Stories of some High Altitude Sickness and Emergency Cases in Bhutan

Trekking Tale of Bhutan

Stories of some High Altitude Sickness and Emergency Cases in Bhutan

From the early days of tourism till the mid 90s, Bhutan was lucky to have had very few casualties since there were not many trekkers and also that those who came for the treks were well equipped and seasoned mountaineers and trekkers. And also since the sector was managed by the government, all the guides were professionally-licensed trekking guides. After the privatization in 1991, the number of tourist arrivals increased drastically and with it the number of trekkers and the trekking guides.  With the increase in the number of trekkers, the number of casualties also increased.

Most of the cases in treks are that of mild High Altitude Sickness (HAS) which are treatable on the spot through some oral medication; resting for a day or two or returning back to the lower base camps. Only on severe cases where the tourist has fractured his or her arms or had head injury or severe tooth ache or a serious case of HAS, the patient has been evacuated immediately by helicopter.

Whenever tour operators required helicopters for emergency evacuation of tourists from the treks or tours from 80s to mid 90s, they used Indian Army helicopters from Hashimara, West Bengal, a short distance from the border check point of Phuentsholing.  Getting the helicopter was time-consuming as there were a lot of paper works needed.  Getting a helicopter from Indian Army involved bilateral relation between the two countries. The Tour operators had to write to TCB who would in turn would write to Royal Bhutan Army (RBA) and the RBA in turn would write to Indian Army Base in Hashimara, West Bengal. But it is pertinent to mention here that the helicopter was always made available for the rescue mission. All the helicopters would land and take off from Lungtenphu in Thimphu those days.  Since 2000, the tour operator has started using helicopters on hire from Kathmandu, Nepal, for all the rescue missions in Bhutan especially for tourists. It is much easier and faster get the services of a chopper from private helicopter companies in Kathmandu Nepal. Since then, the emergency and rescue mission on high altitude trekking routes have become more doable and safe.

If the use of helicopter service were not available for quicker evacuations from the trek routes, many cases of casualties may have occurred in Bhutan.  It is of utmost importance for Bhutan to retain the services of a helicopter in Paro for rescue and emergency missions.

From the record, Yu-Druk was the first trek company to rescue its client by helicopter from Jangothang Base Camp in 1992.

Very few tourists have died due to HAS and other heart-related diseases  in Laya and Linghi but they have not been documented or recorded since the patients who have died are either from small tour companies or the  trekking companies are not giving us information on those events

There was a major snow storm in 1995, and quite a few groups of tourists were stranded in Jangothang base camp in Laya, Linghi and others. Some of the tourists were stranded there for at least a week, while those who needed immediate medical attention were evacuated by a helicopter. Some trekkers were able to climb down to Jangothang base camp in a few days when the snow started melting and the weather became more favourable and friendly. Those days it was not easy to do rescue operations as it was difficult to arrange helicopters through the Indian Army route. Moreover, the weather was very bad and was difficult for helicopter to actually land in those places due to severe weather. Once the weather was cleared and snow started melting, the tour operators and the then Department of Tourism were able to send rescue team to rescue those in the lower elevations.

It is pertinent to note that most of the HAS cases have happened in between Laya and Lingshi, and a few cases have also happened at Jangothang and Thanza. Its mainly because of continuous gain in altitude from Thangthangkha to Laya.  If the trekkers are not fit and are not seasoned, there is a good chance of getting HAS along this stretch.

The most common illness the trekker in Bhutan get is HAS as all treks are above 10,000 feet. Anyone can get HAS once above 10,000 feet. The weak could succumb to it. It appears that most of the trekkers did not acclimatize properly and did not have rest before climbing trekking higher and higher.  Most of have rushing and did not rest adequately or had symptoms of HAS from Thangtangkha since it is a long trek and also the altitude gain is over 2,000 feet. Either the trekkers did not inform their guides for fear of being escorted back to the lower camps or because the guides were not able to recognize the signs and symptoms of HAS in their clients. Sometimes the trekkers insisted on completing the trek pretending to be okay when they were not. In a few cases, the tourists had to be evacuated by helicopter on a little higher altitude because they had adamantly refused to be escorted to the lower base camps.

A guide recalls an incident where a woman tourist had died in Lingshi some five years ago since her guide was not able to recognize the signs and symptoms of HAS and also she did not inform her guide since she wanted to complete the trek. Now with so many professional trekking guides who are trained to recognize the symptoms and signs of HAS, there are a fewer casualties on trek despite the increase in the number of trekking expeditions.  The trekkers are also briefed properly about trekking in Bhutan and the dangers of HAS, and how difficult it is in Bhutan to arrange rescue missions unlike in Nepal and other parts of the world. It is pertinent to mention again that majority of the tourists who come to do high altitude trekking in Bhutan are fit and seasoned trekkers and have done several similar treks in Nepal and in other parts of world, and that they are mentally and physically  prepared.