Health

Medical

CIFOR has a working agreement with international health facility SOS Medika Clinic in Jakarta that hosts English-speaking doctors who provide general care for adults and children and treat a range of conditions. The primary clinic visited by CIFOR expats is located in South Jakarta, an hour’s drive from Bogor, and is open 24-hours, 7-days a week.

Health tips

Indonesia is a hot and humid country that carries its share of tropical diseases. Many of them can be avoided by taking simple medical, hygienic or safety precautionary measures.

  • Use mosquito repellent when outdoors.
  • Clean food thoroughly – especially those eaten raw, such as salads.
  • Drink only bottled water and avoid ice in areas where hygiene is questionable.
  • Wash hands frequently.
  • Avoid food and drinks from street vendors.
  • Don’t leave uncooked meat or seafood out.

Before moving to Indonesia, we recommend bringing a stock of medication that you think you and your family may need, at least a 6-month supply, until you have found a doctor and health facility that you are comfortable with.

Risks:

 

  • Asthma

    The quality of air in Bogor is better than Jakarta, but still may not be as good as what you are used to. Along with pollution, dust and mold can at times set off asthma.

    Bring your own asthma medication upon your arrival if you are prone to it. Once you have found a medical practitioner you can trust, you can easily obtain asthma drugs in pharmacies in Jakarta or Bogor.

  • Cholera

    An acute infection of the small intestines caused by bacteria found either in food or contaminated water. Symptoms include diarrhoea and/or vomiting. Cholera is easily treated when coupled with awareness of symptoms. Consistent hydration is crucial – severe dehydration, which can sometimes cause death, can be prevented with simple and inexpensive rehydration solutions, such as Pocari Sweat, found in most grocery and convenience stores.

  • Dengue fever

    Dengue is the most common disease you will hear about in Bogor and Jakarta, transmitted by mosquito bite. The mosquito that carries the virus is black with white stripes and breeds in clean, still water in and around the house.

    The incubation period is between 7 to 10 days after a bite. Symptoms include high fever for 3 days, combined with severe headache, muscle pains, loss of appetite, sometimes nausea/vomiting and extreme fatigue. By the 3rd day a rash may appear.

    After the 3rd day of fever, several blood tests may be required to measure white blood cell count (WBC), which can drop perilously with dengue. There is no treatment for the virus but constant monitoring is essential and assisted hydration (in hospital) may be necessary for persons too weak or unable to drink.

    Because the disease is common in Indonesia, most hospitals and doctors are able to adequately treat patients with the virus. In severe and rare cases where the WBC drops below safe levels, blood transfusion may be required.

  • Diarrhoea

    If this is your first time to live in a developing country or in the region, in the months after your arrival you may be subjected to regular bouts of diarrhoea as your body learns to adjust to the climate, food and native bacteria. While not usually serious, it is essential to stay hydrated. Gatorade is hard to come by but there are lots of alternatives, such as Pocari Sweat or coconut juice (kelapa mudah), which can be found in most grocery and convenience stores.

  • Hepatitis

    This is a virus that primarily affects the liver. There are 3 types you need to be aware of – Hepatitis A is contracted through contaminated water or food, while Hep B and Hep C are transmitted through blood-to-blood contact (via unsterilized needles, blood transfusions or sexual intercourse). There are vaccines for A and B, which you may consider getting before arrival in Indonesia. Symptoms include fever, jaundice, yellow eyes and vomiting.

  • Insect bites

    In the event a spider or another insect bites you, immediately douse the bite with cotton wool soaked in 70% alcohol for up to an hour to neutralize the enzymes and bacteria on the skin surface. This may help reduce the chance of infection.

    If in a day or two you notice a white head surface and the area around the bite is red and warm and/or slightly raised, seek medical attention right away to avoid the spread of infection in the body. You may be given antibiotics and instructions on how to dress the bite if it turns into a larger wound.

  • Malaria

    Incidences of malaria in Bogor and Jakarta are rare, but the risks are higher when you travel to the field. Symptoms include fever, chills, sweats, headache, body aches, nausea, vomiting and fatigue.

    To avoid malaria, use mosquito repellent, with Deet preferably, and sleep under mosquito nets. Malaria-carrying mosquitos are usually active between 1700 and 1900 hours.

  • Typhoid fever

    Caused by the bacteria Salmonella Typhi, typhoid is usually transmitted by water or food, just like cholera. People who are infected excrete live bacteria in their feces and urine. Good hygiene such as washing hands and disinfecting toilets regularly is important in preventing spread the bacteria.

    Diagnosing typhoid is not easy. Stool cultures are sensitive in the early and late stages of the disease but often must be supplemented with blood cultures to make the definite diagnosis. Doctors will also rely on symptoms such as a fluctuating temperature that raises and falls during the day and peaks at night; tenderness of the abdomen, often on the left; a thickly coated tongue; loss of appetite; a general feeling of being weak that tends to fluctuate with the temperature, but increases with time and a loss of weight over time.

    Doctors in Indonesia have a tendency to declare typhoid when in fact there is dengue or another type of infection present. In these cases, a second opinion may be necessary.

    Note: If you suspect you may have typhoid, take complete bed rest. The typhoid bacteria attack the lining of the intestine, which can perforate if the patient is too active.

  • Tuberculosis

    Tuberculosis, or TB, is an infectious bacterial disease that tends to affect the lungs, but can also spread to other parts of the body. You won’t acquire TB by touching someone infected. You can catch it when breathing in bacteria in the air when someone who has a TB lung infection coughs, sneezes, shouts, or spits (common in some cultures) close to you.

    Symptoms can include a cough lasting 3 weeks or longer, pain in the chest, coughing up blood or sputum, unexplained weight loss, fatigue, shortness of breath, fever and loss of appetite, or pneumonia. Treatment can be from 6 to 9 months, and usually effective if medication is taken consistently.

    Avoid going to crowded areas, especially in areas known to have high incidences of TB, usually in the rural areas. If you have children who will spend time with helpers or a nanny, it would be advisable to have them tested for TB before they begin working with you. An initial chest x-ray may be sufficient and if additional tests are advised, blood or skin tests can be conducted (the TB skin test alone may not be effective in catching cases of latent TB).

  • Chikugunya fever

    A viral disease transmitted to humans by the bite of infected mosquitoes. The Aedes aegypti (recognizable by its black and white stripes) and the Aedes albopictus mosquitoes are the primary carriers. Ades aegypti is also a carrier for dengue fever, which is transmitted in the same way.

    Acute Chikungunya fever typically lasts a few days to a couple of weeks, but as with dengue, and other arboviral fevers, some patients have prolonged fatigue lasting several weeks.

    Additionally, some patients have reported incapacitating joint pain, or arthritis which may last for weeks or months.

    Overall symptoms include fever, rash, headache, fatigue, nausea/vomiting and muscle and joint pain. Because symptoms are similar to those of dengue, blood analysis is necessary to differentiate between the two viruses. Cases are rarely fatal, though recovery may take several weeks.

  • Tips on avoiding mosquito bites

    Taking a few measures to avoid being bitten can help reduce the risk of contracting mosquito born diseases.

    • Mosquitos are most active in the early morning and late afternoon so wear long sleeves or trousers or use mosquito repellent.
    • Mosquitos are attracted to dark colors so avoid wearing blue and black outdoors at peak hours.
    • Consider installing screens in your homes. Most houses don’t have screens but landlords may agree to install them before you move in.
    • Regularly apply mosquito repellent to you and your family members. See other important information below.

    Deet is the most common and effective active ingredient found in mosquito repellents but recent studies are showing that certain mosquitos can become less sensitive to it over time. Read the label on repellents, especially when applying on children.

    Finding effective non-Deet, natural mosquito repellents in Indonesia can be tough and are often on the expensive side (try Baby Organics Insect Repellent online or at Mothercare stores in Jakarta). Citronella oil is readily available and cheap, but not everyone responds equally to natural based repellents – be sure to test products on individual members of your family.