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Bhutan

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Travel To Bhutan

Dubbed a happy country, Bhutan is becoming the favorite destination of many travelers around the world. Bhutan is a Buddhist country whose cultural history is influenced by Tibetan culture. Bhutan is still a monarchy. Bhutan’s land area is covered by 74% of the jungle, of which 26% are designated as protection land. Bhutan is the highest point of the surface of the earth, a rugged, mountainous country within a narrow river, and the flowing river flows into the great primordial lava, making it feel distinct from it. Bhutanese tourism must be a rich country with low tourism technology, but each year there are 7000 foreign visitors, people are very serious and love the profession of doing good jobs. This makes it easy for visitors to enjoy the day-to-day shopping.

1. Understand

1.1 Destination today

Bhutan remains a unique and special country, but for better or worse, it has opened its doors and hearts to the outside world and joined the global community. There is now almost one mobile phone for every Bhutanese and there are more than 75,000 registered vehicles (though there are still no traffic lights). The challenge ahead for the government is to bring the benefits of globalisation and capitalism to Bhutan without undermining the very things that Bhutanese cherish about their unique culture.

Democracy & Parliament
Bhutan’s parliament consists of the king (Druk Gyalpo), the National Council (upper house) and the National Assembly. The National Council consists of 25 members, 20 of whom each represent one of the dzongkhags (political districts) and there are five additional members nominated by the king. Interestingly, candidates for the National Council must not be members of a political party.

For the first (2008) and second (2013) elections, the National Assembly had 47 seats across the 20 dzongkhags. The constitution allows for adjustments to be made to the National Assembly as the population increases (to a maximum of 55 seats), and as the distribution of voters across dzongkhags changes.

Modernisation & Gross National Happiness
Despite the rapid uptake of technology, democracy and global trends, Bhutan is very aware of the dangers of modernisation and the government continues to assume a protective role in Bhutanese society. Bhutan was the first country to ban not only smoking in public places but also the sale of tobacco. Also banned are Western-style advertising billboards and plastic bags.

Issues of sustainable development, education and health care, and environmental and cultural preservation are therefore at the forefront of policy making; as are the tenets of Buddhism, which form the base of Bhutan’s legal code. Every development project is scrutinised for its impact on the local population, religious faith and the environment. Bhutan’s strict adherence to high-value, low-impact tourism is a perfect example of this. Bhutan is one of the few places on Earth where compassion is favoured over capitalism and wellbeing is measured alongside productivity. This unique approach is summed up in the much-celebrated concept of Gross National Happiness. However, even this much lauded approach has lost some of its gloss in recent years as Bhutan responds to its citizens’ demands.

Challenges & Changes
Bhutan is a tiny nation with abundant natural riches and a small, sustainable population surrounded by much larger countries with massive populations and economies. This situation has presented opportunities (the export of hydroelectricity to India provides around 50% of government revenue), but also threats in recent decades.

A rapidly growing economy and increased consumerism have led to soaring imports, primarily from India. The flow of Indian rupees (to which the Bhutanese ngultrum is pegged) out of the country resulted in a cash crisis in 2012. Many Bhutanese say they have simply caught the global bug of overspending and overborrowing. The irony of this happening in the country that introduced Gross National Happiness is not lost on the Bhutanese and is openly discussed. In the last decade, the road network has increased by over 600% and this is married to a proportional surge in car ownership. Increased mobility and aspiration has led to unprecedented migration from rural villages to urban centres where there is chronic youth unemployment. But what teenager wants to be a yak herder if it means being out of mobile phone range?

At the 2015 Climate Summit in Paris, Bhutan did not pledge to be carbon neutral; it pledged to remain carbon negative. The tiny, well-forested nation absorbs three times the carbon its economy produces. To further its green credentials, Bhutan is aiming to cut its fossil fuel dependency on India by moving to electric cars, banning export logging and achieving 100% organic food production. Hydro power is seen as the holy grail, and although it is certainly not an entirely clean or entirely green energy source, its importance to Bhutan cannot be overstated. The future earnings from the hydro-power projects in construction are already earmarked for Bhutan’s burgeoning foreign debt. An ambitious plan for 10,000 MW (megawatts) by 2020 has had a reality check through project delays and limited construction funds from India. The most likely scenario is about 3500 MW by 2020. Currently Bhutan has five operating schemes generating 1582 MW, six schemes under construction (4228 MW) and five proposed projects (8170 MW).

1.2 History

Bhutan’s early history is steeped in Buddhist folklore and mythology; it features tremendous deeds and beings with supernatural powers. It’s said that a saint who had the ability to appear in eight different forms, one of them being Guru Rinpoche, visited Bhutan on a flying tiger and left the imprint of his body and his hat on rocks. School texts describe demons that threatened villages and destroyed temples until captured through magic and converted to Buddhism. Tales abound of ghosts who destroyed temples, and angels who rebuilt them.

Lost in the Mists of Time
Researchers have attached dates to many events and protagonists in Bhutan’s vibrant history, though these often do not seem to fit together into a credible and accurate chronology. When reading Bhutanese history, it’s easier to let your imagination flow. Try visualising the spirit of the happenings rather than rationalising events as historical truth. This will, in part, help prepare you for a visit to Bhutan, where spirits, ghosts, migoi (yetis), medicine men, and lamas reincarnated in three different bodies are accepted as a part of daily life.

Bhutan’s medieval and modern history is better documented than its ancient history, but is no less exotic. This is a time of warlords, feuds, giant fortresses and castles, with intrigue, treachery, fierce battles and extraordinary pageantry all playing feature roles. The country’s recent history begins with a hereditary monarchy that was founded in the 20th century and continued the country’s policy of isolationism. It was not until the leadership of the third king that Bhutan emerged from its medieval heritage of serfdom and seclusion.

Until the 1960s, the country had no national currency, no telephones, no schools, no hospitals, no postal service and no tourists. Development efforts have now produced all these – plus airports, roads and a national system of health care. Despite the speed of modernisation, Bhutan has been famously cautious in opening its doors to tourism, TV and the internet in an effort to preserve its national identity and the environment. More recently, the exceedingly popular fourth king ensured his special place in history and the beginning of a new era for Bhutan by forsaking absolute power, introducing democracy and abdicating in favour of his son.

Early History & the Arrival of Buddhism
Archaeological evidence suggests the low-lying valleys of present-day Bhutan were inhabited as early as 1500 to 2000 BC by nomadic herders who moved their grazing animals to high pastures in summer. Many Bhutanese still live this way today. The valleys of Bhutan provided relatively easy access across the Himalaya, and it is believed that the Manas Chhu valley, in particular, was used as a migration and trade route from India to Tibet.

Some of the early inhabitants of Bhutan were followers of Bon, the animistic tradition that was the main religion throughout the Himalayan region before the advent of Buddhism. It is believed that the Bon religion was introduced in Bhutan in the 6th century AD.

Buddhism was possibly first introduced to parts of Bhutan as early as the 2nd century AD, although most historians agree that the first Buddhist temples were built in the 7th century under the instruction of the Tibetan king Songtsen Gampo.

Many of the important events in the emerging country’s early history involved saints and religious leaders and were therefore chronicled only in scriptures. Unfortunately, most of these original documents were destroyed in fires in the printing works of Sonagatsel in 1828 and in Punakha Dzong in 1832. Much of what was left in the old capital of Punakha was lost in an earthquake in 1897 and more records were lost when Paro Dzong burned in 1907. Therefore, much of the early history of Bhutan relies either on reports from British explorers, on legend and folklore, or the few manuscripts that escaped these disasters.

Guru Rinpoche

Guru Rinpoche (Precious Master) is one of the most important of Bhutan’s historical and religious figures and his visit to Bumthang in AD 746 is recognised as the true introduction of Buddhism to Bhutan. He is a notable historical figure of the 8th century and his statue appears in almost all Bhutanese temples built after this first visit.

He is also regarded as the second Buddha possessing miraculous powers, including the ability to subdue demons and evil spirits, and his birth was predicted by Sakyamuni, the historical Buddha. His birthplace was Uddiyana in the Swat valley of what is now Pakistan. Uddiyana is known in Dzongkha as Ugyen, and some texts refer to him as Ugyen Rinpoche. He is also known as Padmasambhava. Padma is Sanskrit for ‘lotus flower’ and is the origin of the Tibetan and Bhutanese name Pema; sambhava means ‘born from’.

He travelled in various manifestations throughout Tibet, Nepal and Bhutan, meditating in numerous caves, which are now regarded as important ‘power places’. He preserved his teachings and wisdom by concealing them in the form of terma (hidden treasures) to be found by enlightened treasure discoverers called tertons. His consort and biographer, Yeshe Chhogyel, urges us not to regard Guru Rinpoche as a normal human being, because by doing so we will fail to perceive even a fraction of his enlightened qualities.

Bhutanese and Tibetans differ over a few aspects of his life; we refer here to the Bhutanese tradition.

The Story of Kurjey Lhakhang
In 746 Guru Rinpoche made his first visit to Bhutan. At this time, the Indian Sendha Gyab had established himself as the king of Bumthang, with the title Sindhu Raja. He was feuding with Naochhe (Big Nose), a rival Indian king in the south of Bhutan, when Naochhe killed the Sindhu Raja’s son and 16 of his attendants. The raja was so distraught that he desecrated the abode of the chief Bumthang deity, Shelging Kharpo, who then angrily took revenge by turning the skies black and stealing the king’s life force, bringing him near to death.

One of the king’s secretaries thus invited Guru Rinpoche to Bumthang to use his supernatural powers to save the Sindhu Raja. The Guru came to Bumthang and meditated, leaving a jey (imprint) of his kur (body) in the rock, now surrounded by Kurjey Lhakhang.

Guru Rinpoche was to be married to the king’s daughter, Tashi Khuedon. He sent her to fetch water in a golden ewer. While she was away, the Guru transformed into all eight of his manifestations and, together, they started to dance in the field by the temple. Every local deity appeared to watch this spectacle, except the stony-faced Shelging Kharpo who stayed hidden away in his rocky hideout.

Guru Rinpoche was not to be set back by this rejection, and when the princess returned he changed her into five separate princesses, each clutching a golden ewer. The sunlight flashing off these ewers finally attracted Shelging Kharpo, but before he ventured out to see what was going on, he first transformed himself into a white snow lion. On seeing the creature appear, the Guru changed into a garuda, flew up, grabbed the lion and told Shelging Kharpo in no uncertain terms to behave himself. He therefore recovered Sendha Gyab’s life force, and for good measure converted both the rival kings to Buddhism, restoring the country to peace.

Shelging Kharpo agreed to become a protective deity of Buddhism; to seal the agreement the Guru planted his staff in the ground at the temple – its cypress-tree descendants continue to grow and tower over the Kurjey Lhakhang.

Further Visits by Guru Rinpoche
The Guru returned to Bhutan via Singye Dzong in Lhuentse and visited the districts of Bumthang and Mongar as well as Lhuentse. He was returning from Tibet where, at the invitation of the Tibetan king Trisong Detsen, he had introduced Nyingma Buddhism and overcome the demons that were obstructing the construction of Samye Monastery.

At Gom Kora, in eastern Bhutan, he left a body print and an impression of his head with a hat. He flew in the form of Dorji Drakpo (one of his eight manifestations) to Taktshang in Paro on a flaming tigress, giving the famous Taktshang Goemba the name ‘Tiger’s Nest’.

It is believed that Guru Rinpoche also made a third visit to present-day Bhutan during the reign of Muthri Tsenpo (764–817), the son of Trisong Detsen and the 39th king of Tibet.

The Eight Manifestations of Guru Rinpoche
The Guru is depicted in eight forms (Guru Tshengay). These are not really different incarnations, but representations of his eight main initiations, in which he assumed a new personality that was symbolised by a new name and appearance. Because initiation is equivalent to entering a new life, it is a form of rebirth. Therefore the eight forms follow the chronology of Guru Rinpoche’s life.

He emerged as an eight-year-old from a blue lotus on Lake Danakosha in Uddiyana, and was adopted by King Indrabodhi. Then he was called Tshokye Dorji (Diamond Thunderbolt Born from a Lake). He later renounced his kingdom and went to receive teachings and ordination from the master Prabhahasti in the cave of Maratrika (near the village of Harishe in eastern Nepal), becoming Sakya Senge (Lion of the Sakya Clan). In this form he is identified with Sakyamuni, the historical Buddha.

After studying the teachings of the Vajrayana and mastering the sciences of all Indian pandits, he obtained full realisation and was able to see all the gods and deities. Then he was called Loden Chogsey (Possessor of Supreme Knowledge). He took as his consort Mandarava, the daughter of the king of Zahor (in the Mandi district of Himachal Pradesh, India). This enraged the king, who condemned them both to be burned, but through his powers the Guru turned the pyre into a lake and converted the kingdom to Buddhism. Then he was called Padmasambhava.

He returned to Uddiyana to convert it to Buddhism, but was recognised as the prince who had renounced his kingdom and was condemned to be burned along with his consort. Again he was not consumed by the fire and appeared sitting upon a lotus in a lake. This lake is Rewalsar – also called Tsho Pema (Lotus Lake) – in Himachal Pradesh, and is an important pilgrimage spot. His father, King Indrabodhi, offered him the kingdom and he became Pema Gyalpo (Lotus King), remaining for 13 years and establishing Buddhism.

When he was preaching in the eight cremation grounds to the khandromas (female celestial beings), he caught the life force of the evil deities and he turned them into protectors of Buddhism. Then he was called Nyima Yeozer (Sunbeam of Enlightenment). Later, 500 heretic masters tried to destroy the doctrine of Buddha, but he vanquished them through the power of his words and brought down a thunderbolt destroying the non-Buddhists in a flash of hail and lightning. He was then called Sengye Dradrok (Roaring Lion).

When he came to Bhutan the second time and visited Singye Dzong in Kurtoe and Taktshang in Paro, he was in the form of Dorji Drakpo (Fierce Thunderbolt). He subdued all the evil spirits hindering Buddhism and blessed them as guardians of the doctrine. In this form, Guru Rinpoche rides a tigress.

Medieval Period
The grandson of Trisong Detsen, Langdharma, ruled Tibet from AD 836 to 842. As a follower of Bon, he banned Buddhism, destroyed religious institutions and banished his brother, Prince Tsangma, to Bhutan. It is believed that many monks fled from Tibet and took refuge in Bhutan during this period. Despite the assassination of Langdharma and the reintroduction of Buddhism, Tibet remained in political turmoil and many Tibetans migrated to western Bhutan.

Between the 9th and 17th centuries, numerous ruling clans and noble families emerged in different valleys throughout Bhutan. The various local chieftains spent their energy quarrelling among themselves and with Tibet, and no important nationally recognised political figure emerged during this period.

Establishing the Bhutanese Form of Buddhism
Back in Tibet, Lama Tsangpa Gyarey Yeshe Dorji (1161–1211) founded a monastery in the town of Ralung, just east of Gyantse, in 1180. He named the monastery Druk (Dragon), after the thunder dragons that he heard in the sky as he searched for an appropriate site upon which to build a monastery. The lineage followed here was named after the monastery and became known as Drukpa Kagyu.

In the 11th and 12th centuries there was a further large influx of Tibetans into Bhutan. Many Drukpa lamas left Tibet because of persecution at the hands of the followers of rival Buddhist lineages. Most of these lamas settled in western Bhutan and established branches of Drukpa monastic orders. Western Bhutan became loosely united through the weight of their teachings. Charismatic lamas emerged as de facto leaders of large portions of the west, while the isolated valleys of eastern and central Bhutan remained separate feudal states.

One of the most important of these lamas was Gyalwa Lhanangpa, who founded the Lhapa Kagyu lineage. He established the Tango Goemba on a hill above the northern end of the Thimphu valley and built a system of forts in Bhutan similar to the dzongs found in Tibet.

Lama Phajo Drukgom Shigpo (1184–1251), a disciple of Lama Tsangpa Gyarey, came to Bhutan from Ralung and defeated Lama Lhanangpa. He and his companions developed the small Dho-Ngen Dzong on the west bank of the Wang Chhu and took control of the Tango Goemba. Lama Phajo is credited with forging the Bhutanese form of Buddhism by converting many people to the Drukpa Kagyu lineage. Other lamas resented his presence and success, and they tried to kill him through the casting of magic spells. Phajo, though, turned the spells back on these lamas, destroying several of their monasteries.

Between the 13th and 16th centuries, the Drukpa Kagyu lineage flourished and Bhutan adopted a separate religious identity. Several important Druk Kagyu teachers from Ralung were invited to preach and set up monasteries in western Bhutan. Among the visitors to Bhutan during this period was Lama Ngawang Chhogyel (1465–1540). He made several trips and was often accompanied by his sons, who constructed several monasteries. They are credited with building the temple of Druk Choeding in Paro and Pangri Zampa and Hongtsho goemba near Thimphu.

Perhaps the most famous Druk Kagyu teacher was the colourful and unconventional Drukpa Kunley (1455–1529). He is remembered today with immense affection and faith by the Bhutanese and is closely associated with the beautiful temple of Chimi Lhakhang between Lobesa and Punakha.

1.3 Basic stats

Currency
Bhutanese Ngultrum (Nu)

Inflation
5.7%

Language Spoken
Dzongkha

Time
Bhutan Time (GMT/UTC plus six hours; 30 minutes later than India, 15 minutes later than Nepal)

Population
741,919

GDP
US$2612 per capita

Population per Sq Km
Bhutan: 19

USA: 35

India: 420

Percentage: Belief Systems
* 75 Buddhist

* 22 Hindu

* 3 Other

If Bhutan Were 100 People
* 50 would be Bhote

* 25 would be Nepali

* 15 would be tribal

2. On the ground

2.1 Activities

There are numerous opportunities to leave the vehicle for a day and stretch your legs. You won’t regret organising a day hike, particularly if you are moving quickly between regions. There are also more serious treks, ranging from three to 24 days.

Bird-Watching
Bhutan is rightly celebrated for its wintering populations of the vulnerable black-necked crane, but with over 600 recorded bird species and a spectacular range of habitats, this tiny country is a birdwatchers’ paradise.

Although these companies specialise in birdwatching tours, Bhutan’s plentiful mature forests and lack of hunting makes any travel a bird-spotting opportunity.

  • Bhutan Birding & Heritage Travels
  • Sunbird Tours
  • Wings

Fishing

Fishing with lure or fly for brown trout is possible in many rivers, though it is frowned upon by many Bhutanese for religious reasons. A licence (Nu 500 per day) is required (ask your tour agency) and fishing is prohibited within 1km of a monastery, temple, dzong or shedra (Buddhist college). A closed season applies from October to December and fishing is banned on many religious days throughout the year. A legendary game fish of subcontinent rivers, the golden mahseer, is considered threatened in Himalayan rivers because of habitat destruction, dam building and pollution. Although Bhutan has been relatively free from the type of development that threatens natural river ecosystems, the recent surge in hydro-power developments has scientists and anglers concerned.

Yangphel Adventure Travel operates fly-fishing tours and encourages a ‘catch and release’ approach.

Golf
The international-standard golf course, Royal Thimphu Golf Club, in Thimphu, is open to nonmembers.

Cycling
Mountain biking is popular with Bhutanese and expats alike. Tour companies that specialise in cycling tours, have bikes for hire and can advise on routes include Yu-Druk Bicycle and Bhutan Biking Tour. Internationally, check out Bhutan By Bike. Some adventure-travel companies organise trips that allow bikers to bring their own cycles and travel throughout Bhutan accompanied by a support vehicle; otherwise local mountain-bike hire costs an extra US$30 per day.

Long journeys are challenging because there’s a lot of uphill peddling and approaching vehicles roar around corners, not expecting cyclists. Local cycling excursions in the Paro, Thimphu and Bumthang valleys offer a safer and less-strenuous mountain-biking experience. Suggested places:

  • Cheli La For a wild ride, get dropped off at the top of this pass and ride 35km nonstop, downhill, either on the main road or on logging roads via Gorina.
  • Paro valley The paved road to Drukgyel Dzong and the return trip along the unpaved western farm road from Satsam make this a 30km day trip.
  • Phobjikha Bike trails here are part of the local ecotourism initiative, and there are also new opportunities to follow graded logging roads to Tsele La and overnight to Tikke Zampa.
  • Punakha Offers several dedicated mountain-bike trails.
  • Tango and Cheri A fine day trip north of Thimphu, combining biking and hiking.
  • Thimphu to Paro An interesting ride, though traffic can be heavy as far as Chhuzom (the turn-off to Phuentsholing).

Tour of the Dragon & Dragon’s Fury
Bhutan’s premier mountain-bike event is the tortuous Tour of the Dragon (www.tourofthedragon.com), a race of 268km from Bumthang to Thimphu in just one day. The course gains 3790m and descends 3950m and crosses four mountain passes on Bhutan’s famously winding roads. The tour takes place on the first Saturday in September and international registration costs US$250. If all that sounds a little too extreme, there is the gentler Dragon’s Fury, a mere 60km doddle ascending 1740m from Metshina to Dochu La before the roll down to Thimphu. It’s run on the same day as the Tour of the Dragon and international registration costs US$100.

Rafting & Kayaking
Though the rafting scene in Bhutan is still developing, those who have scouted the rivers feel that it has great potential.

Small groups of paddlers have been exploring 14 rivers and over 22 different runs that vary from class II (beginner with moderate rapids) to class V (expert only). However, unless you are a seasoned river rat, and can organise the special permission required, there are essentially only two day trips on offer: the Pho Chhu and Mo Chhu, both in the Punakha valley.

Most companies can book you on either of these trips. The fees depend on the group size: five or more US$75 per person; less than five US$375 per raft. The following companies run rafting and kayaking trips.

Northwest Rafting Company US-based operator with a four-day trip on the Drangme Chhu in Eastern Bhutan.

  • Druk Rafting Service
  • Lotus Adventures
  • Xplore Bhutan

Treks

Why Go?
Almost two-thirds of Bhutan still lies beyond the reach of any road. Composed of rugged Himalayan summits, high passes, pristine forests, turquoise lakes, rolling yak pastures, traditional villages and a healthy sprinkling of exotic wildlife from hornbills to snow leopards, this is perhaps one of the world’s best-preserved (and least-explored) landscapes.

Bhutan offers a wide range of treks, from tough high-altitude expeditions to the base camps of snowcapped Himalayan giants to relaxing community-based village trails linked by subtropical forest. And with walks ranging from two days to one month, there’s a trek for everyone.

Perhaps the best part of all is that you can trust your Bhutanese tour agent, guide and cook to take charge of every conceivable camping chore, leaving you to simply relax, enjoy the trail and soak up the extraordinary scenery. Shangri-La indeed.

Best Views

  • Jangothang, Jhomolhari trek
  • Thanza, Snowman trek
  • Pangalabtsa pass, Dagala Thousand Lakes trek
  • Chebisa valley, Laya–Gasa trek
  • Soi Yaksa valley, Jhomolhari Loop trek
  • Best Cultural Sights
  • Khaine Lhakhang, Rodang La trek
  • Jili Dzong, Druk Path trek
  • Lingzhi dzong, Jhomolhari trek
  • Laya village, Laya–Gasa trek
  • Nabji village, Nabji trek

Top Tips
You’ll enjoy your trek much more if you are in decent physical shape, so spend a month or more beforehand doing some training hikes and breaking in your trekking shoes.
During the day you won’t have access to your main bag on a trek, so always carry the following items in your daypack: sun hat, rain shell, spare T-shirt, camera, MP3 player, fleece, water bottle and purification, and trail bars.
For the same reason always have the following emergency items on your person: toilet paper, blister kit, sunscreen, first-aid kit, headache tablets, acetazolamide (Diamox), whistle and torch.
You won’t find much electricity on longer treks so consider a solar-charging device such as a Solio (www.solio.com). During particularly cold nights keep your batteries in your sleeping bag to stop them from draining.

2.2 Sleeping

Tour operators will book you into hotels approved by the Tourism Council of Bhutan (TCB). Since most visitors effectively pay the same rate across the category, it makes sense to ask for information about the various options when you make your travel arrangements.

Hotels Tourist-quality hotels range from simple but comfortable pine-clad rooms included in the daily fee to luxurious five-star resorts attracting a premium tariff.
Local Hotels These hotels tend to be noisier and with firm mattresses and are a last resort only.
Homestays The only accommodation in some parts of the east and providing unparalleled immersion into local culture.

Hotels

Accommodation in Bhutan ranges from simple mountain huts to five-star luxury resorts, though most tourists will stay in comfortable midrange tourist hotels equipped with electricity, telephone, TV, private bathroom and hot water. Every hotel has a restaurant that serves buffet meals when a group is in residence and offers à la carte dining at other times. Many hotels in Thimphu and Paro have wi-fi, but internet connectivity diminishes as you head away from these centres.

Larger hotels offer standard, deluxe and suite accommodation, although the difference between standard and deluxe in many hotels is minimal. When you book a trip, you may specify which hotel you wish, but your agent may have a list of hotels with whom they have contracts or relationships. Changes and cancellations will be much simpler and upgrades more likely in these hotels. You’ll find that smaller agencies often have a hard time getting guaranteed rooms at hotels owned by larger tour companies. During the low season (December to February, June to August), hotels often discount their rooms by as much as 30% so you may be able to negotiate an upgrade during these months.

During tsechu (dance festival) time, tourist hotels add a hefty surcharge, but they still get booked up and you may well find yourself ‘bumped’ into budget digs, such as the local hotels used by domestic travellers and Indian traders. Also out east, where there is not an oversupply of hotels, your only choice may be a local hotel. These can still be comfortable, though the mattresses (thin) and toilet facilities (squat or with makeshift plumbing) may not be quite what you’re used to.

A confirmed hotel reservation does not always guarantee a booking in hotels as small as those in Bhutan. A large tour group can exert a powerful influence and you may discover that there is an extended negotiation taking place between your guide and the desk clerk when you check-in. Don’t worry; something will be arranged.

Bhutan has a growing number of luxury options, including the Uma, Amankora, Zhiwa Ling and Termalinca resorts. For these you will have to pay a substantial supplement on top of the standard tourist tariff. These hotels are marked as ‘luxury’. For these luxury hotels you should get at least a 30% discount off the full rate during the low season.

Winter is cold in Bhutan and central heating is rare. In Thimphu and Paro there are small electric heaters, and in Bumthang many hotel rooms are heated by a wood stove called a bukhari, which often has a pile of rocks on the top to retain the heat. These stoves are flued to the outside and should not be at risk of causing carbon monoxide poisoning. Nevertheless, not all flues are 100% sealed and fires do consume oxygen, so some venting, such as opening a window, is recommended. Unless you are trekking, you won’t need to carry bedding or a sleeping bag.

If there is an electric water heater (called a geyser) in the room, check that it’s turned on when you check in. The better hotels supply bottled drinking water in the rooms, but if you come across an open water flask in your room, don’t drink from it.

Indian travellers and resident foreigners often get an automatic 20% or 30% discount on hotel room rates, while Bhutanese may get 50%.

Hot-Stone Baths
Most hotels offer a dotsho (traditional hot-stone bath), a simple coffin-like wooden box containing water warmed with fire-heated rocks. The red-hot rocks tumble and sizzle into the water behind a grill that protects the bather’s skin. More traditional places add natural herbs such as artemisia. You’ll need to book a couple of hours in advance for the rocks to heat up; expect to pay around Nu 2000 for the experience, double this in top-end places. Bring a towel and soap in cheaper places.

2.3 Eating

Since most travel in Bhutan is via an all-inclusive package, most of your meals will be in the shape of a hotel or trekking-camp buffet, with a mix of continental, Indian, Chinese and Bhutanese dishes, plus vegetarian options and rice. The food is fine but is specifically created to not offend anyone, so it can be bland. Small groups can often order from the menu, though the buffet meals offer a wider selection. If you find the tourist food bland, request some of what your guide is eating. It will be much tastier, if you can take the heat.

The Basics
Your guide will arrange all your meals in advance, whether that’s a roadside restaurant or at your accommodation. However, your guide should be able to suggest a new venue if you are staying in the same hotel for several days.

Hotel restaurants Most of your meals, especially breakfast and dinner, will be a buffet at your place of accommodation.
Roadside restaurants Well organised with pre-arranged buffets but if you turn up unannounced the pickings may be slim.
Local hotels and restaurants Not always as hygienic as they should be, these places will test your chilli tolerance.
Cafes Espresso and cream cakes are slowly making inroads into Bhutan

Practical Information

On long day drives or hikes you will not return to your hotel for lunch, and most tour operators arrange a packed lunch. This is usually delicious and can even be a hot lunch packed inside a series of metal containers packed inside a wide insulated flask.

The food in hotels is often the best in town, but if you want to sample local restaurants, especially in Thimphu or Paro, your guide can arrange it. Your tour operator should pay for your restaurant meals, with the exception of a few upper-end restaurants in Thimphu and casual visits to cafes for snacks. In almost all restaurants it’s a good idea to order an hour or more in advance, or expect to wait forever. If you are ordering from a menu, don’t be surprised if many of the offerings are not available.

Due to the unique nature of travel in Bhutan, restaurant opening hours have little meaning. Almost all tourists will have breakfast in their hotel and guides will pre-arrange lunch and dinner in restaurants or hotels, which will normally offer a buffet or set meal at whatever time your guide determines.

Staples & Specialities

The Bhutanese love chillies, so much in fact that some dishes consist entirely of chillies, accompanied by chilli-infused condiments. The mouth-scorching meals will bring tears of joy to the eyes of chilli lovers, and tears of pain to everyone else! Although chillies are ubiquitous, don’t expect the aromatically spiced dishes typical of the subcontinent. These can only be found in the Nepali-influenced south of Bhutan or in an Indian restaurant.

Bhutan’s national dish is ema datse, large green (sometimes red, but always very hot) chillies, prepared as a vegetable, not as a seasoning, in a cheese sauce. Hotel and trekking cooks make some excellent nonspicy dishes, such as kewa datse (potatoes with cheese sauce) and shamu datse (mushrooms with cheese sauce). More seasonal are the delicious asparagus and unusual nakey (fern fronds), the latter typically smothered in the ever-present datse.

Beef and fish come from India or Thailand, usually flown in frozen and safe. During the summer you may be limited to chicken, or a vegetarian diet in more remote parts of the country. Yak meat is available, but only in winter. Dessert is most often a modest presentation of fruit – apple, banana, pineapple or orange, depending on the season.

Foremost among several Tibetan-influenced snacks are momos, small steamed dumplings that may be filled with meat or cheese – delicious when dipped in a chilli sauce. Fried cheese momos are a speciality of several Thimphu restaurants. Look for the strings of rock-hard, dried yak cheese, chugo, hanging from shop rafters, but be careful of your teeth.

Although there is plenty of white rice, the Bhutanese prefer a locally produced red variety, which has a slightly nutty flavour. At high altitudes wheat and buckwheat are the staples. In Bumthang, khule (buckwheat pancakes) and puta (buckwheat noodles) replace rice as the foundation of many meals.

Chewing the Nut

One of the great Bhutanese vices is chewing doma nut, also known by its Indian name, paan. The nut (from an Areca palm) is mixed with lime powder (the ash, not the fruit), and the whole collection is rolled up in a heart-shaped betel leaf and chewed slowly. It’s a bittersweet, mildly intoxicating concoction and it stains the mouth bright red. The blood-like stains you see on Bhutanese pavements are the result of spat out doma effluent. Or they’re just bloodstains…

2.4 Drinking and nightlife

Cafes with espresso, cakes and wi-fi are popping up all over Thimphu, but away from the capital they are thin on the ground. Thimphu is also the place for cosy bars and cocktails; elsewhere you will be mostly restricted to your hotel bar serving local and imported liquor and local beer. Remember bars are closed on Tuesdays. The capital has a limited number of dance clubs and live music venues.

Nonalcoholic Drinks

Avoid drinking tap water anywhere in Bhutan. Bottled water is widely available and most hotel rooms have kettles.

Indian-style sweet milky tea (ngad-ja) is widely available and often referred to as either masala tea or ‘ready-made’ tea. Less satisfying is the tourist equivalent, a tea bag that you only get some flavour from after endless prodding. Bhutanese frequently drink sud-ja, Tibetan-style tea with salt and butter, which is more like soup than tea, and surprisingly tasty and warming on a cold day. Filter coffee and espresso is available in top-end hotels and a few cafes in Thimphu and Paro, but elsewhere ‘coffee’ is invariably of the instant variety.

Alcoholic Drinks

The best beer brewed in Bhutan is the very good Red Panda weissbier, a tangy unfiltered wheat beer bottled in Bumthang. Bhutan Brewery produces Druk Lager, Druk Supreme and the high-alcohol (8%) Druk 11000. Imported beers, such as Singha and Tiger, are available, but the well-priced locally brewed products dominate the shelves.

There are several brands of Bhutanese whisky but the most common local brew is bang chhang, a warm beer-like drink made from wheat. The favourite hard drinks are arra, a spirit distilled from rice, and sinchhang, which is made from millet, wheat or rice.

Drinks, including bottled water, are usually charged as extras, and payment is collected at the end of the meal or the following morning when you check out of the hotel.

2.5 Entertainment

Thimphu has a modern cinema showing Bhutanese movies where the scenery is unmistakably Bhutan, although the themes often pay homage to Bollywood.

Always be on the lookout for archery competitions no matter where you are in Bhutan. These tournaments of skill are usually very entertaining, combining singing, drinking, chanting and deadly arrows!

2.6 Shopping

Handicrafts, including Bhutan’s celebrated textiles, extraordinary masks and Buddhist paraphernalia, are on most visitors’ shopping lists. Traditionally haggling was not as common here as in Nepal or India, but these days you’ll notice the price will drop remarkably as soon as you lose interest in a purchase. Overall the quality is good and vendors are happy to let you browse without the hard sell so common in neighbouring countries.

2.7 On the ground

Which region of Bhutan you decide to visit will most likely depend on how much time you can afford to spend here. The vast majority of visitors quite naturally focus on the west and Thimphu. With its excellent tourist infrastructure, fantastic sights and spectacular festivals, it allows you to see the most of Bhutan in the shortest amount of time.

Central Bhutan on the other hand sees fewer tourists and is a quieter, dreamier collection of alpine valleys and historical monasteries. The winding roads east are for adventurers, weaving researchers and migoi (yeti) hunters. It offers warmer, wetter and wilder climes, tougher travel and, some would say, the ‘real’ Bhutan, untouched by group tourism or even much of the modern age.

Thimphu

  • Shopping
  • Museums
  • Modern Bhutan

Traditional Handicrafts
Thimphu not only has the best handicraft shops in the country (it does), it’s also the best place to actually see the products being made, from traditional paper and incense factories to local silversmiths and weaving workshops.

Bhutanese Culture
The best general museums are not in Thimphu (try Paro and Trongsa instead), but for specialised interests such as Bhutanese medicine, traditional country life and the country’s rich textile tradition, this is the place.

Cultural Collisions
Thimphu is the beachhead for globalisation in Bhutan. It’s the place for contemporary Bhutanese art and culture, as well as espresso coffee and pizza. And there’s nowhere better to witness cultural collisions that sum up Bhutan’s inherent quirkiness – monks with mobiles and lamas with laptops are a daily sight.

Western Bhutan

  • Architecture
  • Trekking
  • Scenic Views

Religious Monuments
If you only visit two towns in Bhutan, make them Paro and Punakha. The west is blessed with the country’s loveliest dzong (Punakha), one of its oldest lhakhangs (Kyichu Lhakhang) and its most dramatic monastery (Taktshang Goemba). These are the big sights that you simply have to see.

Mountain Exploration
From awesome Jhomolhari to the remote land of Laya, and the well-worn trails of the Druk Path, Bhutan’s most popular trek, the west offers you lots of opportunities to combine cultural sights with a walk in the mountains.

Himalayan Majesty
In October or November, a trip to the Dochu La, with its view of Himalayan peaks framed by chortens and prayer flags, is a literal highpoint, rivalled only perhaps by views of Jhomolhari from the upper Paro valley.

Central Bhutan

  • Architecture
  • Hiking
  • Buddhism

Bhutanese Heartland
The heartland of central Bhutan is Bumthang, a delightful collection of Swiss-style valleys sprinkled with golden-roofed chapels, remote red-walled goembas and sacred temples, including the fabulous 1500-year-old Jampey Lhakhang.

Valley Trails
Bumthang offers the best day hikes through bamboo forest and yak meadows, past chortens to remote monasteries. The delightful Bumthang Cultural trek goes through moss-covered forests, while the villages of Ura and Shingkhar are great for strolls.

Sacred Landscape
The line separating fact and fiction can be fuzzy in Bhutan. Stand where Guru Rinpoche wrestled a snow lion, run your hand over meditation caves etched with the body prints of saints and peer into a lake full of treasure visible only to the virtuous. It’s a sacred landscape.

Eastern Bhutan

  • Off the Beaten Track
  • Dramatic Drives
  • Handicrafts

Remote Adventures

Bhutan’s wild east is for the hardy. Long, winding drives ending in simple accommodation is the norm here. Temples and villages are more traditional and you are likely to have them to yourself. Just don’t come during the monsoon…

Changing Landscapes
Roads in the east often inch along sheer cliff faces on a ledge not quite wide enough for two vehicles. Expect a thrilling drive. The variety of landscapes is equally impressive, from the heights of Thrumshing La and the lush Himalayan foothills down to the subtropical.

Village Looms
Eastern Bhutan is the heartland of the country’s rich weaving traditions. Enthusiasts can wander the village looms of Khoma and find out which natural dye comes from insect secretions at Khaling.

3. Organize your time

3.1 Itineraries

A long weekend in Paro and Thimphu – 4 Days
If you have limited time or money, you can get a good impression of Bhutan in just four days by concentrating on Thimphu and Paro.

Count on two full days in picturesque Paro, visiting Paro Dzong and the National Museum. On the second day, hike up to the dramatic Tiger’s Nest, Taktshang Goemba, and visit lovely Kyichu Lhakhang. After lunch, make the three-hour drive to Thimphu, stopping at the charming Tamchhog Lhakhang en route.

On day three you could squeeze in a long day trip over the Dochu La to Punakha Dzong, the most beautiful dzong in the country. In March, budget an hour to walk through the colourful rhododendron forests above Dochu La. On the way back to Thimphu, pop into the nearby Chimi Lhakhang, the temple of the ‘Divine Madman’.

Day four is in Thimphu. Go to the weekend market and visit Cheri Goemba or Tango Goemba in the upper Thimphu valley. If handicrafts are your thing, hit the National Textile Museum and National Institute for Zorig Chusum. Late in the afternoon, drive back to Paro; most flights depart early in the morning.

Haa to Punakha – 7 Days
If you’re thinking about a four-day trip, consider a seven-day trip. It’s not that much more money and, really, when are you next going to be in Bhutan? A week gives you more time to get a feel for Bhutanese culture and enables you to get off the beaten track in either the Haa or Phobjikha valleys, while still seeing the major dzongs and monasteries of western Bhutan.

Figure on two full days in Paro, including visits to Taktshang Goemba and Kyichu Lhakhang in the Paro valley, and a full day (or two) in Thimphu. A few tips: try to be in Thimphu on a Saturday or Sunday to see the weekend market and avoid Paro on Monday, when the National Museum is closed. If you’re lucky, you may be able to catch a weekend archery tournament in Thimphu or Paro.

To get off the beaten track, add on an overnight trip to the Haa valley, on the road that links Paro to Thimphu. The road goes over the highest driveable pass in Bhutan, the Cheli La, and it’s worth a short detour to visit Kila Nunnery or Dzongdrakha Goemba. Arrive in Haa at lunchtime, and spend an afternoon, and maybe the next morning, exploring the Juneydrak Hermitage and Shelkar Drak, before continuing on to Thimphu.

With the extra days you can definitely add an overnight trip over the mountains to Punakha. This way you’ll have time to make the 1½-hour return hike to the nearby Khamsum Yuelley Namgyal Chorten, as well as visit Chimi Lhakhang, and maybe even a short rafting trip.

If you don’t visit Haa, you might be able to add on a day trip to the Phobjikha valley, especially worthwhile in winter (November to February) when the valley’s black-necked cranes are roosting. Bring some warm clothes and a torch (flashlight).

At some point during your trip, ask your guide to arrange a Bhutanese hot-stone bath, available in most tourist hotels (for a charge). Throw in a festival and you have the perfect introductory visit to Bhutan.

To Bumthang – 2 Weeks
A 10-day itinerary should just about allow you two or three days in Bumthang, with overnight stops in Paro, Thimphu and Punakha and a quick stop in Trongsa. But a full two weeks will let you see the same places in more depth, at a more relaxed pace, with time for a couple of day hikes.

If you are travelling before 2018, check with your agent to see whether the current roadworks will slow you down.

Follow the four-day itinerary for your first days. From Thimphu, a night in the Phobjikha valley will give you a chance to see Gangte Goemba and also view the rare and endangered black-necked cranes (November to February). Phobjikha is a great place to explore by mountain bike.

From Phobjikha, it’s a day’s drive over the Pele La to the superb dzong and museum at Trongsa and on to Jakar in Bumthang. Leave early, as there’s lots to see en route, including the Nepali-style Chendebji Chorten, which is a perfect place for a picnic.

If you have two full days in Bumthang, spend one day doing a loop in the Chokhor valley, taking in the Jampey Lhakhang, Kurjey Lhakhang and walking to Tamshing Goemba. Your second day here should be spent exploring the Tang valley, visiting Membartsho (Burning Lake) and the interesting Ogyen Chholing Museum near Mesithang. If you have an extra day, overnight in the Ogyen Chholing Guest House and hike down to the road via the remote rural chapels of Choejam Lhakhang and Narut (Pelphug) Lhakhang.

The Bumthang valley is a great place for some hiking, so budget half a day to stretch your legs after a week’s driving. From Jakar, it’s a two-day drive back to Paro, so spend a night near Wangdue Phodrang. Alternatively, save some time by flying back from Bumthang to Paro.

If you intend to visit India in conjunction with Bhutan, consider driving from Thimphu or Paro to Phuentsholing instead of flying, which will add a day to the itinerary. From here you are only a few hours from Darjeeling, Kalimpong and Sikkim, as well as the airport at Bagdogra, which has frequent flights to Delhi and Kolkata (Calcutta).

Eastern explorations- 16 Days

It takes at least two weeks to make a trip out to the little-visited far east and we’d suggest throwing in a couple of extra days to allow for some rest and recuperation.

There’s a lot of driving involved (up to five hours a day in eastern Bhutan) but it should now be possible to fly back to Paro from Yongphula (near Trashigang). You could also avoid the long drive back to Paro by exiting Bhutan at Samdrup Jongkhar, as long as you have arranged an Indian visa in advance. This is a particularly good trip if you’re interested in traditional weaving.

Follow the earlier itineraries from Paro as far as Bumthang (or fly there), from where you can see the highlights of the east in five or six days. From Bumthang, day one takes you on a dramatic drive over the Thrumshing La (3750m) and Bhutan’s wildest road to Mongar. Stay here for two nights and make a scenic day trip up to remote Lhuentse Dzong and the nearby traditional weaving village of Khoma. To cut down on the driving, consider instead a day’s hiking off the beaten track around Mongar.

Day three takes you on to funky Trashigang, with an optional two- or three-hour detour along the way to Drametse Goemba, Bhutan’s most important Nyingma monastery. Accommodation standards in the east are not as good as western Bhutan, so bring a sense of humour as well as bug spray.

Figure on two nights at Trashigang, with another great day excursion to Trashi Yangtse, with stops en route at the pilgrimage site of Gom Kora, the old Trashi Yangtse dzong and the Nepali-style Chorten Kora. March and April bring two important pilgrimage festivals to this region. Spend a second day here to go crane-spotting in Bomdeling Wildlife Sanctuary or to hike via Dechen Phodrang pilgrimage site.

From Trashigang, it’s a full day’s winding drive down to the plains at steamy Samdrup Jongkhar. From there, take a three-hour taxi ride to Guwahati (check in advance for planned strikes) then fly to Kolkata, Delhi or Bangkok, or take the overnight train to West Bengal for Darjeeling and the Nepal border.

3.2 When to go and weather

High Season (Mar–May, Sep–Nov)

The weather is ideal in spring and autumn. Book flights well in advance; accommodation options can fill up.
Himalayan views are best in October, while rhododendron blooms peak in March and April.
Shoulder Season (Dec–Feb)

Bhutan has seasonal tariffs so there’ll be fewer tourists and good savings to be made by travelling outside the high season.
The weather is still pleasant, though it can be cold in December and January.
Low Season (Jun–Aug)

Monsoon rains and leeches put an end to most treks, although high-altitude flowers are at their peak.

3.3 Month by month

Top Events

  • Thimphu Tsechu, September/October
  • Paro Tsechu, March/April
  • Punakha Drubchen, February/March
  • Ura Yakchoe, April/May
  • Jampey Lhakhang Drup, October/November

February

The mercury stays low in Phobjikha and Bumthang, but things are warmer in the lower elevations of Punakha and the east, and there are loads of festivals, with few crowds.

Punakha Drubchen

The balmy Punakha valley hosts this unique three-day event, whose highlight is a dramatic re-creation of a 17th-century battle, featuring hundreds of costumed warriors. A three-day tsechu then follows. The festival follows the lunar calendar, so it can fall in March.

Chorten Kora
Thousands of pilgrims from eastern Bhutan and Arunachal Pradesh circumambulate this stupa during two festivals, set two weeks apart. Unlike monastic festivals, this celebration feels more like a local fair. The main festival is from the 13th to 15th of the first lunar month, so can happen in March.

Losar
Bhutanese mark their New Year by painting their houses, visiting the local monastery, and holding epic archery and darts tournaments. The event follows the lunar Bhutanese calendar and there are lots of regional variations, so it can happen anytime between mid-January and mid-March.

Nomad’s Festival
Highlanders from as far away as Laya and Sakteng attend this tourism fair in the upper Bumthang valley, selling such local products as conical hats from Laya and fermented cheese from Sakteng. Traditional games and masked dances make it an interesting (if slightly contrived) addition to the festival scene.

March

Spring, from March to May, is an excellent time to visit Bhutan, for both touring and trekking. Mountain views can be cloudy, but the magnificent rhododendrons are in bloom and bird life is abundant.

Gom Kora
Hundreds of people travel to this pilgrimage site in the east of the country for a night of celebrations and ritual circumambulations of the sacred black rock. It takes place between the 8th and 10th of the second lunar month, so can be held in April.

April

April is the second most-popular month to visit Bhutan, partly because temperatures are comfortably warm. The Paro tsechu is a big draw and trekking is good.

Paro Tsechu
This very popular festival features four days of cham (religious ritual dance) followed by the predawn unfurling of a giant thangka (painted or embroidered religious picture) depicting the eight manifestations of Guru Rinpoche. The first day’s ceremonies are in Paro Dzong, before the action moves outside. It can also be held in March.

Trekking
Warm weather and continued rhododendron blooms at higher elevations make this a fine time to trek, but there’s less chance of blue skies at the top of the mountain. Bring some rain gear just in case.

May

The end of spring brings warm and dusty weather, with rain and cloud increasing towards the end of the month. The lighter crowds and good weather still make it a good month to visit, though it’s already hot at lower elevations.

Ura Yakchoe
A small-town vibe marks this three-day festival featuring religious processions, dances and local moonshine. The only problem is that dates are notoriously unreliable. The festival can happen in April, but is only fixed a few weeks in advance.

Monk Processions
On the first day of the fourth lunar month, the entire monk body moves from Punakha to the summer residence in Thimphu. The procession includes the Je Khenpo (Chief Abbot) and several sacred relics, and local people line up along the route to receive a blessing.

June & July
Monsoon clouds can obscure views and cancel flights at Paro airport. As the rains intensify, roads can wash away. The spectacular wildflowers at this time of year in the high valleys are a botanist’s dream.

Nimalung Tsechu
Bumthang is the place to visit in the fifth lunar month. Nimalung Goemba has a three-day festival starting on the eighth day, with the final day coinciding with the nearby Kurjey tsechu. Can be held in July.

Kurjey Tsechu
Monks from Trongsa Dzong perform religious dances for this one-day festival in Bumthang. The date also marks the birthday of Guru Rinpoche, which is celebrated by prayer ceremonies across Bhutan. A three-day tsechu at Nimalung Goemba starts two days before Kurjey tsechu.

Monsoon Madness
The summer monsoon (June to September) dominates Bhutan, which receives more rainfall than any other Himalayan region. The rains peak during July, making road travel to the east precarious, but the lush foliage and fresh mushrooms, mangoes and avocados go some way to compensate.

September

The first half of the month is still rainy, but by the end of it the monsoon has washed the Himalayan skies clear and several big festivals coincide with the beginning of the main tourist season.

Thimphu Tsechu
Crowds can be thick during the four days of spectacular monk dancing in Trashi Chhoe Dzong (over 3000 tourists attend each year). The event can also fall in October. The preceding three-day dromchoe festivities (celebrating the defeat of the Tibetans in the 17th century) are generally open to Bhutanese only.

Haa Tsechu
Sleepy Haa only truly wakes during this festival. Monk dances are held on the eighth and ninth days of the eighth lunar month in the courtyard of the Lhakhang Kharpo, before the final day’s action moves to nearby Wangchulo Dzong.

Tamshing Phala Choepa
The Bumthang valley offers a double shot of festivals in the eighth lunar month. From the ninth to 11th you can enjoy dances at Tamshing Goemba, before relocating three days later to nearby Thangbi Goemba for three days of festivities. Both festivals can be held in October.

Gasa Tsechu
You may have to camp to catch this remote three-day festival, but if you do, you’ll get to see masked dances and the performance of a 300-year-old folk song called goenzhey, believed to have been composed by Zhabdrung Ngawang Namgyal when he first came to Bhutan via Laya in 1616.

October

October is the single most popular month to visit Bhutan. Temperatures are warm, mountain views are clear and tour groups are everywhere. Make your hotel and flight bookings well in advance.

Jampey Lhakhang Drup
Cham dances and bonfires commemorate the establishment of this 7th-century temple. The first evening features a famous midnight ‘naked fire dance’. The fun lasts from the 15th to the 18th of the ninth lunar month, so it can occur in November. The four-day Jakar tsechu occurs a week before.

Prakhar Tsechu
This three-day festival at Prakhar Goemba, in the Chumey valley, shares the same dates as the Jampey Lhakhang Drup, so you can easily double up.

Trekking Heaven
Trekking is superb everywhere in Bhutan in October and this is when most tour companies operate their treks. Nights can be cold at high elevations, but the views of snowy peaks such as 7314m Jhomolhari are superb.

November

A good month weather-wise, though pack a jumper for the evenings. Several smaller festivals offer a good alternative to the over-visited Paro and Thimphu tsechus.

Black-Necked Crane Festival
This modern festival in Phobjikha is held on 11 November. Local children perform dances in crane costumes in the courtyard of Gangte Goemba to celebrate the winter return of more than 300 black-necked cranes.

Mongar Tsechu
Mongar offers a smaller, more intimate festival experience than most others in Bhutan, with more opportunities for photography and cultural interaction. The little-visited Trashigang tsechu occurs on the same three days, which can fall in December.

Ngang Lhakhang Shey
This three-day festival at Ngang Lhakhang (Swan Temple) in upper Bumthang features some unusual dances by noblemen from two local clans, as well as masked dances. The festival can fall in December.

Trashigang Tsechu
A little-visited, three-day festival in the far east that includes the unveiling of a large thangka and the displaying of a statue of Guru Rinpoche in the main courtyard on the last day. It shares the same dates as tsechus in Mongar and Pemagatshel.

December
December marks the beginning of winter, with possible snow at higher elevations, though it’s not a bad time for touring western Bhutan. The high passes to Haa and the east may be temporarily snowbound.

Lhuentse Tsechu
Very few tourists make it to this remote monastic festival, way out in the extreme northeast of the country. Festivities also take place simultaneously in nearby Dungkhar. The festival can be held in January.

Trongsa Tsechu
This is one of the oldest and least-visited festivals in the country. Three days of dancing run from the ninth to the 11th of the 11th lunar month, so it can be held in January. The final day features the hanging of a giant thondrol (a special-occasion thangka).

Druk Wangyel Tsechu
This new festival on 13 December features masked dances performed by the Bhutan Army atop the Dochu La, set against a rather splendid backdrop of Himalayan peaks.

Tourism Festivals
Several new tourism-oriented festivals have been inaugurated in Bhutan in recent years. While they may lack the authenticity of Bhutan’s main religious tsechus, they can be fun and are worth a visit if you are in the region. All offer traditional sports such as archery, wrestling and darts, plus mask dances, cultural dances and plenty of local foods and products. Apart from the Nomad’s Festival in upper Bumthang, try the Alpine Festival in Haa in the first or second weekend in July, the Mushroom Festival in Ura in August and the Takin Festival at Gasa in the third weekend of February.

4. Planning tools

4.1 Bhutan is known for

Fitting in Like a Local

Get a gho (or a kira) Locals love it when a chilip (foreigner) wears Bhutanese national dress, especially during a holiday or festival.

Watch an archery tournament There’s nothing more Bhutanese than the good-humoured banter of a datse (archery) or khuru (lawn darts) game.

Hang some prayer flags Earn some good karma by buying some prayer flags and hanging them at a mountain pass such as Dochu La.

Overnight in a rural farmhouse The digs are simple but the welcome warm – overnight with a local family in Ngang Lhakhang or Khoma.

Sample some local snacks Try jellied cow skin, dried yak cheese and fresh betel nut at the Paro Weekend Market.

Himalayan Treks

Without doubt, the best way to experience Bhutan is on foot, especially if you can combine a trek with a festival and the highlights of Paro and Thimphu. Come in October and November for mountain views and March for rhododendron blooms.

Druk Path Trek The walk between Paro and Thimphu takes in high-altitude lakes and remote hermitages.

Jhomolhari Trek Combines some of Bhutan’s best high-mountain scenery, with remote villages, high passes and yak pastures.

Laya-Gasa Trek Perhaps the best combination of scenery and culture, with a visit to the unique people of remote Laya.

Bumdrak Trek A short and luxurious overnighter, with a visit to several remote chapels and the Tiger’s Nest at Taktshang Goemba.

Snowman Trek One of the world’s toughest, most expensive and ultimate treks across the roof of the Bhutan Himalaya.

Pampering Yourself

Bhutan’s top-end travel is anything but tough. Uber-luxury resorts guarantee six-star treatment, with muscle-melting spas and hot-stone massage.

Hot-Stone Bath Stone, wood, hot water and artemisia herbs provide the quintessential Bhutanese experience, available at most tourist hotels.

Termalinca Not quite the Promised Land, but the milk-and-honey body wrap comes close enough; nonguests are welcome at the spa here.

Uma Paro Massage, complimentary yoga and Ayurvedic oil treatments, all featuring Como bath products.

Zhiwa Ling The Menlha (Medicine Buddha) spa here offers a tasty red rice or lemongrass body polish.

Taj Tashi Choose your mood – invigorating masala spice rub or relaxing coconut skin softener?

Wildlife & Wildflowers

Bhutan is a paradise for botanists and birders. Mountain goats and langur are easily spotted; red pandas are more commonly seen on beer labels than in trees.

Phobjikha valley Winter (end of October to mid-February) offers guaranteed sightings of one of over 300 black-necked cranes.

Dochu La One of the best places to wander through a magical forest of pink, white and yellow rhododendron blooms (March and April).

Motithang Takin Preserve Get up close to Bhutan’s odd-looking and endearing national animal, said to have inspired the legend of the golden fleece.

Royal Manas National Park Tourism is in its infancy here, but the wildlife and bird-spotting in this subtropical forest ranks as some of Asia’s best.

Day Walks

Sometimes it’s just nice to get out of the car and hike to a hillside monastery or temple. Lose the crowds and meet monks, villagers and fellow pilgrims on an equal footing.

Tango & Cheri Goembas Excellent excursion from Thimphu to two of Bhutan’s most historic monasteries.

Taktshang Goemba A two-hour hike up to the dramatic Tiger’s Nest Monastery, with more temples above.

Bumthang valley The best single destination for day hikes to silent meditation retreats and valley viewpoints.

Ura & Shingkhar Hike between these charming villages, up to a nearby retreat or into Thrumshing La National Park.

Dochu La Choose from short walks through rhododendron forests to longer hikes connecting nearby monasteries.

Cheli La Walk downhill to Kila Nunnery or uphill to a sky burial site.

Phobjikha valley Spot black-necked cranes on the lovely Gangte Nature Trail walk in this charming hidden valley.

Sacred Sites

Protector deities, spirits and saints lurk behind every pass, river junction and lake in Bhutan. These pilgrim spots are imbued with sacred significance and hold a key to understanding how Bhutanese see their world.

Taktshang Goemba Bhutan’s most famous and revered site, tied on to the cliff face by little more than the hairs of angels.

Gom Kora Pilgrims flock to this remote chorten in the far east for its collection of rock footprints, relics and bizarre sin tests.

Changangkha Lhakhang Always bustling with mothers and their babies seeking a blessing from the red-faced protector, Tamdrin.

Membartsho The serene and sacred ‘burning lake’, where Pema Lingpa found underwater treasures and performed miracles.

Hidden Gems

Bhutan’s big shows are its dzongs and festivals, but don’t overlook the charm of the country’s smaller, less-visited monasteries and temples.

Juneydrak Hermitage The Haa valley is a great place to get off the beaten track, and this timeless hermitage is its highlight.

Kila Nunnery Perched just below the Cheli La, Kila is an hour’s walk and about two centuries off the main highway.

Dumtse Lhakhang Pilgrim paths wind upwards at this snail-shell-shaped chapel past some of the country’s best medieval murals.

Tago Lhakhang A charming and easily missed 15th-century chapel inside a chorten, just south of Paro.

Dechen Phodrang Sacred stones and towering cypress trees mark this pilgrimage site, seemingly lost in time.

Festivals

Many people time their entire trip around one of Bhutan’s colourful tsechus (dance festivals). Expect swirling mask dances, playful clowns, spectacular costumes and superb photo opportunities.

Paro Tsechu Popular with groups – and with good reason – but perhaps too popular for some people’s taste.

Ura Yakchoe A quiet rural festival, though the dates are notoriously changeable. Camping is a good idea here.

Punakha Drubchen One of Bhutan’s most unusual festivals re-enacts an ancient battle; held in February or March.

Kurjey Tsechu Brave the monsoon rain and avoid the tourists, plus you can hit the nearby Nimalung tsechu at the same time.

Arts & Crafts

Bhutan’s arts and crafts vary from sacred murals to bamboo bows. For high religious art visit the dzongs and monasteries, but for handicrafts, try these fascinating workshops.

National Institute for Zorig Chusum Watch students perfect the 13 traditional arts and crafts.

Jungshi Handmade Paper Factory View the whole papermaking process.

National Textile Museum Thimphu’s impressive new complex showcases Bhutan’s most impressive art form.

Tshenden Incense Factory Breathe in the fragrance of juniper, sandalwood and high-altitude herbs at this workshop near Bondey.

Khoma Village, Lhuentse Every household has a loom in this remote centre of ‘brocade-style’ weaving excellence.

Yathra Workshops, Zungney Shop for hand-woven woollen blankets at these roadside looms on the drive to Bumthang.

4.2 Money and costs

Currency
Bhutanese Ngultrum (Nu)

Daily Costs

Fixed Daily Rate: US$250

All tourists must pay US$250 per person per day (US$200 a day from December to February and June to August), with a US$40/30 surcharge per person for those in a group of one/two. This covers accommodation, transport in Bhutan, a guide, food and entry fees.
Possible extra charges include hot-stone baths, cultural shows, horse riding, rafting, mountain bikes and tips.
Children under 12 years are exempt from the royalty component (US$65).
Budget: Less than US$150

Money

Tours are prepaid so you’ll only need money for drinks, laundry, souvenirs and tips; for this, bring cash. There are ATMs in most main towns, but it would be wise not to rely entirely on being able to use plastic. Credit cards are accepted in some hotels and souvenir shops, but only in major cities or well-touristed areas.

Currency
The unit of currency is the ngultrum (Nu), which is pegged to the Indian rupee. The ngultrum is further divided into 100 chetrum. There are coins to the value of 25 and 50 chetrum and Nu 1, and notes of Nu 1, 5, 10, 20, 50, 100, 500 and 1000. The Nu 1 coin depicts the eight auspicious symbols called Tashi Tagye, while each note depicts a different dzong.

Indian rupees may be used freely anywhere in Bhutan (don’t be surprised if you get change in rupees). Officially 500 and 1000 Indian rupee notes are not accepted due to large amounts of counterfeit notes; however, in practice 500s are usually accepted. Ngultrums cannot be used in India.

It is OK with the Bhutanese if you bring a reasonable amount of Indian currency into Bhutan, though Indian regulations prohibit currency export.

ATMs
Bank of Bhutan (BoB), Bhutan National Bank and Druk PNB Bank ATMs usually accept foreign credit cards; however, it would be prudent to get your cash in Thimphu or Paro before heading out into the countryside, particularly the far east. Transactions are limited to Nu 10,000 or Nu15,000.

Bargaining
Bargaining is not a Bhutanese tradition, and you won’t get very far with your haggling skills here, except with trail-side vendors on the hike to Taktshang and in the local handicrafts section of the Thimphu Weekend Market.

Cash
If you plan to make a major purchase, for example textiles or art, consider bringing US dollars in cash. Most shops will accept this, and it can save you the hassle of exchanging a large quantity of money in advance and then attempting to change it back if you don’t find the exact piece you were looking for.

Credit Cards
Cards are accepted at major handicraft stores and some of the larger hotels in Thimphu and towns that get many tourists, but you will often be charged a surcharge of up to 5% to cover the fees levied by the credit-card companies. PINs have to be four digits.

Changing Money
Tourist trips are fully prepaid, so you could in theory manage in Bhutan without any local money at all, though you’ll probably want to change at least US$50 to US$100 to pay for laundry and drinks, plus whatever you need for souvenirs and tips.

The exchange counters at the airport, larger hotels and the banks in Thimphu and Phuentsholing can change all major currencies, and sometimes Scandinavian currencies. If you are heading to central and eastern Bhutan, you will do better sticking to US dollars. In smaller towns, foreign-currency exchange may be an unusual transaction so be prepared for delays. You’ll often get a slightly lower rate (10% lower) if changing US-dollar bills in denominations less than US$100. US-dollar bills that are pre-1993 are generally not accepted.

You may change your unused ngultrums back to foreign currency (though usually only into US dollars) on departure from Thimphu or Paro. Travellers departing via Samdrup Jongkhar didn’t have this facility at the time of research. You may need to produce your original exchange receipts. Ngultrums are useless outside of Bhutan (except as a curiosity).

Bhutan has two major banks, the Bank of Bhutan (www.bob.bt) and the Bhutan National Bank (www.bnb.bt), each with branches throughout the country. Both change cash with no commission and charge 1% for travellers cheques. The Bank of Bhutan’s main branches are generally open 9am to 1pm Monday to Friday and 9am to 11am on Saturday, though the branches in Trongsa, Trashigang and Mongar are open on Sunday and closed Tuesday. It also has a branch in Thimphu that stays open later. Newer banks with forex include the Tashi Group’s T-Bank and Druk PNB with limited but expanding branches.

Tipping & Tax
You will usually be accompanied throughout your visit to Bhutan by the same tour guide and probably the same driver. Though it’s against the official TCB policy, these people expect a tip at the end of the trip. Many leaders on group tours.

Exchange Rates

Australia A$1 Nu49
Canada C$1 Nu51
Europe €1 Nu76
India Rs100 Nu100
Japan ¥100 Nu61
UK £1 Nu96
USA US$1 Nu67

4.3 Travel with children

Children aged under five are exempt from the minimum daily tariff and five-to-12-year-olds get a 50% discount, so it needn’t break the bank if you bring kids along. Kids may become bored with long, monotonous drives, limited availability of TV and the internet, and little other entertainment available. On the other hand, they will be immediately accepted by local kids and their families, and they could make many new friends. Lonely Planet’s Travel with Children has lots of useful advice and suggestions.

Bhutan Land of the Thunder Dragon, by Freda Ferne, is a children’s book on Bhutan; see www.bhutan-an-introduction.co.uk if you want more info or wish to buy.

4.4 Gay and lesbian travelers

4.5 Travel with disabilities

Like most Asians, the Bhutanese believe that what one does in private is strictly a personal matter, and they would prefer not to discuss such issues. Public displays of affection are not appreciated, though, and everyone, regardless of orientation, should exercise discretion. Officially, male homosexuality is illegal.

4.6 Arriving in destination

A cultural tour in Bhutan is a challenge for a traveller with physical disabilities, but is possible with some planning. The Bhutanese are eager to help, and one could arrange a strong companion to assist with moving about and getting in and out of vehicles. The roads are rough and pavements, where they exist, often have holes and sometimes steps. Hotels and public buildings rarely have wheelchair access or lifts, and only the newest will have bathrooms designed to accommodate wheelchairs.

4.7 Entry and exit formalities

Entry procedures are generally simple because your tour guide will meet you on arrival. Be sure to carry your visa authorisation form from the Ministry of Foreign Affairs.

Customs Regulations

You will receive a baggage declaration form to complete when you arrive in Bhutan. For tourists, the main purpose of this form is to ensure that you re-export anything you bring into the country. List any expensive equipment that you are carrying, such as cameras and laptops. Don’t lose the form as you must return it when you leave the country.

Duty-free allowances include 1L of liquor. You can bring in only one carton (300) of cigarettes and these attract a 200% duty upon arrival. A packet or two is normally allowed in gratis. There are no restrictions on other personal effects, including trekking gear, brought into the country.

Departure formalities are straightforward, but you’ll need to produce the form that you completed on arrival and may need to show all of the items listed on it. A lost form means complications and delays. If you lose the form, let your guide know as soon as possible so that special arrangements can be made to avoid any inconvenience.

The export of antiques and wildlife products is prohibited. If you wish to purchase a souvenir that looks old, have your guide clear it as a nonantique item with the Division of Cultural Properties, part of the Department of Culture inside the Ministry of Home and Cultural Affairs. Customs authorities pay special attention to religious statues. It would be prudent to have any such statue cleared, old or not.

Visas
Visas are arranged by your tour company and issued on arrival only to those on a prepaid all-inclusive tour.

Obtaining a Bhutan Visa
Unlike in most countries, where visas are issued from embassies abroad and stamped into your passport before you travel, visas for Bhutan are issued only when you arrive in the country, either at Paro airport or (if entering by road) at Phuentsholing, Gelephu or Samdrup Jongkhar. You must apply in advance through a tour operator and receive visa approval before you travel to Bhutan.

All applications for tourist visas must be initialised by a Bhutanese tour operator and are approved by the Ministry of Foreign Affairs in Thimphu. The operator submits an online visa application with a copy of the photo page of your passport to the Tourism Council of Bhutan in Thimphu. It, in turn, checks that you have completely paid for your trip (including the US$40 visa fee) and then issues an approval letter to the tour operator. With this approval in hand, the tour operator then makes a final application to the Ministry of Foreign Affairs, which takes up to three days to process the visa.

It’s not necessary to fill in a special visa application form. Just send a scan of your passport photo and your passport information pages to your tour operator/local travel agent. You may also need to provide your permanent address and occupation.

When the visa clearance is issued by the Ministry of Foreign Affairs, it sends a visa confirmation number to the tour operator and to Druk Air/Bhutan Airlines. The airline will not issue your tickets to Paro until it receives this confirmation number and then rechecks the visa information when you check in for the flight.

The actual visa endorsement is stamped in your passport when you arrive at one of the ports of entry for tourists. You will receive a visa for the exact period you have arranged to be in Bhutan. You will normally have already paid the visa fee of US$40 directly to your tour company. If some unusual event requires that you obtain a visa extension, your tour operator will arrange it.

It’s surprisingly efficient considering all the time, distance and various levels of bureaucracy involved. When you arrive in Bhutan, the visa officer will invariably be able to produce your approval form from the file and the visa will be issued on the spot. It’s very helpful to have a printout of the scanned visa authority to aid the immigration officials and airline to find your information quickly.

Indian Travellers in Bhutan
Indian nationals are allowed to travel on their own in Bhutan, with or without the services of a tour operator. If they choose to liaise with an operator, they are currently charged a minimum daily fee of US$135 per person (US$175 for teams of three people or less).

Indians don’t require a visa to enter Bhutan, and are given a seven-day entry-cum-stay permit at the immigration offices upon presentation of a passport or government-issued ID such as a voter’s registration card. This permit allows travel only within Phuentsholing, Thimphu and Paro, and can be extended at the Immigration Office in Thimphu for successive periods of three weeks each. Bring at least one passport photo. One can also request a route permit here to travel beyond the three above-mentioned towns. If you are driving yourself, you will need a route permit from the Royal Safety Transport Authority (RSTA) at the bus station at Phuentsholing.

Indians without stay permits can wander freely in Phuentsholing and go five kilometres into Bhutan during the day, but must return to India before 10pm.

Visas for Neighbouring Countries

India
Nationals of most countries need a visa to visit India. If you are travelling overland to or from Bhutan via the border post in Phuentsholing, Gelephu or Samdrup Jongkhar, you will need an Indian visa.

The government of India strongly prefers that you obtain your Indian visa in the country that issued your passport. It’s usually a simple task to get your Indian visa before you leave home, but it’s complicated to get one if overseas. It is possible to obtain a three-day transit visa overseas if you have confirmed flights in and out of India and can produce the appropriate tickets. Otherwise, you must pay a fee to the overseas embassy to send a fax to the Indian embassy in your own country and wait up to a week for a reply.

Tourist visas are generally issued for six months, are multiple entry, and are valid from the date of issue of the visa, not the date you enter India. This means that if you first enter India five months after the visa was issued, it will be valid for one month.

Nepal
Visas for Nepal are available on arrival at Kathmandu airport or at land border crossings, including Kakarbhitta, the road crossing nearest to Bhutan. You will need one passport photo to fill out a visa form manually. However, if arriving at Kathmandu’s Tribhuvan airport you can insert your electronic passport into a visa registration machine, which will take your photo and fill out your form. If you are making a side trip to Bhutan from Kathmandu, you can get a multiple-entry visa the first time you arrive in Nepal. However, you can also simply get another visa on arrival when you return to Nepal. You can also obtain a visa for Nepal in advance from embassies abroad or from the Nepali embassy or consulate in the gateway cities of Bangkok, Delhi, Dhaka or Kolkata.

If you are simply transiting through Kathmandu, you can get a 24-hour transit visa for US$5.

Travel Permits

Restricted-Area Permits

All of Bhutan outside of the Paro and Thimphu valleys is classified as a restricted area. Tour operators obtain a ‘road permit’ for the places on your itinerary, and this permit is checked and endorsed by the police at immigration checkpoints strategically located at important road junctions. The tour operator must return the permit to the government at the completion of the tour, and it is scrutinised for major deviations from the authorised program. In general you won’t be aware that any of this is going on in the background.

There are immigration checkpoints in Hongtsho (east of Thimphu), Chhukha (between Thimphu and Phuentsholing), Rinchending (above Phuentsholing), Wangdue Phodrang, Chazam (near Trashigang), Wamrong (between Trashigang and Samdrup Jongkhar) and in Samdrup Jongkhar. All are open from 5am to 9pm daily.

Permits to Enter Temples
During times when there aren’t festivals, tourists are allowed to visit the courtyards of dzongs and, where feasible, the tshokhang (assembly hall) and one designated lhakhang in each dzong, but only when accompanied by a licensed Bhutanese guide. This provision is subject to certain restrictions, including visiting hours, dress standards and other rules that vary by district.

The TCB has a small list of places tourists cannot visit, with the assumption that all other places can be visited. You can generally visit any lhakhang that is private or village run. Dzongs are open to all during the time of a tsechu, when you may visit the courtyard, but not the lhakhangs. Your tour company will deal with all the necessary paperwork, so let them know in advance if there are specific goembas or chapels you wish to visit.

If you are a practising Buddhist, you may apply for a permit to visit certain dzongs and religious institutions usually off-limits. The credibility of your application will be enhanced if you include a letter of reference from a recognised Buddhist organisation in your home country.

Passports
If your passport has less than six months of validity left, get a new one before setting off, because many countries in this region will not issue visas to persons whose passports are about to expire.

Keep your passport safe. No country other than India has the facility for issuing a replacement passport in Bhutan. If you lose your passport, you must travel ‘stateless’ to another country to get it replaced. You should carry some additional form of identification and a photocopy of your passport to help in such an event.

Indian and Bangladeshi travellers do not need a passport to visit Bhutan, but will need some form of (photographic) identification, such as a voter’s registration card.

5. Practical information

5.1 Getting around

Road Transport

Because Bhutan does not have a centimetre of passenger railway track, the only way to see the country is either by foot or by road, or the rather limited domestic air service, which is restricted to Paro, Bumthang and Gelephu at the time of research.

There is one main road: the National Highway, a stretch of tarmac that winds its way up and down mountains, across clattering bridges, along the side of cliffs and over high mountain passes. At the time of research the National Highway was in the process of being widened to double lanes. Until you experience the mountain roads of Bhutan you may not be able to fully appreciate the immensity of this undertaking. Nevertheless, rivers, mudflows and rockfalls present continual hazards, especially when it rains – and this won’t change with the new wider road. Roads can easily become blocked due to snow or landslides and can take anywhere from an hour to several days to clear. Take plenty of reading material.

If you are travelling on a tourist visa, the cost of all transport is included in the price of your trip and you’ll have a vehicle available for both short- and long-distance travel.

Air

Bhutan has limited domestic air services. Airports have been developed in Yongphula (south of Trashigang in the far east), Gelephu (in southern Bhutan, near the border with India) and Bathpalathang/Jakar (Bumthang, central Bhutan). At the time of writing, only Druk Air had scheduled domestic flights from Paro to Bathpalathang (via Gelephu fortnightly). Check with your tour company to see the current status.

The Royal Bhutan Helicopter Service operates charter flights, sightseeing and medical evacuations from its base in Paro.

Bicycle

Some travellers bring their mountain bikes to Bhutan, and several companies can help arrange this kind of tour.

Bus

Only locals, residents and budget Indian tourists are likely to travel on buses. Public buses are crowded and rattly, and Bhutan’s winding roads make them doubly uncomfortable. The government’s Bhutan Post Express and other companies’ minibuses have earned the nickname ‘vomit comets’ as so many passengers suffer from motion sickness when travelling in them. Private operators such as Dhug, Metho and Sernya use more comfortable Toyota Coasters that cost about 50% more than the minibus fare.

Buses run at least once daily from Thimphu to Phuentsholing, Haa, Paro and Punakha. Long-distance buses run between one and three times weekly from Thimphu to Zhemgang, Samtse, Trashi Yangtse, Mongar, Phobjika and Trashigang. Fares are cheap.

A public bus service operates throughout Thimphu from Chang Lam, including to Dechenchoeling in the north and Simtokha and Babesa to the south. Routes, fares and timetables are available at www.bhutanpost.bt.

Car & Motorcycle
Since all transport is provided by tour operators, you normally do not have to concern yourself with driving. If for some reason you are arranging your own transport, you are still far better off using the services of a hired car and driver or a taxi. Driving in Bhutan is a harrowing experience. Roads are narrow and trucks roar around hairpin bends, appearing suddenly and forcing oncoming vehicles to the side.

Motorcycle trips in Bhutan can be arranged through Himalayan Roadrunners and Saffron Road Motorcycle Tours. The local company Knight Adventure Tours can organise motorcycle tours. Contact the Black Dragons Motorcycle Club (www.facebook.com/pages/Bhutan-Dragons-Motorcycle/516531518397044) in Thimphu for advice on tackling Bhutan’s roads.

Your Own Vehicle

If you drive a vehicle into Bhutan, you can get a 14-day permit at the Phuentsholing border. You will need the help of a tour operator to handle the paperwork. If you are driving a vehicle that is registered overseas, you will need a carnet in order to get through India.

Indian visitors may travel throughout most of Bhutan in their own vehicle, upon getting all relevant documents such as registration papers, insurance policies, emission and fitness certificates and individual driving licences endorsed by the Road Safety and Transport Authority at the border. Traffic regulations are the same as in India and are strictly enforced.

Driving Licence

NGO staff and volunteers who insist on driving in Bhutan should obtain a driving licence issued by the Road Safety and Transport Authority. Bhutanese licences are also valid throughout India.

An International Driving Permit is not valid in Bhutan. An Indian driving licence is valid in Bhutan, and it’s possible for Indian nationals to drive in Bhutan; but unless you are an accomplished rally driver or are from a hill station such as Darjeeling and have experience in motoring in the mountains, it’s safer with a professional driver.

Road Rules

Traffic keeps to the left and is much more orderly than in most other south Asian countries. Speeds are low in towns and on rural roads; you will be lucky to average more than 30km/h on the roads in the hills.

As is the case throughout Asia, it is important that the police establish who was at fault in any traffic accident. This means that the police must arrive and make the decision before any of the vehicles can be moved, even if the vehicles are blocking a narrow road. A relatively minor accident can block the road for hours while everyone waits patiently for the police to arrive from the nearest town.

Local Transport

Taxi

There are taxis in Phuentsholing, Paro, Jakar and Thimphu. Taxis may have meters, but drivers rarely use them. For long-distance trips they operate on a flat rate that is rarely open to negotiation. Taxi drivers have a habit of charging foreigners, including Indians, as much as they can – one of Bhutan’s few rip-offs.

You should expect to pay Nu 70 for a local trip within Thimphu, Nu 1000 to Nu 1500 for a full day. If you are travelling between Thimphu and Phuentsholing, look for a taxi that is from the place to which you want to go (vehicles with BT-2 number plates are from Phuentsholing and those with BT-1 number plates are from Thimphu or Paro) – you may be able to negotiate a lower price.

5.2 Flights and getting there

In-Flight Entertainment

The flight from Kathmandu to Paro provides the most dramatic view of Himalayan scenery of any scheduled flight (snag a window seat on the left if you can). Look for the impressive Bodhnath stupa to the north as the plane takes off. Soon a continuous chain of peaks appears just off the left wing. The captain usually points out Everest (8850m; a black striated pyramid), Makalu (a grey chair-shaped peak) and Kanchenjunga (a huge massif), but if you have trekked in Nepal and are familiar with the mountains you can pick out many more. The elusive Shishapangma (8013m) is sometimes visible inside Tibet. Other recognisable peaks are Gauri Shankar (7185m), with its notched shape, Cho Oyu (8153m), Nuptse (7906m), with its long ridge, Lhotse (8501m) and Chhamlang (7319m).

When you pass Kanchenjunga, look for the dome-shaped peak on the western skyline. That is Jannu (7710m), which some French climbers have described as a ‘peak of terror’; the Nepalis have renamed it Khumbakarna. Once past Kanchenjunga, the peaks are more distant. This is the Sikkim Himalaya; the major peaks, from west to east, are Chomoyummo (6829m), Pauhunri (7125m) and Shudu Tsenpa (7032m).

As the plane approaches Paro you may be able to spot the beautiful snow peak of Jhomolhari (7314m) and the grey ridge-shaped peak of Jichu Drakye (6989m). The plane then descends, often through clouds, banking steeply into the wooded valleys of Bhutan. Depending on the approach pattern that day, you may see Taktshang Goemba and Paro Dzong as you descend. Paro airport is often described as the scariest airstrip in the world but it’s really not that bad.

Airports & Airlines
Bhutan has one international airport, Paro, and two airlines, government-owned Druk Air, which has offices in Paro and Thimpu, Jakar and Gelephu, and a private airline Bhutan Airlines, a division of Tashi Air, with an office in Thimphu.

The Druk Air and Bhutan Airlines schedules change by season, but usually there are several flights per week from Kathmandu, New Delhi, Singapore and Bangkok, either direct or via Dhaka, Kolkata or Bagdogra, depending on the day of travel. Less frequently there are flights to Guhawati and Ahmedabad. Extra flights are put on during the Thimphu tsechu (dance festival) in October and the Paro tsechu in April.

At the time of research only Druk Air and Bhutan Airlines were operating international flights to Bhutan. There are only a few aircraft that can operate on a runway that is as short and high as Paro’s. All landings and take-offs in Paro are by visual flight rules (VFR), which means that the pilot must be able to see the runway before landing, and see the surrounding hills before take-off. This means that no flights can be operated at night or in poor visibility, so when Paro valley is clouded in, flights are delayed, sometimes for days. When this happens your tour program will have to be changed and everything rebooked. The upside of such a delay is that you can probably add some spontaneity into your schedule in Bhutan and make a few modifications as you go.

Reconfirm your Druk Air flight before departure and also once in Paro, to ensure that the schedule has not changed.
Check-in early for Druk Air flights as they occasionally depart before the scheduled time, especially if the weather starts to change for the worse.
Flights are often delayed because of weather and Druk Air recommends that you travel on nonrestricted tickets and allow at least 24 hours’ transit time with your connecting flight in order to minimise the complications of delays. It makes sense to budget a couple of days’ sightseeing in Kathmandu or Bangkok.

Druk Air Offices Abroad

  • Druk Air Bangladesh
  • Druk Air India (Kolkata)
  • Druk Air India (New Delhi)
  • Druk Air India (Siliguri)
  • Druk Air Nepal
  • Druk Air Thailand

Druk Air Sales Agents Abroad

  • DNATA (Bangladesh)
  • Druk Asia (Singapore)
  • Global Union Transportation (Hong Kong)

Tickets

It is possible to purchase Druk Air and Bhutan Airlines tickets online using a credit card. There are no discounts or student fares, except for citizens of Bhutan.

It’s also possible to have your agent book your tickets and email you the e-ticket. In the event of a cancellation you are likely to get a refund quicker this way and your agent should get direct notifications if there are changes to the flight times. Your agent will also email you a scan of your visa clearance from the Department of Immigration and you may need to show a printout of this when you check-in. The Paro airport departure tax is included in the price of the ticket.

You may need to also buy a ticket to and from the place where you will connect to Druk Air. For most travellers this essentially means Delhi, Bangkok, Singapore or Kathmandu, depending on where you are travelling from and which city you’d rather transit through. Delhi, Singapore and Bangkok offer the most international connections, but Kathmandu will give you an extra taste of the Himalaya. Other connections via Kolkata or Dhaka are possible, but fewer discounted international air fares are available to these places.

Transit Baggage
Although Bhutan’s airlines say they have interline agreements with other carriers, your ticket to Paro will be separate from your other international tickets. This means you cannot check your baggage all the way through to Paro via a connecting flight. You will need to reclaim your baggage and recheck it at the Druk Air counter. The only exception to this might be Thai Airways if your lay-over is less than eight hours.

When you depart from Bhutan, Druk Air claims it can check bags through to your final destination if you give them the flight details during check-in but be aware that this information is handwritten on the baggage tags. Call us travel cynics but we don’t fully trust the system.

The significance of not being able to check through your luggage is that you may have to go through immigration at your transfer airport to pick up your luggage in order to check-in again. Depending on the country, this can create visa problems. Bangkok, Singapore and Kathmandu transit is relatively easy, requiring either no visa or free transit visas on the spot, but in Delhi you’re likely to need to find a staff member to get your bag from the carousel and recheck it in for you as you can’t exit the transit area without an Indian visa.

Land

Border Crossings
Crossing between Bhutan and India (and then to Nepal) is relatively straightforward at the following three points found along Bhutan’s southern border:

Phuentsholing The primary border crossing from India into Bhutan, on the border with the Indian state of West Bengal.
Samdrup Jongkhar Much less used but still possible for exit or entry, in the far east on the border with the Indian state of Assam.
Gelephu Again little used but still possible for exit or entry on the border with Assam.
India
To & from Phuentsholing
The gate between Phuentsholing and Jaigaon (just across the border) opens at 6am and closes at 9pm for vehicles, but people can cross on foot until 10pm. If you are travelling to or from Bhutan via Phuentsholing, all roads lead through Siliguri in West Bengal, the major transport hub in northeast India. Heading into India, you can make road connections from Phuentsholing or Jaigaon to the train station in Siliguri (169km, six hours) or the airport in Bagdogra (which has flights to Kolkata, New Delhi, Guhawati and Paro). From Siliguri it’s easy to arrange a share-taxi or bus on to the Indian hill stations of Darjeeling (77km), Gangtok (Sikkim; 114km) or Kalimpong, and also the Nepal border at Kakarbhitta.

The nearest main-line Indian train station to Phuentsholing is in New Jalpaiguri (near Siliguri). From there it’s a 12-hour rail journey to Kolkata or a 33-hour trip to Delhi. You can travel by road direct to New Jalpaiguri from Phuentsholing or drive to Siliguri where you can simply flag down a taxi.

If you are headed to Bhutan, Bhutan Transport Services (Sevoke Rd) operate a direct bus service at 7.15am and noon daily between Siliguri and Phuentsholing (Rs 90, four hours). You can sometimes find Bhutanese taxis (yellow-roofed minivans with number plates beginning with ‘BT’) looking for a return fare. You can technically buy a seat for around Rs 400, but you might eventually have to charter the whole taxi for about Rs 1600. Indian bus companies also operate regular services between Siliguri and Jaigaon on the Indian side of the Bhutanese border.

Bhutanese vehicles may travel freely in India and a Bhutanese tour operator can easily arrange a vehicle to any of these destinations. There are also taxis and shared hire cars available in both Phuentsholing and Siliguri.

Foreigners
Don’t forget to get your passport stamped when leaving India. If your transport has already deposited you in Bhutan, you can simply walk back across the border to complete the paperwork.

Your guide will meet you at the gate and help you obtain your Bhutanese visa in Phuentsholing at the Immigration checkpoint.

Indian Nationals
To go through immigration at Phuentsholing, Indian nationals are required to submit a passport-size photograph, a copy of their identification document such as passport or voters’ identity card, and a filled-in application form at the Immigration Office, which sits on the 1st floor of the Regional Revenue and Customs Office, located in front of Hotel Druk. A permit is then handed out by the immigration authorities, which must be stamped in at the check-post in Rinchending, en route to Thimphu.

Please note that these rules are changeable upon short notice, especially during politically sensitive periods or due to unforeseen security issues.

To & from Samdrup Jongkhar & Gelephu
Foreign and Indian tourists are allowed to enter or exit Bhutan at Samdrup Jongkhar (Eastern Bhutan) and Gelephu (Central Bhutan). Be aware that strikes (bandhs) that affect all road transport and can close borders are relatively common in Assam and can be called at short notice and last for a week. Check on the status of Assamese separatist groups before you decide to travel by land through Assam.

The primary reason you would want to exit into Assam is to avoid the long drive back over the mountains to Thimphu after visiting central and eastern Bhutan. From Samdrup Jongkhar and Gelephu, drive down to Guwahati in Assam, from where you can fly to Kolkata, Delhi, Bangkok or Bagdogra, or get a train connection to numerous Indian destinations. Due to security concerns, all Bhutanese vehicles have to travel in a convoy, so expect delays. Six kilometres from the Samdrup Jongkhar border at Darranga, and 10km from the Gelephu border at Deosiri, is a Foreigners’ Registration Post, open 24 hours, where you must get your entry/exit stamp. Carry photocopies of your passport photo pages and Indian visa as these may be asked for.

Another alternative to Guhawati is a long, but flat, drive west through the Indian duars (low hills) to Siliguri.

Nepal
Panitanki (aka Raniganj), in northern West Bengal, is opposite the eastern Nepal border town of Kakarbhitta. A long bridge separates the two towns across the Mechi River. Bhutanese tour operators can pick you up or drop you at Panitanki, or you can arrange for them to take you to Bhadrapur or Biratnagar to catch a flight to Kathmandu. The border post at Panitanki is officially open 24 hours but the Nepali Immigration post at Karkarbhitta is only open 7am to 10pm.

Panitanki is only one hour (35km) from Siliguri (India). Buses (Rs 30) to Panitanki and shared jeeps (Rs 100) to Kakarbhitta run regularly on this route and taxis are easy to arrange (Rs 500). A cycle-rickshaw across the border to Kakarbhitta costs Rs 100. Buses depart Kakarbhitta at 5pm daily for Kathmandu (NRs 1150-1375, 16-plus hours), a long rough drive via Narayanghat, Mugling and the Trisuli River valley. See Lonely Planet’s Nepal for details of what to see and do along this route.

A better option is to take a taxi (NRs 1000) from Kakarbhitta to Bhadrapur and take a domestic flight to Kathmandu (US$165). There is a larger airport at Biratnagar, a four-hour drive from the border, from where a flight costs US$135. Yeti Airlines and Buddha Air are the most reliable airlines. Jhapa Travel Agency in Kakarbhitta will be able to book a taxi and a flight.

5.3 Health

The main health concerns in Bhutan are similar to those in other south Asian destinations: there is a relatively high risk of acquiring traveller’s diarrhoea, a respiratory infection, or a more exotic infection. The infectious diseases can interrupt your trip and make you feel miserable, but they are rarely fatal. If you go trekking, there are also risks associated with accidents and altitude sickness. Falling off trails, or having a rock fall on you as you trek, is rare but can happen.

The following advice is a general guide only and does not replace the advice of a doctor trained in travel medicine.

Before You Go

Pack medications in their original, clearly labelled containers. A signed and dated letter from your physician describing your medical conditions and medications, including generic names, is also a good idea. If carrying syringes or needles, be sure to have a physician’s letter documenting their medical necessity. If you have a heart condition, bring a copy of your ECG taken just prior to travelling.

If you take any regular medication, bring double your needs in case of loss or theft. You can’t rely on many medications being available from pharmacies in Bhutan.

Insurance
Even if you are fit and healthy, don’t travel without health insurance – accidents do happen. Declare any existing medical conditions you have – the insurance company will check if your problem is pre-existing and will not cover you if it is undeclared.

You may also require extra cover for adventure activities such as rock climbing. If your health insurance doesn’t cover you for medical expenses abroad, consider getting extra insurance.

Find out in advance if your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. (In many countries, doctors expect payment in cash.) You may prefer a policy that pays doctors or hospitals directly rather than you having to pay on the spot and claim later. If you have to claim later, make sure you keep all documentation. Some insurance companies ask you to call them (they suggest reversing the charges, an impossibility from Bhutan) at a centre in your home country, where an immediate assessment of your problem is made.

Vaccinations
Specialised travel-medicine clinics are your best source of information; they stock all available vaccines and will be able to give specific recommendations for you and your trip. Most vaccines don’t produce immunity until at least two weeks after they’re given, so visit a doctor four to eight weeks before departure. Ask your doctor for an International Certificate of Vaccination, which will list all the vaccinations you’ve received.

Recommended Vaccinations
The World Health Organization recommends the following vaccinations for travellers to Bhutan (as well as being up to date with measles, mumps and rubella vaccinations):

Diphtheria and tetanus (for adults) Single booster recommended if none taken in the previous 10 years. Side effects include sore arm and fever.
Hepatitis A Provides almost 100% protection for up to a year; a booster after 12 months provides at least another 20 years’ protection. Mild side effects such as headache and sore arm occur in 5% to 10% of people.
Hepatitis B Now considered routine for most travellers, it is given as three shots over six months. A rapid schedule is also available, as is a combined vaccination with Hepatitis A. Side effects are mild and uncommon: usually headache and sore arm. Lifetime protection occurs in 95% of people.
Polio Bhutan’s last case of polio was reported in 1986, but it has been reported more recently in nearby Nepal and India. Only one booster is required for an adult for lifetime protection. Inactivated polio vaccine is safe during pregnancy.
Typhoid The vaccine offers around 70% protection, lasts for two to three years and comes as a single shot. Tablets are also available; however, the injection is usually recommended as it has fewer side effects. Sore arm and fever may occur.
Varicella If you haven’t had chickenpox, discuss this vaccination with your doctor.
The following immunisations may be recommended for long-term travellers (more than one month) or those at special risk:

Japanese B Encephalitis Three injections in all. Booster recommended after two years. Sore arm and headache are the most common side effects. Rarely, an allergic reaction comprising hives and swelling can occur up to 10 days after any of the three doses.
Meningitis Single injection. There are two types of vaccination: the quadrivalent vaccine gives two to three years’ protection; meningitis group C vaccine gives around 10 years’ protection. Recommended for long-term backpackers aged under 25.
Rabies Three injections in all. A booster after one year will then provide 10 years’ protection. Side effects are rare – occasionally headache and sore arm.
Tuberculosis A complex issue. Adult long-term travellers are usually recommended to have a TB skin test before and after travel, rather than vaccination. Only one vaccine given in a lifetime.
Required Vaccinations
The only vaccine required by international regulations is for yellow fever. Proof of vaccination will only be required if you have visited a country in the yellow-fever zone within the six days prior to entering Bhutan. If you are travelling to Bhutan from Africa or South America, you should check to see if you require proof of vaccination.

Medical Checklist
Recommended items for a personal medical kit:

  • Antifungal cream, eg Clotrimazole
  • Antibacterial cream, eg Muciprocin
  • Antibiotic for skin infections, eg Amoxicillin/Clavulanate or Cephalexin
  • Antibiotics for diarrhoea, eg Norfloxacin or Ciprofloxacin for bacterial diarrhoea; Tinidazole for giardiasis or amoebic dysentery
  • Antihistamine, eg Cetrizine for daytime and Promethazine for night
  • Antiseptic, eg Betadine
  • Antispasmodic for stomach cramps, eg Buscopan

In Bhutan
Availability of Health Care
There are no private health clinics or physicians in Bhutan, but all district headquarters towns have a hospital, and will accept travellers in need of medical attention. The best facility is the Jigme Dorji Wangchuck National Referral Hospital in Thimphu. It has general physicians and several specialists, labs and operating rooms. Treatment is free, even for tourists. If you are seriously ill or injured, you should consider evacuation to the excellent medical facilities in Bangkok. It is difficult to find reliable medical care in rural areas. Your closest embassy and insurance company are good contacts.

Self-treatment may be appropriate if your problem is minor (eg traveller’s diarrhoea), you are carrying the appropriate medication and you cannot attend a recommended clinic. If you think you may have a serious disease, especially malaria, do not waste time – travel to the nearest quality facility to receive attention. It is always better to be assessed by a doctor than to rely on self-treatment.

In most large towns there are shops that sell medicines. Most of the medical supplies mentioned in this section are available without a prescription.

Traveller’s Diarrhoea

Traveller’s diarrhoea is by far the most common problem affecting travellers – between 30% and 50% of people will suffer from it within two weeks of starting their trip. In over 80% of cases, traveller’s diarrhoea is caused by a bacteria, and therefore responds promptly to treatment with antibiotics, such as Norfloxacin. Keep in mind, though, that a couple of loose stools are little cause for concern.

Loperamide is just a ‘stopper’ and doesn’t get to the cause of the problem. It can be helpful, for example, if you have to go on a long car trip. Don’t take Loperamide if you have a fever, or blood in your stools, and seek medical attention quickly if you do not respond to an appropriate antibiotic.

Amoebic dysentery is very rare in travellers but is often misdiagnosed. Symptoms are similar to bacterial diarrhoea: fever, bloody diarrhoea and generally feeling unwell. You should always seek reliable medical care if you have blood in your diarrhoea. Treatment involves two drugs: Tinidazole or Metronidazole to kill the parasite in your gut, followed by a second drug to kill the cysts.

Giardia lamblia is a parasite that is relatively common in travellers. Symptoms include nausea, bloating, excess gas, fatigue and intermittent diarrhoea. The parasite will eventually go away if left untreated but this can take months. The treatment of choice is Tinidazole.

Coughs, Colds & Chest Infections
Respiratory infections usually start as a virus and are exacerbated by urban pollution, or cold and altitude in the mountains. Commonly, a secondary bacterial infection will intervene – marked by fever, chest pain and coughing up discoloured or blood-tinged sputum. If you have the symptoms of an infection, seek medical advice or commence a general antibiotic.

Dengue Fever
This mosquito-borne disease is becomingly increasingly problematic throughout the tropical world, especially in the cities. As there is no vaccine available it can only be prevented by avoiding mosquito bites. The mosquito that carries dengue bites day and night, so use insect avoidance measures at all times. Symptoms include high fever, severe headache and body ache. Some people develop a rash and experience diarrhoea. There is no specific treatment, just rest and paracetamol – do not take aspirin though, as it increases the likelihood of haemorrhaging. See a doctor to be diagnosed and monitored.

Hepatitis A
A problem throughout the region, this food- and water-borne virus infects the liver, causing jaundice (yellow skin and eyes), nausea and lethargy. There is no specific treatment for hepatitis A – you just need to allow time for the liver to heal. All travellers to Bhutan should be vaccinated against hepatitis A.

Hepatitis B
The only sexually transmitted disease that can be prevented by vaccination, hepatitis B is spread by body fluids, including in sexual contact. The long-term consequences can include liver cancer and cirrhosis.

Hepatitis E
Hepatitis E is transmitted through contaminated food and water and has similar symptoms to hepatitis A, but is far less common. It is a severe problem for pregnant women and can result in the death of both mother and baby. There is currently no readily available vaccine, and prevention is following safe eating and drinking guidelines.

Influenza
Present year-round in the tropics, influenza (flu) symptoms include high fever, muscle aches, runny nose, cough and sore throat. It can be very severe in people over the age of 65 or in those with underlying medical conditions such as heart disease or diabetes; vaccination is recommended for these individuals. There is no specific treatment, just rest and paracetamol.

Japanese B Encephalitis
This viral disease is transmitted by mosquitoes and is rare in travellers. Like most mosquito-borne diseases it is becoming a more common problem in affected countries. Most cases occur in rural areas and vaccination is recommended for travellers spending more than one month outside cities. There is no treatment, and a third of infected people will die, while another third will suffer permanent brain damage.

Malaria
For such a serious and potentially deadly disease, there is an enormous amount of misinformation concerning malaria. You must get expert advice as to whether your trip actually puts you at risk. For most rural areas, the risk of contracting malaria far outweighs the risk of any tablet side effects. Before you travel, seek medical advice on the right medication and dosage for you.

Malaria is caused by a parasite transmitted by the bite of an infected mosquito. The most important symptom of malaria is fever, but general symptoms such as headache, diarrhoea, cough or chills may also occur. Diagnosis can only be made by taking a blood sample.

Two strategies should be combined to prevent malaria; mosquito avoidance and antimalaria medications. Most people who catch malaria are taking inadequate or no antimalarial medication.

Travellers are advised to prevent mosquito bites by taking these steps:

Use a DEET-containing insect repellent on exposed skin. Wash this off at night, as long as you are sleeping under a mosquito net. Natural repellents such as citronella can be effective, but must be applied more frequently than products containing DEET
Sleep under a mosquito net impregnated with pyrethrin
Choose accommodation with screens and fans (if not air-conditioned)
Impregnate clothing with pyrethrin in high-risk areas
Wear long sleeves and trousers in light colours

Use mosquito coils

Spray your room with insect repellent before going out for your evening meal
There are a variety of medications available. The effectiveness of the Chloroquine and Paludrine combination is now limited in many parts of South Asia. Common side effects include nausea (40% of people) and mouth ulcers.

The daily tablet Doxycycline is a broad-spectrum antibiotic that has the added benefit of helping to prevent a variety of tropical diseases, including leptospirosis, tick-borne disease and typhus. The potential side effects include photosensitivity, thrush, indigestion, heartburn, nausea and interference with the contraceptive pill. More serious side effects include ulceration of the oesophagus – you can help prevent this by taking your tablet with a meal, and never lying down within 30 minutes of taking it. It must continue to be taken for four weeks after leaving the risk area.

Lariam (Mefloquine) is a weekly tablet. Serious side effects are rare but include depression, anxiety, psychosis and having fits. Anyone with a history of depression, anxiety, another psychological disorder, or epilepsy should not take Lariam. It is considered safe in the second and third trimesters of pregnancy. Tablets must be taken for four weeks after leaving the risk area.

Malarone is a combination of Atovaquone and Proguanil. Side effects are uncommon and mild: most commonly nausea and headache. It is the best tablet for those on short trips to high-risk areas. It must be taken for one week after leaving the risk area.

Rabies
Rabies is considered to be endemic in Bhutan. This uniformly fatal disease is spread by the bite or lick of an infected animal – most commonly a dog or monkey. You should seek medical advice immediately after any animal bite and commence post-exposure treatment. Having a pre-travel vaccination means the post-bite treatment is greatly simplified. If an animal bites you, gently wash the wound with soap and water, and apply iodine-based antiseptic. If you are not pre-vaccinated you will need to receive rabies immunoglobulin as soon as possible.

Tuberculosis
While rare in travellers, medical and aid workers and long-term travellers who have significant contact with the local population should take precautions. Vaccination is usually given only to children under the age of five, but adults at risk are recommended to have pre- and post-travel tuberculosis testing. The main symptoms are fever, cough, weight loss, night sweats and tiredness.

Typhoid
This serious bacterial infection is spread via food and water. It gives a high and slowly progressive fever, headache and may be accompanied by a dry cough and stomach pain. It is diagnosed by blood tests and treated with antibiotics. Vaccination is recommended for all travellers spending more than a week in Bhutan. Be aware that vaccination is not 100% effective so you must still be careful with what you eat and drink.

Environmental Hazards
Even on a cloudy day sunburn can occur, especially at altitude where the atmosphere is thinner. Minimise the risk by applying sunscreen and wearing sunglasses and a hat outdoors.

Drinking Water
Never drink tap water
Bottled water is generally safe – check the seal is intact at purchase
Avoid ice
Avoid fresh juices – they may have been watered down
Boil water – this is the most efficient method of purifying it; let it boil a bit longer at higher altitudes
Purify water – the best chemical purifier is iodine but this should not be used by pregnant women or those with thyroid problems
Use water filters – should also filter out viruses; ensure your filter has a chemical barrier such as iodine and a small pore size, eg less than four microns
Food
Eating in restaurants is the biggest risk factor for contracting traveller’s diarrhoea. Ways to avoid it include eating only freshly cooked food, and avoiding shellfish and food that has been sitting around in buffets. Peel all fruit, cook vegetables and soak salads in iodine water for at least 20 minutes.

High Altitude
If you are going to altitudes above 3000m you should get information on preventing, recognising and treating Acute Mountain Sickness (AMS). AMS is a notoriously fickle affliction and can also affect trekkers and walkers accustomed to walking at high altitudes. AMS has been fatal at 3000m, although 3500m to 4500m is the usual range.

Symptoms
Mild symptoms of AMS are very common in travellers visiting high altitudes, and usually develop during the first 24 hours at altitude. These will generally disappear through acclimatisation in several hours to several days.

Symptoms tend to be worse at night and include headache, dizziness, lethargy, loss of appetite, nausea, breathlessness and irritability. Difficulty sleeping is another common symptom.

AMS may become more serious without warning and can be fatal. Symptoms are caused by the accumulation of fluid in the lungs and brain, and include breathlessness at rest, a dry irritative cough (which may progress to the production of pink, frothy sputum), severe headache, lack of coordination (typically leading to a ‘drunken walk’), confusion, irrational behaviour, vomiting and eventually unconsciousness.

The symptoms of AMS, however mild, are a warning – be sure to take them seriously! Trekkers should keep an eye on each other as those experiencing symptoms, especially severe symptoms, may not be in a position to recognise them. One thing to note is that while the symptoms of mild AMS often precede those of severe AMS, this is not always the case. Severe AMS can strike with little or no warning.

Acclimatisation
With an increase in altitude, the human body needs time to develop physiological mechanisms to cope with the decreased oxygen. This process of acclimatisation is still not fully understood, but is known to involve modifications in breathing patterns and heart rate, and an increase in the blood’s oxygen-carrying capabilities. These compensatory mechanisms usually take about one to three days to develop at a particular altitude. Once you are acclimatised to a given height you are unlikely to get AMS at that height, but you can still get ill when you travel higher. If the ascent is too high and too fast, these compensatory reactions may not kick into gear fast enough.

Prevention
To prevent Acute Mountain Sickness:

Ascend slowly. Have frequent rest days, spending two to three nights at each rise of 1000m.
Bear in mind the climber’s adage ‘climb high, sleep low’. It is always wise to sleep at a lower altitude than the greatest height reached during the day. High day climbs followed by a descent back to lower altitudes for the night are good preparation for trekking at high altitude. Also, once above 3000m, care should be taken not to increase the sleeping altitude by more than 400m per day. If the terrain won’t allow for less than 400m of elevation gain, be ready to take an extra day off before tackling the climb.
Drink extra fluids. The mountain air is dry and cold, and moisture is lost as you breathe and sweat, which may result in dehydration.
Eat light, high-carbohydrate meals for more energy.
Avoid alcohol as it may increase the risk of dehydration, and don’t smoke.
Avoid sedatives.
When trekking, take a day off to rest and acclimatise if feeling overtired. If you or anyone else in your party is having a tough time, make allowances for unscheduled stops.
Don’t push yourself when climbing up to passes; rather, take plenty of breaks. Given the complexity and unknown variables involved with AMS and acclimatisation, trekkers should always err on the side of caution and ascend slowly.
Treatment
Treat mild symptoms by resting at the same or lower altitude until recovery, usually in a day or two. Take paracetamol or aspirin for headaches. If symptoms persist or become worse, however, immediate descent is necessary – even 500m can help.

The most effective treatment for severe AMS is to get down to a lower altitude as quickly as possible. In less severe cases the victim will be able to stagger down with some support; in other cases they may need to be carried down. Whatever the case, do not delay, as any delay could be fatal.

AMS victims may need to be flown out of Bhutan as quickly as possible – make sure you have adequate travel insurance.

The drugs acetazolamide (Diamox) and dexamethasone are recommended by some doctors for the prevention of AMS. However, you should be aware that their use is controversial. They can reduce the symptoms, but they may also mask warning signs; severe and fatal AMS has occurred in people taking these drugs. Drug treatments should never be used to avoid descent or to enable further ascent.

Insect Bites & Stings
Bedbugs and fleas don’t carry disease but their bites are very itchy. You can treat the itch with an antihistamine.

Ticks are contracted after walking in rural areas. Ticks are commonly found behind the ears, on the belly and in armpits. If you have had a tick bite and experience symptoms such as a rash at the site of the bite or elsewhere, fever or muscle aches, you should see a doctor. Doxycycline prevents tick-borne diseases.

Leeches are found in humid rainforest areas. They do not transmit any disease but their bites are often intensely itchy for weeks afterwards and can easily become infected. Apply an iodine-based antiseptic to any leech bite to help prevent infection.

Bee and wasp stings mainly cause problems for people who are allergic to them. Anyone with a serious bee or wasp allergy should carry an injection of adrenaline (eg an EpiPen) for emergency treatment. For others, pain is the main problem – apply ice to the sting and take painkillers.

Skin Problems
Fungal rashes are common in humid climates. There are two common fungal rashes that affect travellers. The first occurs in moist areas that get less air such as the groin, armpits and between the toes. It starts as a red patch that slowly spreads and is usually itchy. Treatment involves keeping the skin dry, avoiding chafing and using an antifungal cream such as Clotrimazole or Lamisil. Tinea versicolor is also common – this fungus causes small, light-coloured patches, most commonly on the back, chest and shoulders. Consult a doctor.

Cuts and scratches become easily infected in humid climates. Take meticulous care of any cuts and scratches to prevent complications such as abscesses. Immediately wash all wounds in clean water and apply antiseptic. If you develop signs of infection (increasing pain and redness), see a doctor.

Women’s Health
In the urban areas of Bhutan, supplies of sanitary products are readily available. Birth-control options may be limited, so bring adequate supplies of your own form of contraception. Heat, humidity and antibiotics can all contribute to thrush. Treatment is with antifungal creams and pessaries such as Clotrimazole. A practical alternative is a single tablet of Fluconazole (Diflucan). Urinary tract infections can be precipitated by dehydration or long road journeys without toilet stops; bring suitable antibiotics.

Pregnant women should receive specialised advice before travelling. The ideal time to travel is in the second trimester (between 16 and 28 weeks), when the risk of pregnancy-related problems are at their lowest and pregnant women generally feel at their best.

During the first trimester there is a risk of miscarriage and in the third trimester complications such as premature labour and high blood pressure are possible. It’s also wise to travel with a companion. Always carry a list of quality medical facilities available at your destination and ensure you continue your standard antenatal care at these facilities. Avoid rural travel in areas with poor transport and medical facilities. Most of all, ensure travel insurance covers all pregnancy-related possibilities, including premature labour.

Malaria is a high-risk disease during pregnancy. WHO recommends that pregnant women do not travel to areas that have Chloroquine-resistant malaria. None of the more effective antimalarial drugs is completely safe during pregnancy.

Traveller’s diarrhoea can quickly lead to dehydration and result in inadequate blood flow to the placenta. Many of the drugs used to treat various diarrhoea bugs are not recommended in pregnancy. Azithromycin is considered safe.

Although not much is known about the possible adverse effects of altitude on a developing foetus, many authorities recommend not travelling above 4000m while pregnant.

 

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