Thursday, 4 February 2016

Preparation for Kailash Mansarovar Yatra (Medical and Physical planning) - 2018 experience of our Guide Lakhpat Sherpa



Kailash Manasarovar Yatra has its own significance and sanctity because of the spiritual association; in spite of the unpredictable harsh conditions several thousand enjoy the pilgrimage on this route. The region is located 18000 plus feet above sea level. With our experience we are saying in every group/overall about 50% of the yatris are affected by altitude sickness and nausea. Our small outline and a brief experience could help the pilgrims in better preparing for the yatra since it is a combination of high climb on foot (trekking) and by transport (long drives and uphill tough terrains with huge mountains all around). Here the Group experience Nature managed i.e., unpredictable extreme climate from snowing to frozen atmosphere, with sunlight, harsh wind and even rain are experienced simultaneously, and there is no greenery around. Pilgrim must be optimistic and should plan in advance to combat with the yatra natural shades and our body management system.



 Getting Prepared:

·   Check for a proper acclimatization and minimum relaxation and stoppage so that we are less affected and tour is best planned by a tour operator.

·   We must plan a judicious baggage with appropriate shoes and warm clothes (thermals, sweaters), socks, cap and Jackets.

·   To combat the extreme climate our body must be adjusted so we must start with the morning and evening walk for one hour (wearing proper shoes)  and try Pranayam (under the guidance of trainer). It is advisable to do this 4-6mnths before the yatra in order to set the body system and meticulously combat the tough terrain.

·   Blood sugar, cholesterol and triglyceride, urea and creatinine, Blood Pressure and ECG must be checked 6 months prior to your trip so that remedy could be devised and yatra could be planned.

·   Develop the habit of taking Multivitamins and these days after checking with the doctor Vitamin D is also essential; Evion 400 & Calcium tablets 180 days minimum prior to your tour. Although there is no such guideline still we suggest so that yatra is conducted peacefully and enjoyed thoroughly with full attention on the mesmerism created by the almighty all around and mission is succeeded well.
·   Pilgrims with the ailments like Asthma or breathing problems, heart problem and high blood pressure, recent injuries, sugar are advised to avoid the yatra until they are fit or guided by the Doctor.

 Kailash Mansarovar Yatra 2018


Altitude Sickness

High altitude: 5000ft to 11500 ft
Very high altitude: 11500ft to 18000ft

The way altitude increase , atmospheric pressure decreases where the percentage of Oxygen remains at certain level ; the pressure of the oxygen is slow ; oxygen is thinner; and this leads to altitude sickness, usually most of the pilgrims could climb around 1500-200 m in a day, without any hastle whereas 50% of Pilgrims develop issues  when they touch 3000m. The distance climbs (gaining height), high altitude and rest and improper acclimatization and poor preparation before the yatra (walk etc. as guided above) are the factors and reasons of  Altitude sickness.

High Altitude illness include the following  

1. Acute Mountain sickness
2. High altitude pulmonary edema (HAPE)
3. High altitude cerebral edema (HACE)

The observant reasons vary from individual to individual, most important is persistent headache Burning or watery eyes, giddiness, dryness in nose and hard to breath, Nose bleeding, and sleep disorder are seen. Fatigue is most easily seen and felt. Gastrointestinal symptoms include vomiting, loss of appetite, distension of abdomen and nausea.

Threat to life can be observed with the conditions like HAPE the real symptoms are breathlessness when you are at ease or resting, cyanosis (blue tinge in finger tips), persistent coughing, fever and giddiness.

HACE common symptom is irritability lethargy, difficulty in walking (gait impairment), drowsiness, mental status altered, coma and these kinds of conditions oxygen is given to the patient, and sending back to the plains and lower altitude is the only option.  Steroids do help under the guidance of the physician.

Medicines required:

1. Acetazolamide (Diamox)
2. For pain relief – Hifenac (aciclofinac sodium).
3. Anti allergics  – Deslor/Allegra 120
4. Antiemitics – ondansetron - tablet and  injections
5. Anti - diarrhoeal
6. Glucose, ORS, Paracetamol
7. High blood pressure medicines
8. Nasal spray-saline - otrivin
9. Antibiotics are to be carried by doctor’s advice
10.   Sunscreen with SPF 50


 Diamox tablet 250mg minimum should be taken to combat altitude sickness at least once daily from the day we start gaining height and should be better taken in the morning and should be continued unless we return the base. The side affect of this medicine is tingliness affect so we must consume optimum water and combine with multivitamin so that tour is healthy with enough substitutes.

Finally with our experience we say if yatra is meticulously planned with enough of medical care and walk we could enjoy best of the Yatra in full swings and optimum so preparation and is essential and minimum baggage and body temperature consistency is essential. It is essential first you take care of yourselves and be observant of your co yatris so that immediate medical aid could be extended and we conclude the yatra successfully.

(NTP Team leader and Guide experience Lakhpat Sherpa (2015) Kailash Mansarovar Yatra)

9 comments:

  1. I love traveling. This info would be really helpful for me in future

    Kailash Tour

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  2. Lessons Learnt and Tips for Kailash Mansarovar Trip
    I have booked one of the oldest Tourist Operator in Nepal named Touch Kailash and even his brother is also doing the same business. They take a ride on us. You can’t imagine. If you read this, you will be surprised that this much un-hearted and unethical people are living in this earth. There are number of business to make money but they should not have selected this noble and holy business to cheat people and extract their blood.

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  3. Points to remember
    1. Don’t go with package less than 2 Lakh Indian Rupees.
    2. Wherever I say Tibet, please keep it in your mind that it is China (Kailash and Mansarovar are part of China, it is hard to believe, but it is true). China has put fence around Manasarovar lake for almost 30km and no one is allowed to take bath. Full time 5 number Chinese securities are there to stop us taking bath in Manasarovar. At one place we managed to collect water in water bottles and poured in our head.
    3. Say strictly to the tour operator to apply for separate visa for your family/your group (not group visa). Tour operator will save few thousands INR if they apply as group visa. If you are part of group visa then your yatra is not in your hands. It will always depend on every individual (say 50 persons in the group and one person is sick and the other 49 has to wait). You can’t be separated while going to yatra and when you finish parikrama and if you want to come early there is a chance, but you have to pay Chinese Young 160 (approximately 1,650 Indian Rupees per head i.e if you are 10 people in your group you have to spend INR 16,500 just to be separated from the group).
    4. Say strictly to your tour operator that for your group they have to arrange food separately. Tour operator will always save lot of money by clubbing 6 to travel agencies travelling during the same time and they will have single kitchen to prepare food and you have to stand in the que in cold climate and in rain for hours to eat each meal.
    5. Always ask your tour operator to arrange the 4 wheel drive car for your group (Not in mini bus or van) from the starting till yatra finish. They will say once you cross Nepal border then it is not in our hands Tibetan agency will take care and we can’t ensure (pure hum buck).

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  4. 6. Ensure tour operator has already arranged permit from Nepal authorities (it is easy to obtain).
    7. Don’t get into the car unless you have proper Visa from authorities to enter China (Tibet) which they normally obtain from Delhi, India (Indian Embassy and Chinese Embassy in Delhi).
    8. If the Tour operator say 2 lakhs is the package cost, then get the detailed breakdown from him (expenses every day or every stage like cost of permit, cost of Hotel in each place for how many nights and star rating and even possible name of the hotel, cost of transport (inside Nepal, Kathmandu to Chinese Border, Chinese Border to Darchen, Darchen to Saga, Saga to Mansarovar, Mansarovar to Yama dwar), cost of breakfast, lunch, Dinner for 15 days separately). Ask name of the hotel in every place and star rating and if they don’t provide as mentioned ask for reimbursement. They will say it is a lump sum (whole) figure then don’t accept. Because most of the time they will never fulfill even 20% as mentioned in the Itinerary. Ask them to include reimbursement cost in the Itinerary. If they don’t agree then look for other tour operator. Don’t pay full, always hold some money at least 20% till the end. The payment terms should be: advance INR 10,000 (to be paid 15-30 days before yatra), upon obtaining Nepal permit and Chinese visa pay 50%), rest upon completion of yatra before drop you in Kathmandu airport. In some cases, pilgrims have paid the agent in India and he run away with money without paying Nepal/Tibet (Chinese) agent and you will be struck in Nepal itself.
    9. Always visit their office before start the yatra, to ensure there is proper office and get the mobile number of Owner and minimum 3 or 4 other numbers (make sure that is working), ask the WhatsApp number of them (once you enter china (Tibet) you can contact them only through WhatsApp using Wi-Fi in hotels. Sometime you can’t call outside China (Tibet) with Chinese sim.

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  5. Hard time undergone and false promises everyday by travel agent:
    1. Agent applied for group visa of 32 without our knowledge. We are team of 8. The itinerary and date provided for 14 people is different. Itinerary of remaining (18 person) is different. Starting date of 14 people is 21 June 2018 and for others it is 25 June 2018.
    2. They have showed the Nepal permit and asked the full payment and we paid full. It is a blunder we have done.
    3. As promised they started our Yatra exactly on 21 June 2018 (Thursday), Since Kathmandu hotels are expensive, instead of keeping us in Kathmandu they just kept us in cheap rate hotel (prison) near Chinese border for 4 days and we can’t move due to border check post on either side.
    4. When we called the owner of the tour operator he promised next day you will start for yatra, since we haven’t received your Chinese visa.
    5. Next day when we called he said one person out of 32 has some problem with ID proof (passport), hence it is delayed and we can start the trip next day at 7 AM.
    6. Next Day we are ready in the morning and called him, he told that Saturday and Sunday holiday for Embassy and Monday Morning we will start.
    7. We lost our hope and thought of cancelling the yatra and come back. Then one local guy was arranged to negotiate and he has provided different itinerary starting 25 June 2018 and finish the whole yatra within 7 days instead of 13 days but the amount is same (since we paid 100% already).
    8. We thought we came this much far and if we want to come next time, we have to wait for visa process again for minimum one week in Nepal or Delhi and we have travelled this much far. Why to repeat the same process let’s wait for two more days. We don’t have passports in our hand, we felt like we gave our head to crocodile.
    9. Finally, instead of Monday, they started the Yatra on Tuesday.
    10. Intentionally instead of starting in the Morning, they have started around 10 AM (Nepal Time) and when we reach the Chinese Border they closed for Lunch (2 Hours). When we had a word with rest of the group of 18 (which I have mentioned in point 1), enquired about one-person passport issue, they have mentioned we have agreed to the itinerary 5 months back and we have provided all our passports 2 months back and there is no issue at all. Totally the travel agent cheated us in each and every step. While waiting in the Chinese border they have showed us the visa and passport and they have obtained the visa on 21st itself. They were different stories every day until 25th that they haven’t obtained visa.

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  6. 11. There was a rush and we managed to complete the process and cross the border. It took another 3 hours.
    12. By the time we finished the formalities in the border and check point in between where you have to get down with passport and a Chinese officer will come and cross-check each passport with the list of approved grouped visa in his hand.
    13. By the time we reach Keyrung it is 5 PM (Chinese Time) and the authority to issue permit to enter Saga is closed at 5.30 PM.
    14. So we stayed in Keyrung that night just travelled only 1.5 hours from border, wasted the whole day.
    15. There only we come to know the full drama of all Travel Agents. When we went to have Dinner there are 270 persons standing in the que already for Dinner. They make us wait in Chinese border for 4 days for this, to save few thousands in food also. They want to move whole 300 persons in one go, so that they can save money in catering. If they do it separately each travel agent has to arrange separate kitchen and they couldn’t save this much. I don’t want to mention how the quality will be if they prepare it for 300 persons. For that we have to stay in que for hours.
    16. All the tour operators thought about saving money in catering, but they forget that there are only limited rooms available in Mansarovar and while doing parikarama close to Kailash Mountain. I will explain later our suffering due to this blunder by travel agents.
    17. Next day morning 10AM (Chinese time) the authority will commence the duty and our Tibetian and Chinese guide went there with our passport to obtain permit. They managed to get permit around 12:30. Then we started from Keyrung.
    18. Some people claimed to have rest in Keyrung one day and other day rest in Saga. Lot of negotiations and finally some people agreed to start from Keyrung, since they want to be there on Manasarovar for full moon day. During travel they have provided packed lunch and it is horrible.
    19. In Manasarovar everyone has to stay in porta cabin and 5 or 7 bed in a room and two of them don’t have bedsheets (Kambali). Suffer in freezing cold.
    20. Again someone wish to take rest prior to parikarama in Darchen. Tour operator agreed for that. They say as acclimatization.

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  7. 21. Tour operator asked us to be ready in early morning to move to new hotel called Hotel Himalaya. But after reaching there someone booked the whole hotel, so no place and have to look for low grade hotel. Some get the room in the same hotel, since checkout time was 12 noon, waiting in foot path for 4 hours.
    22. Next day we kept our luggage in cloak room and took a hand bag with some items for parikarama and stay beside the hill 2 nights. Even they couldn’t keep a room and asked to vacate next day morning before starting for parikarama though some of the old people could not even go for parikarama. They have provided some cheap hotel for those old people and kids. Some agency silently collected the room key saying that you will loose the key during parikarama and vacated all the rooms by travel agents without people knowledge.
    23. The hand bag should not be heavy too, since we have to walk first day 14 miles, 2nd day 22 miles (including steep mountain of 1 km high) and third day is easy just 3 hours walk in flat ground.
    24. There are only three buses available and rest of them has to wait for 2 hours for the buses to drop the people and come back.
    25. It was told that hot water will be provided during parikarama all the way, horse/bull will carry the lunch and hotwater. But it is not. While starting they provide a parcel lunch and a water bottle. Once you finish 14 miles walk you will get hotwater in the camp. Luckily I had some Chinese young to buy water bottle after 4 hours of walk.
    26. Due to lack of oxygen in air (there will be heavy wind but less oxygen), our body will extract oxygen from the water we drink and since we consume more water and the bottle emptied quickly. We can’t carry too many water bottle due to weight. We have to fill water from the flowing river and drink at some point there are some well sort of thing which helped us fulfill our thurst.
    27. Just before completing the first day parikrama, half-an-hour before there was a hail storm (big ice cubes hitting you hardly).
    28. Some of them are lucky to get proper shelter and very few has to stay in temporary tent and due to the heavy wind air will come from bottom and you can’t sleep and at the same time you have to be ready mentally and physically for the second day to walk for 22 miles including claiming steep mountain. Your oxygen level will go down if you don’t sleep well. Only hot water provided in the camp helped us to survive.
    29. Since only limited space available at Zutulphuk (second day camp) the tour operator discouraged us to go for second day parikrama. They are using our low oxygen level and tied to stop us. Out of approximately 200 people only 21 people has managed to complete the second day parikrama.
    30. After completing hard task of 22 miles, there was no place to sit in the camp and nothing to drink. We have to pay from our pocket to buy water bottles. Even second day last phase was very hectic since this time the ice cubes larger (half of golf ball) size to hit us.

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  8. 31. As expected no rooms and need to go back to hotel. Some travel agency doesn’t inform about the lack of room in camp. They are totally disappointed.
    32. Since tour operator hasn’t taken prior approval for bus permit, we are being transferred in small groups by mahendra car to the bus.
    33. Once we reached the city at 12 night, we have to walk half kilometer for food (some curd rice and rasam) was provided.
    34. Then roam around few hotels to accommodate the 21 person. Almost 7 hotels to accommodate 21 person.
    35. I am lucky and haven’t get any room, I slept in walkway in hotel without any bedsheet and the dresses and bags are wet due to evening rain.
    36. Next day morning early morning to start to go back. No room to even take bath. Requested someone to use the washroom for few minutes.
    37. Since all these delays and hickups due to the travel agent he agreed to pay for visa cancellation, while standing in the que in Chinese border (immigration), he refused to pay and he forced me to pay that 160 Chinese Young.
    38. I understand who I am. This yatra is essential to break our egos. Only upper middle class can afford this Yatra and all their egos will be vanished if they came across all these hurdles. We use to fight with travel agent representative in the beginning and at one stage we understand the programme is not in our hand and it is fixed by the group of agents and we have to just go in flow. There is no use of arguing. Only while coming back we can do something, that too after crossing the China border.
    39. It is not 100% spiritual yatra, since travel agent take a ride on us. I was thinking about lord shiva only while I was doing parikarama i.e only 2 days. Rest of the 5 days is just uncertainities/if and buts situation.
    40. While coming back from Chinese border to Kathmandu in a nasty road that too in the mountains, is really thrilling experience. But the torrential rain has started just a day before and there are full of mist and we couldn’t see anything in front of you. Every 5 minutes you will see big trucks passing either opposite side or one the same way that too fully loaded. You will feel like you are doing rock safari for 5 hours and you can feel number of bones in your body. That too one truck came down the hill and only spare parts I could see in the road.
    41. At some places due to loose soil the bolders are slowly coming down and the soil covered the road. Afternoon 2PM in Nepal look like 7PM due to mist, rain and worst weather. Once we reached city, I felt free but struck up in traffic and our car has stopped at same place for atleast 40 minutes and I managed to reach airport one hour before the flight time because of Brazil v Mexico football match and the roads are almost empty after that bottle neck point.

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  9. Things to take for parikrama (keep it in one separate bag and don’t touch day until the day):
    1. Buy 20ml glucose liquid some 20 numbers (like tube).
    2. One spare socks
    3. Inner wear 2 sets
    4. Wear thermal wear and above that one rain coat
    5. Night remove rain coat and wear one more dress
    6. Take one flask to take hot water 1 litre or 2 litre based on your fitness to carry weight
    7. Wear good brand shoe normal walking shoe (someone suggested to cover ankle that is waste, you have to walk above the small stones and your shoe should give good cushion effect and only the bottom buttom should be good nothing else).
    8. Someone say take dry fruits (never follow that). Take water fruits like plumps. May be bigger dry grapes. Taking nuts, dates will not help. It will create thirsty and you don’t have enough water.
    9. Head light weightless (useful if u want to walk in night (due to delay in walking) or second day if you start early morning and in camp the lights are switched off after dinner).
    10. Drink lot of hot water in night whenever you get up (especially after first day of walking).
    11. Everyone suggest during parikrama have only hot water and no solid food (its true, your body waste more energy to digest).
    12. Have chinese young during parikarama to buy water bottle (5 CYN) and tea (5CYN). You can fill hot water in the shop if you pay. Very hard to get it but you have to request.
    13. Facial Cream essential (coconut oil not enough).
    14. Face mask: not essential
    15. Expect high radiation, so may be you can wear sunglasses. But not essential.
    16. Lip balm essential.
    17. Ear plug or sponge and above that monkey hat.
    18. Oxygen cylinder small one (1 number for first day last half an hour, 2 number for second day while climbing the steep mountain); not essential but for weaker person.
    19. Lot of thin carry bags (two days tooth paste, sunscreen lotion, coconut oil (it will be freezed))
    20. Everyone suggest tissue paper and wet tissue. But not required everywhere the river is flowing beside you have empty small water bottle two number and you can manage.
    21. Ladies can keep napkins, since someone may face period issue due to height and lot of travel, though it’s not your date.
    22. If you take pony/horse, you have to pay for horse as well as the person. Don’t sleep while you are riding in the horse, it will push you down. While crossing any small river or any flow of water ask that guy to stop and get down walk and then climb into the horse.
    23. You can hire person to carry your luggage, but someone will just walk without even giving company to you. It is better to hire ladies (tibetian) or some Nepali man who can speak Hindi and cooperative.
    24. Some use horse for the first day and go by walk on second day.
    25. Lemon 3 or 5 number (for 3 days parikrama)
    Things to take to Kathmandu:
    1. You can carry anything upto weight restriction in your flight.
    2. Before starting for Yatra, you have to keep your things in locker/cloak room in hotel and then they will provide one big bag and you can keep upto 5 kg and one small bag which you carry for parikrama.
    Things to take until Darchen (things for two days’ travel and stay 2 or 3 nights):
    1. Mobile charger.
    2. Carry two sets of dress, towels, inner wears, soap, brush and shampoo.
    3. You can wear one dress and top one jacket provided by travel agent.
    4. This bag you will keep it in Darchen Hotel (may be Himalayan Hotel).

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