Healthcare

Indonesia is a developing country with developing country health issues. Basic sanitation and pollution issues underline many of Indonesia’s health challenges, but an awareness of these issues and the practical means of managing them are, for the majority of participants, is all that is required for a healthy semester. ACICIS staff in Indonesia are always on hand to assist in health-related matters. Indonesia has an extensive healthcare system and premium services are available.

Pre-Departure Preparation

Prior to departure, consult your doctor or a Travellers Medical and Vaccination Centre (found in most major cities) to discuss vaccination requirements. This should be done as early as possible as some vaccinations require repeat visits spaced out over weeks. At a minimum, all participants must be fully vaccinated against COVID-19 to meet Indonesian immigration requirements.

Beyond this, Hepatitis A and B vaccinations along with typhoid are generally recommended for travel to developing countries such as Indonesia. Check with your doctor about the use of anti-malarial medication during your semester. Malaria is not of significant concern in Java or Bali, but is endemic to various other parts of the country. You should also consult with your doctor regarding the need for a Rabies inoculation or any other available pre-departure vaccinations. Their advice may differ depending on what parts of Indonesia you plan on visiting.

Asthmatics or students with other respiratory conditions should seek medical advice on the possible implication of heavy pollution on their condition. An asthma management plan, preventers, bronchodilators and preferably emergency supplies of Prednisone have been steps taken by past students. Candidates with common allergies such as peanuts are also advised that their diet will be curtailed as it is a common ingredient in Indonesian foods. It is important to advise ACICIS of any allergies well in advance of program commencement.

If you require medication for any personal conditions, bring an adequate supply with you. Obtain a signed medical statement from your doctor confirming the medicine is prescribed and you need to carry a 6 to 12 month supply in the event that you are questioned by Indonesian customs upon arrival. Please note that some drugs used to treat attention deficit hyperactivity disorder (ADHD) are illegal in Indonesia. If you take medication for ADHD, make sure to consult with ACICIS well in advance of departure, as you may be required to obtain supporting documentation from an Indonesian Embassy or Consulate.

It is advisable to have a general medical and dental health check before departure.

Disclosure of any physical and mental conditions that may impact upon a candidate’s wellbeing in Indonesia is strongly encouraged by ACICIS. All such disclosures are kept in the strictest confidence.

Sufferers of mental illness (past or current) are advised to carefully discuss their plans with a mental health professional well in advance of departure, and develop strategies for managing any potential impacts deriving from the move abroad. It’s important to note that psychiatric and psychological services are limited in Indonesia.

Finally, come in good shape and learn to walk before you run! Adjusting to the climate and new cuisine (and new bugs) takes an inevitable toll on new arrivals.

In-Country Preventative Measures

ACICIS staff take healthcare issues very seriously. Each semester they manage a varying number of illness cases ranging from routine check-ups to hospitalisations. We have managed students with every conceivable complaint from dengue fever to dislocated thumbs and have every confidence that the presence of our in-country staff makes the management of any health issues a routine affair for students.

During orientation participants are counselled on preventative measures for these and a range of health threats in Indonesia. Our in-country handbooks outline basic preventative steps for mosquito borne viruses such as dengue fever, influenza, and malaria, and common bacterial infections such as typhoid, as well as detailed information on available medical services in the respective city of study.

For more specific information on diseases and disease prevention for travellers see the website of the American Center for Disease Control and Prevention. They also have great Indonesia specific information.

It is a condition of all ACICIS programs that participants hold a current travel insurance policy that includes coverage for emergency medical repatriation coverage. It is an Indonesian immigration requirement that participants hold a medical insurance with coverage for COVID-19 treatment of at least USD$25,000.

Health Insurance

Health and Travel Insurance cover is obligatory on all ACICIS programs. All participant policies must include cover for medical evacuation and repatriation and COVID-19 treatment (at least USD$25,000). As some applicants will be covered by policies in operation at their home university or industry organisation, advice and assistance should be requested from relevant staff on these matters. If you are searching for your own insurance, we recommend you look for one which has no excess when it comes to making a claim. Students who have unfortunately been hospitalised in the past have had to pay excesses up to $500. This is the last thing you want to be worrying about when you’re sick and trying to understand hospital bureaucracy in a foreign country!

Common Health Concerns

COVID-19
COVID-19 remains a concern throughout Indonesia. Members of cohorts at greater risk of serious illness (e.g. over 70s, those with pre-existing health conditions) need to carefully consider this risk and consult with their doctor prior to committing to study in Indonesia.

At the time of writing, all international arrivals are required to comply with strict immigration and quarantine controls. These controls include mandatory full vaccination against COVID-19 as a precondition to visa issuance and entry into Indonesia. Beyond ensuring that they are fully vaccinated at least 14 days prior to departure (including all booster doses that they are eligible for), it’s important that participants closely monitor the COVID-19 situation in their city of study and Indonesia more broadly, follow the advice of ACICIS and local authorities and take the following basic preventative steps:

• Wearing a mask
• Practicing good hand hygiene, including frequent hand washing and sanitising
• Physical distancing wherever possible (e.g. avoiding large crowds).
• Monitoring for symptoms and getting tested if required

ACICIS participants are required to comply with all national, provincial and local government restrictions imposed to limit the spread of COVID-19. This includes installation and use of the Peduli Lindungi app (used for check in and contact tracing purposes) and compliance with all “Large Scale Social Restrictions” (PSBB) put in place by Indonesian authorities. PSBB have previously included measures such as bans on non-essential commercial activity (e.g. bars, nightclubs and cafes, dining in at restaurants) and suspension of all non-essential domestic travel. Penalties for failure to comply with government health directions include fines and deportation.

Mosquito-borne disease
Participants must take precautions against diseases carried by mosquitos such as malaria, dengue fever and Japanese encephalitis. Thankfully, these diseases can be avoided with some simple steps:

• Cover up with long, loose-fitting clothes, including trousers and socks.
• Wash and use good quality mosquito repellents regularly, and avoid wearing perfume or scented body lotion as these attract mosquitoes.
• Consider using a specialised mosquito net or sleeping under a sheet (Indonesians typically don’t use a selimut unless in cold areas).
• Mosquito coils and other anti-mosquito methods are readily available in Indonesia, as are insect sprays.
• You can also try sleeping with a fan on full-blast to blow the mosquitoes off course or spray your room a couple of hours before sleeping.

You should check with your doctor about the worth of using anti-malarial medication. Most students decide not to take anti-malarials during the study program, preferring other precautions instead, and only take medication when they are in an isolated or remote area. You should make this choice carefully in consultation with your doctor.

Food and water
Most ACICIS participants have suffered from a case of traveller’s diarrhoea. Fortunately, the vast majority cases clear up after a day or two of discomfort and a few rushed toilet trips. Usually contaminated food or water is blamed as the culprit. There are, however, a few precautions that can be taken minimise the risk of food and water borne illnesses:

• Do not drink straight out of the tap in Indonesia. You should at least make sure that any drinking water has been boiled for 10 minutes, or use bottled water which is safe, cheap and readily available.
• Be wary of ice. In Indonesia, ice is generally ok, having been made in sterile factories and delivered to businesses as enormous clean blocks. It is the way the business chops the ice up into smaller blocks for your drink (on the footpath outside the warung!) that is of concern – be selective.
• Be careful when eating fruit – skinless varieties are generally safe (unless they have been washed with tap water). Wash fruit eaten with skin on (i.e. apples) yourself.
• Be selective where you eat. Western restaurants are not as safe as some people may have you think – kitchens often lack knowledge of correct hygiene required to prepare western food. Local places are often safer – get an idea of how clean the people running the warung/roadside stall/streetside tent are before sitting down and eating. Try to avoid the friendly push cart vendors – they can’t wash their dishes, so hygiene is poor.

Pollution
Participants need to understand how polluted Indonesia can be. Anyone with asthma or any other respiratory illness must see their doctor before leaving home and come armed with a peak flow meter, an asthma management plan, preventers, bronchodilators and preferably emergency supplies of Prednisone.

Dehydration
Students should drink constantly from the time they arrive in Indonesia. Be aware that the change in climate, particularly from cold winters to 30°C plus weather in Indonesia, greatly increases the risk of dehydration. Caffeinated beverages and alcohol will increase dehydration, so it’s a good idea to limit your intake of these.

Rabies
Rabies is of particular concern in Bali province and on Nias. It is, however, important to take adequate precautions (e.g. avoiding contact with animals such as monkeys, bats and particularly stray dogs) throughout Indonesia. This includes in situations where you may be encouraged by others to interact with animals (e.g. at tourist destinations and sanctuaries). If bitten or scratched by an animal, it’s important to immediately wash the wound with soap and water and seek medical attention as soon as possible.

Participants should consult with a doctor regarding the need for a rabies inoculation, particularly if they are staying in Indonesia for a semester or plan on taking part in activities which may involve working with animals.

Bites and Scratches
In the tropics, bites and scratches (especially coral scratches) can rapidly become septic, so it’s wise to thoroughly clean the lesion with soapy water and apply an antiseptic solution.

Sexually Transmitted Diseases (STDs)
STDs are common in Indonesia. Awareness levels remain low among the general public, however. Participants who are sexually active while in Indonesia should take all the obvious precautions. Always use protection.