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Health & Safety Tips to get ready for your visit to magical Nepal
Nestled between China and India, Nepal is an amazing small country with a long ancient history, a vibrant rich culture and breath-taking natural panoramas.
However, it is also one of the poorest and least developed countries in all Asia. An estimated 30% of Nepali live below the poverty line – some 82% of Nepali live on less than USD$2 per day.
After volunteering one month in Kathmandu and after exploring the surrounding areas, we put together a list of useful tips to make your visit to this wonderful country as amazing as it should be. Enjoy!
Are you ready for Nepal? - Busy Kathmandu street in Thamel
MEDICAL INSURANCE
Let’s start with the most boring stuff - as with any overseas travel, a comprehensive travel and medical insurance is highly recommended. Yes, it takes time to research the right one for you and it might not be as cheap as you would like, but don’t leave this to the last minute.
There are great websites which can help you compare different Travel Insurances and save you some precious time.
To learn more check out our blog post here under Insurance.
TIP – For most of us Nepal means Himalayas and incredible hiking at very high altitude, which is exciting but not covered by many insurance policies (medical treatment, accidents and evacuation by helicopter over 2,500 mt of altitude for example). Check for exclusions to ensure you are covered for the activities you plan to undertake.
We decided to buy a separate insurance cover with Worldsnomad for our hiking on the Annapurna Circuit which covers us up to 6,000 mt of altitude.
Hiking at altitude in Nepal
VACCINATIONS & MEDICATIONS
Although no particular immunization is required to enter Nepal, keep in mind hospitals and medical infrastructures do not offer the same healthcare standards as in more developed countries. So check with your doctor which vaccinations are recommended before travelling and plan to get them in advance as you might need more than one injection.
As a guideline, you might consider the following vaccinations for Nepal:
Diphtheria (risk dependent on bacteria spread through coughing or sneezing)
Tetanus (risk dependent on bacteria spread through cuts, scratches or wounds)
Hepatitis A (risk dependent on contaminated water and food)
Rabies (more below)
Typhoid (risk dependent on contaminated water and food)
These following vaccinations are also to be considered (ask for your doctor’s advice):
Hepatitis B (risk dependent on fluid exchange, such as sexual intercourse or tattoos)
Japanese B Encephalitis (risk dependent on mosquitos bites and on time of year and location)
Poliomyelitis (risk dependent on contact with infected human feces or saliva)
DID YOU KNOW? - If you are entering Nepal from an area infected with yellow fever, you are required to be vaccinated before entering the country.
Kathmandu Valley luckily is malaria free, but if you are travelling to the Terai region outside of Chitwan, you may need to take malaria prophylaxis. Check with your doctor.
Over-the-counter medicines such as pain relievers, cough syrup, and most high altitude medications are commonly available at pharmacies. However, our suggestions is to bring with you a small first aid kit and any medication you are taking or you would use in Nepal for emergencies, along with the prescription.
LEARN MORE ABOUT VISA, ELECTRICITY AND PHONE / INTERNET IN NEPAL? Click HERE!
Girl drinking water from a blue refillable plastic jar in Nepal
WATER
Nepal is among the richest in terms of water resource availability as water is abundant throughout the country in the form of snow covers, rivers, springs, lakes, and groundwater.
Unfortunately water in Nepal, especially in cities like Kathmandu, Bhaktapur, or Dhulikhel, is not safe to drink, also for many locals, due to pollution and population growth.
Therefore, the following tips should help you avoid any contaminated water (and any unpleasant stomach-ache or worst infections such as thypo or even colera).
Drink only bottled water (NPR70 to 90 per bottle) or treated water, usually sold in 2 litres blue refillable plastic jars. These jars come new at NPR400 and every refill costs NPR40 – you`ll save money plus you help the environment.
Check out these other tips to travel more sustainably.
TIP – When buying bottles water or soft drinks, check the seal has not been opened and there is no deposit inside the liquid.
Treat water with iodine or chlorine tablets if you aren’t sure it`s safe - wait 30 minutes after treating before drinking. A large box of Chlorine can be bought for about NPR20.
You can buy a water filter – we always bring this filter (Life Straw) with us when travelling as it`s compact and light.
Check out other types of water filters here under Safe to Drink.
Avoid ice cubes in your drinks - These are usually made with untreated water.
Drink lot of water (between 2 and 3 liters of water per day) – With Nepal’s humid or hot climates, sweating can cause dehydration much more easily.
Would you eat these? - Street market in Kathmandu, Nepal
FOOD
Nepali cuisine will definitely be a highlight during your visit – rich flavors, a clash of spices and ingredients which will leave you wonder “what did I just eat?”.
However, it is important to take all precautions possible when eating in Nepal due to poor standards of hygiene, use of untreated water and new tastes which can upset your stomach in no time. Below are some tips to enjoy your meals without missing out on delicious food.
BEEN INVITED FOR DINNER BY LOCALS? FIND OUT THE FOOD ETIQUETTE IN NEPAL HERE
Peel your fruits (bananas, pomegranates and mangoes for example) - Remember “If you can peel it, cook it, eat it, otherwise forget it”.
Avoid raw vegetables and salads – These are usually left unpeeled and they are washed with untreated water in some restaurants. Remember, hygiene controls in Nepali restaurants are not as strict as in more developed countries.
Meat or veggies? – We’re sorry for all meat lovers but Nepali cuisine is mostly based on vegetarian food and it is also the safest option. Meat, especially mouton or buffalo, is a delicacy and the most common meat type here is chicken. In any case, hygiene standards are really poor in regards to meat so better avoid it for your time in Nepal or eat it in recommended restaurants and when well cooked.
Street food – Even if some street vendors might seem pretty legal and clean, some snacks may have been cooked a long time ago and again hygiene standards are probably non-existent. Ergo, just take pictures of the colorful stands and head for a safer meal.
More below
Yummy street food in Nepal
Avoid very spicy meals – Nepali food is generally not extremely spicy and a little spicy won’t hurt, but always be careful and ask how spicy your meal will be – don’t even go for mild spicy, order the least spicy they can do which is already hot!
What about lassis, fruit juices and shakes? – These might be made with untreated water. So you might want to avoid them if you feel the restaurant’s standards are not high.
Avoid dairy products – Craving for a refreshing ice-cream in hot Kathmandu happens often, however milk and some dairy products like ice-cream may contain E Coli bacteria which cause gastroenteritis and urinary tract infections, so it is usually safer to avoid them.
FINF OUT ABOUT NEPALI DELICIOUS MEALS HERE (under Eating Out)
Avoid very spicy food in Nepal!
DIAHRROEA
Since we’re talking about food and water, one of the most common symptom you might have after eating or drinking contaminated food / water is diarrhoea. So what to do when the Montezuma curse is released upon us?
The best thing to do is to rest and keep drinking plenty of water to avoid dehydration.
TIP – Instead of water of locally rehydration salts (like Electrobin / Jeevan Jal) you can mix 1 lt of water with 1 teaspoon of salt and 8 teaspoons of sugar to reabsorb the liquids and salts lost with diarrhea. Fruit juice is also a good alternative.
Use medicinals - Antibiotics such as Ciprofloxacin or Metronidazole tabs should work fine. However, avoid taking medications like Ioperamide (Immodium) as they will promptly stop the diarrhea but also cause constipation, not effectively helping you release the bacteria – only use it in an emergency like long bus ride.
Seek medical advice – only if you are vomiting profusely, have bloody diarrhoea, have fever or if your diarrohea lasts for more than 24/48 hours.
Monkey looking for food at Pashupatinath Temple in Kathmandu (Nepal)
DOGS & MONKEYS
So many times we were tempted to cuddle a cute furry friend in the street – but please don’t!
The risk of rabies transmitted by dogs’ as well as by monkeys’ bite is very high, so avoid close contact with both. For example, do not bring food around temples as monkeys will grab it and avoid getting too close to baby monkeys with their mothers. If a dog starts following you, do not give him attentions and try to leave him behind – do not feed him at all costs!
In Nepal each year about 32,000 people are treated for dogs’ bite and around 200 people dies of rabies.
So if you get bitten by a dog or a monkey, take immediate action (cleaning the wound with plenty of water and soap to remove bacteria) and seek medical attention as soon as possible. Even if you have previously been vaccinated, you still need post-exposure doses within 24 hours of the bite. If you have not been vaccinated previously, you will require doses immediately.
Stray dog in Nepal looking for cuddles
MOSQUITOS & OTHER BITING ANIMALS
Definitely not our favorite animals! Luckily enough Kathmandu Valley and the Himalayas is malaria free, but mosquitoes can still carry other diseases. So try to avoid their bites by covering your skin and use insect repellent, especially at dusk and dawn. Mosquito nets are also helping during the night.
Malaria prophylaxis might be needed if you travel in the lowlands of Terai region outside Chitwan.
Another not so desired animal encounter are leeches in monsoon season or in grassland and jungle. Wear socks and boots at all times when walking in these places.
FIND OUT THE BEST SEASON TO VISIT NEPAL HERE (and avoid leeches!)
And if you get one, don`t panic – you can remove it sliding a little stick between the sucker and your skin or it will fall off on its own once it has finished feeding. Do not inflame or put salt on the leech, as these methods will cause it to fall off but also regurgitate its stomach contents into the wound apparently. Some people would instead prevent bites by rubbing some salt on your socks and legs or spray them with mosquito repellent before starting the hike.
Travel in group is always safer and much more fun!
PERSONAL SAFETY
In our experience Nepali people are friendly and helpful – they will help you with directions or recommendations as much as they can if you ask, and smile back at you with a Namaste.
Want to learn more about culture and religion in Nepal? Read our cultural tips here.
However, as in many other countries, you might want to avoid to be caught in certain situations – keep reading and stay safe!
Keep your room and valuables locked when you are away from your accommodation
Travel with others – Especially if you are a woman, it is generally safer to get around with other people.
Avoid staying out after dark – If you`re having dinner out, try to stay in group or take a taxi back to your place. As in many big cities Kathmandu has its own share of drunk people in the streets and you might want to have nothing to do with them.
Avoid political demonstrations and strikes – Crowds are favorite places for many pickpockets, plus demonstrations can give rise to violent episodes.
Watch out for scams – In touristy places many people might pretend to “practice their English” and start walking with you around, asking for money later for having been your guide.
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