Potosi, Bolivia, is considered by some to be the highest permanently occupied city in the world. Some small towns in Nepal may beg to differ. Regardless, the altitude is a whopping 13,420 feet. It makes the head spin.
I spent an afternoon in a local orphanage. A sad place, the children seemed to live in a state of perpetual ennui. Needless to say, they were poor in a country that is among the world's poorest.