High Himalayan rescue

The Himalayan Rescue Association Nepal (HRA) is a voluntary, non-profit set up in 1973 to reduce casualties among trekkers and porters in the Himalaya.

Its aid-post in Pheriche at an altitude of 4,250m has been saving lives of Nepali and foreign hikers for 50 years. It is staffed twice yearly during the trekking season by volunteer doctors. 

Another permanent aid-post in Manang at 3,550m has been treating patients since 1981. Ivan Somlai and Basanta Thapa were instrumental in opening the Manang aid post.

The HRA started Everest ER medical camp at Everest Base Camp in 2003 to mark the 50th anniversary of the first ascent of the world’s highest mountain in 1953.

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 Everest ER provides medical support to the porters, climbers, expedition staff and visitors and promotes safety. Luane Freer spearheaded the establishment of Everest-ER. HRA also has a temporary medical camp at Gosainkunda lake during Janai Purnima Festival to provide free medical care to Nepali pilgrims. Young Nepali volunteer doctors from the Mountain Medicine Society of Nepal (MMSN) have been working here since 1997. 

For the first time, HRA staffed the Manang, Pheriche Aid-posts and HRA Everest-ER with all Nepali volunteer doctors in spring 2021 due to the pandemic.

The HRA has published pamphlets on mountain safety, especially dealing with the prevention of altitude illness and updated information on prevention and treatment.

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Major credit for the foundation of HRA goes to John Skow, an American national, who in 1973 went to Khumbu on completion of his assignment as a Peace Corps volunteer in Nepal. It saddened him to see trekkers severely ill from altitude illness, which is 100% preventable.

He organised a meeting of officials from the ministry of health, doctors and trekking companies which figured out that this was in the best interest of their clients and hence good for business.
Joining HRA were John Dickinson from Shanta Bhawan Hospital and Mr Tek Chandra Pokharel from the trekking industry.

The charismatic Peter Hackett was one of the first doctors to volunteer at the Pheriche aid post. Based on his experience of seeing patients there, he co-authored a milestone article in 1976 (including a placebo controlled, double blind, randomised controlled trial using Diamox) in the journal Lance, ‘The incidence, importance, and prophylaxis of acute mountain sickness’.

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This paper is a classic in its field and clearly helped establish the relevance of the HRA in tackling altitude illness in all its spectrum, from the relatively benign acute mountain sickness to life-threatening high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE) in the Himalaya.

An example of the usefulness of the HRA was recently illustrated this spring season. A comatosed porter was brought to the Pheriche aid post by passing fellow porters who appeared to know nothing about him except that he was found very drowsy and somnolent in a teahouse. The HRA staff got to work right away and determined, with the help of a portable butterfly ultrasound, that the patient had HAPE which probably led to HACE. 

He was treated suitably with oxygen and dexamethasone. In two days the patient, under the competent care of the volunteers, was able to walk and was subsequently helicoptered out.

Since its inception in 1973, the HRA has quietly helped countless sojourners to the high Himalaya and saved many lives. Many Nepalis used to dismiss altitude illness as a “bideshi” (foreign) disease, Nepali trekkers, mountaineers, porters, pilgrims and soldiers now take it much more seriously.   

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Buddha Basnyat, MD is Medical Director of HRA, and Gobi Bashyal is CEO.