It seems inevitable that when the subject is best, the conditions are anything but. Shooting at altitude, there are some key things to remember that may not be exciting but are vital.
Bring as many charged batteries as you can manage. They are as crucial at high altitude or in the cold as socks. Sleep with your batteries to keep them warm and juiced. Tuck them into a pouch within a sleeping back or, better yet, slip them into a pocket of something you are wearing in bed. Cameras should be shoved into sleeping bags too, as they often need a long startup time in the mornings.
Portable reflectors allow you to use the sun at any time for portraits. Silver and gold-sided reflectors can be folded up and are brilliant for shooting light into the entrance of tents, or catching a bit more light in a face without the obscene blitz of a flash going off. They are subtle and should be practiced with before you head out into the field.
With subjects such as the Tibetan nomads I study, you need time for them to get to know you. They need to start ignoring you before you will get great shots. I often simply put everything on automatic and just blast away at odd angles without bringing the camera up.
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