For Salkantay Trek 4D only Overall our experience with Visit South America was great, so... read more great that I am starting my review that way. Our contact Hilton was available through text/phone for questions during our trip planning and even during our trip. Everything was great until the day before our trek. We were not aware that Visit South America contracts another company (Salkantay Trekking) for the trek. We arrived for the orientation and met our tour guide Andre (unfortunately I do not know his last name) and pretty soon we perceived him to be bothered by our questions. The pick up for the trek would be around 4am the next morning. Unfortunately, through no fault of anyone's I woke up very nauseas and vomitted less than an hour into the bus ride to the start of the trek. At that point I suspected I had food poisioning, Once we reached the starting point I then began experiencing diarrhea. I advised both Andre and Jordy (the other guide) about my symptoms and they did not provide any advice or alternatives for me at that point. To summarize I proceeded to hike for about five hours until we reached the campsite and continued to vomit. I am a strong person and honestly felt like I was dying. Andre made comments to me indicating that it was all attitude which felt incredibly condescending and offensive. I was not offered a horse or medical attention even as I was... Overall our experience with Visit South America was great, so great that I am starting my review that way. Our contact Hilton was available through text/phone for questions during our trip planning and even during our trip. Everything was great until the day before our trek. We were not aware that Visit South America contracts another company (Salkantay Trekking) for the trek. We arrived for the orientation and met our tour guide Andre (unfortunately I do not know his last name) and pretty soon we perceived him to be bothered by our questions. The pick up for the trek would be around 4am the next morning. Unfortunately, through no fault of anyone's I woke up very nauseas and vomitted less than an hour into the bus ride to the start of the trek. At that point I suspected I had food poisioning, Once we reached the starting point I then began experiencing diarrhea. I advised both Andre and Jordy (the other guide) about my symptoms and they did not provide any advice or alternatives for me at that point. To summarize I proceeded to hike for about five hours until we reached the campsite and continued to vomit. I am a strong person and honestly felt like I was dying. Andre made comments to me indicating that it was all attitude which felt incredibly condescending and offensive. I was not offered a horse or medical attention even as I was vomitting and falling along the way. Andre's recommendation was that I continue with the trek, knowing that the second day would be the most challenging. At this point I was severely dehydrated and altitude sickness kicked in. Finally, that evening Andre mentioned the option to see a doctor but was not enthusiastic about this option. I ultimately decided to return back to Cusco the next day and saw a doctor who had been at the camp the whole time in the morning who basically said I was so dehydrated and my oxygen levels were so low that I should go straight to a clinic. No doubt this trek is challenging, but I feel that the guides were nothing short of negligent. Visit South America helped us as much as they could and offered transportation back but we did have to pay for our own train ride to Machu Picchu which thankfully I was better for and was able to see. Again this review is mostly for Andre from Salkanty Trekking Company. I'm all into spirituality and mental strength but there comes a time when you need medical attention and that is where they failed. More read less