Tsum Valley Trek
July 9, 2016
Trekking Grade
July 9, 2016

Trekking Information

Trekking Seasons:

Trekking in Nepal is an all season activity. The most popular trekking seasons are spring (February – May) and Fall (September to November), but even in the summer monsoon, trekking is popular in the rain shadow regions north of the Himalayas in areas such as Mustang, Upper Manang and Dolpo.

Main Season : Mid of September to Early December

Second Season: March to May

Monsoon Season : High Himalayan trekking such as Mustang , Dolpo

Winter season : Low land Himalayan trek Up to 3000 meters and enjoy with snow.

Trekkers’ Information Management System (TIMS):

TIMS card is for your safety.

With the distinction of Nepal as a trekking destination and its growing charm, a provision of the Trekkers’ Information Management System (TIMS) has been implemented to ensure safety and security of the trekkers and to control illegal trekking operations.

As a trekker entering a protected area in Nepal, you will be asked to provide some information about the dates of your trip, the itinerary, and a contact number. These data will be inserted in the visitors’ database, where they can be accessed for park management purposes or in case of accidents and/or natural calamities, in order to inform the concerned institutions about the trekkers inside the park at anytime.

TIMS cards should be collected by both Free Individual Trekkers (FITs) and trekkers taking the service of government authorized trekking agencies.

Past experiences have revealed that difficulties were seen while carrying out rescue operations during times of accidents and natural calamities. Due to the lack of proper record system of trekkers, rescue and search missions used to face difficulties in spotting the missing trekkers. Based on the data collected through TIMS cards, however, it will be possible to know the position of a trekker in case a rescue operation is needed.

The provision of Trekkers’ Information Management System (TIMS) came into effect on January 1, 2008. Since then, the Trekking Agencies Association of Nepal (TAAN) and Nepal Tourism Board (NTB) started recording trekkers’ details and began issuing TIMS Card to trekkers.

NTB and TAAN signed a Memorandum of Understanding (MoU) on March 18, 2010 to implement the TIMS system in a new format from April 1, 2010. NTB and TAAN have introduced separate TIMS Cards for FITs and organized groups. FITs need to have Green TIMS cards by paying Nepali currency equivalent to US $20 per person, while those travelling in groups need to have Blue TIMS cards by paying Nepali currency equivalent to US $10 per person. Trekkers taking the service of trekking agencies can pay fee for TIMS card in US dollars.

Where and how to obtain a TIMS Card?

Free Individual Trekkers:

Free Individual Trekkers can obtain TIMS cards at the offices of Nepal Tourism Board in Kathmandu and Pokhara,

TAAN Secretariat at Maligaon and TAAN Pokhara Secretariat in Pokhara upon filling the TIMS application firm.

Organized Trekkers:

Trekking companies will collect trekkers’ data and enter it in the central database and will provide trekkers with a TIMS card after paying fee prescribed above.

Opening Hour/s:

TIMS counter at TAAN follows regular working hours (10am-5pm) and 365 days a year
NTB Offices follow government working hours and days.
Trekking agencies open 12 hours a day seven days a week.

Documents Required:

To obtain TIMS Card you need copy of:

a) Passport

b) two (2) Passport-size Photographs.

Why is TIMS Necessary?

The following considerations have been taken into account in the process of issuing TIMS:

All important details regarding trekkers and trekking routes shall be maintained in a computerized Database Management System, which can be useful for the trekkers’ safety and security. In order to help carry out search and rescue operations for trekkers in case of natural calamities and other accidents by means of Authentic Information Service. To maintain a record system that includes personal details of trekkers, trekking area, trekking routes, handling agencies, duration, etc. The data generated from the system will be useful to all concerned stakeholders such as tourism organizations, Government agencies, diplomatic missions, tour operators, research institute, etc.

Unauthorized trekking operations will be controlled, thus, resulting in better management of trekking services, which will not only benefit trekkers and field staff, but also trekking companies and Government agencies. Occasional untoward incidents will also be better prevented. Plus, TIMS will upgrade the service standard and will contribute to better management of sustainable mountain tourism development in Nepal.

TIMS will not be required for:

Foreign guests invited by the Government of Nepal
Authorities from the various diplomatic missions present in the country, who hold official letter/s and travel at their own risk
Visitors on certain missions recommended by the concerned Governmental Department(s);
Foreign Nationals possessing a residential visa.

Revenue collected from distribution of TIMS cards is shared into three equal parts for following purposes:

Nepal Tourism Board (NTB) will use the first part for printing TIMS cards, holograms, managing issuing counters and use the remaining amount for tourism marketing, publicity and promotion.
The second part is utilized in the welfare of trekking workers like buying medical and accident insurance policy for them and conducting rescue operations in case of accidents. The amount is also used to launch various programs as a part of corporate social responsibility (CSR) and meet administrative expenses.
The third part is utilized to develop infrastructures, promote, conserve, maintain trekking trails. A substantial amount is also utilized to explore, develop and promote new destinations besides organizing training and workshops for sustainable and responsible tourism development.

Acute Mountain Sickness (AMS)

Some people are more susceptible to altitude sickness than others. If you suffer from a case of altitude sickness it does not mean that you can never go to high altitudes again. However, it does mean in the future, you should pay attention. Awareness of altitude sickness has caused some trekkers to be unnecessarily anxious as they trek. The progression of symptoms is usually gradual, and you will have plenty of time to react appropriately. Design your itineraries to allow plenty of time for acclimatization so that you will be able to adjust to the increase in altitude. Human bodies have the ability to adjust to higher altitudes when given enough time. If a person travels up to high altitudes more rapidly than his or her body is able to adjust, AMS symptoms develop.

The treatments of AMS are first and foremost not to ascend with symptoms and if symptoms are severe, to descend. In rare cases where the descent is difficult or impossible a portable pressure chamber is effective. Three medications have also been proven useful for treating and preventing AMS: Acetazolamide (Diamox), Dexamethasone (Decadron), Nifedipine. Your physician and local Public Health Service are the best sources for further information.

Altitude sickness—also known as acute mountain sickness (AMS), altitude illness, hypobaropathy, or soroche—is a pathological effect of high altitude on humans, caused by acute exposure to low partial pressure of oxygen at high altitude. It commonly occurs above 2,400 metres (8,000 feet) It presents as a collection of nonspecific symptoms, acquired at high altitude or in low air pressure, resembling a case of “flu, carbon monoxide poisoning, or a hangover”. It is hard to determine who will be affected by altitude sickness, as there are no specific factors that correlate with a susceptibility to altitude sickness. However, most people can ascend to 2,400 meters (8,000 ft) without difficulty.

Acute mountain sickness can progress to high altitude pulmonary edema (HAPE) or high altitude cerebral edema (HACE), which is potentially fatal.

Chronic mountain sickness, also known as Monge’s disease, is a different condition that only occurs after very prolonged exposure to high altitude.

Oxygen Level in Altitude

Altitude (in meters)   Oxygen Rate

8848   33 %

4500  57 %

8000   36 %

4000   60 %

7000   41 %

3500   64 %

6000   47 %

3000   68 %

5500   50 %

2500   73 %

5200   52 %

1000   88 %

5000   53 %

Sea level   100 %

Causes

The percentage of oxygen in air, at 21%, remains almost unchanged up to 70,000 feet (21,000 m). The RMS velocities of diatomic nitrogen and oxygen are very similar and thus no change occurs in the ratio of oxygen to nitrogen. However, it is the air density itself, the number of molecules (of both oxygen and nitrogen) per given level, which drops as altitude increases. Consequently, the available amount of oxygen to sustain mental and physical alertness decreases above 10,000 feet (3,000 m). Although the cabin altitude in modern passenger aircraft is kept to 8,000 feet (2,400 m) or lower, some passengers on long-haul flights may experience some symptoms of altitude sickness.

Dehydration due to the higher rate of water vapor lost from the lungs at higher altitudes may contribute to the symptoms of altitude sickness.

The rate of ascent, altitudes attained, amount of physical activity at high altitude, as well as individual susceptibility, are contributing factors to the onset and severity of high-altitude illness.

Altitude sickness usually occurs following a rapid ascent and can usually be prevented by ascending slowly. In most of these cases, the symptoms are temporary and usually abate as altitude acclimatisation occurs. However, in extreme cases, altitude sickness can be fatal.

Signs and symptoms

Primary symptoms:

Headaches are the primary symptom used to diagnose altitude sickness, although a headache is also a symptom of dehydration. A headache occurring at an altitude above 2,400 metres (8,000 feet = 76 kPa), combined with any one or more of the following symptoms, may indicate altitude sickness:

Lack of appetite, nausea, or vomiting
Fatigue or weakness
Dizziness or lightheadedness
Insomnia
Pins and needles
Shortness of breath upon exertion
Nosebleed
Persistent rapid pulse
Drowsiness
General malaise
Peripheral edema (swelling of hands, feet, and face).
Severe symptoms
Symptoms that may indicate life-threatening altitude sickness include:
Pulmonary edema (fluid in the lungs)
Symptoms similar to bronchitis
Persistent dry cough
Fever
Shortness of breath even when resting
Cerebral edema (swelling of the brain)
Headache that does not respond to analgesics
Unsteady gait
Gradual loss of consciousness
Increased nausea
Retinal hemorrhage

The most serious symptoms of altitude sickness arise from edema (fluid accumulation in the tissues of the body). At very high altitude, humans can get either high altitude pulmonary edema(HAPE), or high altitude cerebral edema (HACE). The physiological cause of altitude-induced edema is not conclusively established. It is currently believed, however, that HACE is caused by local vasodilation of cerebral blood vessels in response to hypoxia, resulting in greater blood flow and, consequently, greater capillary pressures. On the other hand, HAPE may be due to general vasoconstriction in the pulmonary circulation (normally a response to regional ventilation-perfusion mismatches) which, with constant or increased cardiac output, also leads to increases in capillary pressures. For those suffering HACE, dexamethasone may provide temporary relief from symptoms in order to keep descending under their own power.

HACE can progress rapidly and is often fatal. Symptoms include fatigue, severe dyspnea at rest, and cough that is initially dry but may progress to produce pink, frothy sputum. Descent to lower altitudes alleviates the symptoms of HACE.

HACE is a life threatening condition that can lead to coma or death. Symptoms include headache, fatigue, visual impairment, bladder dysfunction, bowel dysfunction, loss of coordination, paralysis on one side of the body, and confusion. Descent to lower altitudes may save those afflicted with HACE.

Prevention

Ascending slowly is the best way to avoid altitude sickness. Avoiding strenuous activity such as skiing, hiking, etc. in the first 24 hours at high altitude reduces the symptoms of AMS. As alcohol tends to cause dehydration, which exacerbates AMS, avoiding alcohol consumption in the first 24-hours at a higher altitude is optimal.

Altitude acclimatization

Altitude acclimatization is the process of adjusting to decreasing oxygen levels at higher elevations, in order to avoid altitude sickness. Once above approximately 3,000 metres (10,000 feet = 70 kPa), most climbers and high-altitude trekkers take the “climb-high, sleep-low” approach. For high-altitude climbers, a typical acclimatization regimen might be to stay a few days at a base camp, climb up to a higher camp (slowly), and then return to base camp. A subsequent climb to the higher camp then includes an overnight stay. This process is then repeated a few times, each time extending the time spent at higher altitudes to let the body adjust to the oxygen level there, a process that involves the production of additional red blood cells. Once the climber has acclimatised to a given altitude, the process is repeated with camps placed at progressively higher elevations. The general rule of thumb is to not ascend more than 300 meters (1,000 ft) per day to sleep. That is, one can climb from 3,000 (10,000 feet = 70 kPa) to 4,500 meters (15,000 feet = 58 kPa) in one day, but one should then descend back to 3,300 meters (11,000 feet = 67.5 kPa) to sleep. This process cannot safely be rushed, and this is why climbers need to spend days (or even weeks at times) acclimatizing before attempting to climb a high peak. Simulated altitude equipment that produces hypoxic (reduced oxygen) air can be used to acclimate to high altitude, reducing the total time required on the mountain itself

Altitude acclimatization is necessary for some people who move rapidly from lower altitudes to intermediate altitudes (e.g., by aircraft and ground transportation over a few hours), such as from sea level to 8,000 feet (2,400 m) as in many Colorado, USA mountain resorts. Stopping at an intermediate altitude overnight can alleviate or eliminate occurrences of AMS.

Medical treatment

The drug acetazolamide may help some people making a rapid ascent to sleeping altitude above 2,700 metres (9,000 ft), and it may also be effective if started early in the course of AMS. TheEverest Base Camp Medical Centre cautions against its routine use as a substitute for a reasonable ascent schedule, except where rapid ascent is forced by flying into high altitude locations or due to terrain considerations. The Centre suggests a dosage of 125–250 mg twice daily for prophylaxis, starting from 24 hours before ascending until a few days at the highest altitude or on descending;] with 250 mg twice daily recommended for treatment of AMS. The Centers for Disease Control and Prevention suggests a lower dose for prevention of 125 mg acetazolamide every 12 hours. An undesirable side-effect of acetazolamide is a reduction in aerobic endurance performance. Dosage of 1000 mg/day will produce a 25% decrease in performance, on top of the reduction due to high-altitude exposure. The CDC advises that Dexamethasone be reserved for treatment of AMS and HACE during descents, and notes that Nifedipine may prevent HAPE.

A single randomized controlled trial found that sumatriptan may help prevent altitude sickness. Despite their popularity, antioxidant treatments have not been found to be effective medications for prevention of AMS. Interest in phosphodiesterase inhibitors such as sildenafil has been limited by the possibility that these drugs might worsen the headache of mountain sickness.

A promising possible preventative treatment for altitude sickness is myo-inositol trispyrophosphate (ITPP), which increases the amount of oxygen released by hemoglobin.

For centuries, indigenous peoples of the Americas such as the Aymaras of the Altiplano, have chewed coca leaves to try to alleviate the symptoms of mild altitude sickness. In Chinese and Tibetan traditional medicine, extract of root tissue of Radix rhodiola is often taken in order to prevent the same symptoms.

Oxygen enrichment

In high-altitude conditions, oxygen enrichment can counteract the hypoxia related effects of altitude sickness. A small amount of supplemental oxygen reduces the equivalent altitude in climate-controlled rooms. At 3,400 meters (11,155 feet = 67 kPa), raising the oxygen concentration level by 5 percent via an oxygen concentrator and an existing ventilation system provides an effective altitude of 3,000 metres (10,000 feet = 70 kPa), which is more tolerable for surface-dwellers.

Other methods

Increased water intake may also help in acclimatisation to replace the fluids lost through heavier breathing in the thin, dry air found at altitude, although consuming excessive quantities (“over-hydration”) has no benefits and may cause dangerous hyponatremia.

Oxygen from gas bottles or liquid containers can be applied directly via a nasal cannula or mask. Oxygen concentrators based upon pressure swing adsorption (PSA), VSA, or vacuum-pressure swing adsorption (VPSA) can be used to generate the oxygen if electricity is available. Stationary oxygen concentrators typically use PSA technology, which has performance degradations at the lower barometric pressures at high altitudes. One way to compensate for the performance degradation is to utilize a concentrator with more flow capacity. There are also portable oxygen concentrators that can be used on vehicular DC power or on internal batteries, and at least one system commercially available measures and compensates for the altitude effect on its performance up to 4,000 meters (13,000 ft). The application of high-purity oxygen from one of these methods increases the partial pressure of oxygen by raising the FiO2 (fraction of inspired oxygen).

Also, the use of Nitric Oxide has been proven to address and relieve altitude sickness. 12 scientists recently released a study in which Mount Everest trekkers were allowed to naturally adapt to altitude during their ascent. They were tested for nitric oxide levels along the way. The scientists found that their bodies naturally produced more nitric oxide as they climbed higher. “Our results suggest that nitric oxide is an integral part of the human physiological response to hypoxia.” Scientific Reports

Treatment

The only reliable treatment and in many cases the only option available is to descend. Attempts to treat or stabilise the patient in situ at altitude is dangerous unless highly controlled and with good medical facilities. However, the following treatments have been used when the patient’s location and circumstances permit:

Oxygen may be used for mild to moderate AMS below 12,000 feet (3,700 m) and is commonly provided by physicians at mountain resorts. Symptoms abate in 12–36 hours without the need to descend.

For more serious cases of AMS, or where rapid descent is impractical, a Gamow bag, a portable plastic hyperbaric chamber inflated with a foot pump, can be used to reduce the effective altitude by as much as 1,500 meters (5,000 ft). A Gamow bag is generally used only as an aid to evacuate severe AMS patients, not to treat them at altitude.

Acetazolamide may assist in altitude acclimatization.
and prevents further impairment of pulmonary gas exchange.”

Other treatments include inject able steroids to reduce pulmonary edema, this may buy time to descend but treats a symptom, it does not treat the underlying AMS.

Trekking Information

Trekking grade

Easy
Moderate
Strenuous
Challenging

Types of Trekking

Tea House Trek
Tented camp
Backpackers trek

Trekking permit

Trekkers planning to travel to controlled areas in Nepal opened for group trekking need to get Trekking Permit issued by the Department of Immigration under the Home Ministry. The government has opened following previously restricted trekking areas for group trekkers. Trekking permits will not be issued to individual trekkers in those trekking areas. The areas and required fees are as follows:
1 DOLPA DISTRICT
a. Areas of Upper Dolpa For the first 10 days US$ 500 per person and after 10 days US$ 50 per day person or equivalent foreign currency

b. Areas of Lower Dolpo Per week per person US$ 10 or equivalent convertible foreign currency.

2 MUSTANG DISTRICT
Areas of Upper Mustang For the first 10 days US$ 500 per person and after 10 days US$ 50 per day per person, or equivalent convertible foreign currency.
3 GORKHA DISTRICT

a. Manaslu Region From September to November US$ 70 per week per person and after 7 days US$ 10 per day per person or equivalent convertible foreign currency. From December to August US$ 50 per week per person and after 7 days US$ 7 per day per person or equivalent convertible foreign currency.
b. Areas of Chhekampar and Chunchet VDC (Sirdibas-Lokpa-Chumling-Chhekampar -Nile-Chhule Area) From September to November, per person US$ 35 for first 8 days and from December to August per person US$ 25 for first 8 days or equivalent convertible foreign currency
4 MUGU DISTRICT
Areas of Mugu, Dolpu, Pulu and Bhangri For the first 7 days US$90 per person and after 7 days US$ 15 per day per person or equivalent convertible foreign currency.
5 MANANG DISTRICT
Areas of Nar and Phu From September to November, US$ 90 per week per person and December to August US$ 75 per week per person or equivalent convertible foreign currency.
6 DOLAKHA DISTRICT
Gaurishankar and Lamabagar Per week per person US$ 10 Or equivalent convertible foreign currency.
7 RASUWA DISTRICT

Thuman and Timure Per week per person US$ 10 Or equivalent convertible foreign currency.
8 HUMLA DISTRICT

Simikot and Yari (Areas of Limi and Muchu village Development Committee, and area way to Tibet via Tangekhola of Darma Village Development committee) For the first 7 days US$ 50 per person and after 7 days US$7 per day per person or equivalent convertible foreign currency.
9 SANKHUWASABHA

Areas of Kimathanka, Chepuwa,Hatiya and Pawakhola VDCs) For the first four weeks, US$ 10 per person per week and After four weeks, US$20 per person per week or equivalent convertible foreign currency.
10 TAPLEJUNG DISTRICT

Kanchanjanga Region (Areas of Olangchung Gola, Lelep, Papung and Yamphudin VDCs) Per week per person US$ 10 or equivalent convertible foreign currency.
11 BAJHANG DISTRICT

(Areas of Kanda, Saipal and Dhuli) For the first 7 days, US$ 90 per person and After seven days US$ 15 per day per person or equivalent convertible foreign currency.
12 DARCHULA DISTRICT

(Areas of Byas VDC) For the first 7 days, US$ 90 per person and after 7 days US$ 15 per day per person or equivalent convertible foreign currency.
Note:
a. To get a group trekking permit an application form with other relevant documents should be submitted through any registered trekking agency of Nepal.
b. Trekking fee can be paid in Nepalese currency: Notwithstanding anything written in above, the Indian citizen can pay in Nepalese currency equivalent to US Dollars.

 

For more details please contact: sapkotatr@gmail.com

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