Mardi Himal Trek emergency & health guide: hospitals, rescue, altitude and permits

Emergency numbers

Nepal has no public mountain rescue service. Above Forest Camp, a serious injury or altitude sickness that does not improve on descent means a helicopter from Pokhara, ordered by your trekking agency or your insurer. Before you go, buy insurance that covers trekking and helicopter evacuation up to at least 4,500 m, save its 24-hour assistance number, and give a copy to your guide.

Rules to know

• ACAP entry permit: the whole trek is in the Annapurna Conservation Area. It costs NPR 3,000 for foreigners and NPR 1,000 for SAARC nationals; children under 10 need none. Buy it online on the NTNC e-permit site (card, 2.9% charge, sent by email) or in cash at the ACAP counters in Pokhara (+977 61 453376) and Kathmandu (+977 1 5322406), and show it with your passport at the checkpoints.
• Licensed guide and TIMS card: since 1 April 2023 foreign trekkers in Nepal must trek with a licensed guide booked through a registered agency, which issues the TIMS card (NPR 2,000; NPR 1,000 for SAARC nationals). Checks on the Annapurna routes have been patchy, but the rule is in force and you can be turned back or fined, so plan to go with a guide.
• Altitude: High Camp is at about 3,550 m and the base camp at about 4,500 m. Climb slowly, drink plenty and do not go higher with a headache that does not pass. If it gets worse, or you are breathless at rest, confused or unsteady, go down at once: that is the treatment.
• Base camp day: there is no accommodation above High Camp, only a seasonal tea stall. Leave High Camp before dawn, agree a turnaround time with your guide, and do not walk the narrow ridge in cloud, snow, ice or strong wind. In winter the path to the base camp can be closed by snow.
• Climbing Mardi Himal (5,587 m) needs a separate peak permit, and Machhapuchhre (6,993 m), the sacred mountain above the ridge, is closed to climbers. The trek ends at the base camp.
• Drones: flying in the Annapurna Conservation Area needs permission from the Ministry of Home Affairs, the Department of Tourism, the Civil Aviation Authority of Nepal and ACAP.
• Water and rubbish: treat or filter all water, and refill instead of buying plastic bottles. Water sources above Low Camp can dry up or freeze. Carry your rubbish back to Pokhara.
• Season: October and November are the best months, March to May the second best. In December to February expect snow above Low Camp and frozen water at High Camp; in the monsoon (June to September) expect rain, leeches, cloud and landslides on the roads to Kande and Siding.

The nearest hospitals with a 24-hour emergency department are all in Pokhara: CIWEC Hospital in Lakeside, Manipal Teaching Hospital in Phulbari and the government hospital (Pokhara Academy of Health Sciences) at Ramghat. They are 1 to 1.5 hours by road from Kande and a few hours by jeep from Siding. Tell your guide and someone at home your plan, and check the weather before the base camp day.

Nearest hospital for each stage

Hospitals

Clinics and doctors

The only health post on the route is near Australian Camp on the first stage; it gives first aid in office hours and cannot treat altitude sickness. There is no clinic or doctor at Forest Camp, Low Camp, High Camp or Siding: your guide's first-aid kit and going down are the first treatment.

Pharmacies, cash and supplies

• Pharmacies:
• ATMs:
• Shops: Kande, Pitam Deurali
• Bus stops: Kande

There is no pharmacy on the trail. Buy what you need in Pokhara: blister care, rehydration salts, water purification tablets and, if your doctor agrees, acetazolamide for altitude. Pokhara has many pharmacies in Lakeside and at the hospitals, but no duty-pharmacy rota. Bring enough Nepali rupees in cash for the whole trek: there are no ATMs after Pokhara and teahouses do not take cards.

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