Nepali Times

When American Peace Corps volunteer John Skow travelled to Khumbu region in 1973, he was disheartened to see the number of Nepali porters and trekkers who died from something easily preventable like acute mountain sickness (AMS). The same year, Himalayan Rescue Association (HRA) was started with the goal of saving lives and improving trekking safety.

For the past four decades, HRA has been instrumental in bringing about a sharp decline in AMS casualties. From March to May and September to November, volunteer doctors run an hour long class every day at the clinics in Pheriche (Everest) and Manang (Annapurna) where trekkers and their guides are taught about the importance of acclimatisation through gradual ascent. They learn how to prevent and identify the onset of frostbite, hypothermia, AMS, and life-threatening complications like water collection in the brain (high altitude cerebral edema, HACE) or in the lungs (high altitude pulmonary edema, HAPE).

The clinics, run completely by volunteers, also treat hundreds of injured or sick trekkers and locals. While international patients pay for the services, locals are charged a nominal fee so they don’t abuse the system. HRA ‘rescues’ patients by treating altitude sickness and other illnesses and saves lives, but it is rarely involved in actual rescue of climbers in the Himalayas using high-powered, medically-equipped, state of the art helicopters.

HRA has been successful in fighting acute mountain sickness. However, despite its best efforts, many porters and climbers still suffer from severe frostbite every year. Not much has changed in the treatment of frostbite since the 19th century when Napoleon’s army succumbed in its attempt to conquer Moscow in subzero temperatures. In Nepal, there are no readily available, cost-effective, modern breakthroughs to treat frostbite. Therefore prevention is critical.

Even as it attempts to address these challenges, HRA’s work in the field of alpine safety and rescue remains unparalleled in South Asia and as the organisation completes 40 years, the entire team deserves praise for quietly carrying out methodical and conscientious medical work and research under difficult conditions.