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Valley north of the Kanji La (Trek 6); shepherds spend the summers in the upper valleys and high mountain meadows, tending yaks, sheep and goats

It is strongly recommended to visit a doctor before leaving your home country. Do this well in advance – at least one month – of your trip as you will probably be advised to have a course of vaccinations (hepatitis A, typhoid and tetanus). You don’t need malaria prophylaxis for Ladakh, but it is quite possible to get infected on the way to Leh. However, unless you are spending some time in the lower parts of India, avoiding mosquito bites and using a strong mosquito repellent should be sufficient precaution. Seek the correct medical advice concerning malaria. MASTA (Medical Advisory Service for Travellers Abroad) is a useful source of information in advance of your trip. See www.masta-travel-health.com.

If you spend an adequate amount of time on acclimatisation you will not need any medications for altitude sickness. If you need to adjust rapidly, however, you may want to use drugs that support the process. See below and consult your doctor, and go to the website of the International Society for Mountain Medicine at www.ismm.org. Soluble multi-vitamin and mineral tablets are recommended; choose different flavours.