 MIN RATNA BAJRACHARYA |
Travel medicine literature abounds in discussions of medical problems in tourists and trekkers although it is primarily limited to altitude and gastrointestinal problems. Trekkers and climbers journey into remote areas in Nepal. Many employ local porters, but there is very scant literature on medical problems of porters.
To rectify this lack of knowledge, I carried out a study in the Manaslu region a decade ago where the elevation ranged from 480m to 5,100m. The trek started from Gorkha Bazaar and went to Arughat and followed the Budi Gandaki up to its origins near the treacherous Larkya Pass. Then down to Bhimthang and a little beyond past some Gurung villages where the trail finally merges with the trekkers along the Marsyangdi River. The path ascends from here to Bahun Danda and finally to Beshisahar in Lamjung. In the late nineties when we did this trek there were no motorable roads till Beshisahar.
I studied a total of 132 Nepali porters during three trips (each trip lasted 22 days) around the Manasalu region. The porters were carrying loads of about 30 kg. In this study we did not include the Sherpa trekking staff as porters as the division of labour was clearly distinct. Persistent, bothersome high altitude cough followed by altitude sickness and gastroenteritis (diarrhoea) were the most common problems encountered amongst the porters. Other problems in this porter cohort included skin infections, fever, scabies, alcohol intoxication, snow blindness, conjunctivitis, and even anxiety attacks. Orthopaedic problems were conspicuously absent. Many people think that Nepali porters are immune to altitude sickness, and perhaps other illnesses, because they are natives. However this study showed that lowland porters are just as susceptible to high altitude illnesses as westerners and most Nepali ethnic groups. There is some evidence to suggest that Sherpas may be genetically protected from altitude sickness, but this is not yet a "done deal". This study clearly illustrates that expedition medical providers and trip leaders need to be observant and prepared to treat the frequent and diverse medical problems among the porter staff on the trek.
