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BASICS CULTURE AND ETIQUETTE caused by a burrowing mite, generally affects the spaces between fingers and toes. Shampoos and lotions are available in Nepal. Air out your bedding and wash your clothes thoroughly. Worms may enter your body through the skin (especially the soles of the feet), or through food. An itchy anus is a common symptom, and you may even see them in your stools. They are easy to treat with worming tablets, available locally.
Animal bites and leeches For animal bites or scratches, immediately wash the wound with soap and water for at least five minutes then rinse with Providone iodine (found in Nepal); if this isn’t available, use 40–70 percent alcohol – local raksi may do the trick. This should kill any rabies virus on the spot but anyone bitten by an animal should immediately get themselves to a Kathmandu clinic for expensive post-exposure rabies shots (see p.117). The disease’s incubation period is ten to ninety days – ideally, you’re supposed to capture the animal alive for observation! Thickly vegetated country, such as the Terai national parks or low-lying trekking areas, can come alive with leeches during the monsoon. Protect yourself by wearing insect repellent, long clothing and perhaps gaiters. There is a small risk of infection, particularly if you pick them off and the mouth parts get left behind in the wound. It’s best to leave them – they won’t take so much blood that they’ll harm you. Otherwise, the advised way to remove a leech is to break its suction by gently sliding a fingernail around first the thinner, then the thicker end of the animal. Locals tend to use a rapid finger flick and take their risks – and this may be the only practicable solution in thickly infested areas. Using salt, iodine or, worst of all, heat from a lighter or match will make a leech drop-off but not before it effectively vomits into the wound.
In the event of serious injury or illness, contact your embassy (see p.117) for a list of recommended doctors. The majority are in Kathmandu and speak English. It’s a good idea to register with your embassy or consulate on arrival, especially if you go trekking or rafting. Hospitals are listed in the Kathmandu and Pokhara sections of the guide; others are located in Dhulikhel, Tansen, Kolhalpur and the bigger Terai cities. Most are poorly equipped, and are not too hygienic – doctors routinely prescribe a course of antibiotics to all patients for this reason. Also note that you have to pay on the spot for all services, medicines and items used by the doctor, so it’s important to have cash with you.
MEDICAL RESOURCES W cdc.gov/travel The official US government travel health site. W ciwec-clinic.com This Kathmandu clinic is an authoritative source of information. W iamat.org The International Association for Medical Assistance to Travellers provides a list of English-speaking doctors in Nepal plus guidance on diseases and inoculations. W istm.org Website of the International Society for Travel Medicine. W masta-travel-health.com MASTA (Medical Advisory Service for Travellers Abroad) has a list of UK travel health clinics. W www.thehtd.org The Hospital for Tropical Diseases Travel Clinic is the only UK medical facility dedicated to tropical diseases. W tripprep.com Travel Health Online has a comprehensive database of necessary vaccinations for most destinations.
Culture and etiquette
Many different ethnic groups coexist in Nepal, each with their own complex customs. In the Kathmandu Valley, where they mix the most, there’s a high degree of tolerance of different clothes and Getting medical help lifestyles – a fact that travellers sense, and often abuse. Away from the tourist In a non-emergency, make for one of the travellerareas, however, ethnic groups are quite oriented clinics in Kathmandu. Run to Western parochial, and foreign ways may cause standards, these can diagnose most common ipi8hfBu+Fu1Tqp6g5eaALs= offence. That said, many taboos relax the ailments, write prescriptions and give inoculations. further and higher you head into the In other cities and towns, local clinics (often mountains, as Hindu behavioural norms attached to pharmacies) can usually provide are only partially shared by Buddhist adequate care. An array of Indian-manufactured and animist ethnic groups. medicines are available without prescription in the pharmacies of all major towns, though be sure to check the sell-by date, and be aware that fake medicines are widespread so it’s best to bring any medicines you might need from home (see below).
The do’s and don’ts listed here are more flexible than they sound. You’ll make gaffes all the time and Nepalis will rarely say anything. When in doubt, do as you see Nepalis doing.
