Annapurna Base Camp Trek emergency & health guide: hospitals, rescue, altitude and permits

Emergency numbers

Nepal has no state mountain rescue service. Above Chhomrong the only fast evacuation is a private helicopter from Pokhara, arranged by your guide, your lodge or your insurer, and paid for by you or your insurance. Before you go, check that your policy covers trekking to at least 4,200 m and helicopter evacuation, and save its 24-hour assistance number in your phone.

Rules to know

• ACAP entry permit: NPR 3,000 for foreigners and NPR 1,000 for SAARC nationals, free for children under 10. Buy it online at epermit.ntnc.org.np (card, plus 2.9%) or in cash at the permit counters in Kathmandu and Pokhara: at a trail check-post it costs double. It is valid for one entry and cannot be refunded. Carry it and register at every check-post.
• Guide and TIMS: since April 2023 the Nepal Tourism Board issues the TIMS card (NPR 2,000) only through registered trekking agencies, so foreign trekkers are officially expected to walk with a licensed guide. Checks in the Annapurna region have been inconsistent, but plan for the rule and confirm the current situation with your agency or the permit counter.
• Altitude: ABC is at 4,130 m and Deurali to ABC climbs about 900 m. Sleep at Machhapuchhre Base Camp (3,700 m) if you can. With a headache and nausea or dizziness, do not go higher; if it gets worse, go down at once.
• Avalanches: between Himalaya, Deurali and MBC the trail crosses avalanche paths. An avalanche at Deurali buried four Korean trekkers and two Nepali guides on 17 January 2020. In winter and spring, after snow, ask at the lodges and wait if the trail is closed.
• Drones are strictly prohibited in the Annapurna Conservation Area without prior approval from the authorities.
• No campfires: ACAP asks trekkers to wear warm clothes instead, carry out their rubbish and batteries, and refill water bottles at safe drinking water stations or purify their own water instead of buying bottled water.
• Money: lodges take cash in Nepali rupees and rarely cards. Bring enough from Pokhara for the whole trek, including extra for hot showers, charging and Wi-Fi, which cost more the higher you go.
• Season: October and November and March to May are the main seasons. In the monsoon (June to September) expect daily rain, leeches and landslides on the roads and lower trail; in winter expect snow above Deurali.

Before you set off, the ACAP permit office answers at epermit@ntnc.org.np, on +977 61 431102 (10:00 to 17:00) and on WhatsApp/Viber +977 9856038358. Mobile signal is patchy above Chhomrong: tell your next lodge when you expect to arrive, carry a head torch, warm layers and a first-aid kit, and never walk the upper gorge alone in bad weather.

Nearest hospital for each stage

Hospitals

Clinics and doctors

These health posts in Ghandruk and Chhomrong give first aid and treat minor illness during the day. They are not hospitals, and above Chhomrong there is no health post at all, so serious cases go to Pokhara.

Pharmacies, cash and supplies

• Pharmacies: Nayapul
• ATMs: Nayapul
• Shops: Nayapul, Ghandruk, Chhomrong
• Bus stops: Nayapul

There are small pharmacies in Nayapul and Birethanti at the start, and none higher up. Buy everything in Pokhara: rehydration salts, painkillers, blister care, water purification and any altitude medicine your doctor prescribes. Carry all your cash in Nepali rupees from Pokhara as well: lodges rarely take cards and you should not rely on an ATM on the trail.

Pharmacies, ATMs, shops and stops: © OpenStreetMap contributors. Hospitals and health centres checked online.