DEET-based insect repellent
DEEP VEIN THROMBOSIS (DV T )
Deep vein thrombosis (DVT) occurs when
blood clots form in the legs during plane flights,
chiefly because of prolonged immobility. The
longer the flight, the greater the risk. Although
most blood clots are reabsorbed uneventfully,
some may break off and travel through the
blood vessels to the lungs, where they may
cause life-threatening complications.
The chief symptom of DVT is swelling or
pain of the foot, ankle, or calf, usually but not
always on just one side. When a blood clot
travels to the lungs, it may cause chest pain
and difficulty in breathing. Travellers with
any of these symptoms should immediately
seek medical attention.
To prevent the development of DVT on
long flights you should walk about the cabin,
perform isometric compressions of the leg
muscles (ie contract the leg muscles while sit-
ting), drink plenty of fluids, and avoid alcohol
JET LAG & MOTION SICKNESS
Jet lag is common when crossing more than
five time zones; it results in insomnia, fatigue,
malaise or nausea. To avoid jet lag try drink-
ing plenty of fluids (nonalcoholic) and eating
light meals. Upon arrival, seek exposure to
natural sunlight and re-adjust your schedule
(for meals, sleep etc) as soon as possible.
Antihistamines such as dimenhydrinate
(Dramamine) and meclizine (Antivert, Bon-
ine) are usually the first choice for treating
motion sickness. Their main side effect is
drowsiness. A herbal alternative is ginger,
which works like a charm for some people.
In government-run clinics and hospitals,
services such as meals, washing and clean
clothing are normally provided by the pa-
tient's family. If you are unfortunate enough
to be on your own in a Bali hospital, contact
your consulate - you need help.
The best hospital on Lombok is in Mata-
ram, and there are more basic ones in Praya
and Selong. There are pharmacies in the main
towns and tourist centres, but the choice of
medicines is limited.
Self-treatment may be appropriate if your
problem is minor (eg traveller's diarrhoea),
you are carrying the appropriate medication
and you cannot attend a recommended clinic.
If you think you may have a serious disease,
especially malaria, do not waste time - travel
to the nearest quality facility to receive at-
tention. It is always better to be assessed by a
doctor than to rely on self-treatment.
Outside of tourist centres, buying medica-
tion over the counter is not recommended, as
fake medications and poorly stored or out-of-
date drugs are common. Check with a large
international hotel for a recommendation of
a good local pharmacy.
INFEC TIOUS DISEASES
Otherwise known as Avian Influenza, the
H5N1 had claimed more than 50 victims in
Indonesia by mid-2006. Most of the cases
have been in Java, west of Bali. The infection
was not showing any signs of diminishing and
treatment has proven to be very difficult. Trav-
ellers to Bali and Lombok - neither of which
had had a confirmed case by mid-2006 -
may wish to check the latest conditions before
their journey. See Internet Resources (see
opposite) for some good sources of current
diarrhoea treatment - consider an
oral rehydration solution (eg Gastro-
lyte), diarrhoea 'stopper' (eg lopera-
mide) and antinausea medication (eg
Never drink tap water.
Bottled water is generally safe - check
the seal is intact at purchase.
first-aid items such as scissors, Elasto-
plasts, bandages, gauze, thermometer
(but not mercury), sterile needles and
syringes, safety pins and tweezers
Avoid fresh juices - they may have been
Boiling water is the most efficient
method of purifying it.
ibuprofen or another anti-inflammatory
indigestion medication (eg Quick Eze or
The best chemical purifier is iodine. It
should not be used by pregnant women
or those people who suffer from thyroid
laxative (eg Coloxyl)
migraine medication - take your per-
Water filters should also filter out
viruses. Ensure your filter has a chemical
barrier such as iodine and a small pore
size, eg less than four microns.
steroid cream for allergic/itchy rashes (eg
1% to 2% hydrocortisone)
sunscreen and hat
thrush (vaginal yeast infection) treat-
ment (eg clotrimazole pessaries or diflu-
tests, hotel visits and arrange medical evacua-
tion. A basic consultation costs 600,000Rp.
International SOS (Map p100 ;
Ural or equivalent if you're prone to
There is a wealth of travel health advice on
the internet. The World Health Organization (WHO;
www.who.int/ith/) publishes a superb book called
International Travel & Health, which is re-
vised annually and is available online at no
cost. Another website of general interest is
MD Travel Health (www.mdtravelhealth.com) , which
provides travel health recommendations for
every country. The Centers for Disease Control &
Prevention (CDC; www.cdc.gov) website also has good
general information. For further information,
LonelyPlanet.com (www.lonelyplanet.com) is a good
place to start. You can also check the websites
of various foreign embassies in Indonesia (see
Lonely Planet's Healthy Travel - Asia & India
is a handy pocket-sized book that is packed
with useful information including pretrip
planning, emergency first aid, immunisation
and disease information and what to do if
you get sick on the road. Other recommended
24hr) is near BIMC
and offers similar services at similar prices.
At both these places you should confirm
that your health and/or travel insurance will
cover you. In cases where your medical con-
dition is considered serious you may well
be evacuated by air ambulance to top-flight
hospitals in Jakarta or Singapore. Here's where
proper insurance is vital as these flights can
cost more than US$10,000.
In Kuta, Nusa Dua and Ubud there are also
locally owned clinics catering to tourists and
just about any hotel can put you in touch with
an English-speaking doctor.
In more remote areas, facilities are basic; gen-
erally a small public hospital, doctor's surgery
or puskesmas (community health care centre).
Specialist facilities for neurosurgery and heart
surgery are nonexistent, and the range of avail-
able drugs (including painkillers) is limited.
Travel insurance policies often have an emer-
gency assistance phone number, which might
be able to recommend a doctor or clinic, or use
its contacts to find one in a remote area.
Health care is not free in Bali, and you will
get more prompt attention if you can pay cash
up-front for treatment, drugs, surgical equip-
-bali.com; JI Ngurah Rai 505X;
IN BALI & LOMBOK
AVAILABILIT Y & COST OF HEALTH
Bali's best public hospitals are in Denpasar
and Singaraja. In the first instance, foreigners
would be best served in one of two private clin-
ics that cater mainly to tourists and expats.
BIMC (Map p100 ;
This mosquito-borne disease is becomingly
increasingly problematic throughout South-
east Asia, especially in the cities. As there is
no vaccine available it can only be prevented
by avoiding mosquito bites. The mosquito
that carries dengue bites day and night, so
use insect avoidance measures at all times.
Symptoms include high fever, severe headache
761263; www.bimcbali.com; JI Ngu-