Knowing where to find medical help before you need it is one of the most important preparations for any Nepal trek. The gap between recognising a medical emergency and accessing qualified care can be the difference between a bad day and a tragedy — and in remote mountain environments, that gap is measured in hours or days.
Nepal's medical infrastructure for trekkers is better than many assume, particularly on the major routes. The Himalayan Rescue Association (HRA) operates seasonal aid posts at key altitude points on the Everest and Annapurna circuits. Kathmandu has internationally accredited hospitals with altitude medicine specialists. Helicopter evacuation can reach most trekking regions within 1–2 hours in flyable weather.
But the coverage is uneven. In the far west, in Dolpo, in Humla, and on many off-the-beaten-path routes, the nearest qualified medical care may be days away by foot and hours by helicopter in ideal conditions. Understanding this distribution is essential for trip planning, medical kit preparation, and insurance decisions.
Kathmandu: Base-Level Medical Infrastructure
Before you leave Kathmandu for any trek, know the city's main hospitals and travel medicine resources.
CIWEC Travel Medicine Center
Location: Lazimpat, Kathmandu Phone: +977-1-4424111 Speciality: The most respected travel medicine clinic in Nepal, staffed by international physicians familiar with altitude illness, tropical diseases, and expedition health.
CIWEC is where most experienced trekkers and expedition members go for pre-trek medical consultations, Diamox prescriptions, vaccinations, and post-trek evaluation. If you need a Diamox prescription before your trek, CIWEC is the most experienced provider in Kathmandu.
Nepal International Clinic
Location: Naxal, Kathmandu (near the Royal Palace) Speciality: General travel medicine, altitude sickness consultation, vaccinations
Another solid option for pre-trek consultations, particularly for those without CIWEC appointments.
Norvic International Hospital
Location: Thapathali, Kathmandu Facilities: Full surgical and emergency facilities, ICU, laboratory, radiology
The best option for post-trek emergencies or serious illness requiring hospitalisation. Accepted by most international travel insurance providers.
Patan Hospital (Patan Academy of Health Sciences)
Location: Patan (Lalitpur), 30 minutes from Thamel Note: Teaching hospital with good emergency medicine but longer waits than private hospitals
The Himalayan Rescue Association (HRA)
The Himalayan Rescue Association is a non-profit organisation founded in 1973 that operates the most important network of altitude medicine resources in Nepal. Their aid posts are staffed by volunteer physicians (mostly from international programmes) and local medical assistants during the trekking seasons.
HRA Pheriche Aid Post (4,240m) — Khumbu Region
Location: Pheriche village, Everest Base Camp trail Elevation: 4,240m Season: March–May (spring), September–November (autumn) Services: Altitude sickness consultation, emergency treatment, oxygen, evacuation coordination Fee: Donations requested; sliding scale based on ability to pay Altitude medicine lectures: Daily at 3 PM during trekking season — essential viewing for anyone heading above 4,000m
Pheriche is 30 minutes from Dingboche (4,410m), where most trekkers spend their acclimatisation days. The post sees hundreds of patients each season, primarily with AMS, HACE, and HAPE. Evacuation coordination is a core service — the post maintains contact with helicopter operators.
Note: An alternative post operates from Khunde (3,840m) in the Namche area, run by the Khunde Hospital funded by the Hillary Himalayan Trust.
HRA Manang Aid Post (3,519m) — Annapurna Region
Location: Manang village, Annapurna Circuit Elevation: 3,519m Season: March–May, September–November Services: Altitude consultation, emergency care, oxygen, evacuation coordination Altitude lectures: Daily at 3 PM during trekking season
The Manang post is equivalent in services to Pheriche. The Annapurna Circuit passes directly through Manang, and the post occupies a critical position before the major push to Thorong La (5,416m). Physicians here have experience with the full spectrum of altitude illness and the specific acclimatization challenges of the circuit.
Attend the HRA Altitude Lecture
The daily HRA altitude lectures at Pheriche and Manang are among the most practical medical education available to trekkers. In 45 minutes, the physician on duty covers AMS recognition, treatment, descent criteria, and the specific risks of the sections ahead. It is free, targeted to your exact situation, and potentially life-saving. Attend if you can.
HRA Machermo Aid Post (4,470m) — Gokyo Region
Location: Machermo village, Gokyo Lakes trail Elevation: 4,470m Season: October–November (autumn only) Services: Basic altitude consultation, emergency care, evacuation coordination
The Machermo post covers the Gokyo Lakes approach and the Three Passes Trek junction area. It is smaller than Pheriche and may not be staffed continuously throughout the season — check current status with the HRA Kathmandu office before departing.
Route-by-Route Medical Coverage
Everest Base Camp / Three Passes
Namche Bazaar (3,440m): The Khunde Hospital (3,840m) is 2–3 hours above Namche. Namche has a health post for basic care. Several pharmacies stock altitude medications.
Tengboche (3,860m): Basic health post. Limited supplies.
Dingboche (4,410m): Basic health post. The HRA Pheriche post is 30 minutes below. This is effectively your last reliable medical resource before Lobuche.
Lobuche (4,940m): No dedicated medical facility. Lodge owners have basic first aid and can coordinate evacuation.
Gorak Shep (5,164m): No medical facility. Helicopter landing zone near the lodges.
Gokyo (4,750m): No dedicated medical facility. Machermo HRA post is 2 hours below.
Evacuation: Helicopter landing zones at Pheriche (4,240m), Dingboche (4,410m), Chhukung (4,730m), and several lower villages. In good weather, evacuation from Gorak Shep can be arranged to Kathmandu via Lukla in 2–3 hours.
Annapurna Circuit
Besisahar (760m): District hospital. Full range of services for the altitude of the region.
Chame (2,670m): Health post. Basic medications available.
Manang (3,519m): HRA Aid Post (seasonal). The most important medical facility on the circuit.
Thorong High Camp (4,950m): No medical facility. Limited first aid with lodge staff.
Muktinath (3,800m): Basic health post.
Jomsom (2,720m): Airport town with better health facilities. Regular flights to Pokhara (25 minutes). This is the effective evacuation point for the upper circuit.
Evacuation: Jomsom airport allows fixed-wing evacuation to Pokhara in all but the worst weather. Helicopter service throughout.
Annapurna Base Camp
Chhomrong (2,170m): Health post. Evacuation point — porters can carry stretchers from here.
ABC Sanctuary (4,130m): No dedicated medical facility. Lodge owners have basic first aid. Helicopter landing is technically possible near the sanctuary (weather and altitude permitting) but is considered challenging.
Evacuation: The ABC evacuation window via helicopter is narrow due to altitude and weather. In serious emergencies, lower altitude landing zones (Chhomrong, Jhinu Danda) are more reliable.
Langtang Valley
Syabrubesi (1,460m): District hospital level care.
Langtang Village (3,430m): Basic health post (rebuilt after 2015 earthquake).
Kyanjin Gompa (3,870m): No dedicated medical facility.
Evacuation: Helicopter landing zone at Kyanjin Gompa. Syabrubesi is the evacuation hub with road access to Kathmandu (7–8 hours).
Manaslu Circuit
Dharapani (1,860m): Health post and the last reliable pharmacy before the circuit proper.
Samdo (3,875m): Basic health post.
Evacuation: The Manaslu Circuit has fewer reliable helicopter landing zones than the Khumbu due to valley width. Dharapani is the primary evacuation point for serious emergencies.
Remote Routes (Dolpo, Humla, Far East)
These routes have minimal medical infrastructure. The nearest physician may be multiple days away by foot and hours by helicopter in good weather.
Dolpo: Juphal has a health post and an airstrip. For Upper Dolpo, the nearest evacuation point is Juphal (several days away). All serious emergencies require helicopter evacuation.
Humla/Simikot: Simikot has an airstrip and a basic health post. No HRA presence. Satellite communication is essential.
For these regions, a comprehensive first aid kit, satellite communication device, and thorough Wilderness First Aid or Wilderness First Responder training is strongly recommended rather than just suggested.
Helicopter Evacuation: How it Works
The Process
- Identify the emergency and confirm that evacuation is needed, not just descent
- Contact your insurance company's 24/7 emergency line — they coordinate directly with operators
- Get a deposit authorization from your insurance company — helicopter operators require financial guarantee before departure
- Identify the nearest safe landing zone — your guide should know this; confirm in advance
- Signal the landing zone — smoke signals, bright clothing, mirrors, or the GPS coordinates shared with the operator
- Estimated arrival time: 45 minutes to 2 hours from Kathmandu in good weather; add time for weather delays
Insurance Requirements
Travel insurance for Nepal must include helicopter evacuation coverage. The absolute minimum is $20,000. For expeditions or remote routes, $50,000+ is advisable.
Key insurers with Nepal-specific experience: World Nomads (verify altitude limit — must cover 6,000m+ for Khumbu), Global Rescue, International Medical Group (IMG). Read the policy small print carefully — some policies exclude pre-existing conditions or require "medically necessary" evacuation rather than allowing precautionary descents.
Costs Without Insurance
Helicopter evacuation without insurance:
- Khumbu to Kathmandu: $3,500–$5,000 USD
- Annapurna region: $2,500–$4,000 USD
- Remote western regions: $5,000–$8,000+ USD
These costs are non-negotiable, must be pre-paid (or guaranteed by insurance), and are payable by cash or credit card transfer. A single evacuation can exceed the total trip budget for most independent trekkers.