Before leaving your country, do not forget to check with a doctor on needed vaccinations (typhus can be taken orally). Hospitals in Indonesia (Rumah Sakit) are normally open in the mornings. In the evenings doctors often give private consultation. If there is no hospital where you are, there is usually a public health center instead (Puskesmas). Sometimes it is manned by a doctor and if not, by a paramedic. Midwifes (Bidan) can be an alternative in remote areas.

Traditional healers (dukun) are found everywhere. They are often frowned upon, but can actually be quite useful. Many dukun are modern and use their knowledge without the mantras. Some illnesses and in combination with your own awareness and common sense, the dukun can be useful, especially when massage is needed. A good dukun has a lot of experiences of local illnesses. Malaria, for an example, can often be treated with traditional medicines, like seeds and leafs from the papaya tree. Health care is very cheap in Indonesia, but quality can differ a lot between hospitals and doctors.

Medicines are sold in apotik (pharmacy). If you are prescribed antibiotic, be sure that you get enough, at least for 5 days or more. Indonesian doctors tend to prescribe them for 3 days only. An advice from a traditional healer (dukun) in Berastagi was: "Your own happiness and your lust for life is the best medicine".

MALARIA

Malaria is a parasite spread by mosquitoes. Indonesia has Malaria, but is not considered a high risk country. In remote areas and on islands you can expect Malaria to be present. If you know the risks and know the symptoms and take precautions there is no reason to stay away for the sake of Malaria. Every year several tourists die from Malaria (Worldwide) due to unawareness of the risks, delayed diagnosis and treatment, and not informing their doctor where they have been. Consult your doctor about prophylactics if you plan to visit remote areas and be careful to consume the medicine according to instruction.

If you have bad luck and contract Malaria it takes between one and several weeks before you notice any symptoms. The symptoms can differ from person to person. Headache, nausea, some fever and aches for a week until it takes hold is common. When taking hold there are periods of 30-60 minutes of feeling very cold followed by fevers for 4-5 hours with sweating. Vomiting and diarrhea is common. There are several strains of malaria. Plasmodium Vivax is unpleasant, but rarely fatal to healthy adults. Plasmodium falciparum can be fatal, but is easier to get rid of. It has lately become more common in the eastern parts of Indonesia.

Chloroquine will protect against P. vivax and give some protection against P. falciparum. Chloroquine with proguanil is recommended. A second choice is mefloquine. Prevention of especially the falciparum malaria is getting more difficult, as resistance to drugs is spreading. This malaria can be fatal and must always be considered if you get an unexplainable fever.

Do always try to protect yourself from mosquito bites, whether or not you use prophylactics. Be extra careful between dusk and dawn. Use long sleeves and long trousers at night, preferably of light colors. Use insect repellant on exposed skin. Sleep in screened rooms under a mosquito net. Burn mosquito coils at night. Always suspect malaria, as there are no prophylactics that give complete protection. Seek medical treatment as soon as possible.

DENGUE FEVER

Dengue fever (Demam berdarah) is like malaria spread by mosquitoes. There are no prophylactics available. Symptoms are headache, pain behind the eyes, high fever, muscle and joint pains, and rash. In later stage hemorrhages under the skin occur. It is most common in big cities and can be fatal if you are less healthy. See a doctor immediately if you suspect you have Dengue fever. Take paracetamol to diminish the fever or accompanying headache. Don’t take aspirin, which can make the condition worse. The mosquito that spreads dengue fever seems to be more active during the day.

DIARRHEA

Tourist diarrhea is common in any tropical country, especially while traveling, due to different sets of bacteria foreign to your stomach. Common sense is the best weapon against stomach upsets. Try to adjust to the new environment. Drinking water served in Indonesian restaurants is always boiled. If you feel insecure, bottled water is for sale almost everywhere. Expensive restaurants are not always cleaner than cheaper ones. If you like spicy food, you are better off. Chilies are very good for your general health and they do preserve the food. Combantrin is effective and easily available if you get worms. Ice intended for drinking is made of boiled water. Ice for keeping fish is never boiled. If you want to be sure, don’t use ice. Fresh vegetables or fruits are usually not rinsed with boiled water. Freshly cooked food from food-stalls is usually quite safe to eat, though. If you drink water from a stream in the jungle, be sure that there is no paddy fields up-stream. If you have a bad diarrhea, see a doctor. Don’t wait too long and drink enough.

HEAT PROBLEMS

Dehydration is common among tourists as Indonesia is a hot country. Dehydration is especially common if you have diarrhea. Typical symptoms are headache and sleepiness. Just keep up the intake of plain water. Coffee and beer is bad if you suffer from dehydration. Mineral salt, for example Oralith is an inexpensive remedy. Prickly heat is also a common problem for visitors from colder climates due to excessive sweating. Use an aseptic soap and talcum powder.

OPEN WOUNDS

Be careful with open wounds. They can infected quickly and take a long time to heal in the heat. An effective and simple way to treat infected wounds: Apply a salt water (mix table salt and bottled water) to the wound, preferably with a spray bottle. Wet a clean cotton bud with the salt water solution and clean out ALL dirt from the wound, including any yellow puss. It is very important to get it really clean this first time. Rinse well and let air dry before you cover with a plaster. After this it is all about maintenance. Wound should be dry and healing after 3 days. Spray salty water to rinse from any dirt five or six times a day. Clean out with wet cotton bud if you need to to remove dirt or puss. Keep the wound open when possible, but cover when you move around or to keep the flies away. This method does not affect the body’s natural healing process. Alcohol also kills bacteria, but will also hinder the formation of a scab. Salt is alkaline and kills bacteria. Salt not only cleans, but also help drying out the wounds.

Prevention is the best way to avoid infected wounds. Mosquito bites are commonly scratched inadvertently and then easily infected. Some ways to help prevent skin to get broken and infected:

• Good sandals which protect the toes from being scuffed, stubbed or damaged.
• Good mosquito/bug repellent.
• When bitten, apply some traditional balm, for example Balsem Lang. It makes the itchiness go away.
• Good soap, to help reduce the chance of infected hair follicles.
• Drinking 8 glasses of water a day- keeps your body hydrated and clean within!

VENEREAL DECEASES

Practice safe sex only. Condoms protect both from HIV and Hepatitis B. Officially, the number of HIV/AIDS cases is relatively low in Indonesia, but that is very likely just the tip of iceberg. Not many Indonesians test themselves and awareness is extremely low outside Jakarta and Bali. Condoms can be bought in the apotik.