Nepal

MAIN HEALTH RISKS

• Malaria is present in the Terai; strains are mildly resistant to chloroquine (zone 2). Protection from mosquitoes (long-sleeve clothes, repellent, mosquito net) is capital.
• Epidemics of Japanese encephalitis and acute diarrhea may occur during the monsoon.
• After the end of the rain season, from mid-June to mid-September, the risks of cholera, typhoid and shigella epidemics diminish quickly, but poor sanitary conditions persist, even out of monsoon periods.
• Altitude sickness is to be taken seriously: respiratory (dyspnea) and/or neurological troubles (headaches, vomiting, sleep disturbances...) may occur above 3,000 meters. These symptoms may worsen and even lead to death if they are not dealt with.
• Typhoid fever and hepatitis A are hyper-endemic, hepatitis B strongly endemic.
• Epidemics of meningitis and Japanese encephalitis occur regularly.
• Rabies is frequent.
• Tuberculosis is frequent in the country.
• Diarrheic diseases are common. In July 2008, a dysentery outbreak hit Khandbari and the Sankhuwasabha district.

FOOD SAFETY

• Gastric diseases are common among tourists who are not accustomed to local food or who do not take precautions.
• Do not drink tap water and favor bottled mineral water, without ice ; avoid eating ice cream and sherbet.
• Avoid eating raw or undercooked dishes, especially meat or fish. If possible, order hot dishes.
• Bring anti-diarrhea medication with you.
• Wash your hands thoroughly before each meal.

IMMUNIZATIONS AND MEDICATION

• It is required to present a certificate of immunization against yellow fever for travelers who are coming from an endemic area.
Systematically:
• Hepatitis A: the vaccination is available for children at least one year old. For persons who were born before 1945, who have spent their childhood in a developing country or who have had an icterus, it may prove useful to search previously for serous antibodies in order to avoid an unnecessary shot.
• Hepatitis B: the vaccination is available for children at least two months old.
• Diphtheria, tetanus, poliomyelitis: get a booster shot before leaving if your last shot is more than ten years old.



Depending on the duration and conditions of the trip:
• Typhoid fever: if the stay is occurring in precarious hygiene condition. The immunization is available for children at least 2 years old.
• Rabies: recommended for long stays in isolation. The immunization should be given to children as soon as they are able to walk.
• Japanese encephalitis: in case of a long stay in the Terai region during the rain season.
• Tuberculosis: in case of a long stay, it is recommended to have children immunized against tuberculosis as soon as they reach the age of one month, and against mumps, measles and rubella when they reach the age of nine months.
• Recommended chemoprophylaxis against malaria, for a trip to Terai: chloroquine and proguanil (commercial name: Savarine) or proguanil and atovaquone (commercial name : Malarone).

HEALTH INFRASTRUCTURES

Kathmandu
• Ciwec Clinic Travel Medicine Clinic, Yak & Yeti Road, Durbar Marg, P.O. Box 12895: phone + 977 1 442 4111, fax + 977 1 422 4675
• Nepal International Clinic, GPO Box 3596, Lal Durbar: phone + 977 1 4434 642 / 35 357, fax + 977 1 434 713
• Peace International Clinic, PO Box 8974 CPC 315, Lazimpat: phone + 977 1 439 087, fax + 977 1 423 304
• Patan Hospital: phone + 977 5 521 048 ou 034

EMERGENCY CONTACTS

• Firemen: 100
• Police: 100
• Ambulances: 228 094

CLIMATE

• Climate is tropical in the south of the country, temperate in the valleys and cold in mountainous areas.
• The rain season (monsoon) begins in June to end in September, with violent and abundant rains; temperatures are then high, and mountains are cloudy.
• Valleys and northwestern Nepal suffer less from the rain during the monsoon season.
• From October to March, the weather is sunny and dry, with violent winds in the mountains.
• In the Himalaya, winters are cold and summers rather cool.
• When to go: between October and March.