Fitness: Preparing for Your Trek

If visitors are planning to trek in Nepal, they should be in moderate physical fitness. However depending on the physical aptitude of the trekker, they can choose from hundreds of hiking and trekking routes which can be short day hikes to harder destinations. This way, if travellers are not as fit but would still like to experience hiking, they can choose treks that are easier to do.


Comparatively, trekking in Nepal is considered difficult by other standards worldwide. This is due to the high altitude based steep ascents and descents, as well as difficult trails and routes. Hence, it is best to be prepared physically when expecting to have a true trekking experience in Nepal.

An example of the amount of physical fitness preparation, a 15-days trek to Everest Base Camp, or Annapurna Circuit with high altitude, a minimum of 4 days/week for a month of cardio exercise is required. Shorter treks and hikes around Kathmandu Valley only require one to be of reasonable shape to walk several hours a day.

Medical Kits and Vaccinations

Since there are less options for good medical care in trekking sites out of kathmandu, it is a wise decision for trekkers to carry a small medical kit. We have suggested the basic medical kit content that is usually useful for trekking. Most of these items can be purchased at an inexpensive price in Kathmandu and Pokhara.

Travel/trekking medical kits should include:

  • Basic first aid supplies (bandages, sterile cleaners, gauze, tape, etc)
  • Band-aids and blister care
  • Paracetamol and aspirin for pain relief. Ibuprofen for pain and fever relief as well as anti-inflammation.
  • Any prescription medicines that an individual is already taking
  • Rehydration salts in case of diarrhea – Loperamide (Imodium) is useful as well for temporary relief of symptoms
  • Antibiotics (like ciprofloxacin)
  • Antifungal cream
  • Cold tablets and nasal decongestant
  • Diamox – especially for treks above 3,500 meters

There is no mandatory vaccinations required to enter Nepal unless someone is coming from a country where yellow fever is prevalent, in this case, traveler must show proof of their immunization against yellow fever. It is recommended to get the following vaccination prior to arrival in Nepal:

  • Hepatitis A
  • Typhoid
  • Tetanus
  • Other immunizations to consider getting: Hepatitis B, Japanese Encephalitis, Rabies, Influenza, Polio, Tuberculosis
  • Malaria tablets are only necessary if travelers plan on spending long periods of time in the lowland Terai region


*Travelers with health problems should consult with their doctor on their travel plans to Nepal. It is also advised that all foreign travelers have an insurance policy (see our insurance section) specific to Nepal travel.

In Nepal Food, Water, and Hygiene

Diarrhoea is one of the common sickness that can put off an enjoyable travel holiday. Nepal being a poor country, it is important for tourists to eat and drink from hygienic sources since, cooking practices and water in Nepal are not always the cleanest. The best is to purchase food that is cooked well in a hygienic eatery. It is advised that tourists should only drink purified water, or bottled mineral water. To avoid pollution of plastic bottle, it is recommended that you purify your own water using purification tablets, water filter and UV light treatment (e.g. SteriPen).

Animals and Rabies

Since rabies is prevalent in Nepal, tourists should avoid close contact with dogs and monkeys, which are wandering freely around human space. In order to avoid an unforeseen harm, tourists should avoid petting or feeding domestic or wild animals.

Altitude Awareness

In general, the trekking routes in Nepal are in high altitudes. Many popular ones, such as Everest Base Camp and parts of Annapurna Circuit, are located 2500 meters (8200 feet) high. In this respect, unaccustomed trekkers run in the risks of getting an altitude sickness or acute mountain sickness (AMS). AMS can get serious in a short amount of time and even lead to comas or death, and can affect anyone even veteran mountaineers. Acclimatization, allowing one’s body to adapt to altitude change, is an important aspect of trekking, making sure to not overdo on their trekking destinations each day. Trekkers should be wary on symptoms (such as nausea, breathlessness, dizziness, difficulty sleeping, low appetite) that could be due to high altitude and take precautions accordingly.

 If symptoms of AMS persists or worsens on rest days, trekkers should descend to a lower altitude to recover. If symptoms does not get better, then trekkers need to descend immediately. Symptoms such as severe headache, lack of coordination, strange behavior, irritating cough leading to vomiting are signs of possible pulmonary or cerebral edemas (when liquid builds up in lung or brain). These are dangerous life-threatening conditions and should be treated as medical emergencies and be immediately descended to lower-altitude.

Measured to prevent AMS:

This is not a complete solution or prevention of altitude sickness but it would help prevent most of it. When preparing for major ascent, trekkers should give themselves additional acclimatization days, which are not just rest days, but days where the body is given a dummy trial of climbing a high point and then descending back to lower altitude where their body had adjusted. It is important to stay hydrated with proper diet and no smoking to further cope with the stress of dramatic altitude change. Diamox can help reduce mild symptoms of AMS but is not a cure for AMS.

Emergency Medical Treatment

The medical facilities out of Kathmandu and urban centres are minimal. Usually a few districts have local health posts which may not be accessible easily at all times. In cases of accidents and injuries, Nepal International Clinic in kathmandu and CIWEC clinic (Kathmandu and Pokhara branch) are one of the better clinics in Nepal. During emergencies, rescue operations which can be very expensive, are done by helicopter evacuations to hospitals in Kathmandu (or internationally if conditions are severe). Hence to avoid paying heavy out of pocket fees for medical treatments, it is important to get insurance coverage.