A small number of bona fide beggars make an honest living from bakshish (alms). Hindus and Buddhists alike have a long and honourable tradition of giving to lepers and the disabled, as well as sadhus and monks. Destitute women make up another large contingent of the begging population: it's terrifyingly easy for a Nepali woman to find herself alone in the world, either widowed or divorced - perhaps for failing to bear a son or because of a dowry dispute. There are no unemployment benefits in Nepal, and the state pension for senior citizens is just Rs100 a year; anyone who can't work and has no family for support generally turns to begging. Few would choose to do so if they had an alternative.

Giving is, of course, a personal decision. You might resolve only to give to the most needy-looking, or the most persistent, or the most dignified. You might conclude that almsgiving only treats the symptoms of poverty, and decide to support a charity trying to address the causes instead. On the other hand, you could argue that direct giving gets 100 percent of the money to the target, with no administration, red tape or corruption. At any rate, it's important to give the matter some thought.

In the hills, ailing locals will occasionally approach foreigners for medicine , knowing that they usually carry first-aid kits. It's probably best not to make any prescriptions unless you're qualified to diagnose the illness. However, before leaving the country you can donate unused medicines to the dispensary at Kathmandu's Bir Hospital, which distributes them to the destitute, or to the Himalayan Buddhist Meditation Centre in Kathmandu, which gives them to monks.