Health  Tips –

Immunization:

 Although specific immunization is not required to enter Nepal, many travelers like to protect themselves against diseases such hepatitis, meningitis, Japanese encephalitis etc. as normal precaution. Malaria in Nepal is officially eradicated. However, it is reported  sometimes in the Terai plain (tropical low land) of Nepal, so better take precautions if you plan to go that part.   If there breaks symptoms any disease at epidemic level here, you will be alerted. For any your personal medical conditions and needs, better consult your doctor.

Medical Facilities:

In major cities like; Kathmandu, Pokhara, Chitwan, Lumbini, Nepalgunj, Biratnagar and others, there are well equipped big hospitals, clinics, and nursing homes providing quite a high standard of medical services. There are some hospitals in major towns and health posts in villages.

AMS (Acute Mountain Sickness) or Altitude Sickness:

At sea level one can breath easily as whole atmosphere of pressure pushes in on the air. As one goes higher elevation, there is less atmospheres and hence less atmospheric pressure pushing in on the air breathed into the lungs. Our bodies experience that lack of air pressure as a lack of oxygen. Until the body has a chance to adapt such thin air pressure, one may experience symptoms of mountain sickness known as AMS. Different peoples’ bodies adapt or acclimatize at different rates. These acclimatization rates are not at all related to what kind of physical shape one is in. A super fit olympic marathon runner or an obese or a young strong climber are equally likely to have symptoms of altitude sickness (AMS) at the same altitude.

SYMPTOMS of AMS – the symptoms of altitude sickness are rather vague, variable, and easy to attribute to other causes. However, when at high altitude, assume any of the following symptoms are mountain sickness until proven otherwise.

IF YOU HAVE SYMPTOMS:

1. Rest – do not over exert yourself,
2. Do not go higher,
3. Drink lots of fluids. Avoid alcohol,
4. Let someone know how you are feeling,
5. Try aspirin or paracetamol for headache discomfort,
6. Avoid any sedatives – especially sleeping pill or narcotics. These will slow your breathing and worsen your symptoms,
7. Consider use of Acetazolamide (Diamox) to prevent or treat symptoms.
8. If symptoms are severe or worsening, return to lower altitude. 

With the help of physician, consider the use of other medicines such as dexamethasome every 6 hours, nifedipine 10 mg 8 hourly or oxygen.

Acetazolamide (Diamox) is the primary, first-line, and found to be effective medication for preventing acute mountain sickness (AMS) by accelerating acclimatization. Possible side effects of acetazolamide include tingling (pins and needles feeling) of hands, toes, lips, increased urination, and change in taste of carborated beverages. These symptoms are merely annoyances, resolve when the drug is stopped, and do not indicate allergic reaction.

Travellers who have allergies to sulfa antibiotics  and have never tried acetazolamide  should not take this medicine. Acetazolamide is as sulfa derivative, there is a slight possibility of allergic cross reaction.

Dexamethasone (a steroid) is used as a second-line, effective alternative, while ibuprofen can manage minor symptoms. Proper hydration and slow, gradual ascent are crucial alongside medication

PREVENTION:

The best preventive measure is acclimatization that is walking steadily and gaining altitude slowly. This way the body starts adapting slowly to the thin air pressure of the high altitude.  Besides acting to treat symptoms of mountain sickness, acetazolamide can also help prevent or decrease severity of AMS symptoms before they occur.  Especially for people who have been to high altitude before and have had AMS, taking acetazolamide 24 hours before going high is very helpful in preventing altitude sickness. Drinking lots of water while taking acetazolamide is very important, since acetazolamide makes one urinate more. Most people do just fine at high altitude with nothing more than a few annoying symptoms of headache or shortness of breath with exertion. Being able to identify to know what to do about mountain sickness can help prevent serious problems.

Note: 

 The above medical information are just general tips. For more reliability and specific needs, you need to contact your doctors.

Insurance:

 A travel insurance policy that covers medical treatment  and also rescue if outdoor activities are involved in the trip is recommended for all tourists.

Safety & Security 

Nepal is a peaceful country and people are friendly in general.

A general precaution needs to be taken for safety like, avoid; late evening walk alone, acceptance of foods/drinks/smoke from strangers, changing money with unauthorized persons, befriending with dubious persons, exposing money/ jewelry items etc. If you need to ask any info or direction, try to talk to the people in the shops/ office/ house or even better with police but, not a good idea with other fellow strangers.

There is a special police unit, Tourist Police to deal with tourists issues. The contact is;

Tourist Police Nepal

Bhrikutimandap, Kathmandu. (Inside the premises of Nepal Tourism Board)

+977-01-4247041, +977-9851289444, 1144 (Toll Free, Hot line)

Email:- policetourist@nepalpolice.gov.np

Website:- https://cid.nepalpolice.gov.np/cid-wings/tourist-police/

For other emergency cases, contact numbers are;

Dial 1144 (Toll Free, Hot line) for Tourist Police.

Dial 100 for Police assistance

Dial 103 for Traffic Police assistance

Cultural Do’s and Don’ts –

 *  Greeting:  “Namaste” (palm-to-palm greeting) is the traditional greetings in Nepal.  Also handshakes are becoming common these days but, Namaste is more common especially with women.

*  Dining & Hand Usage:  Polite way is  right hand for eating, passing food, or giving/receiving items. The left hand is considered not well mannered.

*  Temple/ Shrine/ Monastery Etiquette:

Remove shoes before entering homes, temples, or monasteries. Walk clockwise around stupas or temples.

*  Dress Code: Dress modestly, especially in rural areas, to avoid offending locals. Too much exposing dress is not common.

*  Photography: Always ask permission before photographing people or taking photos inside temples.

*  Affection Display:  Public displays of affection (kissing, hugging) between men and women is considered offensive in Nepali culture.

*  Feet and Head: Do not point your feet at people, temples, or sacred objects. It is considered offending. Also avoid touching someone’s head.