When something goes wrong, from illness and injury to theft and getting home
The four situations that interrupt trips here and what happens in each, because knowing in advance is most of the reassurance.
By the Lakeshore team · 6 min read · Updated 5 October 2026
Most trips run without incident. A few don't, and whether a bad day turns into a ruined holiday almost always depends on whether anybody knew the plan in advance.
I'm the person who takes the call when something happens, so this is written from the office side of things.
These are the four, in order of how often they come up.
Stomach illness, by far the most common
It ends more treks early than altitude, injury and weather put together. The cause is nearly always water or hands, not food, and you can prevent most of it with a filter bottle and hand sanitiser used every time before you eat.
If it happens, stop. Rehydrate with salts, not 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's blood or a high fever, or it lasts more than about forty-eight hours, we get you down and to a clinic in Pokhara. Usually that's just a jeep and a phone call.
Injury
It's mostly ankles and knees, and almost always on the way down. Poles prevent a good share of these injuries.
Your guide carries a first-aid kit and is trained to strap an injury and assess it. 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 can't walk, either you're carried, which does happen and is how a lot of evacuations work, or a helicopter comes in if the terrain and weather allow. That's where your insurance matters, and it's why we hold your policy number before you leave.
Altitude illness
Altitude sickness has its own guide, but the short version belongs here too. Don't go higher with symptoms, go down if they get worse, and never leave someone alone.
The treatment that always works is going down, and on the Annapurna routes you can usually lose several hundred metres within a couple of hours. Being able to drop that fast makes these treks safer.
Your guide makes the descent call, helped by the daily oximeter check. Please don't argue with it. It's the one decision on the trip we ask you to hand over completely.
Theft and lost documents
Theft on the trekking routes is rare, because teahouses are family homes and everyone knows everyone. In the cities the risks are the usual ones: bags in crowds and phones on the street.
Keep photos of your passport, visa page, insurance policy and permits on your phone and in your email. Replacing a lost passport means a trip to an embassy in Kathmandu, and it's far quicker with a copy.
Report anything stolen to the police for the insurance paperwork. We'll go with you and translate. A claim without a police report is usually a claim refused.
Getting home when the plan breaks
More often than an emergency, it's a cancelled flight. Flights to Lukla and Jomsom are grounded routinely, and the answer is spare days at the end of the trip. Make it two, not one.
If you need to leave early for any reason, we rearrange the trek, the transport and the accommodation. Tell us early instead of pushing on and hoping, because the further up a valley you are, the fewer options there are. And if something specific worries you before you book, such as a heart condition, a recent operation or a nervous traveller in the group, say so. We'd rather plan around it than find out on day four.
Walk it with us
Private departures on your dates, guided by the people who wrote this page.
Questions we get asked
What medical care is available on the trails?
There are health posts in the larger villages and seasonal aid posts on the busiest routes, but coverage is thin. For anything serious the realistic plan is to get down to Pokhara, which has full hospitals.
Who decides if I have to turn back?
Your guide, for altitude illness. For everything else it's a conversation, and we'll always give you the plain picture, even when it isn't the one that helps the booking.
Does insurance cover a trek abandoned partway?
That depends on the policy. Curtailment cover is a separate clause from medical cover. Check it before you fly, because it's the one people discover too late.
What if I am travelling alone and something happens?
Your guide stays with you the whole time, and we handle the logistics from the office. That's the strongest practical argument for trekking with a guide if you're on your own.
Can I call you from the trail?
Where there's signal, yes, and your guide carries our numbers. Above the tree line, assume there's no signal and rely on your guide, who will get word out from the next village.
Still deciding?
Tell us your dates, and we'll tell you whether Permits & TIMS Service is right for you. If it isn't, we'll say so.
Nothing to pay online. We confirm your dates first.
Or call the office +977 61-457830