Rajesh Lama, known as LaMa, is a seasoned trekking guide with over 15 years of experience exploring the Himalayas. He is the founder and director of LaMa Walks Trekking and Expedition and also serves as the director of Himalayan Medics, where he trains individuals in wilderness medicine. LaMa’s passion for the outdoors and safety has led him to climb Everest, starting from Sanepa, and he has spent the past decade teaching people how to handle first aid and medical emergencies in remote, doctor-less regions. His expertise in wilderness contexts empowers trekkers and adventurers to improvise and manage health challenges in the most rugged terrains.
When you are packing a first aid kit for a trek, what is the very first item you make sure to include?
To be more specific, it’s not just about naming a single item but understanding that some tools are irreplaceable. Take scissors, for example—you can’t substitute them with something else. While you could improvise a splint for a leg using wood or another hard object, there’s no real alternative for scissors when you need to cut something. Similarly, while tweezers can sometimes be improvised, certain tools, like a kidney tray, are essential for specific tasks such as cleaning a wound. Overall, I recommend prioritizing items that can’t be easily replaced or improvised.
Is there a common first aid item most people forget to pack that you would recommend?
I wouldn’t say I specifically forget items like this, but from experience, I’ve noticed that in cases of severe injuries with heavy bleeding, we might run out of gloves. Since gloves are single-use, they can’t be reused, and we sometimes pack fewer than we end up needing. It’s not about forgetting them, but rather packing based on experience. For example, someone new to trekking might over pack and bring 10-15 pairs of gloves, while with more experience, you learn to pack more efficiently. The goal isn’t to over pack—if there are four people on a trek, I might bring five pairs of gloves, as it’s unlikely that everyone will need them. The number of gloves also depends on the trek’s duration. This approach comes from practical experience.
What is one first aid tip you think every trekker should know before they set out?
That’s a great question. I believe the most important thing is to prioritize your own safety above all else. If you’re safe, you’ll be in a better position to help others. Life isn’t like a Rajesh Hamal movie where the hero can take 10 bullets and still survive, while the villain dies from a single un-touching shot. As much as we all love Rajesh Hamal, real life doesn’t work that way. The best advice I can give is to focus on protecting yourself first.
Do you think a basic first aid kit from the store is enough for trekking, or should people consider customising it?
Himalayan Medics provides first aid kits stocked with a range of essential items designed to meet most needs. However, medications are not included due to regulatory restrictions and the diverse health conditions and preferences of individuals. We leave the selection of medications to the buyer. Beyond that, our kits cover nearly everything required for basic first aid. We also encourage users to personalize their kits to fit their specific needs and preferences.
What is the best way to waterproof a first aid kit for trekking in rainy or humid conditions?
Our first aid kits are not entirely waterproof, although they are made from water-resistant materials. Instead, we focus on ensuring that the backpacks, where the kits are stored, are waterproof. These backpacks include a plastic layer and an additional cover to provide reliable protection during heavy rain.
Are there any natural remedies you have learned along the way that you would include or recommend for a trekking first aid kit?
Natural remedies aren’t my specialty—not that I’m opposed to them; I just don’t have much knowledge in that area. The most natural solution I’ve relied on is clean drinking water. When it comes to blisters, I focus more on prevention than treatment, as they can often be avoided with proper care. I mention water because, for example, if I forget to pack an antiseptic like Betadine, clean drinking water can be a practical alternative in such situations
What would you suggest for a trekker who wants to pack light but still have a well-prepared first aid kit?
You’re welcome to contact Himalayan Medics, but there are other options available as well. If you’re packing for just one person, you only need a few essentials—like a pair of scissors, tweezers, and a couple of rolls of crepe bandages and gauze. Our kits at Himalayan Medics are compact pouches, specially designed for mountain bikers who prefer to travel light and avoid carrying bulky bags.
How important is it for trekkers to have some basic first aid knowledge? What skills do you think are essential?
Basic first aid is crucial for everyone, not just trekkers, because, as the Nepali saying goes, ‘Dasha baja bajayera audaina’ (disasters don’t announce their arrival). Life is unpredictable—we’ve just met, but there’s no guarantee we’ll even get home safely. These skills are invaluable and can make a difference in anyone’s life. Personally, I’ve used them to help my own mother, which remains one of the most meaningful experiences for me. During the 2015 earthquake in Nepal, my mother was injured when the ceiling collapsed. Thankfully, her skull was unharmed, but she was struck on the head as she looked up. That experience taught me a lot about head injuries, such as how bleeding can happen gradually. Despite having taught first aid for years, it was the first time I had seen someone’s skull. Thanks to my training, I was able to treat her and prevent further complications. In another instance during the earthquake, I was in Langtang—a region where many lives were lost. A landslide hit the village, and I encountered a man from Bhaktapur with a broken femur. A femur fracture is life-threatening due to the risk of severe internal bleeding. The femur is the largest bone in the body, surrounded by powerful muscles, and internal bleeding even the size of a fist can be fatal. I heard him screaming for help, but no one dared to approach because of the risk involved. I decided to act and asked my team to keep watch for falling rocks while I went to him. I warned him that it would be painful and asked for his consent to pull him to safety, which he gave. After rescuing him, I improvised a stretcher using a tree branch and cloth—something we teach in first aid training. Without access to a proper cast, I created one from scratch and secured it to his leg. These experiences have reinforced the importance of first aid skills. They can save lives in the most unpredictable and dangerous situations, and I truly believe everyone should learn them.
What do you suggest for trekkers who may have pre-existing conditions? How should they prepare their first aid kits?
I suggest consulting your personal doctor first and following their recommendations. If they prescribe any medication, make sure to verify it and take it with you. It’s also essential to inform your guide about any pre-existing medical conditions so they can assist in case of an emergency. For instance, if you have asthma and carry an inhaler, always inform your guide about its location.
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