
Malaria Prophylaxis for a Medical Elective Abroad 2026
Malaria prophylaxis on a medical elective: check which of Sri Lanka, Nepal, Bali and Zanzibar needs antimalarial tablets and book your travel clinic slot.

Celina Köhsl
7. September 2026

Dashain is Nepal's longest and largest festival, a Hindu celebration of roughly two weeks that empties the cities, sends millions of people home to their villages, and closes almost every office in the country. In 2026 the official holiday days run from Monday 19 October to Thursday 22 October, with Tika, the main day, on Wednesday 21 October. If your clinical placement in Nepal touches those dates, your hospital will run a skeleton rota, the government counters will be shut, and every bus out of Kathmandu will already be booked. None of that has to ruin your elective. It just has to be planned for.
Written by the travel4med Editorial Team, who organise clinical placements in Nepal, Sri Lanka, Bali and Zanzibar.
Dashain is the fifteen day festival that marks the victory of the goddess Durga over the demon Buffalo, and it is the single biggest event in the Nepali year. Families travel across the country to be together. Elders place a red rice and yoghurt tika on younger relatives' foreheads and hand out blessings and money. Houses get cleaned, animals get slaughtered for the feast, and children fly kites from the rooftops.
For you as a visiting student, the cultural detail matters less than one practical fact. Nepal does not do a quiet long weekend. It does a full national stop. Banks close. Immigration counters close. Universities close. Many small clinics close. Your Nepali colleagues will be somewhere else, and they will not apologise for it, because this is the one time of year almost everyone goes home.
Only a handful of the Dashain days are official public holidays, and those are the ones that determine what is open. The rest of the fortnight is a slow ramp up in which shops get busier, roads get fuller and work gets thinner.


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The cleanest public source for the dates is the holiday calendar the U.S. Embassy in Kathmandu publishes each December for the year ahead. It lists the days its own office closes in Nepal, which tracks the Nepali public holidays. Here is the 2026 festival block.
| Date in 2026 | Day | Festival day | What it means for you |
|---|---|---|---|
| 19 October | Monday | Astami | Offices shut. The Dashain rush peaks. |
| 20 October | Tuesday | Nawami | Offices shut. Animal offerings at temples. |
| 21 October | Wednesday | Dashami (Tika) | The main day. Families visit elders. |
| 22 October | Thursday | Ekadashi | Offices shut. Travel back begins. |
| 9 November | Monday | Gai Puja (Tihar) | Second closure block opens. |
| 10 November | Tuesday | Gobardhan Puja (Tihar) | Offices shut. |
| 11 November | Wednesday | Bhai Tika (Tihar) | Sisters bless brothers. Offices shut. |
No hospital closes. Emergency departments, inpatient wards, labour rooms and intensive care run through Dashain and every other festival in the calendar, because patients do not stop arriving. What changes is everything built around them.
Expect outpatient clinics to run short hours or not at all on the holiday days. Expect elective operating lists to be postponed. Expect formal teaching, grand rounds and journal clubs to disappear for the week, and expect the senior staff who usually supervise you to be on leave. Some departments run on a single registrar and a couple of interns.
Ask your placement coordinator for the actual rota rather than guessing. Two questions do most of the work: which days is the outpatient department closed, and who is your named supervisor on each of the holiday days? If the answer to the second question is vague, that week is a poor use of your elective time, and you should say so early while the schedule can still move.
The clinical mix shifts, and it shifts in a direction most visiting students have never seen at home. Trauma rises. Nepal Police figures reported by The Rising Nepal show that during the 2024 Dashain period, from 3 to 14 October, the three districts of the Kathmandu Valley alone recorded 130 road crashes in which four people died and 188 were injured. Most of those crashes happened between six and nine in the evening, and motorcycles were involved more often than any other vehicle.
Outside the capital the same pattern repeats on mountain highways. Karnali Province recorded 51 crashes during the 2025 Dashain period, with nine deaths and 123 people injured, according to the Nepal Police Highway Safety and Traffic Management Office. Across the past three fiscal years, 83 people died in crashes during the two big festivals. Police attribute the spike to overloaded vehicles, driver fatigue, alcohol, mechanical failure and poor road surfaces after the monsoon.
The national baseline is already high. Nepal averages at least 75 road crashes a day with about seven deaths, and around 70% of the vehicles involved are motorcycles. So if you want to see blunt trauma, head injury and orthopaedic emergencies in volume, the Dashain weeks will show you more than a quiet February will. Bring the reflective habits from our guide to clinical skills on a medical elective, because a busy emergency department in a low resource setting will test your boundaries as much as your knowledge.
Not sure whether to place your elective before, during or after Dashain? Talk it through with us. Book a free consultation at travel4med and we will map your weeks against the 2026 Nepali calendar before you commit to flights.
There is no single right answer, and it depends on what you want out of the placement. Work through it in this order.

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Badly, if you improvise. Long distance buses fill up days in advance, domestic flights to Pokhara and the hill districts sell out, and fares rise. October is also one of Nepal's stronger months for tourism, with 128,443 international visitors recorded in October 2025, close to pre pandemic levels, so you are competing with trekkers as well as with families going home.
Three rules keep it manageable. Book any internal travel before you fly into Nepal, not after you land. Avoid night travel on hill roads during the rush, which is exactly when the crash figures peak. Keep two or three days of cash, since bank branches close and ATMs in smaller towns run empty over the holidays. Our guide to getting around Sri Lanka and Nepal covers the transport options in more detail.
Paperwork follows the same logic. Immigration and government counters observe the public holidays, so a visa extension that falls in the closure block has to be handled before or after it. Check what your entry permit actually allows in our post on visa requirements for Sri Lanka and Nepal, and do not leave an extension until the last week.
You accept the invitation. That is the honest answer. Nepali colleagues routinely invite visiting students home for Tika, and a rooftop in Bhaktapur with three generations of somebody's family will teach you more about your patients than any textbook chapter on cultural competence.

A few practical notes. Take a small gift, fruit or sweets are fine. Wear something you do not mind getting rice and red tika powder on. Use your right hand for giving and receiving. If animal sacrifice is part of the household's observance and you would rather not watch, say so politely in advance; nobody will be offended, and plenty of Nepali families do not practise it either.
The flip side is real too. Being alone in an empty city while everybody else is with family is one of the sharper moments of homesickness a placement can produce. If that lands on you, our post on coping with homesickness abroad is worth reading before you travel rather than during the low week.
Tihar is the festival of lights, the quieter sibling of Dashain, and in 2026 it closes offices again on 9, 10 and 11 November. It is shorter and gentler than the October block, but it lands in the same way: shops shut, streets fill with oil lamps and marigold garlands, and the working week disappears.
Two days are worth knowing about. Kukur Tihar honours dogs, who are garlanded and given tika, and it is disarming to watch. Bhai Tika, on 11 November, is when sisters bless their brothers, which is the Tihar equivalent of the Dashain Tika day and the one most families travel for.
If your elective runs from late October into December, plan for that second gap. A six week placement that starts on 26 October loses three more working days in the middle, which is manageable if you know about it in advance and disruptive if you do not.
If Nepal is still one of several options for you, read our full country guide to a medical elective in Nepal first, then come back to this calendar question once the destination is settled.
Editorially reviewed by Nils-Andre Stritt of travel4med, who coordinates placement organisation, host institutions and destination logistics for medical and nursing students.

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