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Himalayan High: dangers of the trek
Beyond a shadow of a doubt, the biggest danger that anyone trekking in the Himalaya will face is the altitude. It is the great equalizer when it comes to determining success or failure on a high mountain trek, and even the most physically gifted and prepared hikers can be laid low by the thin air. Common symptoms that are brought on by altitude include headaches, dizzy spells, nausea, shortness of breath, and a loss of appetite. More serious signs of AMS, or Acute Mountain Sickness, include lethargy, sometimes to an extreme level, an inability to sleep, and vomiting.
Most of the members of my trekking group experienced at least one of those symptoms to some degree or another. Nearly everyone reported headaches and nausea of varying degrees, with a few experiencing serious issues. Of our 12 person group, two were unable to complete the trek to Base Camp. One of those suffered considerable nausea and was lacking in strength, so he elected to go down of his own accord. The other, had a full on case of AMS, and was lethargic to the point of not being able to stay awake. She was slurring her words considerably and was physically ill to the point where she couldn't keep any food down. It became so serious that she had to be carried down the mountain by our porters, and would eventually recover at a lower altitude.
Unfortunately, there isn't a whole lot you can do about altitude. It is nearly impossible to prepare for unless you already live in the mountains, and as I said, it effects everyone differently. The best advice I can give is to make sure you're proceeding up the trail at a slow, measured pace, and take the acclimatization process very seriously. Also, ask your doctor for a prescription of Diamox before you go. It is a drug that is very popular with mountaineers and helps ward off many of the effects of altitude sickness.
One ailment that was difficult to avoid is the dreaded Khumbu Cough. It is a dry, sometimes painful, hack that practically everyone hiking in the region contracts. The cough is a result of the extremely dry air and cold temperatures, causing an irritation of the bronchi in the lungs and seems to be exasperated by high levels of exertion. Everyone in my group, without exception, suffered the Khumbu Cough to some degree, including myself. But in an odd twist, my cough wasn't so bad while I was actually in Nepal, but managed to somehow get worse after I came home. Avoiding the cough is not easy, but wearing a mask or covering your mouth and nose with a Buff, can help limit the damage.
The next most common problem that most travelers in the region experience is gastrointestinal issues, most often brought on by the food or water. Trekkers will generally eat each evening in the teahouses that they are staying at, and while the food doesn't taste half bad, it has the potential to be problematic for exhausted hikers who are already dealing with all kinds of other conditions. The fact that all food items, and pretty much everything else for that matter, has to be carried up the mountain by porters, gives it ample opportunity to spoil, especially items that easily perishable such as meats and cheeses.
Like many places in the world, the water can be a challenge to deal with as well. You can fill your water bottles for free in most teahouses, but you'll want to treat it with water purification tablets or use a filter of some kind before drinking it. If you don't, you're likely to suffer terrible GI issues, which isn't a fun thing to experience when you're out on a trail for hours at a time.
Fortunately, I was once again spared any GI issues, but other members of the group were not so lucky. Some suffered from travelers diarrhea, and were frequently looking for a private rock to serve as shelter while they heeded the frequent calls of nature. Others had outright food poisoning, getting sick from the food in general. My advice is to stick to basic foods and avoid anything exotic. You'll also want to avoid meats and cheeses when ever possible, especially as you go higher.
As on any hike, you do run the risk of physical injury while trekking the Khumbu. There are plenty of places on the trail where you can slip and fall, damaging more than just your pride. Twisted ankles and knees are a real possibility, especially considering that some portions of the trail are make-shift stairs carved out of rock. After climbing up those stairs for a couple of hours, your tired legs are more likely to cause a stumble, and while there were a few such incidences in my group, no one was seriously injured.
One other common concern for travelers heading to Nepal is a potential chance encounter with the Maoist Rebels that are known to inhabit the countryside and remain active there, despite the fact that they won control of the government a few years back in democratic elections. In the past, those rebels were known to shake down trekkers for money and occasionally kidnap them as well. But those days are behind us, and visitors can now roam the countryside with out too much fear. They were seldom an issue on the road to Everest to begin with, and on my trek there was little sign of them outside of a few propaganda posters.
Like any trip to remote region of the world, there are always inherent dangers. But the amazing scenery, friendly people, and wonderful culture make this journey one that is well worth taking. Despite suffering issues from altitude, exhaustion, and an extremely nasty cough, I still enjoyed every minute of my adventure in the Himalaya, and suspect that any adventurous traveler would feel the same.