Like all developing countries, the standard of health and hygiene in Nepal is less than in developed countries.
Let’s start by talking about water (when there is some – we are not joking here). Most of the water in Kathmandu is groundwater. With the expansion of the city (and with the recent earthquakes), the water level is declining. In the dry seasons (October to April) there is often a severe shortage of water. Many communities still use the traditional stone water spouts and wells (water provide through the government pipes costs money to buy and is very unreliable in supply and quality). It may be that in your accommodation you will be required to buy tankers of water. This is not something the landlord will pay for unless it is on your lease contract from the beginning. When looking at potential accommodation ask about the water supply. Waterborne diseases are common both in the city and in the villages and care should be taken when drinking and cooking with water. Bottled water should not be considered ‘safe’ as it is also groundwater and some companies are less scrupulous than others about the treatment of the water they are selling. It is possible to treat water yourself through either installing a filter or using iodine and/or other water purifying medicines. Boiling water (and letting it stand and cool before use) is an excellent way to purify it. Ensure any kitchen staff know to dry your plates thoroughly before serving food on them. In restaurants this is more difficult to achieve so just be a little aware of where you are eating.
International clinics and hospitals are available such as CIWEC Clinic situated near the British Embassy. CIWEC has international doctors and is pretty well equipped. It is, unless you have insurance, quite expensive. Another excellent, and cheaper alternative is the Nepal International Clinic, between Jai Nepal Cinema and Durbar Marg.
Water needs to be brought to a rolling boil to kill all the important disease causing organisms. Good evidence is now available to show that there is no need to boil the water for over 3-4 minutes. Some hotels and restaurants may only filter their water. This is certainly not good enough for drinking as, for example, the hepatitis virus can pass through the filter.
Adding Iodine to your Water
The addition of 6 drops of 4% Lugol’s iodine (locally available) to 1 litre of water will also kill all the important disease-causing organisms. Wait for 20 minutes before drinking. The mixture has to be shaken after 10 minutes. Chlorine tablets which are also locally available do not kill giardia and amoebic cysts. Salad vegetables should also be soaked in iodine (6 drops in 1 litre) for 20 minutes before consumption. The iodine may not kill the notorious “blue green algae” (cyclospora), which affects people in the spring and summer in Nepal.
It is important to wash your hands with soap more often than you would do at home. Liquid soap/ hand sanitizer is efficient and easy to keep in your handbag or pocket.
Before going trekking make sure you familiarize yourself with the common symptoms of mountain sickness so that you may be better able to help yourself and others. AMS (acute mountain sickness) causes headache and nausea at high altitude (>2,700 m). The life-threatening problems at altitude are HACE (High Altitude Cerebral Edema) and HAPE (High Altitude Pulmonary Edema).
For more information on altitude sickness check CIWEC Altitude Sickness Page.