Cleanliness may be next to Godliness, but in a practical sense, cleanliness has attracted many trekkers to the Annapurna Sanctuary region. Of course the mountain ringed amphitheatre with a panoramic view of Annapurna 1 (26, 545 ft) and Machhapuchhre (22, 943 ft) among others helps entice visitors. But lately cleanliness has played an important part in attracting trekkers here.

In this trek along the Modhi Khola and its tributaries, many Gurung villages dot the landscape with large campsites and tea houses with clean bathrooms and adequate water supply. The contrast with Kathmandu is stunning. Many rhododendron and magnolia trees were in bloom with tiny gentians and primroses along the path. As you travelled from Ghandruk (6,600ft), to Chomrong (7200 ft) to Dhobhan ( 8350 ft) and beyond to the Sanctuary gates of the Machhapuchhre Base Camp (12,150 ft), the spick and span presentation was hard to believe. A few years ago this trekking route had dirty bathrooms with toilet paper strewn across in many areas of the trail. But the entire area has undergone dramatic changes.

This cleanliness has probably led to less infectious diseases among both locals and visitors. There wasn't a single case of gastroenteritis, which was once a common problem. Even porters along the trail were brushing their teeth, something I had not seen in many years of trekking.

Most tea shop owners have tried to cooperate with one another to look clean and presentable by picking up paper along the trail and collecting cans and bottles at designated sites. Anti-pollution measures have been enforced. From Chomrong onwards it is not possible to buy mineral water because plastic water bottles pollute and are unsightly.

Impressively, it was not possible to bribe someone for mineral water. This is probably one of the few places in Nepal where there is no selective application of the law. Ozone-treated drinking water is often available for those who do not wish to carry iodine tablets or drink boiled water for water purification.

However even along this trek, it was noteworthy to see how the tobacco industry relentlessly pursuing its cigarette sales campaign. A pack of Marlboro cigarettes which costs twelve dollars in New York is sold for two dollars here. Villagers smoking cigarettes (any brand) and cooking their meals in open hearths without a chimney will clearly suffer from more lung diseases.

But remember to take elastic bandages and ibuprofen for sprains and strains along this undulating, magnificent, stair-cased trail.