Dengue fever is now pandemic in Bali. What is worse the various strains of dengue are becoming increasingly more virulent, with the haemorrhagic variety, which can can lead to shock and death, becoming more common. Bali’s main hospitals are full to overflowing with cases and are hard pressed to cope. Whereas previously the experience of dengue in the expatriate community and among tourists was relatively rare, that is now no longer the case. Increasingly in many areas of Bali, popular with foreign residents and visitors, the disease is so common that is now a question of when, not if you will be struck down. Already this wet season Bali’s hotels have had to medevac cases of dengue among their guests to Singapore for urgent treatment. To make matters worse, because of the time required to diagnose the disease correctly it is often mistaken for typhoid and the wrong treatment applied. Even more worrying, there are increasing numbers of cases where people are contracting typhus and dengue at the same time.
If the news of how bad things are here were to become generally known in the travel industry at large it could well become a disaster on a level to SARS or the second Bali bombing in terms of visitors coming to Bali. The resurgent tourism industry, just getting back on its feet with arrivals only now exceeding those of half a decade ago, would be thrown into a pit. A decline possibly the more serious because dengue would spook the relatively unflappable independent visitor who knows Bali and who rents or even buys a villa, even more perhaps than insurance-driven group travel, notorious for cancelling at the least whiff of trouble.
The JAWS Syndrome
No, if Bali gets known as a sink of dengue the Island is in for a rough time. The authorities need to take real note and the private sector needs to take its head out of the sand and convey much more forcibly than they have done to date the potential danger. To say that dengue is endemic in a lot of other destinations may be true, but it misses the point. The point is that it is rife here and no one wants to go on holiday or buy a second home where they are likely to get sick or die from a potentially fatal tropical disease. Particularly one for which there is no treatment other than rest and liquids.
I don’t know what the true facts about the incidence of malaria are here in Bali, but the common perception is that it doesn’t happen here. Lombok yes, but not Bali. One of the reasons I’ve heard advanced for this is that back in the 1950’s the then authorities did such a good job on the eradication of malarial mosquitoes that we’ve been trading on their good work ever since. Perhaps it’s high time to take a look at emulating their good example. I keep hearing that malaria is making something of a comeback here and if nothing’s done to combat the dengue bearing mosquito, I fear the effects could be a lot more dire and widespread than we currently suppose.
While I stoutly maintain what I’m saying here is not a case of special pleading, my wife and I have both emerged from a spell in hospital with dengue, I will own that it does concentrate the mind rather. Dengue was always something that happened to other people, either because they had low immunity or they lived unprotected in the boonies or places of high urban density. There may have been something to that, but today it’s wrong on all counts. Anyone here in Bali can get it. You can be as fit as a fiddle and it can lay you low as the tallest poppy whacked at its base.
We did it for Malaria, Why not Dengue?
If we are to avoid the serious problems to our health and prosperity we need to take action on two fronts. First the appropriate authorities must take effective action to eradicate the dengue mosquito. If in the past they were able to do it for malaria, it must be doable for dengue also. For that to happen responsible monitored action needs to flow right down from Governor, to Regency to banjar. Quite what would inspire the authorities to leap into such action I cannot say, other that they come to see that the costs of inaction exceeds that of action. As I say, the private sector, particularly the hospitality industry and villa development folks, need to be proactive in spelling out the risks of doing nothing or too little.
Second , it’s up to us to take responsibility for protecting ourselves and finding out what can be done so you and your kids don’t get struck down with the illness. The most obvious step, other than not going in for mosquito farming, is to keep your place in good order. Get over any reluctance to fog in the rainy season. Not to fog is not just foolish, risking the safety of your own family, but it risks the health of your neighbours also and is thus antisocial. That doesn’t mean you have to use some cheap, noxious and useless concoction of poison and solar. No, there are ecologically viable options. The best and most economical means of which I am aware is to spray your premises and garden with a solution of neem oil on a weekly basis. Next put fish or Abate in any decorative ponds you have to eradicate mosquito larvae and make sure the water doesn’t stagnate. Then you need to acquaint yourself with the Liligundi plant (Vitex Trifolia). Apparently dengue mosquitoes can’t abide the smell of it.
Get cakes of it to burn like incense and place them strategically in the house and deck areas. You should then get shoots of Lilligundi and plant it around the back of your house and perimeters of your property. If you’ve been very wicked, you can even take sprigs and flagellate yourself. If you’re good you can just crush the leaves and rub them on your body and furniture surfaces. Finally don’t forget DEET. Yes, I know it’s poisonous stuff, but you don’t have to use a can in one go and IT WORKS!
Don’t Dismiss DEET!
Nothing does the job as well. Two years ago researchers compared DEET to a dozen “natural” insect repellents. They went all the way to Lapland in Summer. The thing about the Arctic Circle in Summer is there are zillions of mozzies who’ll eat you alive in no time at all. But, the thing is they’re clean little bloodsuckers, unlike their tropical cousins who’ll take your blood and pox you to boot. Researchers exposed a patch of bare forearm and tested the various formulations. Only DEET worked, keeping the perishers off for 3 to 9 hours depending on the strength. None of the the ”natural” brands worked at all. They were useless. Only one of them worked partially for three hours.
Oh, and for those of a rajassic temprement like myself, you might like to buy yourself one of those mozzie paddles, they look like a short handled squash raquet. They are brilliant for frying the little bastards mid flight. Before retiring I cruise the bedroom with paddle poised and then do a final killing run in our bed under the netting. No Jainist I, I give not a thought to the routine murder of mozzies and roaches, but refuse to dispatch spiders or other less odious creepy crawlies unless they resist all attempts to put them out of the house.
Prevention or Medical Cover? Both!
In conclusion, we should all consider where we’re going to end up when we get sick. If you get dengue badly, that is if your platelets go below 30, it’s best to get out of here, which means you need to have your medical cover in order. Other than that, I reckon Bali’s medical services get a worse rap than they deserve. Prima Medika and Sanglah both have good doctors available and modern wings. SOS Bali has an excellent reputation among people I’ve talked to. I ended up in Prima Medika for 3 nights and have to say their new wing is really very nice, airy and pleasant. The medical attention at senior level, where it counts, is first rate and the prices very reasonable. My only criticisms being some of the junior nursing staff could use more training and that the food all seemed to have the same unappealing odour.
My wife ended up in BIMC for 12 nights and at over US$500 for a room per night was $10,000 the lighter at the end of her ordeal. That’s almost four times as expensive as what I paid per day for care. Now while one is certainly glad that BIMC is here and they are unquestionably professional at what they do, I would counsel caution for anyone who does not enjoy a high level of medical cover. My wife seemed to have a succession of different doctors from Sanglah come to see her but all the medical staff were pleasant and professional. Certain of their Australian admin staff had a hardbitten air that came across unsympathetically however. At stressful times the subject of money is best handled with some tact I’d say.
