In the Himalayas, there are villages that have been there for hundreds of years before the invention of motorized transport. Many of the traditional trade routes that connected parts of China (Tibet, specifically), Bhutan, Northern India and Nepal are still there and use traditional means to move goods. Trains of ponies or donkies were pretty common along the routes that trekkers venture along; carrying commercial goods from the main roads up to the mountain villages. These trade routes were often made more usable by installing stone stairs.
This image is pretty typical of what we saw, although frankly I was quite happy when the trains of propane gas cylinders passed by. I can imagine that there are some risks in transporting dangerous goods along these routes!
What really bothered me though was that these pack animals found going up and down the stairs a lot easier than I did!
Of course, if one doesn't own a pony, there's always the "do it yourself" method.
The main reason I included this image is to show how steep the terrain is. This is the traditional way to transport goods; these people must have very strong neck muscles!