It has become a joke among tourists visiting Nepal that a stomach or chest infection is mandatory. No one has calculated the opportunity cost to Nepal’s tourism from poor water and air quality, but everyone agrees that it must be preventing a lot of people from visiting the country.
US Ambassador to Nepal, Peter Bode, told the second Nepal Travel and Tropical Medicine Conference in Kathmandu last month that health concerns are always at the back of the minds of tourists. “It is now not a question of what Nepal has to do, but what Nepal must do for the tourists coming here,” Bode said.
The conference, which was organised by CIWEC Clinic's Travel Medical Centre, saw the participation of medical and tourism professionals. CIWEC says diarrhoea tops the long list of ailments that afflict tourists. One-third of all sick tourists suffer some form of stomach infection. Sixteen per cent of tourists suffer respiratory problems. The proportion of diarrhoea cases has been consistently high over the years, but CIWEC believes it can be lowered if proper measures are enforced.
“The high rates of diarrhoea have not changed in the 32 years…we can lower these rates by improving restaurant hygiene,” says CIWEC Medical Director Prativa Pandey, adding that this would involve proper training of staff and maintaining regular checks of restaurants.
This is a view echoed by David Schlim, who is president of the International Society of Travel Medicine: “Everyone thought if you don’t eat certain things you won’t get diarrhoea, but that is not the case. Around the world it has been confirmed that eating at unhygienic restaurants is the leading cause of diarrhoea. If we improve hygiene, people will eat here, they will remember they did not get sick, and they will return.”
Five per cent of all sick tourists are afflicted with Acute mountain sickness (AMS) which is also the main cause of death for trekkers and mountaineers. But AMS is preventable if there is awareness of symptoms and care during ascent.
Those who suffer from AMS climb too fast, not giving their bodies time to acclimatise. It is recommended that climbers stop for a day or two of rest every 700m, and sleep at lower altitudes whenever possible. CIWEC feels there is still not enough awareness about these preventive measures.
“Although quick helicopter rescues can be arranged these days, the number of deaths caused by altitude sickness hasn’t gone down,” says Pandey.
Nepal’s tourist numbers doubled in the past four years to 800,000, and is expected to cross 1 million in the coming years. According to the World Travel and Tourism Council, total visitor numbers is expected to grow by nearly 9 per cent in 2014. Last year, tourism contributed Rs 145.3 billion to the GDP (8.2 per cent) and supported 1.12 million jobs. Investment in tourism in 2013 was Rs 14.6 billion and this is expected to rise by 3 per cent.
As the numbers go up, CWIC says the health of visitors should be a number one priority. The Clinic is also worried about death and injury to tourists in highway and aircraft accidents as well as adventure sports like rafting and paragliding, and even rhino attacks in national parks. The number of paragliding companies has increased from one to 19 in the past ten years, and there have been two accidents in the past two months alone, one of them fatal.
Still Schlim remains optimistic: “Nepal is definitely a safe place to visit. The medical infrastructure we have here is excellent, and people are taken care of. What we need to do now is make travellers’ health a priority in tourism.”
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