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Travel vaccines, travel insurance and more. Southeast Asia.
We have so much to explore on our doorstep but if you are planning to travel around the region, you’ll want to stay safe. And that means two things – travel insurance and vaccinations.
Here we recommend some of the jabs you should discuss with your doctor before you set out. And we look at health issues travellers face when holidaying in the different neighbouring countries.
Vaccines for Indonesia
Travellers face issues of local hygiene, unsafe food and water, diseases transmitted by mosquitos and issues caused by accidents. Tetanus and diphtheria vaccinations should be checked, along with others, such as hepatitis A and typhoid.
Dengue fever and zika Virus in Bali, Jakarta and elsewhere in Indonesia are particularly heightened during the rainy season (usually from around October to April).
Rabies. There have been cases of rabies in Bali, both in humans and animals, especially from street dogs in Bali and elsewhere. You should avoid direct contact with all dogs and cats (including pets), monkeys and other animals and get immediate help if you’re bitten or scratched.
Air quality in Indonesia’s major cities can reach levels considered ‘unhealthy for sensitive groups’. Current air quality data for Jakarta can be found on the Air Quality Index website.
Ash plumes from volcanoes can affect air quality and have an impact on health, particularly for anyone with pre-existing respiratory conditions.
Tap water is not potable throughout Indonesia.
For emergency medical assistance dial 118. Contact your insurance/medical assistance company promptly as well.
Avian Influenza (bird flu) There have been more than 150 confirmed human fatalities in Indonesia since 2003. All cases so far have been linked to close contact with poultry. Avoid live animal markets, poultry farms and make sure poultry and egg dishes are thoroughly cooked.
The Gili Islands
A stunning group of three islands that is popular with Singaporeans – Gili Trawangan, Gili Meno and Gili Air are near the coast of the northwest of Lombok Island in Indonesia.
Singaporeans are attracted by the excellent scuba diving, snorkelling and the laid back lifestyle.
Healthcare is extremely limited on the islands. If things become serious you must travel to nearby Lombok by speedboat (around one hour) and head for the city of Mataram where there are a number of hospitals.
If you are in the Gilis for diving, check out the safety record of your dive school and the emergency aid they provide. It is highly recommended you have emergency air evacuation included in your travel insurance policy.
Gili Trawangan has a 24-hour clinic, The Blue Island Medical Clinic, located at Hotel Villa Ombak (the biggest hotel on the island). This clinic can prescribe medicines and perform very minor surgery.
Tourists report that this is the main place to go, although there is another clinic behind the Art Market (Pasar Seni). Be aware, as a foreigner you will be charged a lot more than locals.
Their website claims to have English and Japanese speaking staff. www.blueislandclinic.com
On the other two Gili Islands, Gili Meno and Gili Air, you will find only small local clinics.
Vaccines for Myanmar
Diseases such as dengue fever, Japanese encephalitis, Zika Virus and malaria are endemic. Drug-resistant strains of malaria and tuberculosis are common in many areas. Hepatitis vaccinations are recommended and cholera oral vaccine is worthwhile. Poor sanitation and eating contaminated food can increase the risk of diarrheal illnesses. Drink or use only boiled or bottled water and avoid ice in drinks.
Rabies has been reported in domestic and wild animals, and there have been a number of fatalities.
Air pollution can occur in major urban areas. This may aggravate bronchial, sinus or asthma conditions. Children, the elderly and those with pre-existing medical conditions may be especially affected.
There have been outbreaks of avian influenza (bird flu) in domestic poultry in Myanmar.
Cases of schistosomiasis, a parasitic infection, have been reported in Myanmar. There is no vaccine or medication to prevent schistosomiasis. You should avoid wading, swimming or bathing in freshwater. As the infection may cause no symptoms, all travellers who may have been exposed to schistosomiasis should have a medical assessment.
Competent medical advice and treatment may not be available outside Yangon and Mandalay, and any services provided will not be to the standard of those in Singapore. You may require expensive medical evacuation costing up to tens of thousands of dollars. Make sure you have adequate travel insurance and accessible funds to cover the cost of any medical treatment abroad and repatriation. Avoid intrusive examinations, including emergency dental work, due to irregular hygiene standards and the danger of infection, particularly by hepatitis B and C and HIV/AIDS.
Cash payment is often required prior to receiving medical treatment in Myanmar. Make sure you have adequate travel health insurance and accessible funds to cover the cost of any medical treatment abroad and/or repatriation.
Vaccines for Thailand
Although safer than many other Southeast Asian countries, you should still be vigilant. Health concerns include dengue fever, zika virus and dehydration. Only buy medicine from a reputable pharmacy.
High levels of air pollution can occur in major urban areas, including in Bangkok and Chiang Mai, which is also affected by regional smoke haze.
During March and April there is often smoke haze across parts of the north, north-east and south of Thailand, this can also close regional airports due to visibility. Keep up-to-date with local information and seek medical advice.
For emergency medical assistance dial 1669. Contact your insurance/medical assistance company we as.
Vaccines for Malaysia
Hepatitis A can be caught through contaminated water regardless of where you are staying or eating, as well as typhoid from contaminated food or water. Have this vaccine especially if you are staying with friends or relatives, visiting smaller cities or rural areas.
The states of Perlis, Kedah, Penang and Sarawak have been declared as rabies infected.
From June to October, Malaysia can experience air pollution from forest fires in Indonesia. Updates and health advisories are issued by the Malaysian Department of Environment.
For emergency medical assistance dial 999 or 112 and ask for an ambulance. Contact your insurance/medical assistance company as well.
Vaccines for Borneo
Make sure you are protected against the food and water borne diseases of typhoid and hepatitis A. For those trekking, or staying for longer periods, then consider protection against hepatitis B and rabies. The vaccine against malaria prophylaxis may also be something worth investigating.
Vaccines for Cambodia
The most common diseases in Cambodia are caused by a lack of clean water supply, poor sanitation in areas and hygiene. Health issues include malaria, tuberculosis and diarrheal diseases. Protect yourself against these by discussing them with your doctor.
There’s a risk of zika virus transmission and dengue fever.
Vaccines for Vietnam
Hepatitis A and B may be an issue, especially in the countryside, where hygiene standards may not always be as good as the cities.
Vietnam has a risk of zika virus, dengue fever, malaria and Japanese encephalitis which is prevalent in the summer/wetter months.
For emergency medical assistance dial 115 and ask for an ambulance. Contact your insurance/medical assistance as well.
Health care in the cities is adequate for minor injuries. More complicated treatment may require evacuation to another country. Healthcare in rural areas is extremely basic. Many hospitals require guarantees of payment before they’ll start treatment.
Make sure you have adequate travel health insurance and accessible funds to cover the cost of any medical treatment abroad and repatriation.
Watch out for rice wines. Some unrecognised brand names have been found with high and sometimes fatal levels of methanol.
There have been outbreaks of Avian Flu.
Carry any prescription medication in your hand-luggage with a copy of the prescription. If it has a total import value greater than US$100, then declare it at customs. Some medicines can be difficult to find in Vietnam and many medications on sale are counterfeit.
Vietnam has restrictions on some medicines they class as “addictive” or “psychotropic”. These include medicine for anxiety, depression, insomnia and other conditions. You must not have more than the quantity prescribed by a doctor for 7 days (addictive medicine) or 10 days (psychotropic medicine).
Hoi An is fairly well served for health care with some foreigners reporting good care at the Pacific Hospital in Hoi An, while foreigner prices tend to be cheaper at the Hoi An Hospital.
There are also several pharmacies in the town. The 24-hour Family Medical Practice in Danang (around 30 minutes away by car) has English speaking doctors. For major emergencies they can organise an SOS evacuation. There is also the Fortis Hoan My Danang Hospital in Danang.
The hospital most recommended for tourists is the Lao-China Friendship Hospital, around 5km from the town centre. This hospital may also be known as the Luang Prabang Provincial Hospital or just the Chinese hospital.
Facilities are limited and if you are really sick it is recommended you leave as soon as you can and fly to Bangkok preferably, or Vetienne or Udon Thani. The flights take around an hour and there are several each day.
Two other hospitals in or near Luang Prabang, the Foreigners Hospital (don’t be guided by the name) and the Soldiers Hospital are not recommended for holidaymakers.
Always remember – you can protect yourself from catching many diseases by using common sense and judging cleanliness and hygiene.
- Always wash your hands with soap.
- Avoid mozzie bites by using a good repellant, covering up and/or staying indoors at dawn and dusk.
- Drink bottled water and check the lid hasn’t been tampered with and filled with tap water.
- Brush your teeth and rinse your toothbrush with bottled water.
- As a precaution, close your mouth while showering if you are in a country where the water is unsafe to drink.
In any hospital it is still advised for you to understand what treatment you are getting, and to take responsibility for your own care.
- Make sure anyone who touches you, including doctors, staff and visitors wash their hands with soapy water.
- Ask your doctor to tuck away their tie or anything which can dangle and touch one patient and then another. Research suggests this helps prevent the spread of bacteria or superbugs like MRSA.
- Find out who is treating you – is he or she an attending physician (an experienced doctor), or a resident (a doctor in training)? If you have to have a procedure you may want to get the name of the doctor and do a quick search on the internet. Don’t be put off if you can’t find any information, ask about their background and experience.
- Keep a list of all your medications, why you take them, how many and how you take them. You have a right to see your chart. Request it if you want.
- If you are in a hospital or a medical clinic where you think the level of hygiene could be better, wipe down things in your room like the remote control and bed rails with a sanitiser.
- If your room isn’t cleaned everyday with disinfectant, ask staff to do this. If this still doesn’t get done and you have a relative or friend with you, ask them to clean it.
- Keep an eye on wound dressings and drainage tubes and let your nurse know if they become loose or wet.
- Don't be afraid to ask questions. Understanding your treatment plan will make it easier for you to be involved in your own recovery. As one member of staff goes off shift, ask them to brief you on where you are up to with treatment.
- As you leave hospital make sure you know what after-care you need. You may be feeling groggy and forget what a busy doctor has told you, so write this down.
Remember the vast majority of care in most hospitals is excellent, these tips are designed to help you think about your care, take responsibility for it and help yourself to get better.
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