’s electricity is not smooth. Voltage fluctuation is very common and it is advised that you use a robust power surge protector for your electronics.
Nepal does not produce enough electricity so there are seasons when power may be disrupted for hours – they call it load shedding. Keep in touch with local newspapers or your hotel reception about the hours power may be off. Also, Nepal’s electricity goes on and off randomly all the time.
If you are working on the computers found in the hotels, make sure they have UPS (Uninterruptible Power Supply) otherwise save your work every now and then.
MONEY
The equivalent of $100-$150USD will generally be enough for the duration of your trek, although for longer treks you could carry as much as $200USD. The amount required in Kathmandu for meals, sightseeing, and transport would normally be covered by about $30USD per day.
Souvenir shopping will vary greatly from person to person.
CREDIT CARDS
Credit cards can be used to purchase goods at major stores in Kathmandu. Be aware, you may be charged a higher price than if you pay by cash. While using your cards anywhere make sure that you sign only one voucher and do not leave any spaces.
CULTURAL CONSIDERATIONS
Nepal has only been opened to the West since 1951 and despite the veneer of westernization in certain areas; it remains a very traditional and religious society. As a guest, respect local traditions, protect local cultures, and maintain local pride:
- The traditional greeting in Nepal involved putting your palms together and saying NAMASTE “Nah-mah-stay”.
- Appreciation & respect are shown in Nepal by using two hands rather than one when giving or receiving something, including money.
- When taking photographs, respect privacy, ask for permission, and use restraint.
- Respect holy places, preserve what you have come to see, never touch or remove religious objects. When entering any Nepalese home, temples and monasteries, always remove your shoes.
- Giving/handing out pens, balloons, money, and sweets to village children encourages begging. A donation to a project, health centre, or school is a more constructive way to help.
- Many Hindu temples may not be open to non-Hindus. Always ask permission before entering.
PHOTOGRAPHY
Nepal affords unparalleled opportunities for photography. Ensure that you are familiar with your camera well before your trek, and that your camera battery is strong (and bring a spare).
When taking photographs of local people, please ask their permission first and respect their wishes. This is normal courtesy. All you need to do is hold up your camera and wait for a response.
Older people mostly villagers often do not wish to be photographed as they believe that being photographed can shorten their lifespan.
SECURITY – VALUABLES & LEFT LUGGAGE
We advise you not to leave valuables in your room at any time – keep them with you or deposit them in a safety deposit box available at the hotel reception desk.
While away on your trek, however, your passport, air ticket, valuable personal things, excess cash can be left with us, and our staff will provide you the deposit receipt which you should produce for the return of those valuables.
You can leave excess baggage at the hotel but please do not leave anything in plastic bags; either use a duffel bag or a suitcase. It is best to fit a small lock to your bag as you travel to/from Nepal and on the baggage you leave in Kathmandu.
Whilst trekking, your money and camera should be kept with you all the time. Never leave them lying around unattended.
We've Got You Covered
GENERAL TRAVEL ADVICE
All No Roads staff and teams consider guest safety and wellbeing an absolute priority and always follow the travel advice and guidelines of the World Health Organisation (WHO) and Smartraveller. To further maintain the safety of our travelers, we promote good personal and hand hygiene along with adherence to safe food preparation practices.
SPECIAL DIETARY REQUIREMENTS
We are able to cater to all common special dietary requirements.
Please advise us prior to your departure if you have any food allergies we should be aware of.
The No Roads team will do everything it can to support any trekkers with allergies that might require a special diet, by informing all in-country personnel and ensuring reasonable provisions are made for all meals. We do, however, suggest and encourage all affected guests to assist us by providing this information while travelling in situations or instances where it may be required.
ENVIRONMENTAL ASPECTS
No Roads Expeditions believes the preservation and conservation of the fragile environment is our greatest concern and we try our best to minimize all the negative impacts in the areas we visit. We cook food by kerosene in our all-camping trips. This helps stop deforestation, which is one of the biggest environmental problems in Nepal. We dispose of all the biodegradable rubbish at our campsites, and we bring non-biodegradable items like tin, batteries, plastic etc. back to Kathmandu for proper disposal. Under no circumstances should rubbish be thrown onto the ground. While staying in tea-houses we prefer to stay on where they prepare the meals using Kerosene or alternative energy.
Please do not buy the bottled water on the trail, as the plastic bottles are not recycled. Soft drinks are better, as the glass bottles are carried out and recycled. All washing should be done away from rivers and streams using. We discourage the use of soap, even biodegradable soap as both can be harmful to the environment. Never tip soapy washing water where it will run directly into the source of water. Moreover, we discourage our guests from having hot showers if the water is heated by firewood in tea-houses along the trail. We organize Eco Trekking Workshops every year, which train trekking personnel in the conservation efforts of all the environmental and indigenous cultures of the Himalayan Kingdom of Nepal in association with Kathmandu Environmental Education Project (KEEP). No Roads Expeditions is an active member of KEEP, as part of its commitment to preserving the environment in Nepal.
Old batteries should be brought back to your home country as Nepal has no reasonable way of disposing of them.
At campsites, use toilet facilities that are provided. If you are in the remote, walk off the track and dig a small hole approximately 15cm deep and at least 100m from any watercourse. If safe to do so, burn used toilet paper in the hole (toilet paper takes a long time to degrade). Once fire is out, cover with soil. In rocky and icy mountain terrain (where a hole cannot be dug), cover waste with rocks. Tampons and sanitary pads should be placed in a plastic bag and placed in the rubbish bin back at camp.
By abiding by these simple guidelines, you will be protecting the local environment for the people who live there and for your children’s children.
CLIMATIC CONDITIONS
The temperate climate in Nepal is affected by monsoon, which sweeps up from the Bay of Bengal every summer making mid-June to mid-September wet and humid. The monsoon season is not ideal for trekking with, the exception of a few remote valleys at high elevations.
Autumn (mid-September to November) is usually considered as the best and most popular time for trekking in Nepal. During this season, the usually clear skies and mild to warm days / cool nights enhance your stay in all these fascinating mountains, as the countryside gets lush and green. Gradually it gets cooler later in this season, as the winter approaches.
Winter (December to February) is considered another ideal time to visit Nepal, despite the colder conditions. The skies are clearer still, with magnificent visibility, cool days, and even colder nights. There are fewer trekkers at this time. Occasional winter storms may bring snow to an altitude as low as 2500 meters.
By Spring (March to mid-June), the cold and dry season begins to give way to milder, moister spring conditions. Mornings are usually clear, giving enough time to appreciate and photograph the mountains; occasionally cloud builds up, bringing afternoon rainstorms with the gradual increase in daytime temperatures. This season has clear weather at the higher altitudes. This is also the rhododendron season.
MEDICINES AND FIRST AID
You do not need to carry an extensive medical kit as your Trekking Group Leader carries a comprehensive first aid kit for the group and staff. However, we do advise you to carry your personal medicine.
All trekkers are recommended to carry a personal first aid kit with medicines for common ailments, cuts and bruises, pain killers, etc. Anyone using any prescription medicines regularly should carry a supply for the whole duration of their expedition. Please consult your doctor and include items and medicines that may be required for you or for the area you are travelling in. No Roads does not supply any medicines and takes no legal responsibility for any medical treatment or professional medical support to our clients.
We will do everything we can to support guests that have disclosed a medical condition, allergy, or anaphylaxis, by informing all in-country personnel and ensuring reasonable provisions are made.
We do, however, suggest and encourage all guests in this situation to assist us by reconfirming this information in situations or instances where it may be required to ensure everyone has a safe and enjoyable adventure experience.
*If you have something you are particularly prone to such as ear infections, sinus problems or mild asthma bring what you need with you.
The No Roads Guide will be carrying an extensive Wilderness First Aid Kit.
Your personal first aid kit should contain:
Band-aids, Paracetamol, Deep Heat or other muscle liniment, Blister pads, Crepe bandages, Antibiotic cream for cuts and scratches, ‘Imodium’ tablets, Strapping tape (for knees and ankles), Anti chaffing cream e.g. Pawpaw cream, Foot powder, Waterless hand disinfectant, Anti-malarial drugs (see your doctor), Anti-inflammatory cream, Broad-spectrum antibiotic tablets, Anti-Nausea Tablets.
WOMEN’S HEALTH
On top of the normal health considerations, women are advised to bring a tube of Canesten and an applicator. The Canesten is used for the treatment of thrush (which can be very painful if left untreated) and can be applied to both internal and external thrush.
ALTITUDE (AMS)
Travelers whose itineraries will take them above an altitude of 1,829-2,438 m (6,000-8,000 ft) should be aware of the risk of altitude illness. Travelers are exposed to higher altitudes in a number of ways: by flying into a high-altitude city, by driving to a high-altitude destination, or by hiking or climbing in high mountains. Examples of high-altitude cities with airports are Cuzco, Peru (3,000 m; 11,000 ft); La Paz, Bolivia (3,444 m; 11,300 ft); or Lhasa, Tibet (3,749 m; 12,500 ft).
Travelers differ considerably in their susceptibility to altitude illness, and there are currently no screening tests that predict whether someone is at greater risk for altitude illness. Susceptibility to altitude illness appears to be inherent in some way and is not affected by training or physical fitness. How a traveler has responded in the past to exposure to high altitude is the most reliable guide for future trips but is not infallible.
Travelers with underlying medical conditions, such as congestive heart failure, myocardial ischemia (angina), sickle cell disease, or any form of pulmonary insufficiency, should be advised to consult a doctor familiar with high-altitude illness before undertaking such travel. The risk of new ischemic heart disease in previously healthy travelers does not appear to be increased at high altitudes.
Altitude illness is divided into three syndromes: acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). AMS is the most common form of altitude illness and, while it can occur at altitudes as low as 1,219-1,829 m (4,000-6,000 ft), most often it occurs in abrupt ascents to >2,743 meters (>9,000 ft). The symptoms resemble those of an alcohol hangover: headache, fatigue, loss of appetite, nausea, and, occasionally, vomiting. The onset of AMS is delayed, usually beginning 6-12 hours after arrival at a higher altitude, but occasionally >24 hours after ascent.
HACE is considered a severe progression of AMS. In addition to the AMS symptoms, lethargy becomes profound, confusion can manifest, and ataxia will be demonstrated during the tandem gait test. A traveler who fails the tandem gait test has HACE by definition, and immediate descent is mandatory.
HAPE can occur by itself or in conjunction with HACE. The initial symptoms are increased breathlessness with exertion, and eventually increased breathlessness at rest. The diagnosis can usually be made when breathlessness fails to resolve after several minutes of rest. At this point, it is critical to descend to a lower altitude. HAPE can be more rapidly fatal than HACE.
Determining an itinerary that will avoid any occurrence of altitude illness is difficult because of variations in individual susceptibility, as well as in starting points and terrain. The main point of instructing travelers about altitude illness is not to prevent any possibility of altitude illness, but to prevent the person from dying of altitude illness. The onset of symptoms and clinical course are slow enough and predictable enough that there is no reason for someone to die from altitude illness unless trapped by weather or geography in a situation in which descent is impossible. The three rules that travelers should be made aware of to prevent death from altitude illness are:
Learn the early symptoms of altitude illness and be willing to admit that you have them.
Never ascend to sleep at a higher altitude when experiencing any of the symptoms of altitude illness, no matter how minor they seem.
Descend if the symptoms become worse while resting at the same altitude.
Studies have shown that travelers who are on organized group treks to high-altitude locations are more likely to die of altitude illness than travelers who are by themselves. This is most likely the result of group pressure (whether perceived or real) and a fixed itinerary. The most important aspect of preventing severe altitude illness is to refrain from further ascent until all symptoms of altitude illness have disappeared.
Children are as susceptible to altitude illness as adults, and young children who cannot talk can show very nonspecific symptoms, such as loss of appetite and irritability. There are no studies or case reports of harm to a fetus if the mother travels briefly to high altitude during pregnancy. However, most authorities recommend that pregnant women stay below 3,658 m (12,000 ft) if possible.
Three medications have been shown to be useful in the prevention and treatment of altitude illness. Acetazolamide (Diamox; Lederle Pharmaceutical, Pearl River, NY) can prevent AMS when taken before ascent and can speed recovery if taken after symptoms have developed. The drug appears to work by acidifying the blood, which causes an increase in respiration and thus aids in acclimatization. An effective dose that minimizes the common side effects of increased urination, along with paresthesias of the fingers and toes, is 125 mg every 12 hours, beginning the day of ascent. However, most clinical trials have been done with higher doses of 250 mg two or three times a day. Allergic reactions to acetazolamide are extremely rare, but the drug is related to sulfonamides and should not be used by sulfa-allergic persons, unless a trial dose is taken in a safe environment before travel.
Dexamethasone has been shown to be effective in the prevention and treatment of AMS and HACE. The drug prevents or improves symptoms, but there is no evidence that it aids acclimatization. Thus, there is a risk of a sudden onset or worsening of symptoms if the traveler stops taking the drug while ascending. It is preferable for the traveler to use acetazolamide to prevent AMS while ascending and to reserve the use of dexamethasone to treat symptoms while trying to descend. The dosage for both indications is 4 mg every 6 hours.
Nifedipine has been shown to prevent and ameliorate HAPE in persons who are particularly susceptible to HAPE. The dosage is 10-20 mg every 8 hours.
Newer medications have recently been tried to help prevent AMS and HAPE. In two small trials, gingko biloba, an herbal remedy, was shown to reduce the symptoms of AMS when taken before ascent. Gingko has not yet been compared with acetazolamide, although a study is planned. Inhaled salmeterol (a beta-adrenergic agonist) was demonstrated to help prevent HAPE in a small group of climbers who had previously shown susceptibility to HAPE. Whether salmeterol will prove beneficial in a more general population remains to be seen. The mechanism of action of salmeterol suggests that it could be of benefit in treating already established HAPE, but there are no studies yet to confirm this.
For trekking groups and expeditions going into remote high-altitude areas, where descent to a lower altitude could be problematic, a pressurization bag (e.g., the Gamow bag), can prove extremely beneficial. Persons with altitude illness can be zipped into the bag, and a foot pump can increase the pressure inside the bag by 2 lbs. per in2, mimicking a descent of 1,500-1,800 m (5,000-6,000 ft), depending on the starting altitude. The total packed weight of the bag and pump is approximately 6.5 kg.
For most travelers, the best way to avoid altitude illness is to plan a gradual ascent, with extra rest days at intermediate altitudes. If this is not possible, acetazolamide may be used prophylactically, and dexamethasone and nifedipine may be carried for emergencies.
No Roads Expeditions trip itineraries have been professionally designed to minimize the affects of altitude sickness. Extensive medical kits are carried on all our trips. In addition, Portable Altitude Chamber (a life saving device in case of AMS) is being carried as precautions on high altitude treks and climbing expeditions. All our group leaders / guides are well trained in Wilderness First Aid Course to recognize any symptoms and to act accordingly on the very spot.
Physical Preparation
Over the course of 2019, our guides donated their time and expertise to conduct over a dozen training walks available to ANYONE (yes, open to the public) across such beautiful locations as the Blue Mountains west of Sydney, to the 1000 Steps in Melbourne's outer east!
FITNESS
Training like it is the real deal!
You know what they say (whoever ‘they’ are):
“Failing to prepare is preparing to fail”
The secret is to do exercises that simulate what the expedition will be like, so hiking with a pack up and down hills for a few hours is ideal. Don’t forget to wear in your clothing and walking shoes/boots/socks so you discover any issues with them before it is too late. Wearing in your footwear usually takes several months of walking, not two or three training walks.
Consider training with 15-20kg of weight so that the recommended 12kg on the trek will be lighter than what you’re used to. This will offset the breath-sapping impact of Nepals altitude. If you are planning to use trekking poles, train with them now (they are so common these days, that no one will think that you’re strange).
We all have busy lifestyles so if this is not possible, a hike into the hills every two or three weeks would be beneficial. We believe this will really help you enjoy your time on the expedition.
Never do on the trek what’s not been tested by you (for months) in training.
That is, if you haven’t tried it during months of advanced training, don’t succumb to last minute “bright ideas” (from yourself or others) on the journey unless it has proven okay for you many times in training, for example:
Don’t wrap your feet or toes in sports tape!
Don’t buy new boots or socks just before going on your trek!
Don’t wear new clothes!
Know The Lingo
The discovery of 6 new languages since 2011 brings the total number spoken in Nepal to 129. Most are considered endangered, as only 19 of them have more than 100,000 speakers.
A little effort to speak like a local can be a great icebreaker (as you stumble over the few words you remember) and is always appreciated by those whose homeland you are visiting.
Useful Phrases
Hello, Goodbye – Namaste
Thank you – Dhanyabaad
How are you? – Tapaain laaee kasto chha?
How are you? – Tapain-lai kasto chha?
Excuse me – Hajur
Please (give me) – Dinuhos
Please (you have) – Khanuhos
I – Ma
Yes (I have) – Cha
No (I don’t have) – Chhaina
OK – Theekcha
What is your name? – Tapaainko naam ke ho?
My name is ‘Peter’ – Mero naam ‘Peter’ ho
I hope we meet again – Pheri bhetaunlaa
Please speak more slowly – Bistaarai bolnuhos
Do you speak English? – Tapaain angrejee boln saknuhunchha?
Yes, I speak English – Ho, ma angrejee bolchhu
I only speak a little English – Ma ali ali angrejee bolchhu
I can speak a little Nepali – Ma ali ali Nepali bolchhu
Please say it again – Pheri bhannuhos
Excuse me, sorry – Maaph garnuhos
Where are you going? – Kahaan jaane?
To ‘Lukla’ – ‘Lukla’ ma
I want to change money – Ma paisaa saatna chaahanchhu
May I take a photo? – Ke ma tasbeer khichna sakchhu?
Could you take my photo? – Mero tasbeer khichna saknu hunchha?
I’m a vegetarian – Ma sakahari hun
How much? – Kati
Where? – Kaha?
Here – Yaha
There – Tyaha
Good/Pretty – Ramro
I didn’t understand – Maile bujhina
Can I walk there? – Hidera jana sakinchha?
Checklist
Please make sure you have the following items before you travel to the airport for your flight to Nepal.
- Day pack (backpack) as hand luggage (if possible, take your hiking boots as carry-on as well. Generally, any other items lost in transit can be replaced or covered in Kathmandu).
- Valid passport.
- Photocopy of the main page of your passport.
- Photocopy of your COVID 19 Vaccination Status in addition to any proof on your mobile device.
- Return Airfares and other travel documents.
- Medical/travel insurance papers/certificates plus 2 copies of your policy.
- Credit cards, cash dollars for expenses while in Nepal.
- Personal First Aid Kit
Give Us A Shout
NO ROADS EXPEDITIONS
Office: (03) 95988581
24 hrs Access:
Irene Miller + 61 430 705 222
Peter Miller + 61 425 726 623
Email: info@noroads.com.au
IN COUNTRY
Mountain Monarch
Pradip Kumar Limbu
Managing Director
Phone No: + 977 1 4373881 or + 977 1 4370667
Cell/Mobile: + 977 9851079588