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The cost of getting to India, and travel insurance, also need to be considered. Your insurance should cover not only hospital treatment but also emergency evacuation costs. There is no mountain rescue service organisation in Ladakh. A seriously injured person would need to be transported to the hospital in Leh by Indian Army helicopter, but it will not take off unless your insurance has been confirmed. If trekking independently you will depend on yourself, villagers and their animals, and other trekkers, in case of emergency. If going on an organised trek leave your insurance details at your agent’s office and discuss emergency scenarios there.

Mountain emergency operation is not usually covered by travel insurance, but most agents offer an extension of the standard package for an additional fee. Good insurance covering the costs of a rescue operation in the mountains is often combined with membership of a mountain club, such as the British Mountaineering Council (www.thebmc.co.uk) or the Oesterreichischer Alpenverein (Austrian Alpine Association). The latter has a few branches in other European countries: see www.alpenverein.at, www.aacuk.org.uk, www.alpenverein.com.pl and www.alpenverein.cz. For other countries, please check with your local mountaineering organisation; and make sure that the necessary insurance cover is in place before leaving home.

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