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The Manaslu Circuit Trek is the best all round tea-house hike in Nepal on the Great Himalaya Trail; the new Annapurna Circuit. No camping needed.

Manaslu Trek Hygiene

Your friend

While trekking the Manaslu Circuit Trek, or any other trek in Nepal, you need to pay attention to hygiene to minimise the risk of getting sick.

Some people on forums and in the comments on this site will say that Manaslu is as yet a little undeveloped and that hygiene in tea-houses is poor and claim that a camping trek is the safer way to travel. This misses the point.

You are mainly responsible for your health!

Keep your hands clean!

The unpalatable fact is that there is a connection between the nearest toilet and your sickness.

If the food was really prepared unhygienically, then everyone staying in a place would get sick, whole groups would get sick at once. Usually it is different individuals who get sick at different times.

A doctor from The International Clinic, a travellers clinic in Kathmandu said that around 70% of illness is transmitted through hand contact.

Think about the toilet. Many people use it per day. Some people might miss the hole, some people might be a little explosive, the water in the toilet might be frozen and the toilet blocked. Even if it looks clean, it’s a dirty place contaminated with human excrement. Nice image!

When leaving the toilet, the door handle and lock are certain to be contaminated with human excrement and you have to touch them. Perhaps your shoelace touched the floor, or your belt strap. Your shoe soles certainly are contaminated. Then you walk outside back to the tea-house. Over days and weeks, the toilet to tea-house route becomes contaminated. You open the tea-house door, contaminating the door handle, you pass a papad/papadum to your friend with your fingers while waiting for the meal to come.

The next morning you put your small day rucksack down and your camel pack / hydration pack tube touches the floor. After 30 minutes walking, you put it in your mouth. Yum!

And so it goes on.

At high altitudes, it gets pretty cold and often water freezes making people reluctant or unable to wash their hands. This is when hand sanitizer becomes extra important.

  • Wash your hands frequently and always after using the toilet and just before eating food, even if the water is icy, make the effort.
  • Use hand sanitizer frequently, always before touching food.
  • In groups, make sure there is always hand sanitizer on the table at meal times.
  • Keep your nails cut short!

Dave and I were religious about using hand gel after touching pretty much anything that other people might have touched. We were probably using it every 20 minutes. We had no tummy issues for the whole trip and I promise if there was to be anyone who would normally get sick it would be my husband!“, says Claire from UK, who ran the Manaslu Trail Race last year.

Coughs and colds

While some coughs can happen because of breathing cold, dry air at altitude, most coughs and colds are transmitted by your fingers. Every door handle you touch will have someone’s nose snot on it, guaranteed! Another reason to use hand-sanitizer. Watch how mothers clean the noses of children!

How to cough and sneeze!

Don’t sneeze or cough on to your hands, unless you’re going to wash them immediately without touching any door handles!

Do it like this. Make sure your whole group knows before starting on the trek. Also easy is just to lift up your t-shirt collar and sneeze inside!

Dirty Money

Thanks to Jamie McGuinness for reminding about money. Like the complimentary peanuts on the bar are mixed with many varieties of urine, money in Nepal, especially the Rs 5 and 20 notes have seen everything. Money is pretty dirty and gives a new meaning to filthy lucre. Don’t put it in your mouth (to hold it while counting for instance) and wash your hands after using money and before eating. Treat it as you would lightly-used toilet paper.

Choosing a hand sanitizer

Look for:

  • Alcohol content greater than 60%.
  • Bactericide that stays on your hands after alcohol has evaporated.

And buy a spare bottle or two. It is up high where it is cold that you need it most!


Don’t drink from local taps. Yes, most of it is probably perfectly fine, but you never know. Probably the worst that can happen is that you will get giardia* and you will know about it 7 to 10 days later. But again, you never know. Use a water filter that you carry with you, sterilisation tablets**, or as a last resort, buy boiled water (it takes fuel, usually wood, to heat it). Try not to buy bottled water as the bottle will likely end up in a trash pile at the side of a river.

** ‘Piyush,’ is a Nepali chlorine solution for treating water. It’s good for killing most bacteria, but less effective for giardia cysts, especially at low temperatures.

* Giardia treatment: Albendazole 400mg 1 x day with food for 5 days.


Follow your intuition. Dal bhat is always a good option as it is cooked fresh in huge batches. Problems can occur with cooked food that has been hanging around at room temperature for who know’s how long with flies visiting it. Go with local-style, cooked food where possible.

Have a great trek!

Ps. Toilets

Be a good human being and do your best to keep the toilets clean. Follow some simple rules:

  • The flat footed squat is the natural human resting position – the chair came much later. Many people can’t rest in a squat due to inflexibility. Why not practice a bit before you go?
  • Watch a few youtube videos about how to use a squat toilet.
  • Tell the owner of the toilet if it is not in good condition.
    • There should be a bucket for paper.
    • There should be water for flushing.
  • Don’t throw paper into the toilet. Don’t! They block so easily, then everyone is in trouble.
  • Wash the toilet well after use and leave it nicely for the next person.
  • Report if water is finished.
  • There should be somewhere to wash hands afterwards. If not ask.
  • By doing this, you’ll improve the culture of toilets in Nepal which will make the trek more pleasant for everyone!

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