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Bali & Lombok

Bali Travel Forum
Lombok Travel Forum

Health & Safety in Bali / Lombok

Bali & Lombok are truly tropical countries, and often very humid too. But the climate that helps such vegetation grow, also helps bacteria grow, and worse!!

The chances are you will not experience anything worse than a grumbling stomach from all the fresh / raw / unusual foods and spices you now expect it to digest. But it goes beyond that if you are not careful. For example, wounds take longer to heal and fungal infections are much more prone.

Most of this page in concerned with health and how to keep safe in that respect. I should also point out to those that intend driving, you might want to read the transport page before you decide to do this. You should also be careful when out on the water, as there are many sharp coral reefs and strong rip-tides around Bali and Lombok.

Q. But first, what are the two most common word terms associated with "Bali"?

A. "Paradise" and "Belly" of course - and there's no smoke without fire!

Bali web site owners, have you checked out our Featured Sites Page?

"Balifiles" - Don't be shy to suggest extra text, links or other information.

Bali Belly

This will typically be no more than your stomach's reaction to a sudden massive increase in having to digest fresh and unprocessed foods, especially fruits. A little story! One of the defining moments in humankind's development was the time, through the use of having hands (as opposed to 4 feet) and making tools (spears etc.), we were able to "progress" from being herbivores (early vegans) to meat and veggie eaters. The availability of meat, which is a more processed form of food and requires less digestion, meant our stomachs could become smaller. Because our stomachs became smaller, we had more blood supply for other organs including, for some, the brain. This allowed us to increase the size and power of our brains so that we could invent television and neighbours!

The point is, the more the unrefined the food, that the more your poor stomach has to do to digest it. When you do not recognize this fact, it can suffer and you with it. So, a useful practice is to start eating much, much more salad and fresh fruit around 2 weeks before you set off for the islands.

Having said that, there are a lot more pitfalls waiting to trip you up with a real, even very nasty case of Bali Belly. Now, and completely unlike my normal practice! A lot of what I am now going to tell you is my personal beliefs on this subject. Having suffered horribly with it myself and wondering why those around me, who ate the same dishes, why they were not suffering so. I am going to tell you in order of probability where I believe the greatest risks come from.

MSG (monosodium glutamate)
Considered by many to be a poison, this flavour enhancer is used extensively throughout Asia and should be avoided at all costs as many, many cases of adverse reactions, including stomach problems are attributed to MSG. Most good restaurants will not use MSG and, in fact, advise you that only poor food retailers will use it as their food tastes so bland if they do not! How to ask the waiter not to have MSG? Simply but firmly state "Tan-far fets-zin" (without MSG).

Additives (food colours and flavourings)
Be warned, many of the food additives that have been banned in Australasia, the European Union and North America are still legally in use in Indonesia. Many of the brightly coloured deserts, sweets and cakes you see in Bali & Lombok, may well have substances proven to cause cancer, etc. added. The best advice is, if it looks too pretty to be natural colouring, avoid it. You may find a delightful exception to this rule. The green candies / cakes you often see are made with colourings from leaves (but make sure!).

Food Stalls & Quiet Restaurants
If cooked food has been allowed to get cold, and then simply re-heated, there is a substantial risk that you are eating a hole community of bacteria with it. It's that simple. If the locals (remember also, their stomachs may have become accustomed to certain bacteria) and seemingly knowledgeable / discerning / well travelled tourists avoid it, you should run a mile too.

It's often easy enough. If the cooked food served at your table is too hot (temperature wise), great. Just let it cool a bit! If it is not quite hot, refuse it. This need not apply to every cooked meal, especially Gado Gado. Which is basically fresh vegetables, partially cooked and served with peanut sauce. If the vegetables are fresh, you will know it and it should be great. And this is the very reason the dish is popular with the locals, because it kills the surface germs without cooking out all the goodness.

Soft Drinks
Oh yes! I'm going to be careful not to say, if I am right, that the bottling plants are responsible (as they are owned by the big boys who might sue me). But I'm going to ask to you think about something here. What are the chances, when these drinks are bottled, that they are 100% free from germs / bacteria. Now bear in mind, the hard task of creating a sterile product, even in a less mass produced / tropical environment. Now, what are the principle ingredients of these soft drinks? That's right, water and sugar. If you were bacteria, what would you say to such an environment? Let me help you - "Yummy, yummy!". Now look how restaurants keep these drinks during the storage time BEFORE they go into the fridge. Yes, that's right. Outside in the lovely warm air. Do you catch my drift? Then think carefully about what you drink.

Tomato Ketchup etc.
Think about it. Most restaurants leave their sauce bottles out, never clean them, and simply top them up! Get a picture of bacteria breeding?!

Sea Food
And in particular, shellfish. Being a connoisseur of shellfish, I've got to tell you, if you eat mussels, you always make sure they're from a safe (unpolluted / cold water) source. Now, for some reason, when people go to Bali / Lombok, they suddenly get cravings for prawns and lobster and other such treats. However you are unlikely to catch a Balinese eating shellfish at all, or even fish away from the coast, where it can be cooked immediately. Why do you think that is? Also, did you know that fisherman there have been known to use poison and explosives to catch fish etc. Then you have those lovely warm waters, a cash strapped economy, and billions of gallons of sewerage to deal with from all those lovely tourists, especially in the south. Think long and hard about eating seafood that comes from waters near populated areas, or that has travelled!

Salads
If you ask a waiter(ess) if their salads are washed in safe water, what you expect them to say? If you are honest, aren't they going to automatically say the same thing as when you ask a market trader if that is their best price?! Restaurants can hardly afford to wash salads in bottled drinking water, can they?! So they have to boil / treat water and then let it cool to make it safe. Do they refuse to serve you salad if they run out of safe water? Do they keep safe water from one day to the next? Do they boil it for the prescribed time? If you must eat salad, only buy them from the more respectable restaurants.

Ice & Ice Cream
I always have ice in my cocktails and I always eat ice cream in Bali (it is the world's best). But I never get ice or ice cream from dubious / local sources.

What To Take / Buy / Do Regarding Bali Belly
The main thing to do, no matter how painful, is to keep hydrated. That means rehydration salts (to replenish minerals and salts) and plenty of water / weak tea. Do not drink fruit juice and make sure the bathroom is kept free and the door open!

Mosquitos / Malaria etc.

First of all, you should consult your doctor as to what precautions to take. There is a good general web-site that will be a good guide (Travel Health OnLine), but you should always follow your own doctor's advise first. This is not least for insurance reasons. If you ask certain local doctors if they think you should take Malarial courses, they most often tell you "No, that can add to the problem" (on the basis it helps make the virus immune to that drug and also makes it harder for them to treat you with other drugs). But if you do not follow your doctor's advice, you may invalidate your travel health insurance and that can be mighty expensive.

The greatest risk of Malaria, from what I can gather, is to the very young / old / frail / pregnant (Malaria has killed more people, by a great margin, than all of mankind's wars put together). You are also more likely to catch it in rural areas and during / directly after the rainy season (that's when they need your blood to breed). Lombok is, from what I understand, considered Malarial. I also understand that cases of Malarial infection in Bali have also been reported.

By far, the best form of defence is preparation. Mosquitos are around most of the day, but are particularly prevalent at dusk and dawn. The most susceptible part of the body appears to be the ankles and back of your neck. You should use an insect repellent that contains at least 40% diethyl toluamide (DEET). My personal formula is to use DEET based repellent around the feet / ankles and around the neck / ears. Then I use the natural eucalyptus products everywhere else (that's exposed!). The only time I get bitten is when I let my guard down and don't religiously do this. Yeh, I smell nice!

If you are going to sit outside, especially at dusk / dawn / night. Make absolutely sure you have a fresh coating of this stuff on at this time, and burn some mosquito coils (circular incense burners). I don't like sleeping in a room without a mosquito net, because it only takes the front door to be opened at the wrong time (maids tend to leave the doors open all the time they are cleaning), and one unnoticed mossie. I prefer vertical drop nets - ones that fall from a large frame / canopy, so I am less prone to lean against it while I am sleeping (which presents the mossies with an opportunity). I also like rooms with aircon and fans (not just for comfort), as cool temperatures and good air flow tend to put the little suckers off.

Malaria is not the only thing mossies carry, and they are not the only risk. But they are, by all accounts the greatest. I have only ever witnessed 1 tourist with what I think was Malaria, and that was enough for me. Although, so I understand, the chances / risks are very slight of reacting to a mosquito "bite". And although I have a personal tendency to go out into the most rural areas on my travels. I do everything possible to reduce the risks I face by doing this. If you get bitten and suffer flu like symtpons, get medical advise immediately. And the only way to know for sure if you have Malaria is by a blood test. So make sure they use a sterile needle (travellers health kits include these normally).

Cuts & Infections

If you are going out of the tourist areas of the south, and particularly if you are going swimming / snorkelling / diving. I can not advise you enough to take a sterile travellers first aid kit with you. Having fallen down a broken raised paving slab in Ubud and grazed my leg. Having cut myself on coral (fortunately not poisonous) while on a boat trip to Menjangan Island to find the boat crews / guides do not carry first aid supplies. I can not express to you sufficiently the need to have disinfectant, sterile wipes, bandages and sticking plaster(s). Not only does it take even a small wound a long time to heal because of the climate, but there are general increased bacterial risks because of such tropical conditions. You would be absolutely amazed how many flies suddenly appear, intent on your wound, and how difficult it is to keep them off!

These kits come in handy little pouches that fit onto your belt. They are very light, comparatively inexpensive, and potentially the best investment you will ever make in your life - don't get caught out.

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