Travelers have had different experiences with immunizations and illness. Some are immunized for every illness and still seem to contract them. Others have no immunizations and have no illness. It’s recommended you:
– Google ‘WHO Immunizations Indonesia’ to see what the World Health Organization recommends. Some immunizations should be received 12 weeks prior to departure so schedule a Doctor visit early. OSU Faculty with PrimeCare coverage can receive immunizations from the Travel Clinic at Rankin Family Practice Center on North High St. Uninsured travelers can receive good prices on immunizations from their County Public Health Clinic. Immunizations likely include Hepatitis A, Hepatitis B if you plan to have tattoos, acupuncture, or engage in sexual activity with Indonesian partners, Polio adult booster depending upon your age and the type of vaccine you took as a child, Typhoid, and a Tetanus/Diphtheria booster if your last one was 10 or more years ago.
For faculty covered by Primecare, google ‘Travel coverage – HR OSU Benefits Medical’ and print reference pages that list your international medical coverage. For students, or faculty traveling with students, google ‘OSU OIA Education Abroad travel insurance’ – students must have this coverage. The coverage is highly recommended for faculty.
-The illness you’re most likely to encounter is Traveler’s Diarrhea, usually contracted from contaminated water or food preparation. Exercise caution in drinking water, or consuming uncooked foods. YOU MUST DRINK ONLY BOTTLED WATER in Indonesia. No where is tap water intended for consumption. Exposure to bacteria occurred 6 – 24 hours prior to symptom onset. So if you ate some bad pizza at 6 pm and are sick at 7 pm, whatever is making you sick is probably what you ate for breakfast or lunch. Symptoms differ by patient, but likely include rapid onset nausea, vomiting, and diarrhea, sometimes severe. Use pharmaceuticals listed below to control symptoms. If symptoms exceed 36 hours or are so severe that dehydration is setting in get to a Doctor.
In preparation for your trip, gather medicines to take with you. In Indonesia, medicines from Azithromycin to Viagra are available over the counter at the Apotek (Pharmacy). Here are some common medicines travelers carry with them from the USA or obtained shortly after arrival in Indonesia. Talk with a Doctor before taking medicines:
Purchased in USA
– Sudafed 24 – decongestant for allergies, colds, and for travelers experiencing ear pain during the ascent/descent of flights. 1/day.
– Loperamide – 2 mg. Take one after second bout of diarrhea and additional pills about every 4 hours as symptoms persists. Generally Doctors don’t want you to take Loperamide – the ‘poop it out’ philosophy. But if you need to travel or sleep then you have no choice.
– Dramamine. As indicated, for nausea and vomiting.
– Benadryl – for allergies.
– Tylenol – for headaches.
– Aspirin – take one every 4 – 6 hours during the duration of your 24 – 36 hour flight. This suppresses blood clots forming in the lower extremities. Deep Vein Thrombosis is extremely rare, but is real and serious. Aspirin can help.
– Bandaids, tweezers, sunblock (minimum spf 40), needle/thread, fly spray – using wipes in small packets will be more convenient than a fly spray. This guards against mosquito-born dengue fever spread by day-biters.
– mini pack Kleenex tissues and Wet Wipes in small packs for toileting needs since restrooms outside malls and hotels do not stock these items.
Purchased in Indonesia
– Ciprofloxacilin – antibiotic used for travelers diarrhea in Indonesia. 500 mg x 2 /day maximum 14 days. Can be taken on arrival in Indonesia 500 mg x 1/day to avoid onset of diarrhea maximum 14 days.
– Azithromycin – antibiotic used for travelers diarrhea in countries adjacent to Indonesia. 500 mg/day x 3 days.
– Ondansetron – a pill that goes under the tongue for severe vomiting when you can’t keep a Dramamine down. 1 – 2 at onset, and additional 1 every 3 – 4 hours for symptomatic relief.
Seeing the Doctor in Indonesia. Like the USA, the quality of health care can vary widely and you may have extremely negative or positive interactions with health care professionals. In extremely rural areas you may potentially purchase pharmaceuticals for veterinary use which are also effective for your ailment. Gili Trawangan is an example since there is no resident Physician.
Worst experience of a traveler: A traveler with a routine yeast infection presented at a specialist obgyn hospital in Jakarta and was told by a ob-gyn specialist that yeast infections are only common in, quote “slutty American women and Indonesian women do not have such infections.” (In Indonesia yeast infections are generally called ‘thrush’ in English, and because of the disruption in climate and diet the chances of getting one are slightly heightened. If you’re looking for an Indonesian equivalent to Monistat or other drugs, google ‘Australian Indonesian pharmacy medical concordance’).
Best Experience of a traveler: A traveler presented at an Eye/Ear/Nose Specialist with a classic case of Whooping Cough contracted in the USA. He was treated and medicated within 15 minutes for $15.
Other best experience of a traveler: A traveler with severe diarrhea and vomiting from Travelers Diarrhea was transported by ambulance including services of a doctor, nurse, and driver, hospitalized, treated, medicated and released in 8 hours for $400.
Indonesian law requires that physicians practicing in Indonesia must be fluent Indonesian speakers. They may or may not speak English and their English may be non-existent or it could be quite good. If you can, find a physician who may have been foreign trained to maximize the chances your physician can ask you questions or explain your treatment in English.
Here are some tips:
- Jakarta, MCCC Siloam Hospital, Jl Garnisun Dalam, No.2-3, Semanggi, Jakarta. From Indo cell phones: 021-2996-2777. Ambulance dispatch: 1-500-911
Bali. Singaraja Public Hospital. Jl Ngurah Rai 30, Singaraja. From Indo cell: 0362-22573.
Bali. BIMC Kuta, Jalan ByPass Ngurah Rai, No 100X, Kabupaten Badung, Kuta Beach, Bali, 80361. 0-361-761-263. www.bimcbali.com
Yogyakarta. Rumah Sakit Bethesda, Jalan Jenderal Sudirman 70, Yogyakarta, 55224. From Indonesian Cell Phones: 0-274-562-246. www: Bethesda.or.id
Outside these areas, see recommendations from the Lonely Planet publication Indonesia, or call your travel insurance providers for recommendations
- For routine illnesses especially those contracted locally, like a jelly fish sting or Dengue Fever, local physicians are well equipped to diagnose and treat those. Physicians often have their practice attached to an Apotek (Pharmacy) and are open 8:00-22:00, 6 – 7 days. Bring a local with you, possibly from the hotel, to translate.
- If you have a life-threatening illness, like chest pain or stroke-like paralysis, go to the NEAREST hospital IMMEDIATELY. If possible, try to bring a local with you to translate but do not delay. Also, unlike in the USA, take the first car or taxi to the hospital that is available. Ambulance service and traffic is not necessarily rapid like in the USA. Unlike the USA, it may be quicker to take a taxi to the hospital than to wait for the hospital to send an ambulance to you. (Indonesia does not have 911 services, and ambulances are dispatched from the hospital.)
- If you are managing a complicated illness, like heart disease, cancer, or an auto-immune disease, and you know your illness is worsening and will need complicated and complex intervention, rather than making an emergency return to the USA consider travelling to Singapore. From Jakarta and Bali flights to Singapore are running every couple of hours, and the flight time is 1 (Jakarta) or 2.5 (Bali) hours. Potentially, from the moment you make a decision to travel to Singapore to the moment you are in a Singaporean hospital, it could be as little as 6 hours. After 2 – 3 days treatment you could potentially opt to return to your assignment in Indonesia. This could be much better than returning to the USA, because if you decide to return to the USA it will probably take you a minimum of at least 36 hours to arrange and make the trip. So Singapore medical interventions which are comparable to the USA, represent a more rapid treatment option and if your health is stabilized give you the option to return to Indonesian work. When completing your travel insurance forms and you need to list the countries to which you are travelling, list both Indonesia and Singapore so that you will be sure you are covered.
- Additionally, if you spend enough time in Indonesia you will meet Indonesians who also use faith healers or shaman. Some shaman are scams, intent on taking the patients money. Other shaman harness traditional rituals to capitalize on the power of belief to support mental health, or sometimes sleight of hand to create illusions that cause the patient to believe they feel better. These shaman operate at the edge of traditional muslim teachings, since islam stands against ‘black magic’ but shaman using traditional rituals would argue they are healing and not using supernatural powers. It will be also helpful to understand that large numbers of Indonesians believe in the supernatural, especially ghosts.