Probably the most visited and arduous high altitude pilgrimage site in South Asia is Mount Kailash (6714m), the centre of the universe in Vedic thinking, where thousands of Hindus, Buddhists, and Jains circumambulate the sacred mountain and bathe in the nearby Lake Manasarovar (4560m) every year. Most of these pilgrims are unaware of and ill prepared for the hypoxia (low oxygen) caused by high altitude, and not surprisingly many fall ill and some succumb to their illness.

Unfortunately, because there are no records, the extent of the problem is unknown in Kailash. Often patients are misdiagnosed as having altitude sickness and treated incorrectly. In addition, many of the pilgrims are elderly and have concomitant illnesses. Sometimes the strongly devout pilgrims feel privileged to die in the precincts of the holy mountain and do not want interventions. Indeed, many factors conspire to work against the safety and rescue of these pilgrims.

But closer to Kathmandu is Gosainkunda. On 1 August, the eve of Janai Purnima, Gosainkunda Lake (4300m) will be the venue for the climactic enactment of the greatest Vedic tradition.

In their quest for amrit (the elixir for spiritual immortality), the titans and gods collaborated in churning the ocean. Unfortunately from the murky depths of the ocean, the first thing to rise was Kalakut, a deadly poison.

Luckily, Shiva came to the rescue and swallowed the poison, but he needed to cool off the immense heat generated by Kalakut, so he dove into Gosainkunda. In the memory of this selfless act of Lord Shiva swallowing the poison, every year pilgrims take a holy dip in the lake and wash away their sins. But like Shiva, this pilgrimage is not risk-free journey for commoners.

Starting from Dunche in Rasuwa district, it is best to take four to five nights to reach the lake so that you are properly acclimatised. You need to listen to your body and not push ahead relentlessly disregarding symptoms of acute mountain sickness (AMS) which are chiefly headache and nausea.

Taking diamox, if you don't have sulpha allergy, will help prevent and treat AMS. Drinking two litres of clean water (boiled or treated with chlorine/iodine tablets) per day will help avoid dehydration. Proper rain gear and carrying some table salt to deal with leech bites will also come in handy.

The lake area is inundated with visitors during Janai Purnima so being psychologically prepared for the hardships will go a long way. But you will be amply rewarded for your efforts.