Yarsagumba Fungus: Health Problems in the Himalayan Gold Rush.

Wilderness Environ Med. 2017 Sep;28(3):267-270. doi: 10.1016/j.wem.2017.04.007. Epub 2017 Jul 14. Koirala P1, Pandit B2, Phuyal P3, Zafren K4. Author information 1 Department of Emergency Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA; Mountain Medicine Society of Nepal, Kathmandu, Nepal. 2 Ruru Primary Health Care Centre, Ridi, Nepal; Mountain Medicine Society of Nepal, Kathmandu, Nepal. 3 Department of Internal Medicine, St. Vincent's Medical Center, Bridgeport, CT; Mountain Medicine Society of Nepal, Kathmandu, Nepal. 4 Department of Emergency Medicine, Stanford University Medical Center, Stanford, CA; Department of Emergency Medicine, Alaska Native Medical Center, Anchorage, AK; Himalayan Rescue Association, Kathmandu, Nepal (Dr Zafren). Electronic address: kenzafren@gmail.com. Abstract INTRODUCTION: Seasonal migration of people in search of Yarsagumba fungus creates a population of collectors that faces hardship and health risks in austere high-altitude settings. METHODS: In 2016, our 4-person team performed a 2-day health-needs survey of people collecting Yarsagumba fungus near the village of Yak Kharka (4020 m) in the Manang District of Nepal. RESULTS: There were approximately 800 people, both male and female, from age 10 to over 60, collecting Yarsagumba fungus. They had paid high prices for permits, hoping to recoup the cost and make a profit by selling specimens of Yarsagumba, but the fungus seemed scarce in 2016, resulting in a bleak economic forecast. Most collectors were living in austere conditions, walking long hours to the collection areas early in the morning and returning in the late afternoon. Most were subsisting on 1 daily meal. Health problems, including acute mountain sickness as well as respiratory and gastrointestinal illnesses, were common. Yarsagumba has become harder to find in recent years, increasing hardships and risk of injury. Medical care was almost nonexistent. CONCLUSION: As abundance decreases and demand increases, there is increasing pressure on collectors to find Yarsagumba. The collectors are an economically disadvantaged population who live in austere conditions at high altitude with poor shelter and sanitation, strenuous work, and limited availability of food. Health care resources are very limited. There are significant risks of illness, injury, and death. Targeted efforts by government entities and nongovernmental organizations might be beneficial in meeting the health needs. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved. KEYWORDS: Nepal; Ophiocordyceps; Yarsagumba; high altitude; occupational health; underserved population PMID: 28716290 DOI: 10.1016/j.wem.2017.04.007