All the clients are physically evaluated before signing up for a trip. However there can still be cases where one can suffer from any of the sickness mentioned earlier. In cases like those the only cure is DESCENT.
While on a trek in a remote area if any client suffers from altitude sickness or any other serious injury, the sirdar/guide sends a runner to the nearest telephone/army post/road head to ask for help.
Emergency evacuation becomes necessary in the following cases:

High Altitude Sickness – If the client suffers from High Altitude Sickness, he needs to be lowered immediately.

Injury – In case the client is badly injured – broken bones/fractures or sickness like thrombolysis (blood clotting), paralysis, loss of eyesight – in these cases as well he needs to be evacuated/lowered immediately.

In the above cases evacuation by a chopper/helicopter becomes necessary if the clients are in remote areas.

Clients are monitored and anyone with any symptoms of altitude sickness is not sent on the trek. If anyone is slightly ill in Leh a doctor is called and the person assessed. Visiting charges for doctors is US$15/- to US$20/- per visit. If a client requires oxygen then instead of sending the person to the hospital ( where facilities are basic)he / she is kept in the hotel and Rimo supplies the oxygen at charges of US$30/- per cylinder.

IF the symptoms of altitude sickness persist then the person is sent to Delhi on the next flight. We ask clients to get in touch with their insurance company in such cases and explain the situation. Our telephone numbers / fax numbers given to the Insurance company for further contact is: (+ 91 9810067952 / + 919810009291; fax: +91 124 2806030)

No person with symptoms of altitude sickness is taken on a trek.

On trek, oxygen cylinder and Gamow bag is carried for emergency. It is the leader’s decision and anyone not well is sent back immediately with support staff. We cannot have satellite phones as these are not allowed in India. However we would expect the leader to have one to deal with emergencies.

Procedure for helicopter evacuation:

This is not done immediately like in Nepal though we have been able to get helicopter for rescue within 2 hrs notice in Ladakh where it is still easier than the rest of the Himalaya in India as the Indian airforce have a big base in Leh.

We inform the insurance company about this. Meantime we have to inform the concerned embassy as a clearance from the various ministries is required including that from the district commissioner of Leh.

We have to give a guarantee of payment to the concerned department in the air force. 2 choppers are always sent as this is a sensitive area and the charges of 2 choppers from hangar to hangar are charged between US$2000/- to US$2500/- per hour so about US$5000/- per hour.

Due to the difficulties and long process in getting choppers, we do not call one unless there is such an emergency.

The hospitals in Ladakh cannot cater to critical care conditions. The army hospital in Leh can cater to such requirements. However, we send anyone requiring immediate medical attention to Delhi – 1 hrs flight and 2 flights a day. Before doing this we would have contacted the insurance and they usually have another agent in Delhi who handles everything.

We find that East West Medical Centre who also conducts rescues act fast in emergency cases (we’ve dealt with 2 critical conditions in Sikkim and Kumaon) .The contact doctor is Dr.Chawla - +91 9811029283. He contacts the medical insurance company and takes over totally.

Each member should share their medical / emergency insurance policy numbers and a copy each of everyone’s passport as the same is required for emergency.