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Health in Leh: altitude sickness and dirty water in Ladakh

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As Leh is 3505m above sea level, some travellers, and especially those who arrive by plane from Delhi, experience mild altitude sickness- If you develop any of the symptoms - persistent headaches, dizziness, insomnia, nausea, loss of appetite or shortness of breath - your body has not yet acclimatized to the comparative lack of oxygen in the thin Ladakhi air; don’t worry, it will, probably in as little as 24 hours, though it can take longer. In the meantime, take it easy and drink plenty of fluids -3-4 litres of water a day is recommended. In addition, lay off alcohol, and don’t try to climb any hills for at least three days. For more information, see p.35, or call the hospital’s AMS (Acute Mountain Sickness) hotline: C01982/52014 (daily 9am-5pm) or 01932/52360 (daily 5pm-9am}.

A health problem that affects far more travellers, however, is diarrhoea. Dirty water is invariably the culprit - a consequence of the grossly inadequate sewage system, which can’t cope with the massive summer influx of visitors. Redouble your normal health precautions while you are here: take extra care over what you drink, and avoid salads and raw vegetables unless you know they have been cleaned in sterilized water. Many hotels now filter their own water making it perfectly safe to drink, and the Dzomsa Laundry provides safe water in recycled plastic bottles (see p.607). Meat of any kind is also risky; most of it travels up from Srinagar in unrefrig-erated trucks.

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Old Manali Transport to Leh in Himachal Pradesh

If you can afford to split the Rs12,000 fare, mini-vans and Maruti Gypsy taxis are the most comfortable way to get to Ladakh from Manali and you might get a cheaper deal from a returning vehicle. Backpackers usually travel the 485km to Leh by bus - an arduous, but unforgettable two-day trip (28hr), involving 3 night halt under canvas along the route. HPTDC's daily "luxury" bus, bookable through the tourist office, costs around Rs1000, which includes accommodation at the tent colony near Sarchu. The journey can take three days, with two nights on the road. Other wise, choice is limited to

Pangong Tso in Ladakh

Pangong Tso. 154km to the southeast of Leh, is one of the largest saltwater lakes in Asia, a long narrow strip of water stretching from Ladakh east into Tibet, Only a quarter of the 130-kilometre-long lake is in Ladakh, and the Indian army, who experienced bitter losses along its shores in the war against China in 1962, jealously guard their side of the frontier. Until the mid-1990s, it was off limits to visitors, and tourists still need a permit to come here. The lake, at an altitude of 4267m. with the dramatic glacier-clad Pangong Range to its south and the

Travel insurance

In the light of the potential health risks involved in a trip to India - see opposite - travel insurance is too important to ignore. In addition to covering medical expenses and emergency flights, it also insures your money and belongings against loss or theft. A typical travel insurance policy usually provides cover for the loss of baggage, tickets and - up to a certain limit - cash or cheques, as well as cancellation or curtailment of your journey. Most of them exclude so-called dangerous sports unless an extra premium is paid: in India this can mean trekking, mountaineering, skiing,

Voluntary organizations in Ladakh

With limited resources at their disposal, a handful of voluntary organizations, including LEDeG, battle to protect Ladakh's delicate environment and ancient culture against the sea of change. SECMOL (Students' Educational and Cultural Movement of Ladakh), founded in 1988 by Ladakhi university students, strives to increase awareness of developmental issues and guide younger students through an educational system fraught with chrome inadequacies. In the hope of maintaining pride in Ladakh's traditions, SECMOL teaches local history and runs workshops on handicrafts, agriculture and technology. Volunteer help from TEFL-qualified visitors is especially appreciated at the summer schools run just outside Leh. If you'd

What about the water?

One of the chief concerns of many prospective visitors to India is whether the water is safe to drink. To put it simply, it's not, though your unfamiliarity with Indian micro-organisms is generally more of a problem rather than any great virulence in the water itself. As a rule, it is not a good idea to drink tap water, although in big cities it is usually chlorinated. However, you'll find it almost impossible to avoid untreated tap water completely: it is used to make ice, which may appear in drinks without being asked for, to wash utensils and so on. Bottled

Arranging a trek or tour and hiring equipment for Leh Ladakh

Leh offers a bewildering number of operators for the large volume of tourists who come to Ladakh to trek. Most trek and tour operators offer much the same services sharing much the same resources. Although trekking rates are quite uniform, you can get some cheaper deais on items such as porterage and pony hire by shopping around. You can also rent equipment either through the chosen agency or through places like the Traveller Shop, White House, Fort Road (01982/53048). Expect to pay Rs100 a day for a tent, Rs70 for a sleeping bag, Rs30 for a gas stove and Rs40

Dzomsa laundry in Ladakh

Situated on a strategic corner between Upper Thaka Road and Old Fort Road at one end of the market square, the Dzomsa Laundry provides a vital service in ecology-sound washing, using biodegradable detergent and water at a safe distance from habitation. Dzottna, which Literally means "'meeting point", also serves delicious fresh apricot juice which you can drink while sitting outside watching the world go by. If you're wondering what to do with your empty mineral water bottles, you can recycle them here and have them filled with safe drinking water.

Little Mount Caves in Tamil Nadu

St Thomas is said to have sought refuge from persecution in the Little Mount Caves, 8km south of the city centre (bus #18A, #18B, or #52C from Anna Salai), now 200m off the road between the Maraimalai Adigal Bridge and the residence of the governor of Tamil Nadu. Entrance to the caves is beside steps leading to a statue of Our Lady of Good Health. Inside, next to a small natural window in the rock, are impressions of what are believed to be St Thomas' handprints, created when he made his escape through this tiny opening. Behind the new circular church

Health is the Very Aware

A lot of visitors get ill in India, and some of them get very ill. However, if you are careful, you should be able to get through the country with nothing worse than a mild dose of "Delhi belly", an almost obligatory introduction to the country. The important thing is to keep your resistance high and to be very aware of health risks such as poor hygiene, untreated water, mosquito bites and undressed open cuts. What you eat and drink is crucial: a poor diet lowers your resistance. Ensure you eat a balance of protein, energy, vitamins and minerals. Meat and

Sarchu Serai to Tanglang La in Himachal Pradesh

Sarchu Serai packs up for the season from September 15. Northbound buses thereafter press on over Lachuglang La (5019m), the second highest pass on the highway, to the tent camp at Pang (4500m), which stays open longer. Unfortunately, this means that the drive through one of the most dramatic stretches of the route, through an incredible canyon, is in darkness. Sarchu Serai is also 2500m higher than Manali, and travellers coming straight from Manali nught suffer from the higher altitude here. The army camp at Pang, 3km north of the serai, stands at the mouth of the Pang Gorge at the

North of Leh: Nubra Valley in Ladakh

Until 1994, the lands north of Leh were off limits to tourists, and had been unexplored by outsiders since the nineteenth century. Now, the breathtaking Nubra Valley, unfolding beyond the world's highest stretch of motorable road as it crosses the Khardung La (5578m), can be visited with a seven-day permit (see p.595), which gives you enough time to explore the stark terrain and trek out to one or two gompas. The valley's mountain backbone looks east to the Nubra River and west to the Shyok River, which weave south to meet amid silver-grey sand dunes and boulder fields. To the north

The Ecology Centre of Leh in Ladakh

Five minutes' walk north of the main bazaar (next to the Tsemo-La Hotel), the Ecology Centre (Mon-Sat 10am-5pm; $01982/52646) is the headquarters of LEDeG (the Ladakh Ecological Development Group) - a local nongovernmental organization that aims to counter the negative impact of Western-style "development" by fostering economic independence and respect for traditional culture. This involves promoting "appropriate" technologies such as solar energy, encouraging organic farming and cottage industries, and providing education on environmental and social issues through village drama, workshops and seminars. A garden hosts an open-air exhibition ot solar gadgets, hydraulic pumps, water nulls and other ingenious energy-saving devices

Health Museum Hyderabad

Amritsar in Haryana and Punjab

The Sikh's holy city of AMRITSAR, site of the fabled Golden Temple, is the largest city in Punjab: noisy, dirty, dusty and hopelessly congested. Its one saving grace is the Golden Temple, whose golden domes soar above rheteing streets. Amntsar is also an important staging post or those crossing In do—Pakistani frontier at Wagha, 29km west.

Likkir to Temisgang in Ladakh

A motorable road along the old caravan route through the hills between Likkir and Temisgang makes a leisurely two-day hike, which takes in three major monasteries (Likkir, Rhizong and Temisgang) and a string of idyllic villages. It's a great introduction to trekking in Ladakh, the perfect acclimatizer if you plan to attempt any longer and more demanding routes. Ponies and guides for the trip may be arranged on spec at either Likkir or Temisgang villages, both of which have small guesthouses and are connected by daily buses to Leh.

Trekking in Lahaul and Spiti in Himachal Pradesh

Although the old trade routes to Ladakh and Tibet are now sealed with tarmac, most of this remote and spectacular region is stilt only accessible on foot. Its trails, though well frequented in high season, are long, hard and high, and punctuated by few settlements, so you must be self-sufficient and have a guide. Packhorses and provisions are most readily available in Manali: or Keylong and Darcha (Lahaul) and Kaza (Spiti) if you can afford to wait a few days. A good rope for river crossings will be useful on many of the routes, particularly in summer when the glaciers

Travellers’ Medical and Vaccination Centre

Australia; Level 7,428 George St, Sydney 02/9221 7133; Level 2,393 Little Bourke St, Melbourne 03/9603 5788; Level 6,29 Gilbert Place, Adelaide 08/8212 7522; Level 6,247 Adelaide St, Brisbane 07/3221 9066; 5 Mill St, Perth 08/9321 1977. New Zealand: 1/170 Oueen St 09/373 3531; 6 Washington Way, Christchurch 03/379 4000. General info/health line: it 1902/261 560 (Australia). Inoculations/medications, area-specific advice, list of English-speaking doctors in India, first-aid/medical kits and post-travel examinations. A full rundown of their branches, along with general travellers' health advice.

The Manali-Leh Highway in Himachal Pradesh

Since it opened to foreign tourists in 1989, the famous Manali-Leh highway has deservedly replaced the old Srinagar Kargil route as the most popular approach to Ladakh. In summer, a stream of clapped-out government buses, private minibuses and Enfield motorcycles set off from the Kullu Valley to travel along the second-highest road in the world, which reaches a dizzying altitude of 5328m. Its surface varies wildly, from fairly smooth asphalt through potholes of differing depths, to dirt tracks sliced by glacial streams, traversing a starkly beautiful lunar wilderness peopled only by nomadic shepherds, tar-covered road coolies, and the gloomy soldiers

Western Sikkim

This beautiful land, characterized by great tracts of virgin forest and deep river valleys, offers ancient monasteries such as Pemayangtse and Tashiding and the attractive but rapidly developing hamlet of Pelling. The old capital. Yoksum, lies at the start of the trail towards Dzongri and Kanchenjunga. On the far west, along the border with Nepal, the watershed of the Singalila Range rises along a single ridge, with giants such as Rathong and Kabru culminating in Kanchenjunga itself. Although only two high-altitude trails are currently available, and these are subject to restrictions and high charges, several low-altitude treks provide opportunities to

Spitok to Hemis via the Markha Valley in Ladakh

The beautiful Markha Valley runs parallel with the Indus on the far southern side of the snowy Stok-Kangri massif, visible from Leh. Passing through cultivated valley floors, undulating high-altitude grassland, and snow-prone passes, the winding trail along it enables trekkers to experience life in a roadless region without having to hike for weeks into the wilderness - as a result, it has become the most frequented route in Ladakh. This will, however, change when the new road from Chilling presently under construction is completed. Do not attempt this trek without adequate wet- and cold-weather gear: snow flurries sweep across the

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