Urbanisation in a Low-Income Country: A Case Study of Health System Challenges in Kathmandu

This article addresses the challenges that the health system in Kathmandu faces as a result of rapid urbanisation, and follows with some recommendations for improving the resilience of the Kathmandu health system. Throughout this essay, “Kathmandu” refers to the Kathmandu Valley, including the municipalities of Kathmandu, Lalitpur, Bhaktapur, Kirtipur and Madhyapur Thimi.




There are good reasons why people move from rural areas to the city. In Nepal, rural-born individuals moving to urban areas have a 28% higher chance (increasing from 38% to 66%) of obtaining better occupations than their fathers. (World Bank, 2016). Between 2011 and 2021, Nepal’s urban population increased by over 300% (National Statistics Office, 2022), reflecting a global urbanisation trend of people moving from rural to urban areas. Indeed, Nepal’s urbanisation is the fastest in South Asia (World Bank, 2016). The population density of Kathmandu is 5,169 people per km2, in stark contrast to rural districts such as Manang that have a population density of just 3 people per km2 (National Statistics Office, 2022). These disparities alone lead to numerous resourcing and infrastructure challenges, whilst the pace of urbanisation in Kathmandu is straining the city’s infrastructure, which isn’t able to adapt in such a short period of time. Additionally, those who move from rural to urban areas are rarely, if ever, seen as a distinct population group in their own right, with their own needs and challenges (Khadka et al, 2023). Urbanisation itself has been recognised as a determinant of health (Vlahov, 2007), and the rapid pace urbanisation results in a widening in health and wellbeing inequities (Wamukoya, 2020).

Hospitals and health services


This rapid urbanisation, the impact of Covid, and a recent deal with the UK government (Aryal and Pollitt, 2022) that allows healthcare professionals from Nepal to be recruited to work in the NHS contribute to a system that struggles to cope with demand. In 2016, Nepal had a density of seven health service providers per 10,000 people; the WHO-defined critical threshold is 23 per 10,000 (Pandey, 2016). During the Covid-19 crisis, hospitals in Kathmandu were overwhelmed, and despite having adequate supplies of vaccine, were not able to get vaccines to the people that needed them. Reports were of mismanagement, overcrowding, and long queues whilst the hospital ran out of vaccination cards (Ojha, 2021). Medical supplies are not necessarily the issue in Kathmandu – it is instead the capacity of the system to adequately serve the population. As of 2022, Nepal has on average, 2.8 nurses and midwives for every 10,000 people, compared with 13 in the UK (Haakenstad et al, 2022), and whilst plans exist to build further healthcare facilities with much greater capacity, a shortage of healthcare workers remains a significant challenge (Dhakal, 2023).


Increased pollution and health impacts


An increasingly dense population in a city such as Kathmandu causes increased pollution, and a core challenge is the management of municipal solid waste (MSW). Collection services are rare, and only two municipalities in Kathmandu dispose of waste in sanitary landfills. In most instances, waste is disposed of at riverbanks, dumps, open pits, or simply burned (World Bank, 2016). The release of untreated wastewater into water bodies and the mismanagement of solid waste have polluted Kathmandu river systems, and compounding the problem, Kathmandu faces a scarcity of drinking water: access to piped water over the past decade has actually decreased (Muzzini and Aparicio, 2013).


Nepal has the highest age-adjusted death rate globally for chronic lung disease, 182.5 per 100,000 people (Carson-Chahhoud, 2019). Kathmandu in particular, faces a greater challenge due to its topography – an enclosed valley surrounded by mountains – which traps airborne particulate pollution. Levels of small particulate matter in the Kathmandu Valley can exceed 500 micrograms per cubic metre (Gurung and Bell, 2012), 20 times the World Health Organisation’s safe upper limit. In March 2023, Kathmandu registered the world’s highest Air Quality Index at 181, predominantly due to vehicle emissions and waste burning (Himalayan News Service, 2023). Open burning of MSW is a significant source of air pollution: an estimated 7,400 tons of MSW was burned in just three municipalities near Kathmandu in 2016 (Das et al., 2018). 

Figure 1: ‘Rubbish’, Kirtipur. Credit: Ammalal Sejuwal, Khila Karki, and Vishan Thami. (Khadka et al, 2023)


Of 1.2 million vehicles in Nepal, about 34.25% are primarily in the Kathmandu Valley, and are responsible for around 89% of PM10 emissions (Dhital, 2017). While Nepal has vehicle emission standards, the limited number of Vehicular Emission Testing (VET) centres, all situated within Kathmandu Valley, leads to little testing outside this area. There is even a thriving market in fake test stickers to suggest the vehicle is compliant. A lack of an efficient public transport system also means that many Kathmandu residents are forced to use private vehicles to get around (Saud and Paudel, 2018). This increased traffic has also resulted in an increase in road traffic accidents and traumatic injuries or death (Huang et al, 2017).


Rise of NCDs


Urbanisation increases the major behavioural risk factors for NCDs, namely physical inactivity, low fruit and vegetable consumption, and tobacco and alcohol use (Oli et al, 2013). The prevalence of NCDs such as hypertension and diabetes is increasing across Nepal (Mishra, 2015), with a higher prevalence of conditions such as diabetes in Kathmandu compared to rural areas (Rimal and Panza, 2013). In urban areas, NCDs were the leading cause of mortality, exceeding the rates of death from accidents, suicides, and criminal incidents, according to the 2021 census in Nepal (CHORUS, 2023). Across Nepal, NCDs are estimated to account for 66% of all deaths (WHO, 2016) and this rise in NCDs causes a corresponding increase in demand upon an already burdened healthcare system, particularly challenging because Nepal’s healthcare system isn’t accustomed to treating NCDs, having been traditionally focused primarily on infectious diseases (Rai et al, 2001).




In 2015, Nepal adopted a new constitution, transitioning from a unitary form of governance to a secular federal democratic republic: power and resources were devolved from the central government to seven newly created provinces and 753 municipalities, which also resulted in significant reforms of the health system. Federalisation can lead to both challenges and opportunities, as local governments may be better positioned to understand and meet the specific needs of their communities, but they may also face difficulties due to limited resources, lack of experience, or coordination challenges with other levels of government (Belbase, no date). Since the federalisation of Nepal’s health system, its performance has been improving, though significant work remains (Chen et al, 2023). More health workers are available locally than previously, with less absenteeism, however there are challenges around skills and training. Challenges also exist where local policymakers are less experienced in effective budgeting, compared to their central government counterparts (Wasti et al, 2023). One example of federalisation success is Pokhara, where local government enabled urban primary healthcare clinics to identify vulnerable groups and individuals in their catchment areas and identify ways of improving their access to services (Elsey, 2019).




In order for the health system in Kathmandu to adequately address the a challenges of rapid urbanisation, a number of strategies should be considered:


1 – System resourcing: 

The establishing of baseline requirements for municipalities, such as specific provider-to-patient ratios and the availability of essential resources would guide local healthcare providers in aligning their healthcare systems with national objectives, while still allowing them the flexibility to prioritise local needs. Improved training, recruitment and retention of healthcare workers at the local level is also necessary to reach and maintain an appropriate level of resilience in the healthcare system.


2 – Prevention and treatment of NCDs.

The prevalence of NCDs in the population of Kathmandu is increasing. Education on the causes, harm and impact of NCDs, steps that people can take to prevent them, alongside greater education on treatment, will ease the pressure on the health system.


3 – Addressing social determinants of health:

Addressing air pollution and MSW management, as well as prioritising the supply of clean drinking water is critical in order to reduce the prevalence of NCDs and reduce the burden on the health system. Effective waste segregation and collection would reduce the amount of MSW that is openly burned; bio-gasification of commercial waste and composting of household waste combined with recycling, falling back on well-managed landfill where necessary, would be cost-effective and reduce air pollution significantly (Singh et al, 2014 and Dangi et al, 2009). Measures to improve traffic management, including a transition to electric vehicles, will improve air quality in the Kathmandu Valley and reduce the harmful effects of air pollution.


Kathmandu’s health system faces many challenges arising from rapid urbanisation, including strained infrastructure, increasing pollution, and increased prevalence of NCDs. Addressing these issues requires an approach that includes improving healthcare resourcing, enhancing education and prevention strategies for NCDs, and tackling social and environmental determinants of health. Building on federalisation, improving local governance and providing tailored local healthcare strategies is crucial in adapting to the demands of an increasingly urbanised population. 




Adhikari, B., Pokharel, S. and Mishra, S.R., 2019. Shrinking urban Greenspace and the rise in non-communicable diseases in South Asia: an urgent need for an advocacy. Frontiers in Sustainable Cities, 1, p.5.


Aryal, E and Pollitt, N. 2022. Memorandum of understanding between the Government of Nepal and the Government of the United Kingdom of Great Britain and Northern Ireland on the recruitment of healthcare professionals (text only) (no date) GOV.UK. Available at: https://www.gov.uk/government/publications/memorandum-of-understanding-between-the-uk-and-nepal-on-the-recruitment-of-healthcare-workers/memorandum-of-understanding-between-the-government-of-nepal-and-the-government-of-the-united-kingdom-of-great-britain-and-northern-ireland-on-the-recr (Accessed: 23 November 2023).


Belbase, K., Federalism in Nepal: Issues and Challenges. (No date). Available at: https://classic.iclrs.org/content/blurb/files/krishna%20belbase.pdf (Accessed: 23 November 2023).


Bista, B., Dhimal, M., Bhattarai, S., Neupane, T., Xu, Y.Y., Pandey, A.R., Townsend, N., Gyanwali, P. and Jha, A.K., 2021. Prevalence of non-communicable diseases risk factors and their determinants: Results from STEPS survey 2019, Nepal. PloS one, 16(7), p.e0253605.


Carson-Chahhoud, K., Noori, M., Nejadghaderi, S.A., Sullman, M., Ahmadian Heris, J., Ansarin, K., Mansournia, M., Kolahi, A.A. and Kaufman, J., 2021. The burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: Results from the Global Burden of Disease Study 2019.


CHORUS. Insights Special Issue 4: Special Edition on Urban October in Association with CHORUS – Research on Urban Health (2023) Herd International. Available at: https://www.herdint.com/resources/insights-special-issue-4-special-edition-on-urban-october-in-association-with-chorus-research-on-urban-health/ (Accessed: 23 November 2023).


Dangi, M.B., Cohen, R.R., Urynowicz, M.A. and Poudyal, K.N., 2009. Report: Searching for a way to sustainability: technical and policy analyses of solid waste issues in Kathmandu. Waste Management & Research, 27(3), pp.295-301.


Das, B., Bhave, P.V., Sapkota, A. and Byanju, R.M., 2018. Estimating emissions from open burning of municipal solid waste in municipalities of Nepal. Waste management, 79, pp.481-490.


Dhakal, S. 2023. Civil Service Hospital crowded like a fair. The Annapurna Express. Available at: https://theannapurnaexpress.com/news/civil-service-hospital-crowded-like-a-fair-39837/ (Accessed: 22 November 2023).


Dhital, D. (2017) Vehicle Emission Testing System in Nepal; Still in the Crawling Phase, Academia.edu. Available at: https://www.academia.edu/31317941/Vehicle_Emission_Testing_System_in_Nepal_Still_in_the_Crawling_Phase (Accessed: 16 October 2023).


Elsey, H., Agyepong, I., Huque, R., Quayyem, Z., Baral, S., Ebenso, B., Kharel, C., Shawon, R.A., Onwujekwe, O., Uzochukwu, B. and Nonvignon, J., 2019. Rethinking health systems in the context of urbanisation: challenges from four rapidly urbanising low-income and middle-income countries. BMJ global health, 4(3), p.e001501.


Green, L. (2013) Chapter 11, QUEUEING ANALYSIS IN HEALTHCARE. Patient flow. Edited by Hall, R. AMC


Gurung, A. and Bell, M.L., 2012. Exposure to airborne particulate matter in Kathmandu Valley, Nepal. Journal of Exposure Science & Environmental Epidemiology, 22(3), pp.235-242.


Haakenstad, Annie, Caleb Mackay Salpeter Irvine, Megan Knight, Corinne Bintz, Aleksandr Y. Aravkin, Peng Zheng, Vin Gupta et al. (2022) “Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019.” The Lancet 399, no. 10341: 2129-2154.


Himalayan News Service (2023) Kathmandu one of world’s most polluted city, The Himalayan Times. The Himalayan Times. Available at: https://thehimalayantimes.com/environment/kathmandu-one-of-worlds-most-polluted-city (Accessed: 16 October 2023).


Huang, L., Poudyal, A.K., Wang, N., Maharjan, R.K., Adhikary, K.P. and Onta, S.R., 2017. Burden of road traffic accidents in Nepal by calculating disability-adjusted life years. Family medicine and community health, 5(3), pp.179-187.


Khadka, S., Koirala, B., Baidya, M., Ferhani, A., Jiban, K., Lee, A., Panday, S. and Rushton, S., 2023. The health consequences of urbanization in Nepal: perspectives from a participatory photo project with recent rural-urban migrants. The Highlander Journal, 3(1), pp.37-50.


Kim, B.M., Park, J.S., Kim, S.W., Kim, H., Jeon, H., Cho, C., Kim, J.H., Hong, S., Rupakheti, M., Panday, A.K. and Park, R.J., 2015. Source apportionment of PM10 mass and particulate carbon in the Kathmandu Valley, Nepal. Atmospheric Environment, 123, pp.190-199.


Kumar, R. (2022) Cost of living in a big city, Nepali Times. Available at: https://nepalitimes.com/here-now/cost-of-living-in-a-big-city (Accessed: 20 November 2023).


Lodge, A. 2014. Has air pollution made Kathmandu unliveable? The Guardian. Guardian News and Media. Available at: https://www.theguardian.com/cities/2014/mar/21/air-pollution-kathmandu-nepal-liveable-smog-paris (Accessed: 23 November 2023).


Mayhew, L. and Smith, D., 2006. Using queuing theory to analyse completion times in accident and emergency departments in the light of the Government 4-hour target.


Mishra, K. 2023. Impediments in the Agriculture Sector of Nepal, Nepal Economic Forum. Available at: https://nepaleconomicforum.org/impediments-in-the-agriculture-sector-of-nepal/ (Accessed: 18 November 2023).


Mishra, S.R., Neupane, D., Bhandari, P.M., Khanal, V. and Kallestrup, P., 2015. Burgeoning burden of non-communicable diseases in Nepal: a scoping review. Globalization and health, 11(1), pp.1-10.


Muzzini, E., & Aparicio, G. (2013). “Urban Growth and Spatial Transition in Nepal: An Initial Assessment. Directions in Development”.World Bank Directions in Development http://doi.org/10.1596/978-0-8213-9659-9


National Statistics Office (2022). National population and Housing Census 2021: National Report. Kathmandu Nepal. Available at: https://censusnepal.cbs.gov.np/results/population?province=3&district=28 (Accessed: 14 November 2023).


Ojha, A. 2021. Government mismanagement leads to crowding at hospitals. The Kathmandu Post. Available at: https://kathmandupost.com/health/2021/04/22/government-mismanagement-leads-to-crowding-at-hospitals (Accessed: 23 November 2023).

Oli, N., Vaidya, A., & Thapa, G. (2013). Behavioural Risk Factors of Noncommunicable Diseases among Nepalese Urban Poor: A Descriptive Study from a Slum Area of Kathmandu. Epidemiology Research International, 2013, 1-13.


Pandey, N.R., 2016. Emergency medicine in Nepal: present practice and direction for future. International journal of emergency medicine, 9(1), pp.1-6.


Rai, S.K., Rai, G., Hirai, K., Abe, A. and Ohno, Y., 2001. The health system in Nepal—an introduction. Environmental health and preventive medicine, 6(1), pp.1-8.


Rimal, A., & Panza, A. (2013). Prevalence Of, And Factors Associated With, Type 2 Diabetes And Its Microvascular Complications Among The Elderly In Kathmandu, Nepal. Journal of Health Research, 27, 45-49.


Singh, R.K., Yabar, H., Mizunoya, T., Higano, Y. and Rakwal, R., 2014. Potential benefits of introducing integrated solid waste management approach in developing countries: A case study in Kathmandu city. Journal of sustainable development, 7(6), p.70.


Vlahov, D., Freudenberg, N., Proietti, F., Ompad, D., Quinn, A., Nandi, V. and Galea, S., 2007. Urban as a determinant of health. Journal of urban health, 84, pp.16-26.


Wamukoya, M., Kadengye, D.T., Iddi, S. and Chikozho, C., 2020. The Nairobi urban health and demographic surveillance of slum dwellers, 2002–2019: value, processes, and challenges. Global Epidemiology, 2, p.100024.

Wasti, S.P., van Teijlingen, E., Rushton, S., Subedi, M., Simkhada, P. and Balen, J., 2023. Overcoming the challenges facing Nepal’s health system during federalisation: an analysis of health system building blocks. Health Research Policy and Systems, 21(1), p.117.


World Bank Group, 2016. Moving up the ladder: Poverty reduction and social mobility in Nepal. World Bank.


World Health Organization. Noncommunicable Diseases (NCD) Country Profiles. World Health Organization; 2018. Available from: https://www.who.int/nmh/countries/npl_en.pdf?ua=1.

10 travel tips you might not read elsewhere.

May partner and I have been on the road for around 9 months now, travelling around Europe and South East Asia, and I’ve learned a few things about myself, the world, and how to travel. Some things are obvious, like how important it is to have decent travel insurance, buying local pay-as-you-go sim cards instead of racking up a big roaming bill, and setting some sort of spending budget…

However, here are ten tips (and a few bonus ones) that you might not read on the average travel blog.

Vietnamese lizard
  1. Everything breaks, so get good at fixing stuff, and learn to sew. Pack superglue, electrical tape, and a small sewing kit, and you can fix just about anything. I’ve repaired shoes, shorts, sleeping bags, watches, sunglasses, bags and cameras over the past few months.
    Repair on a sleeping bag.

    Sugru is also a great resource, but each pouch has to be used immediately once it’s opened, so take some, but use it as a last resort. And seriously, learn some basic sewing skills, like darning socks, sewing on buttons, or repairing rips and tears.

    solar charger, water purifier, backpack
    Halfway up to Annapurna base camp
  2. A good first aid kit is crucial. Stock up on antiseptic, plasters, bandages, bite cream, water purifying tabs, tweezers and anything else you might need personally. I even took some emergency tooth filling repair stuff, and I used it. You can also use superglue to patch up wounds, but be careful as it can get very hot when it dries, and the standard stuff sets stiff so it’s not good for cuts over skin that moves, like the soles of your feet.
    Kathmandu, Nepal

    Zinc oxide tape is great to prevent blisters and secure bandages. Electrical tape serves as a superb fix for a wound dressing if you’re going to get it wet. I cut my toes fairly badly while cliff jumping (whilst climbing up, not jumping down) and used bandages and electrical tape for a couple of weeks to keep it bandaged while in the sea.

    Cliff jumping in Vietnam
    Kayaking and paddle boarding in Vietnam

    Also stock up medicine when possible. Painkillers aren’t always available and you can go through them quicker than you’d expect. Take with you antihistamines, sleeping pills, anti-diarrhoea and rehydration salts. If you can, get some antibiotics like amoxicillin for general wound or tooth infections, and metronidazole for stomach bugs  and amoebic nasties.

    Our trekking guides, Santosh and Puskar

    If you find yourself somewhere like Nepal where you can get antibiotics over the counter, buy some. Buy more than you think you need (but not so many that you’ll be thrown in jail for smuggling prescription drugs). If you get an infection and you’re in deepest Cambodia, you really don’t want to leave it until you can find a reliable doctor.

    Walking in the Himalayas

    Buy hand sanitiser when you can find it cheaply, because it gets expensive when you’re remote. You’ll probably acclimatise to the local stomach bugs eventually, but using hand sanitiser regularly will reduce the likelihood of getting a bad one. I wasn’t careful enough in our first week in Kathmandu, and after vomiting in the street, and a very tense taxi ride, rather regretted it.

    Pub Street, Siem Reap, Cambodia
  3. Get a decent knife and learn how to use it and look after it properly. Buy one that locks open so that you don’t cut your fingers off when closing it. Keep it sharp using a decent stone or steel. Sharpening a blunted knife is really difficult, but keeping a knife sharp just takes a bit of discipline. I carried around a stone in my bag for 8 months just for this purpose. You’ll use your knife for everything from preparing food, repairing clothes, and cutting hair!

    Look after your knife.
  4. Eat local food whenever possible. Some of the most amazing food I’ve had travelling has been in the cheapest street stalls and markets. However, good local food isn’t always available. You’ll often find yourself forced to eat whatever is provided, and it might not be to your (or frankly, anyone’s) taste. Tabasco sauce can make all sorts of bland, weird, slightly off, or otherwise less-than-great food palatable. Take a little bottle of your your own with you, and even carry a few spices, salt, pepper, and sugar.
    Nepalese street food on the road to Pokhara.

    Cambodian market food
  5. Keep your hip flask topped up. I recommend whisky because it’s drinkable by itself and goes well mixed with lots of stuff from coke to coffee, gin is pretty nice to carry around but good luck finding tonic in rural SE Asia. Cognac could work for you if you’re an artist or something. Vodka if you’re doing the whole serious alcoholic thing. When you get invited to an impromptu beach party, or a chillout on a porch, you’ll be pleased you’ve got your old faithful hip flask with you.

    Chilling in Lisbon
  6. Buy a bunch of dry bags of different colours and sizes. You can almost never have too many dry bags. They’re really useful for simply keeping your kit organised and separated, so you’re not hunting around for your socks every day or wondering where your favourite big-night-out T-shirt is. It also means that if your bag gets wet or something springs a leak inside, most of your stuff will be ok. I used a big red one to keep dirty washing in (red for danger, obvs), and also used various dry bags for trips to the beach, backpacking in the rain, or kayaking trips. 

    Unpacking along the Annapurna Trek
  7. Be careful using squat toilets. In many parts of Asia, you’ll come across squat toilets. Once you get used to them, they’re actually pretty good, as long as they’re kept reasonably clean. However, make sure you zip up your pockets if possible, or at least put your phone and wallet somewhere else when you’re using a squat toilet. If something falls out, you really don’t want to be rummaging around down there, however fancy and expensive your phone is. 

    Riding around Koh Chang, Thailand.
  8. When travelling, if there are seatbelts, wear them. The same goes for helmets whilst riding motorbikes. It’s cool to be safe, kids. Driving standards outside Europe and the US are significantly lower, and in many places there’s not even a requirement to pass a test in order to drive on public roads. Our coach from Kathmandu to Pokhara overturned after having to avoid a speeding car on the wrong side of the road who’d miscalculated an overtake. We were fine, as was everyone in the coach apart from our Annapurna guide, who smacked his knee hard. We were lucky, but it could have been much worse.
    Everyone was fine, fortunately.

  9. Wear synthetic underwear. Seriously. If you’re walking a lot, or spending a lot of time in hot and humid conditions, you don’t want to be wearing cotton underwear, because they absorb water and will at best be very uncomfortable, and worst cause such severe chafing that you can barely move, or it gets infected. Synthetic underwear doesn’t absorb water, so it’s way more comfortable, particularly for trekking and/or humid weather. It’s also great for impromptu outdoors swimming, because your pants will dry quickly and frankly they’re also less transparent when wet than cotton pants…
    Swimming in cold water in El Bosque, Andalusia.

    Snorkelling in Thailand.
  10. Go offline. Going off-grid can be a great experience, especially if it’s for a decent amount of time. If you get a chance to get out into the wilderness, the mountains, or out to sea, then use that opportunity to go fully offline and away from the distractions of modern life. We went off-grid for about 12 days on our trek to Annapurna Base Camp, and it made an amazing experience even better.
    Prayer flags at Annapurna base camp

    Although initially you might suffer from bad FOMO, or fear that your parents and friends might worry if they don’t hear from you (by the way, you should probably tell people you’re going offline lest they spark an international manhunt), after a few days you’ll feel back in touch with the real world a little more, maybe feel a bit more calm, and able to be more present in the moment. You might even find that after a week or two of being off-grid, you really don’t want to reconnect after all.

    Taking the night train to Saigon
Jade relaxing on a snorkelling trip in Thailand

Finally, here’s a few bonus tips that didn’t quite make it to the top ten:

  • Shower gel is a fine alternative to washing machine detergent. Just don’t use too much.
  • Toilet paper is valuable stuff, always keep some with you, especially on a mountain trek. A roll of toilet paper can cost the same as a night’s accommodation high up in the mountains.

    The Himalayas at sunrise
  • Always carry snacks, because you will definitely find yourself in places or on journeys for considerable lengths of time with no access to food. Individually wrapped cereal bars are great. Try to avoid things that melt.
  • Take digital photos of your passport and other important documents, in case you lose them, or in case you need to show them to someone but don’t have the documents on you.
Putting our feet up during a Himalaya trek.
  • Take rechargeable batteries for torches and other gear, and a charger for them. 
  • Learn to open beer and wine bottles without openers. Don’t use your teeth. 

    Mucking about (fallen angel pose) in Lisbon.
  • Carry some US dollars for emergencies. Almost everywhere accepts them as currency, or at least to change them. They’re often essential to pay for visas at the border around SE Asia too.
  • If it’s within your budget (or someone else’s), get yourself a proper adventure camera. Jade bought me the amazing Olympus Tough TG-5, which is waterproof, drop-proof, and packed with features.

    Olympus TG5 camera.
  • Get a Curve card. It’s a Mastercard, so it’s accepted nearly everywhere, and you can use it instead of your credit and debit cards, so you can keep them safe somewhere and only expose your Curve card to potentially risky ATMs and restaurant owners. Curve also converts currencies for you, saving you money on fees. Shameless promo: sign up for Curve here with code NPWZA and you’ll get £5, and so will I.
  • Take a tablet or laptop with you in order to work, research and book travel, or simply watch Netflix. We spent many, many hours on shonky wifi connections from nearby cafes watching Anthony Bourdain on Netflix. Try to download stuff to watch or listen to later if you know wifi might be patchy.

    Lemon tree in Prado Del Rey, Andalusia
  • Practise mindfulness and meditation; you’ll many have periods of time when all you can do is sit and wait, so you may as well put it to good use, and you can continue to practise when you’re back in the “real” world. If you’re new to it or prefer a little guidance, there are some great apps out there for meditation practice, such as Headspace.
Getting to Annapurna base camp

Travelling is very much about experiencing abstract, intangible things. Meeting new people, seeing different parts of the world, experiencing other cultures, eating different food and finding ways to be at ease with discomfort such as sleeping in bad beds or walking for hours with a heavy pack on your back.

Don’t worry about buying souvenirs. They’re just added weight. Take photos, record the sounds, make memories and friends.

Vietnamese fishing boats

As Bourdain says: “It seems that the more places I see and experience, the bigger I realise the world to be. The more I become aware of, the more I realise how relatively little I know of it, how many places I have still to go, how much more there is to learn.

Wild swimming in a pool in Koh Chang, Thailand.
Jade at Ninh Van Bay, Vietnam.
Getting bamboo tattoos in Thailand
Barcelona beach

Leave a comment with any travel tips you have.