Everest Before Climb

before your climb

Routes, DATES & PRICES

Routes

Everest Base Camp & Kala Patthar: A must for those who want to get up close to the highest peak on the planet. This is the classic Everest trek, taking you to the Sherpa lands of the Solukhumbu and up the Dudh Kosi and into the Sagarmatha National Park. The trip culminates with a visit to Everest Base camp where you will be in and amongst the Summit groups themselves. Before our descent we will visit Kala Pataar (5,545 metres) for stunning views of Everest, Lhotse and Nuptse. A 16 day trip which includes a full itinerary visiting the best sites of Kathmandu.

Everest Base Camp and Island Peak Climbing: For those who want to take on something a little more demanding than your average trek. Island Peak (Imja Tse) offers the opportunity of bagging a peak over 6,000m. The peak was named Island Peak in 1951 by Eric Shipton’s party since it appears as an island in a sea of ice when viewed from Dingboche. The peak was later renamed in 1983 to Imja Tse but Island Peak remains the popular choice. A 20-day trip which includes a full itinerary visiting the best sites of Kathmandu.

Dates

Given the internal structure of our company, we are able to schedule a trek virtually any day of the year, which enables us to operate to traveller requested dates rather than ask them to fit into our scheduled dates. Therefore we would be delighted to schedule for you to start a trek, for any duration, anytime during 2024/25/26.

You are welcome to pick and choose your own dates and route and we will create an itinerary for you, and you can also decide if you would prefer to have your own Private trek, or if you would be happy to open it up for other travellers to consider joining. There is no cost difference between a Private or Open trek.

prices/payment

All prices are based on the size of the 'booking group' (other than solo trekkers added to existing scheduled treks as detailed above), not any final group size should we be able to add other trekkers to your adventures.

Non-refundable Deposit Payments are normally processed as USD 150 per person (plus any additional / upgraded nights accommodation costs) deposit to secure places, followed by Final Balances paid 45 days before arrival.

The simplest way to pay for this deposit is by credit / debit card via Stripe (a payment system similar to PayPal). There is a 3.35% imposed by Stripe for paying by this method.

If you would prefer to pay by International Transfer, you will find the instructions on the invoice we send - though while we won't charge you to make a transfer, in all likelihood your bank will (usually around US$25-45) for this.

So we suggest that you use your credit/debit card to pay the deposit, and then make a bank transfer for the balance later. Note that International Wire Transfers should please be transacted so as to arrive into our bank account free of bank charges. We will confirm the balance received against the balance due. Any bank / SWIFT charges that are deducted from your payment will be invoiced for payment in cash on arrival.

If you would like to save on bank charges by paying the full amount up front, then this can be arranged too; just let us know and we will compile a full invoice for you instead.

Gear & Bags - What To Pack

All trekkers are requested to individually consider bringing all the following items for their mountain adventure - where your personal day sack should not weigh more than 5-6kgs when packed, and your large holdall / cargo bag that you hand to the crew to carry can weigh no more than 15kgs when packed.

- Luggage containers -

+ Sturdy Large Holdall / Cargo Bag, 90-100 litres capacity (for your gear carried by a porter)

+ Personal Daysack, 25-35 litres (for ready-access items)

+ Waterproof rucksack liner or heavy duty plastic sacks - for both the large bag and the daysack

+ Elasticated waterproof bag covers - for both the large bag and the daysack
+ ‘Dry Bags’ for separating items inside your large bag, aswell as offering another level of water

protection in the event of rain falling

- Equipment -

+ Sleeping Bag - ideally rated to -10°C as a minimum
+ Sleeping bag liner - silk ones are lovely!
+ Sleeping mattresses are not required as these will be provided in the tea-houses, but some trekkers will choose to bring their own inflatable mattress to use in conjunction with the mattress provided.
+ Water bottles / hydration bladder - carrying capacity to be 3 litres minimum
+ Headtorch (with spare batteries)
+ Optional - Telescopic / shock absorbing walking poles

Clothing

- Head -

+ Fleece lined / Woollen Hat - especially for summit night
+ Wide brimmed sun hat designed to protect your neck and ears aswell as your face
+ Balaclava / Buff / Wind

- Upper body / Torso -

+ Wicking t-shirts / sports shirts designed to wick moisture away from the skin
+ Lightweight Long-sleeved shirts / micro-fleece
+ Mid-weight fleece
+ Down or synthetic insulated jacket (min 650FP recommended)
+ Thermal base-layer top (Merino wool recommended) - for sleeping and summit night
+ Lightweight trekker gloves for lower altitudes
+ Down or synthetic insulated gloves / mittens for higher altitudes
+ Breathable waterproof jacket

- Lower body / Legs -

+ Lightweight walking trousers (including walking shorts or trousers that can convert to shorts)
+ Thermal base-layer leggings (Merino wool recommended) - for sleeping and summit night
+ Underwear - comfortable and close fitting to avoid chafing
+ Breathable waterproof trousers

- Feet -

+ Comfortable / worn-in waterproof walking boots, with a good tread pattern, good ankle and arch support. Grade B1 recommended
+ Good quality hiking socks (boot length / odour resistant - Merino wool / Bamboo recommended)
+ Gaiters
+ Sports shoes / sliders / flip flops for use in and around camp when not trekking

essentials

- Personal Hygiene Gear -

+ Toothbrush & toothpaste
+ Lightweight travel towel & Flannel
+ Small can of Deodorant
+ Flat packed Wet Ones, travel wipes, or similar, for personal hygiene.
+ Kleenex tissues in plastic travel pouches or toilet paper
+ Hairbrush / comb
+ Sanitary products
+ Lip salve with good UV protection
+ Vaseline, to prevent chafing skin and heel friction blisters

+ Hand Sanitiser

- Health Related Items -

+ Minimum Factor 30+ sun cream
+ Sun barrier cream for nose and ears

+ Vaseline (or similar)

- Personal Small First Aid Kit -

+ Any medication you normally use
+ Pain Killers (Ibuprofen/ Paracetamol)
+ Diamox (Acetazolamide) if you choose to use this - your guide will carry some for you anyway
+ Zinc oxide tape and small scissors
+ Compeed Blister Pads
+ Loperamide Diahorrea Tablets
+ Loperamide Dioralyte sachets or similar rehydration packs
+ Imodium or similar
+ Personal hand sanitiser

+ Ibuprofen, Anti-inflammatory gel, bandages, Loperamide, Amoxycilin, Oral Dexamethasone, and several other items

Your guide will carry a more comprehensive medical kit including additional Acetazolamide.

recommendations

- Other items -

+ Energy gels & hand warmers for summit night - please dispose of these responsibly
+ Energy inducing favourite snacks - including cereal bars, dried fruit and nuts
+ Compact digital camera and spare memory cards
+ Spare pre-charged battery packs and cables for charging phones, cameras, watches etc
+ Sunglasses with UV-filter lenses
+ Glasses, if worn
+ Spare contact lenses and fluid, if worn
+ Watch - trekkers will frequently use watches with GPS features so they can track daily progress

+ Plastic bags (not single use) for dirty clothing
+ Mobile phone. There is signal reception on most parts of the trek. It is a good idea to unlock your phone before you come out so that a local sim card can be used.
+ Books / games and music equipment (iPod or similar) for in camp

+ Separate holdall
+ Casual clothes for general wearing
+ Passport (with additional 6 months’ validity after proposed expedition return date)
+ Tanzanian Entry Visa. (If flying to Nairobi and taking the bus to Arusha, Kenyan visas can be bought on arrival at Nairobi airport.)
+ Air Travel Documents
+ Cash in US dollars in denominations of $10 and $20 and $1 (tipping allowance and local purchases, taxis, meals, etc)
+ Credit Card (recommended for eventualities only - remember transaction surcharges @ 5% are typical)
+ Travel Insurance Documents
+ Vaccination Certificates (Yellow Fever, if visiting a ‘risk zone’ prior to entering Tanzania).

Gear & Documents for activities and transfers pre / post trek - (not taken to the mountain can usually be secured in your accommodation or at our office compound)

As regards equipment we provide, our climbs are configured to aim to ensure the best possible acclimatisation and preparation for the assault by maximising hydration, nutrition and rest. To this end we use mess tents, tables and chairs for virtually all meals. This allows us to have a very leisurely lunch every day under shelter that will typically include a soup starter, light pasta dish and fruit pudding. We therefore provide all the equipment requisite for these arrangements. We supply climbers with lightweight waterproof, breathable sleeping tents and 4cm thick sleeping mattresses. We include lightweight Portable Toilets as standard on all of our climbs.

when to go / weather

Nepal has two seasons. October - May is the dry season and June - September the monsoon season.

The best time to travel:

The main trekking season in Nepal is from mid September to November. After the monsoon season, the air is crisp and dry, making the views excellent. Vegetation at this time is also is lush and green. Daytime temperatures are pleasant, the nights often chilly. Temperatures in Kathmandu reach up to around 27oC degrees during the day, and can drop down to 4oC in November. Pokhara and Chitwan are warmer, with temperatures not dropping below 11oC and sometimes as high as 30oC. Many festivals fall into this season, and although they can slow travel down they are well worth experiencing.

The second main trekking season (including for those operators offering summit treks) is in March and April. At this time nature is in bloom, which is especially impressive in the large rhododendron forests. Temperatures are pleasant, but the air in the middle hills can be hazy, so views there are not quite as good as in autumn. Higher altitudes have fine views. Temperatures in Kathmandu and Pokhara can be up to 25-30oC and rarely drop below 11oC. Chitwan has warmer daytime temperatures of up to 35oC.

Low season: December to February are a low season for travel in Nepal. The mountain views are still very good, but higher trekking routes, like the Annapurna Circuit, may be closed, and there can be large amounts of snow. Temperatures are cold. During the day, temperatures in Kathmandu and Pokhara can reach 20oC, but the nights are cold and higher altitudes experience freezing temperatures. This season is the preferred season for bird watching in Chitwan and to visit the Terai region. May and early June are hot and dusty. Temperatures often rise above 30oC, making outdoor activities arduous.

Monsoon season: From mid of June until September it is monsoon season in Nepal. This doesn't mean it rains all day – it rains almost every day, though most of the rain falls at night. Heavy rain clouds can hide the beautiful mountain views and torrential rain makes paths muddy and impassable. Landslides often block roads, making travel nearly impossible. Additionally leeches make outdoor activities unpleasant. Trekking is not recommended during those months, unless in regions that lie in the rain shadow of mountains, like Mustang and Dolpo. Temperatures lie between 20 and 35oC, and even at night don’t fall below 20oC.

flights, visas & insurance

flights

The Nepal region is served by flights arriving into and departing from Tribhuvan International Airport (KTM). It is operating with one domestic and an international terminal. As a sole international airport, it connects Nepal to over 40 destinations in 17 countries.

Currently Tribhuvan International Airport (KTM) is served predominantly by the following airlines:

Nepal Airlines

Qatar Airways

Fly Dubai

Air India

Nepal is 5 hours and 45 minutes ahead of GMT.

Flights departing Tribhuvan International Airport (KTM) should ideally be booked for no earlier than 1900hrs / 7 p.m. on the last day of activities in country, or anytime in the following days.

- AIRPORT ARRIVAL -

Once you have entered the Arrivals Building, proceed to the Immigration Counter. Once your entry into Nepal has been confirmed, proceed through to the Baggage reclaim area, then proceed through Customs. Be sure to keep all your bags together with you at all times. After you clear customs, and head out of the terminal building, where your Mettle Adventures representatives will meet you outside (wearing a Mettle Adventures t-shirt and carrying a placard with your name on it), amongst a sea of faces of other representatives brandishing boards with names of other adventurers from other companies.

- PASSPORTS -

A passport valid for a minimum of six months beyond visa issuance and/or date of entry, and at least one blank visa page, is required.

We suggest making a copy of the first two pages of your passport and keeping them in a separate bag as a backup. A copy should also be left with your emergency contact.

visas

A Nepali visa is required for travel. We recommend that you apply for this visa 3 months before your trip

Application in Person (UK residents)

Duly completed Visa application form
Valid Passport (with a validity of a minimum period of six months from the date of entry)
Please bring your passport and cash for the visa fee – cards/personal cheques are not accepted

Application by Post (UK residents)

Duly completed Visa application form
Valid Passport (with a validity of a minimum period of six months from the date of entry)
You MUST send your passport with your application
Please enclose postal order or bank draft made payable to ‘Embassy of Nepal’ for the visa fee
Also, please enclose a Self Addressed Envelope with (Recorded delivery) stamp with the application
Once visa application is received by Embassy, the application may take up to 2-3 working days within the UK and up to 2 weeks outside the UK to be processed

A visa for Nepal can be obtained on arrival at the Tribhuvan International Airport, Kathmandu and at the border entry points in Kakadvitta, Birgunj, Bhairahawa, Nepalgunj, Gaddachowki on the Nepal-India border and Kodari on the Nepal-China border.

Since 2014, you can apply for a tourist visa online within 15 days of your date of arrival in Nepal. You'll need the address of your hotel and a recent digital version of a passport-sized photo that you can upload to the application.

A visa is a permission granted to a foreigner to enter and remain in Nepal for a specific period of time. A visa is issued to a visitor who intends to enter into Nepal for the purpose of visit, tourism, leisure, holiday, business, health treatment, attending conference or any other related activities recognised by Laws of the country.

Note:

It should be noted that the possession of Visa is not a final authority to enter Nepal. The Immigration Officer at the Entry point may refuse a holder of visa to enter, if he is satisfied that the holder is unable to fulfil Immigration entry requirements or if the presence of such person or visitors in the Nepal would be contrary to the National Interests.

- VISA COSTS -

Type of Visa Visa Valid for. Fee

Multiple Entry 15 days USD 30

Multiple Entry 30 days USD 50

Multiple Entry 90 days USD 125

Visitors who enter on visas must present a roundtrip ticket and demonstrate they have sufficient funds for their stay.

Before making travel plans from the UK you should check all of the following:

Check the Foreign, Commonwealth and Development Office (FCDO) website for country specific Travel Advisory Notices (travel restrictions) and entry requirements
Check the GOV.UK website for self-isolation (quarantine) rules for when you return to the UK
Read the information on the COVID-19: Health Considerations for Travel page

- nepal PLASTIC BAG BAN -

Nepalese authorities have banned single-use plastics in the Everest region in a bid to cut down on waste left by climbers.

The ban took effect in the Khumbu Pasang Lhamu municipality from January 2020.

All plastic bags, regardless of their thickness are prohibited in Nepal. Visitors to Nepal are advised to avoid carrying plastic shopping bags, storage bags, or garbage bags in their suitcase and hand luggage to Nepal.

- IN-COUNTRY TRANSPORTATION -

The provided transportation in Nepal is via private vehicle, though you may be asked to share with other Mettle Adventures travellers if arriving on the same flight. The transfer to your accommodation in Kathmandu (where our treks are started from) will usually take between 20-30 minutes, so sit back and enjoy your introduction to the sights and sounds of Nepal.

insurance

- APPROPRIATE TRAVEL INSURANCE -

We have no links with any specific Travel Insurance providers, but have heard good things from travellers who have previously used the following providers:

Some banking institutions will also include travel insurance cover as part of their account package, so it may be worth speaking to your bank first.

Please do make sure you read the specifics of any quote / policy and make sure that it includes a policy ceiling above the height you will trek to, and is relevant for the country(ies) you will be visiting.

We also recommend investigating for yourself that in the very rare situation that a helicopter evacuation is called for, such cover is included in your cover, or that you have capital to over that.

If a frequent traveler, it might be worth considering an annual / multi-trip policy rather than a single trip policy.

electrical matters

Nepal has are three associated plug types, types C, D and M.

Plug type C is the plug which has two round pins
Plug type D is the plug which has three round pins in a triangular pattern
Plug type M has three larger round pins

Nepal operates on a 230V supply voltage and 50Hz

You can use your electric appliances in Nepal, because the standard voltage (230 V) is the same as in the United Kingdom. So you don't need a voltage converter in Tanzania, when living in the United Kingdom (other nationalities should check the instructions for their electrical devices a regards to the required power supply).

During a trek in the Everest and Annapurna regions, travellers are recommended to assume that there is limited access to mains power during a trek - though you can usually arrange to charge electrical items in the tea houses where you will be staying (sometimes a cost will be involved)

Therefore, ALL TREKKERS are recommended to carefully consider bringing additional charged battery packs with them for their needs, or a means of providing additional charge (via solar chargers etc) during their trek on the mountain.

training

Reaching any peak or completing any trekking circuit in Nepal usually requires a high degree of physical stamina (which can also be heavily influenced by a suitable nutritional diet plan) and mental fortitude - which Mettle Adventures trekkers thoroughly exhibit. Even for the healthiest and fittest individuals, climbing & trekking mountains qualifies as an extremely challenging endeavor. Ideally, you should start your training regime as soon as possible with the goal of arriving into Tanzania in the best physical condition and confident in your skills / abilities.

We recommend that you will give yourselves 3-6 months to adequately prepare in a relaxed manner. It can be achieved in a shorter time frame, but this can take out some of the relaxed enjoyment, and introduce some frustrations when the clock is ticking.

Trekkers should be focussed on gaining the necessary strength, stamina and skills to meet the physical and technical demands of the trek.

The best fitness and training program mimics the physical and technical demands of your trekking objective, so train by going trekking (including the use of any convenient hills)! The closer you get to your program date, the more your training should look to resemble the trekking itinerary planned and booked for you, with the aim to cover up to 10kms in a session, aswell as include some multi-day activity.

The best training for a trek on Everest is to get your walking boots on and get lots of miles covered. Whether this is two to three hours walking locally or full days away on your nearest hills, you just need to clock up lots of hours on your feet as more than anything else it is just walking for multiple days that people find tiring. And the best cure for this is to have spent lots of hours just walking.

Effective trekking practice allows you to understand the stress your joints & muscles will be put under and how well you can deal with this. It also allows you to wear in your boots (and any other elements of your trekking gear) as this takes some time and can often be uncomfortable. Trekkers should start with a comfortable distance that suits them and slowly try to work their way up to a 5-6 hour trek. If you can do this a few times then you'll be in good condition to climb Kilimanjaro. Where trekkers can build in several consecutive days trekking, that is great as this will give you a good indication as to your ability to cope with consecutive days trekking on the mountain.

Read our websites and correspondence thoroughly to prepare yourself mentally for all details of what to expect, and then get out wearing your trekking gear to make sure that all gear you take is suitable for the trek and you are happy that you will not regret not changing an item once the trek has started.

For a trek in Nepal, you are preparing for:

Trekking with a 5-6kgs (11-13lbs) load in your daysack (that you will carry) for up to 6-7 hours typically
Trekking up to 10kms per day as you approach high/base camp.
A 12+ hour final push to the summit and subsequent descent on summit day
Using core strength and flexibility to navigate uneven terrain
Nothing ensures a personally successful adventure like your level of fitness and training

Bottom line: Plan on being in the best shape of your life and ready for a very challenging adventure, and this will benefit you on and off the mountain!

We recommend the following key principles:

Aerobic (or cardio) training will be a key factor in allowing you to successfully trek in the Himalayas. Aerobic literally means 'requiring free oxygen' and refers to the use of oxygen to adequately meet energy demands during exercise via aerobic metabolism.

Aerobic exercise, unlike anaerobic exercise, requires oxygen for elongated periods of time. Examples of aerobic exercise would be distance swimming, long distance jogging, walking and cycling.

One crucial thing we tell our adventurers is don't rush up the mountain! Trying to ascend too quickly is a huge mistake. All our crew members, from guides through to porters will tell you: 'Slow Slow'. Because of the altitude your body needs time to adjust - no matter your current fitness levels!

Reaching any summit in Nepal is still a marathon and not a sprint! For this reason, all our trek teams are lead by guides each day who will set the pace (slow and steady), and no one will be allowed to trek faster than this guide.

high altitude preparation

Altitude sickness, or Acute Mountain Sickness (AMS), is an illness caused by exposure to the low air pressure, especially low partial pressure of oxygen, which many climbers experience at high altitudes.

AMS is caused by exerting yourself at high altitudes, especially if you have not been properly acclimatised. It is most common at altitudes above 2400 metres.

- altitude & hypoxia -

In statistical terms, altitude is the most important and dangerous of the complications involved to ascending any Himalayan peak. For this reason, people who wish to carry out any such adventures must know some details about how the altitude affects the human body and how altitude can contribute to the possible onset of AMS (Acute Mountain Sickness).

The air is essentially comprised of two gasses: oxygen and nitrogen. No matter the height, the proportion of both gasses is invariable: 21% oxygen and 79% nitrogen. The relation of this concept with Atmospheric Pressure (the pressure played by the weight of atmosphere above terrestrial surface) leads us to the concept of Oxygen Pressure. As we ascend above sea level atmospheric pressure decreases, resulting in the separation of the oxygen molecules (lower Oxygen Pressure), that is why the amount of oxygen which enters the body in one inhalation is reduced. At 5,500m, the oxygen level for each breath taken is 50% of that taken at sea-level.

It is because of this reduction of atmospheric pressure as we ascend that we experience a problem for our body's cellular oxygenation, generating Hypoxia. This brings into play a series of modifications to our physical condition to reach the adaptation to the separation of the oxygen molecules caused by the change in altitude. This set of changes or adaptations of different organs or systems of our body is called Acclimatization.

- acclimatization -

Acclimatization is a gradual process, genetically codified, and as such, it is different from one person to another. It implies modifications on the respiratory and cardiovascular systems, the kidneys, the cerebral circulation, the affinity of hemoglobin 1 by the oxygen and red blood cells count, water metabolism and certain electrolytes, etc. These changes let the person complete activities with certain efficiency and confidence, in spite of the prevailing hypoxia conditions.

Aspects to consider in Acclimatization and prevention of AMS (Acute Mountain Sickness) - Gradual ascent: a slow progression and a good climb plan are unquestionably the best means to achieve a correct acclimatization and minimize hypoxia effect and its undesired derivations in (AMS) (mainly pulmonary edemas and the risky cerebral edema)

Typical recommendations are:

Start your trek below 3000masl.
From the 3000masl, take an acclimatization night every 1000ms you climb.
Once you are well acclimatized (after spending one - two weeks at height) it is easy to ascend 1,000 or 1,500ms a day.

Abundant hydration: It is recommended to drink in abundance, enough to obtain a clear and copious urine. If the volume or urine is small in spite of drinking the correct amount of liquid, we are facing a signal of bad acclimatization. It is very important to drink at least 5 liters per day to prevent AMS.

Diet rich in carbohydrates: We recommend a diet rich in carbohydrates. There are many studies in humans and animals which show that higher levels of oxygen in blood are reached during the first days at altitude with a diet containing 70-80% carbohydrates.

Medication: It is essential to be careful in this aspect, since the medication could be counterproductive. Acetazolamide (Diamox) reduces the incidence and severity of AMS. Until recently, it was believed that for effective prevention, the medication had to be taken one or two days before ascending, however the ultimate studies have shown it works really fast, being able to ingest it the same day of the ascension. The risk of reaction to acetazolamide in a patient with sulfonamide allergy is low. However, acetazolamide is listed as possibly cross-reacting with sulfonamide in drug information and the package insert. For further information, consult your doctor.

Of course, not all trekkers will suffers from AMS, or to the same degree, and it is very difficult to predict who is or is not vulnerable to it. Typically though, a fit person is less vulnerable than an unfit person, because their cardiovascular system can operate at low pressures longer without as much strain. Even so, anyone can be vulnerable at altitudes above 3500 metres, no matter their fitness level, if they have not spent some time getting used to the low atmospheric pressures first - your crew will do all they can to assist you to achieve this.

Undoubtedly the best way to see how you are going to react to high altitude is to go high and try to do some exercises. For most of us (especially trekkers from UK!) that isn't an option so a good training regime is essential (see above - TRAINING).

The key to climbing high is proper acclimatization. Our trek itineraries follow a calculated ascent profile which allow time for your body to adjust to the altitude, and at a pace which is comfortable to the majority of trekkers - SLOWLY!

health & Medical Matters

For the most current information on inoculation requirements and recommendations please refer to:

UK citizens - NHS Fit For Travel

US citizens - USA Travel.gov or USA.gov

AUS citizens - AUS Health.gov

Occasionally travellers may suffer from having an upset stomach when traveling abroad - which could be attributed to the stress of travelling, just as much as a possible change of diet, or ingestion of potentially contaminated food or water. There are some fundamental principles that can help keep you healthy.

Hygiene: It is important that you wash your hands thoroughly before meals and after using the bathroom. If fresh water is not available for washing, we recommend using a hand sanitizer.

Water: The only rule is: don't drink the water, and that includes shower water and ice! Only drink bottled water which has been treated.

Brush your teeth with purified water rather than tap water. You should check bottled water for a good seal and use a napkin to wipe excess moisture from drinking glasses. Take care with fruit juice, particularly if it has been diluted with water. Carefully clean the tops of bottled beverages before opening.

Food: If it is cooked, boiled or can be peeled, you can usually eat it. Salads and fruits should be washed with purified water or peeled where possible. Be wary of ice cream and shellfish.

Always avoid any undercooked meat.

- VACCINATIONS -

Travellers are advised to confirm primary courses and boosters are up to date as recommended for life in Britain - including for example, seasonal flu vaccine (if indicated), MMR, vaccines required for occupational risk of exposure, lifestyle risks and underlying medical conditions.

Courses or boosters usually advised: Diphtheria; Hepatitis A; Tetanus; Typhoid.

Other vaccines to consider: Hepatitis B; Rabies.

Selectively advised vaccines - only for those individuals at highest risk: Cholera, Japanese Encephalitis.

Yellow fever vaccination certificate required for travellers aged 9 months or over arriving from countries with risk of yellow fever transmission and for travellers having transited for more than 12 hours through an airport of a country with risk of yellow fever transmission.

Ideally consult with your travel healthcare practitioner 6-8 weeks in advance of travel. If your trip is sooner, contact them anyway, they may still be able to help and it’s never too late to seek advice.

Notes on the diseases mentioned above

Cholera: Spread through consumption of contaminated water and food. It would be unusual for travellers to contract cholera if they take basic precautions with food and water and maintain a good standard of hygiene. Risk is higher during floods and after natural disasters, in areas with very poor sanitation and lack of clean drinking water. Risk is highest for humanitarian aid workers; those working in refugee camps or slums; those caring for people with cholera.

Diphtheria: Spread person to person through respiratory droplets. Risk is higher if mixing with locals in poor, overcrowded living conditions.

Hepatitis A: Spread through consuming contaminated food and water or person to person through the faecal-oral route. Risk is higher where personal hygiene and sanitation is poor. Risk is highest for those with underlying medical conditions where there is increased risk of severe disease e.g. chronic liver/kidney disease; haemophiliacs; men who have sex with men; people who inject drugs.

Hepatitis B: Spread through infected blood and blood products, contaminated needles and medical instruments and sexual intercourse. Risk is higher for long stays, frequent travel and for children (exposed through cuts and scratches), those who may require medical treatment during travel. Risk is highest for those with underlying medical conditions where there is increased risk of severe disease e.g. chronic liver/kidney disease; haemophiliacs; men who have sex with men; people who change partners frequently; people who inject drugs.

Japanese Encephalitis: Spread through the bite of an infected mosquito. This mosquito breeds in rice paddies and mainly bites between dusk and dawn. Risk is highest for long stay travellers to rural areas, particularly if unable to avoid mosquito bites.

Rabies: Spread through the saliva of an infected animal, usually through a bite, scratch or lick on broken skin. Particularly dogs and related species, and also cats and bats. Risk is higher for those going to remote areas (who may not be able to promptly access appropriate treatment in the event of a bite), long stays, those at higher risk of contact with animals and bats, and children.All travellers should avoid contact with animals (both wild and domestic) particularly dogs and cats. Even when pre-exposure vaccine has been received, urgent medical advice should be sought after any animal or bat bite.

Tetanus: Spread through contamination of cuts, burns and wounds with tetanus spores. Spores are found in soil worldwide. A total of 5 doses of tetanus vaccine are recommended for life in the UK. Boosters are usually recommended in a country or situation where the correct treatment of an injury may not be readily available.

Typhoid: Spread mainly through consumption of contaminated food and drink. Risk is higher where access to adequate sanitation and safe water is limited.

- MALARIA -

Knowledge of Malaria precautions are essential for all travellers.

Malaria risk is an occasional high risk throughout the year in all areas below 1800m.

Avoid mosquito bites by covering up with clothing such as long sleeves and long trousers especially after sunset. Use insect repellent on exposed skin and, when necessary, sleep under a mosquito net.

Check with your doctor or nurse about suitable antimalarial tablets.

For trekkers or safari goers, Atovaquone/Proguanil (Malarone) OR Doxycycline OR Mefloquine are usually advised.

If you have been travelling in a malarious area and develop a fever seek medical attention promptly. Remember malaria can develop even up to one year after exposure.

If travelling to an area remote from medical facilities, carrying standby emergency treatment for malaria may be considered.

Occasionally travellers will develop stomach upsets which are identified as being attributed to the anti-malarial medication they are taking, so travellers are advised to please carefully read all the 'pros & con's for each anti-malarial drug before making a decision on which one to take.

- MEDICAL EMERGENCIES -

While Regional Hospitals exist in the Khumbu region, no Level 1 trauma care exists in the surrounding area.

Stated to be the Best Hospitals in Kathmandu:

Vayodha Hospitals
Huawe international Hospital Pvt. Ltd.
Era Hospital P Ltd