Toze Chu: a braided river (Treks 1 and 2)
Water filtration does not usually change the taste and is helpful in cleaning cloudy sediment-filled water and reducing chemicals. However, filters are ineffective in protecting against viruses.
Generally, water from small streams in Ladakh is clear, but will need chemical treatment for protection against bacteria and viruses. Buy an adequate quantity of solution or tablets before the trip. Use vitamin tablets (vitamin C is effective, particularly against iodine), powdered fruit-flavoured drinks or neutralising tablets to improve the taste of the treated water. Although you will use cloudy and turbid water from a big river at a few camps on some treks, filtering is not the most important gear you need for a trek in the region.
For more information on water treatment check www.high-altitude-medicine.com, www.katadyn.com and www.msrgear.com.
Health and fitness
You do not need to be extremely fit to go on a trekking trip, but you do need to choose the right option. The various styles of trek, the distance covered, flexibility of stages and diversity of routes make trekking possible for people of different physical strengths and age. Trekking is a matter of walking – you don’t need any particular skills to do it! But it has to be said that the fitter you are, the easier the trekking will be, so some preparation in advance is essential. You can train for long walks in Ladakh anywhere: go for longer and tougher walks than usual, carrying on your back the sort of weight you expect to carry on trek. Ideally, of course, your preparation for Ladakh would take place in a mountainous area though this is rarely feasible.
Preparing for a trek at high altitude
A trip to any high altitude region requires acclimatisation. This is the process of adjusting the body to lower oxygen levels at high elevation. Most of us need a few days of acclimatisation to any altitude higher than 2500m. Inadequate adjustment to high altitude can lead to altitude sickness and, in its most severe forms, a quick death, so make sure you learn how to identify the symptoms.
The rarely visited Langthang Valley leads to the Zalung Karpo La – one of the best viewpoints in Ladakh (Trek 1)
Never ignore any symptoms of altitude sickness! If you have a headache combined with dizziness, sleep disturbance, loss of appetite, nausea or vomiting, do not ascend; descend or stay at the same altitude until you recover completely. If you have more severe symptoms that may include breathlessness at rest, fast, shallow breathing, cough, chest tightness, drowsiness and loss of coordination while walking, descend immediately. If it happens at night do not wait until the morning – your life may depend on an immediate descent! If you have previously trekked at high altitude and been unaffected, do not assume that you will never suffer from altitude sickness; it is a fickle condition.
However, providing that you follow a few simple rules, you should not be seriously affected. Search for Altitude Sickness on the Internet, and check the following sites: www.ismm.org; www.high-altitude-medicine.com; and www.merckmanuals.com/professional.
THE EFFECTS OF HIGH ALTITUDE
Learn as much as you can before you go, and check out the medicines on offer to aid acclimatisation: see below. Note the main symptoms above: these in themselves are not a reason to stop the trek, but are good indicators of problems that may be overcome by taking a rest. At altitude difficulty is often experienced with sleeping, breathing patterns may be erratic (Cheyne-Stokes breathing), and the heart might thump a bit disconcertingly; however, none of these is unusual. It is also dangerous to overexert yourself on arrival at any destination, thinking you have no symptoms. These often only begin to appear after an hour or more.
It is particularly important to walk very slowly at all times, especially when climbing any hill. Be sure to admit any problems (if only to yourself at first), and don’t be pressured by your trekking peers. If you experience any serious effects before a pass, you should consider descending. Carrying on with mild symptoms, perhaps just a mild headache, is acceptable so long as it does not get worse or persist all day and night.
Peaks of the Gyamshu massif as seen from the Zalung Karpo La (Trek 1)
Continuing to ascend with any persistent symptoms can lead to the serious risk of pulmonary and cerebral oedema, or even death; sometimes complications from altitude sickness can strike very quickly. There are deaths each year in the Himalayas, where the criterion is ‘Descending is the only safe cure, at any time of day or night.’ However, in Ladakh descent is not an option in all locations. It is therefore of the utmost importance to acclimatise before going higher. For this reason, many groups spend a few days sightseeing in and around Leh before starting their trek.
What else can you do to ward off the effects of altitude? Many trekkers start a course of Diamox (Acetazolamide), a diuretic that thins the blood, makes you urinate more and is generally considered to be of some benefit, although it can have the disturbing side-effect of pins and needles in the fingers. Another option is to try coca. Not the smoking variety, but a version of the substance used by natives of Peru and Bolivia. Coca is available as homeopathic tablets that some trekkers swear by. It can be difficult to locate these in the UK, but French pharmacies stock them, should you be limbering up in the Alps before your trip. Also recommended by some are ginkgo biloba tablets, which appear to work for reasons not yet defined. It is suggested that these can be taken twice a day for five days before arrival and once a day during the trek, but consult your doctor beforehand as they can affect blood count and are not suitable for everyone.
Gamow bag and oxygen cylinders
A Gamow bag is a large plastic bag into which a person suffering from serious altitude sickness can be cocooned under higher air pressure to mimic a lower altitude for a limited period. Mountaineers have, of course, used oxygen for years at altitude. If you are with a commercial trekking group, your staff might have one of these and know how to use them.
Lingshed village (and gompa just above) seen from the Hanamul La (Trek 5)
Other possible ailments on trek
The air at high altitude is drier than at lower elevations, so greater water loss than normal occurs through breathing. Due to processes that take place in our bodies urination is more frequent. Another reason for greater fluid loss during trekking is the enhanced physical exertion at altitude. Therefore one needs to drink more than at lower elevations – you should drink about 5 litres of liquid (preferably water) a day (remember that consumption of coffee, tea and alcohol increases fluid loss). Observe your urine; if it is dark in colour, you must drink more.
Long exposure to direct sunlight may cause dizziness, headache, nausea, weakness or mental confusion. These are symptoms of sunstroke and may lead to severe medical disorders. To avoid it, protect your body, especially the head, from the direct sun. Always wear a hat or head covering. Consider taking your noon breaks in a shady place during the hot days of summer. If you experience any symptoms, stay indoors or in a cool, shady place and drink a lot of water. If your body temperature rises to about 40°C you must be cooled off. If possible take a moderately cool bath or splash water over yourself repeatedly.
Any traveller to India risks an infection or disease that probably does not exist or is rare in their home country. The majority of diseases are transmitted by contaminated food or water, and many by insect bites. Prevention consists of vaccinations as well as the avoidance of risky food and insect bites. Choose restaurants where dishes are prepared