a Personal Medical Kit for Nepal

Trekking in Nepal involves unique challenges like high altitudes, remote trails with limited medical access, and potential for waterborne illnesses, insect bites, and injuries from rough terrain.

Assembling your own first-aid or medical kit, tailor-made to your personal needs, is essential. For the majority of the time, such a kit will cover most situations. It is not a replacement for emergency medical evacuations. But it might buy you time. Keep this kit close by and do not bury it in the bowels of your duffel bag.

Consult a doctor or travel clinic as you assemble this kit, especially if you have pre-existing conditions. Get prescriptions for any medications, and consider vaccinations (e.g., hepatitis A/B, typhoid, rabies).

Below is a recommended list of things to pack. It is not an exhaustive list but a starting point. Nor is it a substitute for professional medical advice.

Medications and Pills

1. Acclimatisation

Treks in Nepal often exceed 3000 metres (9843 feet). Walks to Everest Base Camp, Thorong La Pass in the Annapurna region, or Larkya La Pass on the Manaslu Circuit will take you above 5000 metres (16404 feet). Many trekkers take acetazolamide tablets to help prevent the onset of Acute Mountain Sickness (AMS) and to acclimatise. Some do not, choosing to acclimatise naturally. Here’s a hard fact: Many visitors do not have the luxury of time to truly acclimatise to Nepal’s altitudes. Consult your doctor on the merits of acetazolamide, more widely known under the brand name Diamox. This drug is not suitable for people allergic to sulphur-based medications.

2. Pain Relievers and Anti-Inflammatories:

i. Acetaminophen (e.g., Tylenol, Panadol) for potential headaches during the first day or two at altitude as your body acclimatises. Consult your doctor before use if you have liver problems.

ii. Ibuprofen (e.g., Advil) for muscle strains, reducing inflammation (e.g., in the case of a sprained ankle), and easing mild to moderate pain. Consult your doctor before use if you have liver and kidney problems.

3. Diarrhoea

i. Loperamide (e.g., Imodium) is a fast-acting medication that slows down intestinal movement during an episode of traveller’s diarrhoea. To avoid diarrhoea in the first place, always carefully filter, purify, or boil your water. Also avoid meat, which may not be properly stored—especially late in the trekking season.

ii. Diosmectite (e.g., Smecta) is an alternative to Imodium. It is not as fast-acting but the clay-like powder binds toxins, viruses, and bacteria, while it coats and protects the lining of your intestinal wall.

iii. Antibiotics such as ciprofloxacin or azithromycin can be taken for bacterial infections that cause severe diarrhoea, although it is hard to know if the diarrhoea is caused by bacteria or a virus. Consult your doctor.  

iv. Oral rehydration solution packets – 10-15 are critical for dehydration due to diarrhoea or excessive sweating.

4. Dehydration

Electrolyte drinks and powders will help manage dehydration, which you must avoid at all costs. Dehydration caused by excessive sweating, insufficient water intake, or diarrhoea will impact your trekking performance. It will also impact your acclimatisation, exposing you to AMS. Besides constantly drinking beyond the point of thirst and ensuring that your urine is clear (not thick and yellow), add more salt to your diet. Muscle cramps may be a sign of electrolyte loss.

5. Allergic Reactions

Antihistamines (e.g., Zyrtec) for insect bites, or mild allergic reactions (constant sneezing, runny nose, itchy eyes) to pollen.

6. Motion Sickness

Motion sickness pills on winding roads or travelling long-distance on a bus.

Wound Care and Bandages

1. Blister Treatment

Include moleskin pads and plasters of varying sizes for blister prevention or treatment. Apply one as soon as you notice a “hot spot”, which is an early warning sign of a blister. Blisters are common on long treks, as hot, sweaty feet are a cause of blisters due to friction. To prevent this, wear moisture-wicking socks and keep your feet dry with powder.

2. Adhesive Bandages

Assorted sizes (e.g., Band-Aids) for cuts, scrapes, and blisters from hiking boots.

3. Antiseptic Wipes/Cream

Alcohol wipes and antibiotic ointment to clean and prevent infection in wounds.

4. Tweezers for removing splinters, ticks, or debris.

5. Scissors for cutting tape, gauze, or clothing.

6. Thermometer to monitor fever or hypothermia.

Hygiene

1. Pack alcohol-based hand sanitiser gel for trips to the toilet and around meal time.

2. Pack water purification tablets or use a filter like LifeStraw to prevent giardia or other waterborne illnesses.

Eye and Skin Care

1. Sunscreen with a high SPF (50+) due to intense UV rays at altitude.

2. Lip Balm with SPF to prevent chapped, sunburned lips.

3. Eye Drops for dry eyes from wind and dust. Also useful to wet and lubricate your eyes before removing your contact lenses.