When something goes wrong: illness, injury, theft and getting home

The four situations that actually interrupt trips here, and exactly what happens in each — because knowing in advance is most of the reassurance.

By Sabina Adhikari · 6 min read · Updated 1 August 2026

Most trips run without incident. A few do not, and the difference between a bad day and a ruined holiday is almost always whether anybody knew the plan in advance.

I am the person who takes the call when something happens, so this is written from the office side rather than the brochure side.

Four scenarios, in order of how often they come up.

Stomach illness, which is by far the most common

It ends more treks early than altitude, injury and weather combined. It is nearly always water or hands rather than food, and it is largely preventable with a filter bottle and hand sanitiser used religiously before eating.

If it happens: stop, rehydrate properly with salts rather than plain water, and eat plain food. Most cases settle in a day or two, and a rest day at a lodge is usually enough.

If there is blood, a high fever, or it lasts beyond about forty-eight hours, we get you down and to a clinic in Pokhara. That is a jeep and a phone call, not a drama.

Injury

Ankles and knees, overwhelmingly, and almost always on descent. Poles prevent a meaningful share of them.

Your guide carries a first-aid kit and is trained to strap and assess. If you can walk with support, we walk out slowly, which on the Annapurna routes usually means a few hours to a road head. If you cannot walk, the options are being carried — which happens, and is how a lot of evacuations actually work — or a helicopter if the terrain and weather allow. That is where your insurance matters, and why we hold your policy number before you leave.

Altitude illness

Covered in detail in its own guide, and the short version belongs here too: do not ascend with symptoms, descend if they worsen, and never leave someone alone.

The treatment that always works is going down, and on Annapurna routes you can usually lose several hundred metres within a couple of hours. That escape hatch is a real safety advantage of these treks.

Your guide makes the descent call. If they make it, please do not argue — it is the one decision on the trip we ask you to hand over completely.

Theft and lost documents

Theft on the trekking routes is rare — teahouses are family homes and everyone knows everyone. Cities are ordinary city risk: bags in crowds, and phones on the street.

Keep a photograph of your passport, visa page, insurance policy and permits on your phone and in your email. Recovering from a lost passport is a Kathmandu embassy trip and it is far quicker with a copy.

Report anything stolen to the police for the insurance paperwork — we will go with you and translate. A claim without a report is usually a claim refused.

Getting home when the plan breaks

The most common version is a cancelled flight rather than an emergency. Lukla and Jomsom go down routinely, and the answer is spare days at the end of the trip — two, not one.

If you need to leave early for any reason, we rearrange the trek, the transport and the accommodation. Tell us early rather than pushing on and hoping; options narrow the further up a valley you are. And if you are worried about something specific before you book — a heart condition, a recent surgery, a nervous traveller in the group — say so. We would rather plan around it than discover it on day four.

Walk it with us

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Questions we get asked

What medical care is available on the trails?

Health posts in larger villages and seasonal aid posts on the busiest routes. Coverage is thin. The realistic plan for anything serious is descent to Pokhara, which has proper hospitals.

Who decides if I have to turn back?

Your guide, for altitude illness. For everything else it is a conversation, and we will always give you the honest picture rather than the one that protects the booking.

Does insurance cover a trek abandoned partway?

Depends entirely on the policy — curtailment cover is a separate clause from medical. Check it before you fly; this is the one people discover too late.

What if I am travelling alone and something happens?

Your guide stays with you throughout, and we manage the logistics from the office. This is the strongest practical argument for guided trekking if you are on your own.

Can I call you from the trail?

Where there is signal, yes, and your guide carries our numbers. Above the tree line assume no signal and rely on the guide, who will get word out at the next village.