TREKKING IN BHUTAN

PREPARATION

You don’t need to be a mountaineer with rippling muscles to enjoy trekking. If you are reasonably fit, have a spirit of adventure and are not afraid of walking, you are ready to trek. However, good physical conditioning definitely helps for maximum enjoyment of the trek. The best preparation for trekking is jogging, stair-climbing, cycling and long walks involving up- and down-slopes

WEATHER

Refer to the section for details on Climate.

Important!
While there are general climatic patterns, bear in mind that mountain weather is always unpredictable. It may well snow in autumn and hail in spring. So, always be prepared for the worst in weather when trekking in the mountains

ON THE TRAILS

The trekking trails vary from wide trails to narrow dirt tracks and usually meander up and down along the hillsides thru villages and forests. Depending on the destination, season and altitude reached, the trail may sometimes be snowbound or cross rock and scree in the higher alpine regions.

GREEN TREKKING

Green or eco-trekking practices are measures undertaken to protect the fragile natural environment, such as carrying out or disposable of garbage and burning no wood on the trail. You can help out by following these guidelines:
• Do not litter on the trails. Instead, carry your litter with you and only dispose them designated sites for trash.
• Do Not Disturb: Avoid creating new trails across switchbacks, meadows and in high fragile areas. Make sketches or take photos rather than collect flower, plants and seeds.
• Do not purchase items made from wild animals skins or furs.
• Washing: When bathing or washing clothes your clothes, use biodegradable soaps if possible.

TREKKING ARRANGEMENTS

All our treks are full-service. Pack animals, horses and yaks, carry all luggages, equipment and food. Trekkers walk with just a light daypack containing the personal items desired for that day's activity. Our staff puts up and takes down camp, prepares all meals, and basically takes care of everything.

Trekkers normally just carry a small backpack containing personal effects, camera, water bottle and rain gear while on a trek. Every thing else will be carried by the horses and yaks

EQUIPMENT

Our fully equipped trek consists of essential logistical arrangements which include:
• 3-men tents for 2 persons, sleeping mattress, dining tent, table and chairs, toilet tents, etc. Tents, dining tents and toilets are set up and taken down by our trek team, requiring no help from the trekker

Note: Sleeping bags are not provided but can be rented for US$10-15 per night. However, we encourage our trekkers to bring their own sleeping bags as the sleeping bag is something personal.

MANPOWER

• Guide
We normally have a 8 trekkers to 1 guide ratio. All our trips are escorted by experienced Bhutanese guides. All of them speak fluent English and often converse in local dialects distinct from our national language

• Trekking Staff
During treks there will be a trained cook, a camp coordinator and an assistant (in charge of setting up tents), an assistant cook and someone in charge of dining.

For bigger group size, we add more people.

For example for a group of 10 trekkers, there will be:
- 2 guides, and
- 6 trekking crew including cooks
- 2-3 people with their horses.

• Pack Animals
We use horses on lower altitude treks and yaks on very high altitude treks.

MEALS

We use well trained cooks on our treks. They prepare excellent Indian, Chinese, Bhutanese and Continental dishes. To give you an idea, our trekking food menu will look something like this:

• Morning Tea/Coffee - Wake-up tea/coffee in sleeping tent or dining tent.
• Breakfast – Juice, Tea/Coffee, Bread, eggs, cornflakes, oatmeal etc
• Lunch – Sandwich, Noodles, juice, vegetables, meats (chicken/beef) etc
• Afternoon Tea/Coffee - snacks and cookies upon arrival at the camp.
• Dinner – Soup, Rice/noodles, a variety of meat and vegetable dishes, desert/fruits, tea/coffee

A TYPICAL TREKKING DAY

HEALTH MEDICAL INFORMATION

Vaccinations

There are NO compulsory vaccinations required to enter Bhutan. However, the following vaccinations are recommended:

• Hepatitis A
Hepatitis A is a virus that infects the liver, causing a disease known as viral hepatitis. The disease is distinctly unpleasant, with profound nausea, loss of appetite, and weakness that can last for weeks. It can also be fatal on rare occasions. The virus is passed in human feces (shit), and is acquired the same way that you acquire traveler's diarrhea. Therefore, it is very difficult to avoid through safe eating habits.

• Tetanus
Tetanus bacteria can infect small wounds and cause a fatal infection. The risk is the same throughout the world. For this reason, most people have received tetanus vaccine (usually mixed with diphtheria vaccine for greater effect), since early childhood. Boosters should be obtained every 10 years.

• Typhoid Fever
Typhoid fever is a prolonged febrile illness caused by infection with Salmonella typhi bacteria. The bacteria is passed in human feces (shit), and acquired by eating contaminated food or water. The disease can be treated with antibiotics. However, it makes you very sick and complete recovery can take several weeks.

ACCUTE MOUNTAIN SICKNESS

WHAT IS AMS
High altitudes are stressful on the body, and lack of oxygen up high can produce slightly debilitating effects. Acute Mountain Sickness (AMS) generally occurs in individuals exposed to an altitude over 10,000 feet (3,100 m) who have not had a chance to acclimate to the altitude before engaging in physical activities. The key to alleviating the effects of altitude sickness is simple: take it easy. Go at your own pace.

WHAT CAUSES AMS
AMS is caused by a lack of oxygen. Although the proportion of oxygen in the atmosphere always remains the same (21%), as we go higher the "driving pressure" decreases. The resultant effect is an accumulation of fluid in parts of the body where it does not belong - in the brain, in the lungs, or both. Going too high, too quickly, is the single most important cause of susceptibility to AMS

SYMPTOMS
AMS can develop at any altitude over 3000 meters. Anyone may be affected by AMS regardless of strength or physical fitness. The initial symptoms of AMS are:
• Nausea/Vomiting
• Loss of appetite
• Insomnia/Sleeplessness
• Persistent headache
• Dizziness, light heaviness, confusion, disorientation, drunken gait
• Weakness, fatigue, lassitude, heavy legs
• Slight swelling of hands and face
• Breathlessness and breathing irregularity
• Reduced urine output

Continued ascent in the face of increasing symptoms will lead to two life-threatening complications:

(1) HACE
- high altitude cerebral edema, caused by fluid accumulation in the brain
- Increasing tiredness, severe headaches, vomiting, and loss of coordination are signs of HACE and can lead to unconsciousness and death within 12 hours if progressive symptoms are ignored

(2) HAPE
- high altitude pulmonary edema, caused by fluid accumulation in the lungs
- Increasing shortness of breath, cough, and tiredness are signs of HAPE and can also be rapidly fatal if ignored

PREVENTION

• Acclimatisation
Acclimatization is the word used to describe the adjustments your body makes as it ascends. The best way to acclimatise is to pace your ascent so that you do not ascend too high too fast. However, note that not everyone will acclimatize at the same rate. Therefore, you may have to wait an extra day for some members or be prepared to split the group.

• Avoid excessive exertion in the initial days
Excessive physical exertion at high altitude makes one more susceptible to AMS. It is important to take it easy at high altitude, especially in the initial days. Physical fitness does NOT prevent AMS.

• Maintain adequate hydration
Adequate amounts of fluid (about 3 liters a day) are necessary in the mountains. Dehydration mimics altitude sickness and may even predispose to it. On the other hand excessive water drinking should also be avoided as this may lead to electrolyte imbalances.

• Avoid alcohol and sedatives
Alcohol may dehydrate the trekker but more importantly it depresses breathing or ventilation. Sleeping pills and other sedative should not be used at altitude as they tend to decrease breathing and lead to AMS.

• Maintaining a high carbohydrate diet
A high carbohydrate diet aids ventilation and efficient use of oxygen. The good news is that - in many high altitude places - there is not much alternative: rice, potatoes and other starch-laden foodstuffs tend to be the staple, with not much else to choose from.

• Using Medication
DiamoxR (acetazolamide) 125 mg. tablets taken twice a day is F.D.A. approved for prevention and treatment of A.M.S. It works by stimulating your breathing. This allows you to get more oxygen. Taking antioxidant vitamins (A, C, and E) also helps reduce the effects of high altitudes.

However, please consult your doctor before using any drugs and for further medical advice before traveling to altitude

TREATMENT

Descend to a lower altitude
The best and surest form of treatment for AMS is to descend. When mild symptoms develop, stay at that altitude until the symptoms have gone away. Usually within one or two days you will feel well and can continue your trek.

If the symptoms persist or become worst, then it is necessary to descend to a lower altitude. Keep descending until you show some signs of improvement. You can always re-ascend when you feel better.

** Never ascend when you have any symptoms of AMS! **

OTHER PRECAUTIONS
You should not plan to go high altitude if you have known heart disease, difficulty breathing at sea level or are pregnant (recommended to stay below 3600 meters).

SUGGESTED LIST OF THINGS TO BRING – TREKKING

Due to wide range of temperature and climatic conditions choosing the right clothing and layering it properly is important. Layering clothing is the best way to ensure comfort in changing weather conditions. Based on your activity and the weather, you can make quick adjustments, by putting on more clothing if it is cold or taking off layers as it warms up. Layers act as protection against the sun when it's hot, the rain when it pours, and the cold when the temperature drops.

The following packing lists gives suggestions on the list of things to bring on a trekking trip.

Clothing
[ ] T-shirts (short and long sleeved, preferably non-cotton)
[ ] Long pants/skirts
[ ] Undergarments (preferable disposable)
[ ] Windproof/Waterproof jacket and trousers.
[ ] Woolen/fleece sweaters – preferably a few thin sweaters instead of one thick one
[ ] Thermal clothing - to sleep in at night (during winter months or at high altitudes)
[ ] Socks
[ ] Gloves
[ ] Winter Hat/Beanie/Scarf
[ ] Sunhat/Cap

Travel Documents
[ ] Passport (must have at least 6-months validity)
[ ] Visa
[ ] Money/Travelers Cheques/Credit Cards
[ ] Travel Insurance certificate
[ ] Photocopy of passport and extra passport photos

Others
[ ] 4 season sleeping bag (invest in the best possible 5 to 0 F)
[ ] Good trekking shoes – “Walk them in" prior to arrival to avoid blisters.
[ ] Sandals or track shoes - to wear in the camp, in bathroom and toilet tent or when the boots are wet.
[ ] Backpack/Luggage/Duffel bag
[ ] Daypack – to carry personal requirement for the day e.g., water bottle, sweater, snacks, camera, film etc.
[ ] Wallet and/or money belt
[ ] Personal Toiletries
- Include wet wipes and powder for ‘dry bath’
[ ] Small headlamp and/or flashlight/torch with spare batteries
[ ] Personal medical kit (containing items such as panadol/aspirin, pills for stomach troubles such as charcoal tablets, flu tablets, antiseptic cream and wipes, plasters, knee and ankle guard, deep-heat cream, insect repellent, and any other personal medication)
[ ] Water Bottle (at least 1 litre) – that can hold hot water
[ ] Sun-screen and lipgloss – very essential as the sun is very scorching at altitude and in winter, when skies are clearest
[ ] Sunglasses
[ ] Camera & Memory cards/Film
[ ] Reading materials, games, pen and pencil, note book, diary
[ ] Snacks – dried nuts and fruit, muesli bars, chocolates etc
[ ] Swiss-army knife
[ ] Trekking poles

SUGGESTED MEDICAL KIT
[ ] Antibiotical Ointment - for minor abrasions.
[ ] Antihistamine - Decongestant for colds and allergies, to ease the itch from insect bites or stings, and to prevent motion sickness.
[ ] Antiseptic - for cleaning cuts and grazes
[ ] Bandages and Band-Aids - for minor injuries.
[ ] Blister kit with moleskin - if you are bringing new shoes and walking a lot.
[ ] Calamine lotion or Sting-ease gel or spray - for relieving irritation from bites, stings, and rashes.
[ ] Chap Stick - for protection of your lips from prolonged exposure to sun and wind.
[ ] Cold and flu pills and throat lozenges - for treating minor colds and sore throats.
[ ] Naproxen or Ibuprofen - for treatment of pain, swelling, or fever.
[ ] Rehydration Mixture - treats severe diarrhea.
[ ] Scissors, tweezers, and thermometer - for general health issues.
[ ] Sunscreen - for protection from the sun.
[ ] Insect Repellent - DEET is harsh on your skin but really does the job.
[ ] Lomotil - suppresses diarrhea, nausea, and vomiting.
[ ] Water purification tablets - never drink unpurified water. Using a water purifier is another good option.
[ ] Sunglasses - to safeguard your eyes from harmful sun exposure
[ ] Personal prescription medications (in their original containers) & copies of your
prescriptions

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