What are the health considerations when travelling to East Indonesia?

Fish as part of a healthy diet, health in East Indonesia
For up-to-date medical information, please refer to the website of/ information provided by your home country's Ministry of Health, Ministry of Foreign Affairs or Tropical Medical Bureau.

Vaccinations might be necessary for East-Indonesia

Upon entry from a yellow fever area, evidence of yellow fever vaccination must be provided. Although there may no other compulsory vaccinations be required when starting your East of Wallace adventure, it is recommended to check and complete some standard vaccinations, such as tetanus, diphtheria, pertussis (whooping cough), possibly against polio, mumps, measles, rubella (MMR), influenza, pneumococcal and herpes zoster (shingles) on the occasion of each trip.
For travelling to Indonesia, a vaccination against hepatitis A is recommended, for long-term stays or special exposure also against hepatitis B, rabies, typhoid and Japanese encephalitis is recommended. If necessary, booster vaccinations are required.

Dengue Fever

Dengue fever is common in Indonesia. The viral disease is transmitted by predominantly diurnal mosquitoes. There is a risk of transmission throughout the year with accumulation during the rainy season. A vaccine or chemoprophylaxis is not available. Consistent protection against mosquito bites is the only possible protective measure.

Zika-Virus-Infection

According to the World Health Organization (WHO), Indonesia is classified with a possible transferability of Zika viruses, involving category 1 and/or 2 of the current WHO classification, even if currently no new cases are documented. The transfer risk can vary considerably both regionally and seasonally.

Malaria

In Indonesia, there is a year round risk of malaria. As high risk regions have to be considered the lower areas of Papua, the Moluccas and all islands East of Lombok. A medium risk exists on Sulawesi, especially in the North and Center, in the highlands of West Papua (New Guinea) below 2000 m, as well as on the other islands. There is no absolutely safe protection against malaria. Please check with your medical practitioner on possible Malaria prevention medication. However, adequate protection against mosquitoes (exposure prophylaxis) is considered the most important protection against it. It is therefore advisable to wear light-colored clothing that covers the body and to apply insect repellent on all free parts of the body repeatedly and possibly to sleep under an impregnated mosquito net.

Diarrhea

By adhering to an appropriate food and drinking water hygiene, most diarrheal diseases and cholera can be avoided.

As basic rules are highlighted at this point:

  • Drink only water of safe origin, e.g. bottled water, never tap water.
  • In case of emergency, use filtered, disinfected or boiled water.
  • While travelling, also use drinking water for washing dishes and brushing teeth.
  • For food: cooking, peeling or disinfecting. Be sure to keep flies away from food.
  • Wash hands as often as possible with soap, but always after bowel movements and always before preparing food and before eating.
  • Hand disinfect, where appropriate, use disposable towels.

HIV/AIDS

HIV / AIDS is a major problem in Indonesia and a major threat to those who are at risk of infection: unprotected sexual contacts, tattoos, dirty syringes or cannulas and blood transfusions can pose a significant lethal risk. Condom use is always recommended.

Rabies

Rabies is an almost always fatal infectious disease caused by viruses transmitted by the saliva of infected animals or humans, e.g. by biting, licking of injured areas of skin or saliva droplets on the mucous membranes of the mouth, nose and eyes. Nationally, there is a high risk of bite injuries and thus the transmission of rabies by stray dogs or monkeys. It is not possible for unvaccinated individuals to obtain the necessary medical support after biting injuries in Indonesia’s remote island regions. Reliable protection against the disease is just a vaccine, which is highly recommended to obtain before starting the journey.

Chikungunya Fever

Like Dengue, Chikungunya fever is a viral disease caused by the bite of infected mosquitoes with fever and sometimes long-lasting joint pain, which can recur in Indonesia over and over again. Again, there is no vaccination, only the avoidance of mosquito bites can help.

Japanese Encephalitis (JE)

JE is an inflammation of the brain caused by viruses. These are transmitted by nocturnal mosquitoes. Especially pigs and waterfowls are infected with the virus, without getting sick themselves. Diseases in humans are rather rare, but then often take a severe course and often leave lasting damage or end fatally. There are no effective drugs against JE viruses. Therefore, a careful mosquito repellent and possibly a preventive vaccination is important.

Other Infectious Diseases

Also in Indonesia, the classical avian influenza (highly pathogenic form of avian influenza, bird flu) has occurred. Most of the 33 provinces have reported infected poultry. Human diseases have been known since July 2005 and so far only occurred on some islands (mainly Java and Sumatra, occasionally also Bali and South Sulawesi). However, further cases on other islands are to be expected. The lethality is very high, but so far in most cases direct contacts to infected animals were detectable. Travelers are recommended to avoid contact with live or raw poultry or birds. In addition, infections with the H5N1 virus have occasionally occurred in cats. However, these also seem to be directly related to diseased poultry. Nevertheless, contacts with free-range cats should be avoided. Domestic cats should not come into contact with wild birds or poultry.

Tuberculosis

Tuberculosis is much more prevalent nationwide than e.g. in Central Europe. Transmission takes place from person to person via droplet infection or close contacts. Incorrect or discontinued treatments are increasingly resistant to tuberculosis.

Air Pollution from Forest Fires

In the dry season, large-scale forest fires occur regularly in Kalimantan, central and southern Sumatra, which can be seen in the region as intense and the respiratory system irritating haze. It is recommended to inform yourself about the situation on site, if necessary via the representative offices of the Republic of Indonesia responsible for your respective country. Current air values ​​in conurbations can be checked, for example, via the World Air Quality Index Team and the smartphone app AirVisual.

Methanol Poisoning

Following tragic events in recent years, caution is advised when consuming alcohol. Several illnesses and deaths following the consumption of alcoholic beverages suggest methanol-contaminated beverages. Methanol poisoning can cause serious damage to health and, in the worst case, death.

Medical Supplies

Medical care in Indonesia cannot be compared with that in Europe. It is often not up to par with Western standards in terms of technology, equipment and hygiene standards. Often, Western-trained English-speaking doctors are not available. A sufficient, worldwide health insurance coverage and a reliable travel insurance are strongly recommended. An individual first aid kit should be taken along for the journey and protected from high temperatures.

Especially chronically ill and needy people need to be aware of the health risk of traveling to Indonesia.

Personal health advice by a tropical medicine counseling center / a medical practitioner specialised in tropical medicine / a travel medical practitioner should be obtained and an updated vaccine protection is recommended, even if already experienced with tropical climate from other regions.

Please note in addition to the general disclaimer:

  • The information provided is intended to inform medically educated persons. It does not replace the consultation of a doctor.
  • Deviations from these recommendations may apply for longer trips, entries from different countries and travel to other areas of the Indonesia.
  • All information is always dependent on the individual circumstances of the traveler and may require medical advice.
  • The medical notes are despite maximum efforts always only a counseling service. They cannot cover all medical aspects, eliminate all doubts, or always be up to date. The individual traveller remains responsible for his/her health.