Every year the expatriate population seems to double. Retirement visa’s, affordable luxury accommodation and international marketing drives all make our little Island paradise a very attractive place to live. But what about health care? May people leave this until last on the list of considerations when they fall in love with the glossy brochures and the gentle sea breeze. Don’t forget Bali is still a part of Indonesia, and we are a third world country. Health care to the general population is very basic in comparison, and it is also expensive.
Our health facilities have improved vastly over the past few decades, but they are still a far cry from what most people would expect in their home country. While there are certain clinics, medical centers and hospitals that cater for the higher socio-economic group and tourists, their facilities are still limited.
Don’t wait until you actually need medical attention to rush to the first clinic that looks “clean”. Do your homework. Ask other expatriates what their opinions are. Visit the facilities; check the staff for their ability in English (or other language). Also ask about their pricing structure. Will they give you a discount if you have a resident’s visa (KITAS)? Will they deal directly with your insurance company? (And you DO have health insurance don’t you!). Don’t expect to see a Western doctor at any of the facilities in Bali. It is extremely difficult to get license for overseas doctors to practice here. Some larger medical centers may have access to online or phone consultation with overseas centers.
Health Insurance.
Please, please, please, make sure that you have good health cover. Medical care in Indonesia is now VERY expensive, and you are not covered by your own countries health fund (e.g. Medicare). Medical assistance, and evacuation, can cost anywhere between USD $6,000 and $ 60,000. That fee can double for remote area helicopter retrievals.
Also note that if you consider that you can put yourself on a flight and hop down to Australia for emergency treatment, think again. Even simple (and relatively common) disease such as Dengue fever will not be accepted on a commercial flight. I am more than willing to give you information on which policies may be appropriate for you. Just email me on info@chcbali.com, or call 08123660000.
Vaccinations
The following vaccines are recommended for living in Bali
· Hepatitis A – This is probably the type of Hepatitis that you will be at most risk of contracting in Bali. Spread by poor hygiene practices and through contaminated food and water. Once you have received the full course you are protected for up to 20 years.
· Hepatitis B – Spread through blood and body fluids. Even if you are not sexually active, or partake in other at risk facilities you are still wise to take this vaccine which is valid for up to 10 years.
· Tetanus – Very important to keep your Tetanus cover up to date (every 10 years). It is a very common disease here, usually contracted through open wounds.
· Typhoid – The typhoid vaccine is wise as it is also spread via poor hygiene practices (Food, Flies, Fingers, Feces, Fornication), however it may not give protection against some of the paratyphoid strains.
· Polio – This is one people tend to forget, however we did have an outbreak of polio in West Java several years ago. You will need a booster every 10 years.
· Japanese Encephalitis – JE is a mosquito borne disease, and yes it is present here, but fortunately it is not common. You might want to discuss this vaccine with your travel health or vaccine clinic.
· Tuberculosis – This is a very active disease in Indonesia. You should probably get your TB status checked before you come to Bali as this is quite complex. (Chest X rays, skin tests etc). Some centers are recommending vaccine, some are now saying just treat the disease if you get it.
· Rabies – There have been no documented cases of rabies in Bali for at least 10 years. However, this is a really nasty (fatal) disease, and the post exposure treatment is outrageously expensive, so you might want to consider this one.
Naturally if you have children, their standard vaccine program should be kept up to date.
You should start your vaccination program 3-6 months before travel, as some vaccines are given in courses over several months. Please remember that no vaccine gives 100% protection. If you show symptoms of any disease that you are already immunized against, please seek medical advice immediately.
Kim Patra is a qualified registered nurse and midwife who has been living and working in Bali for almost 20 years. She now runs her own private practice and medical referral service from her Kuta office. Kim is happy to discuss any health concerns with you and she may be contacted via e-mail at info@chcbali.com or Hp. 081 2366 0000.
