Directory - Bali and Lombok

Travel Reference

In-Depth Information

Health Dr Trish Batchelor

medical-expense options; the higher ones

are chiefly for countries that have extremely

high medical costs, such as the USA. You may

prefer a policy that pays doctors or hospitals

directly rather than you having to pay on the

spot and claim later. If you have to claim later,

make sure you keep all documentation. Some

policies ask you to call back (reverse charges)

to a centre in your home country where an

immediate assessment of your problem is

made.

RECOMMENDED VACCINATIONS

Specialised travel-medicine clinics are your

best source of information; they stock all avail-

able vaccines and will be able to give specific

recommendations for you and your trip. The

doctors will take into account factors such as

past vaccination history, the length of your trip,

activities you may be undertaking and underly-

ing medical conditions, such as pregnancy.

Most vaccines don't produce immunity

until at least two weeks after they're given, so

visit a doctor four to eight weeks before de-

parture. Ask your doctor for an International

Certificate of Vaccination (otherwise known

as the yellow booklet), which will list all the

vaccinations you've received.

The World Health Organization recom-

mends the following vaccinations for travel-

lers to Southeast Asia:

Adult diphtheria & tetanus Single booster

recommended if none in the previous 10 years. Side effects

include sore arm and fever.

Hepatitis A Provides almost 100% protection for up to a

year, a booster after 12 months provides at least another

20 years protection. Mild side effects such as headache and

sore arm occur in 5% to 10% of people.

Hepatitis B Now considered routine for most travellers.

Given as three shots over six months. A rapid schedule is

also available, as is a combined vaccination with Hepatitis

A. Side effects are mild and uncommon, usually headache

and sore arm. Lifetime protection occurs in 95% of people.

Measles, mumps & rubella (MMR) Two doses of MMR

are required unless you have had the diseases. Occasionally

a rash and flulike illness can develop a week after receiving

the vaccine. Many young adults require a booster.

Polio In 2002, no countries in Southeast Asia reported

cases of polio. Only one booster is required as an adult for

lifetime protection. Inactivated polio vaccine is safe during

pregnancy.

the injection is usually recommended as it has fewer side

effects. Sore arm and fever may occur.

Varicella If you haven't had chickenpox, discuss this

vaccination with your doctor.

If you are carrying syringes or needles, be

sure to have a physician's letter document-

ing their medical necessity. If you have a

heart condition ensure you bring a copy of

your electrocardiogram taken just prior to

travelling.

If you happen to take any regular medica-

tion bring double your needs in case of loss

or theft. In most Southeast Asian countries,

excluding Singapore, you can buy many medi-

cations over the counter without a doctor's

prescription, but it can be difficult to find

some of the newer drugs, particularly the

latest antidepressant drugs, blood pressure

medications and contraceptive pills.

INSURANCE

Even if you are fit and healthy, don't travel

without health insurance - accidents do

happen. Declare any existing medical condi-

tions you have - the insurance company will

check if your problem is pre-existing and will

not cover you if it is undeclared. You may

require extra cover for adventure activities

such as rock climbing. If your health insur-

ance doesn't cover you for medical expenses

abroad, consider getting extra insurance. If

you're uninsured, emergency evacuation is

expensive - bills of more than US$100,000 are

not uncommon.

Find out in advance if your insurance plan

will make payments directly to providers

or reimburse you later for overseas health

expenditures. (In many countries doctors

expect payment in cash at the time of treat-

ment.) Some policies offer lower and higher

These immunisations are recommended for

long-term travellers (more than one month)

or those at special risk:

Japanese B Encephalitis Three injections in all. Booster

recommended after two years. Sore arm and headache are

the most common side effects. Rarely an allergic reaction

comprising hives and swelling can occur up to 10 days after

any of the three doses.

Meningitis Single injection. There are two types of

vaccination: the quadrivalent vaccine gives two to three

years protection; meningitis group C vaccine gives around

10 years protection. Recommended for long-term back-

packers aged under 25.

Rabies Three injections in all. A booster after one year will

then provide 10 years protection. Side effects are rare -

occasionally headache and sore arm.

Tuberculosis ( TB) A complex issue. Adult long-term

travellers are usually recommended to have a TB skin test

before and after travel, rather than vaccination. Only one

vaccine given in a lifetime.

REQUIRED VACCINATIONS

The only vaccine required by international

regulations is yellow fever. Proof of vaccina-

tion will only be required if you have visited a

country in the yellow-fever zone within the six

days prior to entering Southeast Asia. If you

are travelling to Southeast Asia from Africa

or South America you should check to see if

you require proof of vaccination.

MEDICAL CHECKLIST

Further Reading

366

In Transit

366

Deep Vein Thrombosis (DVT )

366

Jet Lag & Motion Sickness

366

In Bali & Lombok

366

Availability & Cost of Health Care

366

Infectious Diseases

367

Traveller's Diarrhoea

370

Environmental Hazards

370

Women's Health

372

Treatment for minor injuries and common

traveller's health problems is easily accessed

in Bali and to a lesser degree on Lombok (see

p285). But be aware that for serious condi-

tions, you will need to leave the islands.

Travellers tend to worry about contracting

infectious diseases when in the tropics, but

infections are a rare cause of serious illness or

death in travellers. Pre-existing medical con-

ditions such as heart disease, and accidental

injury (especially traffic accidents), account

for most life-threatening problems. Becom-

ing ill in some way, however, is relatively

common. Fortunately most common illnesses

can either be prevented with some common-

sense behaviour or be treated easily with a

well-stocked traveller's medical kit.

The following advice is a general guide only

and does not replace the advice of a doctor

trained in travel medicine.

antifungal cream (eg clotrimazole)

antibacterial cream (eg muciprocin)

antibiotic for skin infections (eg amoxi-

cillin/clavulanate or cephalexin)

HEALTH ADVISORIES

It's usually a good idea to consult your

government's travel-health website before

departure, if one is available:

Australia (www.smartraveller.gov.au)

Canada (www.phac-aspc.gc.ca/tmp-pmv/pub_e

.html)

New Zealand (www.safetravel.govt.nz)

antibiotics for diarrhoea include nor-

floxacin or ciprofloxacin; for bacterial

diarrhoea azithromycin; for giardiasis or

amoebic dysentery tinidazole

BEFORE YOU GO

Make sure all medications are packed in their

antihistamine - there are many options

(eg cetirizine for daytime and prometh-

azine for night)

antiseptic (eg Betadine)

Bali and Lombok

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