Tips for traveling in Asia

So far all my tips for traveling in Asia in one place. Hope it will be useful for your travels.

Tips for traveling in Asia Indonesia

Tips for traveling in Asia Malaysia

Tips for traveling in Asia Vietnam


Have more questions? Need more tips for traveling in Asia, especially in Indonesia? Contact me and I will try to help you :)

 



“Clever” Indonesian medical system

During my stay in Indonesia I already had some “meetings” with the Indonesian medical system. I had some problems with a skin, bees bite and long lasting bronchitis (I tried to get well almost 2 months). But all things that happen and treatment that I got in different places it was quite ok, even if I (like European) didn’t sometimes understood the system – why it’s made so complicated.

But yesterday, when I needed to make my last vaccine from Hepatitis B (like 2 first vaccines I had time to make before coming to Indonesia) I was totally surprised of Indonesian medical system.

So here is the story :)

We came to the clinics at 8:00 am, after couple of minutes waiting in the reception I was registered with a doctor (that starts to work this day only at 10:00 am and works only 2 hours). First strange thing if really only one doctor in whole big clinic can work with the vaccinations? Let it be, we were already there and I wanted to finish this vaccination question as soon as possible, so let’s wait :).

We went to the section, where we need to register for a line to that doctor. Like it’s quite early, I thought that I will be one of the firsts in the line. A little bit before 10:00 am, we already sitting in the front of doctors doors. 10.30 – 11.00 am doctor doesn’t  show up yet!

We went to speak with a nurse about my vaccination, if it will be enough time to make necessary analysis still today. Like I read somewhere that before making vaccination in Indonesia, in some clinics make additional blood test and etc. to check if patient health condition is really good to take the vaccine. The nurse didn’t say anything, just “please wait for a doctor”.

Already 11:15 am, finally doctor show up – but with a big sadness, I‘m not the first one in the line – more 5 people before me. So I’m still waiting for my “magic” vaccine.

Finally doctor invites me almost before 12:00 am (before his working hours finished). 3 min. in his cabinet, he gives the papers for making vaccination and that’s all. No tests, no questions.

I came back to nurse, showed doctors papers, she gave the bill for visiting doctor and explains what to do next. I’m going to pay to cashier for visiting doctor for 3 min. (and waiting almost 2 hours), coming back to nurse to give the copy of payment.

Going to pharmacy, putting the paper that doctor gave (vaccine name), waiting till pharmacy person will call me. Finally I heard my name, get the bill for vaccine. Going to pay for cashier again, coming back to pharmacy, showing the copy of payment and again waiting till they will call my name and will give the vaccine.

Finally, I have the vaccine and the syringe (yeah, you need to pay even for the doctors tools).

Going to another place, showing again all papers, explain what I want, giving the vaccine. Again getting the bill (for injection), going to cashier again, paying and coming back with payment copy.

Only then they made me the vaccine. Finally!!! After almost 4,5 hours in clinic I got my 3rd Hepatitis B vaccine!

After all, I started to think, why I needed to wait for a doctor and pay for his visit (3 min.), if he wrote only the paper. Why the nurse can’t do it, if no additional test needed to be done and etc.? Why needed to make so many payments at different time in different cabinets if would be enough to pay just for all service at once and get it in one place (for example in Lithuania we have special cabinet /places where you can make all vaccines,  it’s like dedicated only to vaccinations)?

In my mind is only 2 thoughts: First they want to earn more money of doing so complicated process and involving more people to whom you will need to pay. Second – because of low unemployment situation in Indonesia they try hire more people and give them even small jobs (I already had many situation in another places when 1 person opens the doors, 2nd asks what you are searching for, 3rd find what you need, 4th gives you a bill, 5th takes your money, 6th pack your stuff and 7th helps you to take out the motorbike from parking ares). The nurse’s makes only documentation, they don’t’ have any right to decide or give any information about medical treatment. Other person makes just vaccinations, others just collect the recipes, other just collects the medicine, others gives you a bill. Everything could be much more easier :).

So what do you think it is? The way to earn more money or the way to engage more people and try to reduce unemployment in the country?

P.S. my advice even if in Indonesia the price of vaccination will be much cheaper than in your country, I suggest (if there is possibility) to make all vaccines before you are coming to Indonesia. First everything will be more clear and second you won’t waste your time and won’t kill nerve cells :D.

Do you have experience with medical systems abroad? Share your experience :)


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Vaccinations for Indonesia

You can find many information what kind of vaccinations for Indonesia you may need, if you are planning to come to here for longer time (or shorter). But the risks to health whilst traveling will vary between individuals and many issues need to be taken into account, e.g. activities in Indonesia, length of stay, in which part of Indonesia you will stay and general health of the traveler. As well maybe some of the vaccines you already got in the childhood?

It’s recommended that you consult with your general practitioner or practice nurse 6-8 weeks in advance of travel. They will assess your particular health risks before recommending vaccines and /or antimalarial tablets. This is also a good opportunity to discuss important travel health issues including safe food and water, accidents, sun exposure and insect bites. Many of the problems experienced by travelers can’t be prevented by vaccinations and other preventive measures need to be taken.

My suggestion:

    • First of all check in your medical report which vaccines you got in the childhood and for how long it valid (or ask your parents)
    • Second, talk with the doctor, give as much as possible information – where exactly you will stay in Indonesia, for how long, what are your plans for traveling around.

The doctor will recommend vaccines and you can choose which one you really need. Don’t make too many vaccines just because of safety. Many things will depend on you, for example where you will eat, how you will take care of your hygiene, how you prevent yourself from mosquitoes and etc.

Before coming to Indonesia I made such vaccines:

      • Hepatitis A (I manage to make only 2 before coming and after all I found out that I didn’t need this one at all, like I got it in childhood)
      • Hepatitis B (I made 2 before coming to Indonesia and 3rd in Indonesia)
      • Tetanus-diphtheria
      • Typhoid

 

Which vaccines to make suggest some internet sources (you can find and other recommendations)
  • Courses or boosters usually advised: Diphtheria; Hepatitis A; Tetanus; Typhoid.
  • Other vaccines to consider: Cholera; Hepatitis B; Japanese Encephalitis; Rabies.
  • Yellow fever vaccination certificate required for travelers over 9 months of age arriving from countries with risk of yellow fever transmission.

Notes on the diseases mentioned above:

  • Cholera: spread through consumption of contaminated water and food. More common during floods and after natural disasters, in areas with very poor sanitation and lack of clean drinking water. It would be unusual for travelers to contract cholera if they take basic precautions with food and water and maintain a good standard of hygiene.
  • Diphtheria: spread person to person through respiratory droplets. Risk is higher if mixing with locals in poor, overcrowded living conditions.
  • Hepatitis A: spread through consuming contaminated food and water or person to person through the faecal-oral route. Risk is higher where personal hygiene and sanitation are poor.
  • Hepatitis B: spread through infected blood and blood products, contaminated needles and medical instruments and sexual intercourse. Risk is higher for those at occupational risk, long stays or frequent travel, children (exposed through cuts and scratches) and individuals who may need, or request, surgical procedures abroad.
  • Japanese Encephalitis: spread through the bite of an infected mosquito. This mosquito breeds in rice paddies and mainly bites between dusk and dawn. Risk is higher for long stay travelers to rural areas, particularly if unable to avoid mosquito bites.
  • Rabies: spread through the saliva of an infected animal, usually through a bite, scratch or lick on broken skin. Particularly dogs and related species, but also bats. Risk is higher for those going to remote areas (who may not be able to promptly access appropriate treatment in the event of a bite), long stays, those at higher risk of contact with animals and bats, and children. Even when per-exposure vaccine has been received, urgent medical advice should be sought after any animal or bat bite.
  • Tetanus: spread through contamination of cuts, burns and wounds with tetanus spores. Spores are found in soil worldwide. A total of 5 doses of tetanus vaccine are recommended for life in the UK. Boosters are usually recommended in a country or situation where the correct treatment of an injury may not be readily available.
  • Typhoid: spread mainly through consumption of contaminated food and drink. Risk is higher where access to adequate sanitation and safe water is limited.
Malaria
Malaria is a serious and sometimes fatal disease transmitted by mosquitoes. You cannot be vaccinated against malaria.
  • Malaria risk is present in most areas, except Jakarta municipality, main cities, urban areas and the main tourist resorts, throughout the year. Risk is highest in rural areas and in the five eastern provinces of East Nusa Tengarra, Maluku, North Maluku, Papua and West Papua.
  • In North Sumatra, Jambi, Bengkulu, Borneo/Kalimantan, Central, South East and North Sulawesi and West Nusa Tenggara, risk is not high enough to warrant antimalarial tablets for most travelers, however, it may be considered for certain groups who may be at higher risk e.g. longer stay in rural areas, visiting friends or relatives, those with medical conditions, immunosuppression or those without a spleen.
  • There is low to no risk in Jakarta municipality, the main cities, urban areas and the main tourist resorts, including Bali and Java.
  • Check with your doctor or nurse about suitable antimalarial tablets. Atovaquone/proguanil OR doxycycline OR mefloquine is the first choice.
  • Malaria precautions: avoid mosquito bites by covering up with clothing such as long sleeves and long trousers especially after sunset, using insect repellents on exposed skin and, when necessary, sleeping under a mosquito net.
  • If you have been traveling in a malaria’s area and develop a fever seek medical attention promptly.
  • Remember malaria can develop even up to one year after exposure.
  • If traveling to high risk malaria’s areas, remote from medical facilities, carrying emergency malaria standby treatment may be considered.
Dengue Fever
A viral illness that is transmitted to humans by mosquito bites. The mosquito that spreads dengue bites during the day and is more common in urban areas. Symptoms include fever, headache, severe joint, bone and muscular pain – hence its other name “break bone fever”. There is no vaccine and prevention is through avoidance of mosquito bites. Every 5 years in Indonesia exist outbreak of Dengue fever, this year (2015) was the 5th year, so many people got it.



Some information used from internet sources.

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