Khumbu shuts trekker clinics

Two mountain medicine clinics that have saved hundreds of lives of trekkers and porters in the Khumbu region of Nepal have been forced to close down by the local municipality, allegedly in collusion with a helicopter company that profits from rescues.

The clinics at above 4,500m in Machermo village on the Gokyo trekking route are run by the International Porter Protection Group (IPPG) and Community Action Nepal (CAN) with support of the Mountain Medicine Society of Nepal (MMSN).

The shelter and rescue centres provided free care for porters and local people, which was paid for by charging trekkers who needed treatment for acute mountain sickness. But a new private clinic set up nearby in October 2019 started lifting trekkers by helicopter to a hospital in Kathmandu appears to have pressured the local government to end the agreement with IPPG.

‘The business model for the new clinic would appear to be to evacuate as many trekkers as possible to Kathmandu where it is alleged they are often subjected to excessive or fictitious investigations and treatment,’ wrote Nick Mason, Chair of IPPG, a UK-based charity.

Volunteer physicians in Gokyo estimate that the new private clinic medevaced up to 50% of patients to a hospital in Kathmandu partly owned by the helicopter company. IPPG used helicopter evacuation of only 5% of the most serious cases.

Last year, the Nepal government promised to investigate after a major scandal was reported in the media about an insurance scam involving unnecessary evacuation by helicopter of trekkers suffering from altitude sickness. Trekking insurance fraud has been reported in Nepal since 2013.

The incidence of fraudulent rescues claiming insurance rose since 2015, as reported by this newspaper and others. Trekking companies were also said to have collaborated with helicopter companies and hospitals to entice tourists to opt for medical evacuation at an inflated fee, and share the profits. 

Nepal’s Tourism Ministry said last year it investigated the scams, issued a report and drafted new rules governing search, rescue, and treatment of trekkers to check fraud. But the rules were never implemented. 

IPPG said its its doctors faced ‘hostility and abuse’ from local lodge owners with close ties to the new private clinic. Then the Khumbu Pasang Lhamu Rural Municipality refused the IPPG permission to operate in Gokyo Valley starting spring 2020. This means the clinic would have to shut down.

In past 17 years the IPPG posts in Gokyo have treated thousands of patients have been treated and saved hundreds of lives of porters and trekkers.

‘We have always viewed ourselves as guests of the Sherpas of the Gokyo Valley, having been originally invited into the valley by the local community and the Sagamartha National Park, and it has been a privilege to serve them,’ Nick Mason wrote. ‘We looked forward to the day when we would be able to hand over the rescue posts and porter shelters fully to the Nepalis.’

Most porters accompanying trekkers are from lower valleys, and suffer from altitude sickness because of poor acclimatisation. Sherpas and other high altitude guides do not suffer from acute mountain sickness as much. 

Trouble reportedly started in the 2019 autumn trekking season, when the new private clinic opened and the IPPG health posts started to feel the pressure from locals. Suspicion has fallen on a private hospital in Kathmandu with its own helicopter company that has started opening a string of clinics in the Khumbu, showing that the over-commercialisation of Nepal’s medical sector is now affecting the Everest region as well.

Edi Albert a volunteer physician in Gokyo wrote: ‘You can imagine the size of the bills presented to the insurance companies.”